Psycho-Babble Medication Thread 1119662

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Assoc Between Psych Medication + COVID risk:

Posted by PeterMartin on May 6, 2022, at 22:12:32

New paper published in JAMA today. Full data in the supplemental tables if interested: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2791969
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May 6, 2022
Association Between the Use of Psychotropic Medications and the Risk of COVID-19 Infection Among Long-term Inpatients With Serious Mental Illness in a New York Statewide Psychiatric Hospital System

Abstract

Importance
Individuals with serious mental illness are at increased risk of severe COVID-19 infection. Several psychotropic medications have been identified as potential therapeutic agents to prevent or treat COVID-19 but have not been systematically examined in this population.

Objective
To evaluate the associations between the use of psychotropic medications and the risk of COVID-19 infection among adults with serious mental illness receiving long-term inpatient psychiatric treatment.

Design, Setting, and Participants
This retrospective cohort study assessed adults with serious mental illness hospitalized in a statewide psychiatric hospital system in New York between March 8 and July 1, 2020. The final date of follow-up was December 1, 2020. The study included 1958 consecutive adult inpatients with serious mental illness (affective or nonaffective psychoses) who received testing for SARS-CoV-2 by reverse transcriptasepolymerase chain reaction or antinucleocapsid antibodies and were continuously hospitalized from March 8 until medical discharge or July 1, 2020.

Exposures
Psychotropic medications prescribed prior to COVID-19 testing.

Main Outcomes and Measures
COVID-19 infection was the primary outcome, defined by a positive SARS-CoV-2 reverse transcriptasepolymerase chain reaction or antibody test result. The secondary outcome was COVID-19related death among patients with laboratory-confirmed infection.

Results
Of the 2087 adult inpatients with serious mental illness continuously hospitalized during the study period, 1958 (93.8%) underwent testing and were included in the study; 1442 (73.6%) were men, and the mean (SD) age was 51.4 (14.3) years. A total of 969 patients (49.5%) had laboratory-confirmed COVID-19 infection that occurred while they were hospitalized; of those, 38 (3.9%) died. The use of second-generation antipsychotic medications, as a class, was associated with decreased odds of infection (odds ratio [OR], 0.62; 95% CI, 0.45-0.86), whereas the use of mood stabilizers was associated with increased odds of infection (OR, 1.23; 95% CI, 1.03-1.47). In a multivariable model of individual medications, the use of paliperidone was associated with decreased odds of infection (OR, 0.59; 95% CI, 0.41-0.84), and the use of valproic acid was associated with increased odds of infection (OR, 1.39; 95% CI, 1.10-1.76). Clozapine use was associated with reduced odds of mortality in unadjusted analyses (unadjusted OR, 0.25; 95% CI, 0.10-0.62; fully adjusted OR, 0.43; 95% CI, 0.17-1.12).

Conclusions and Relevance
In this cohort study of adults hospitalized with serious mental illness, the use of second-generation antipsychotic medications was associated with decreased risk of COVID-19 infection, whereas the use of valproic acid was associated with increased risk. Further research is needed to assess the mechanisms that underlie these findings.

Re: Assoc Between Psych Medication + COVID risk:

Posted by SLS on May 7, 2022, at 9:13:27

In reply to Assoc Between Psych Medication + COVID risk:, posted by PeterMartin on May 6, 2022, at 22:12:32

I didn't read the paper. I don't have the time.

Studying COVID and the entirety of the pharmocopia is very helpful. Using the criterion of "psychotropic" as the drugs tested is short-sighted and could sabotage some people's remissions if the specific drugs tested aren't identified along with the statistical risk of producing COVID for each drug separately. I doubt every drug pigeon-holed as bein a "psychotropic" drug was tested to make such a sweeping statement. Lithium, Nardil, Levoxyl, Saphris, Thorazine, clomipramine, psilycibin, etc. Well, I'm sure that illustrates the point. Since I didn't read the article, were the results presented in this fashion?

- Scott

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