Pharmacotherapy of Mental Disorders Associated with COVID-19
Mental health disorders are closely related to COVID-19 at the biological, psychological, and social levels, and they are receiving more and more attention now. Mental and behavioral disorders may be the manifestations or complications of acute COVID-19, such as acute psychotic disorders, more often in the form of hyperactive delirium, cognitive impairment, anxiety disorders, sleep disorders, depression, and suicide attempts. The post-Covid period is also represented by a wide range of mental disorders, when cognitive impairment, anxiety, depression, and PTSD come to the fore. The problem of early diagnosis and complex therapy of mental disorders associated with COVID-19 at all stages of the disease can be successfully solved using a holistic psychosomatic approach. Medical and psychological support and counseling psychiatric care are provided mainly in the mode of telemedicine. When prescribing psychotropic drugs, the doctor should take into account the risk of drug interactions: lopinavir/ritonavir, chloroquine/hydroxychloroquine, and antibiotics often give potentially dangerous combinations with psychotropic drugs in the treatment of acute COVID-19. At the same time, remdesivir, favipiravir, tocilizumab, baricitinib, and anakinra can be used concomitantly with psychotropic drugs without significant risk of drug interaction (except for the hematological risk with clozapine and baricitinib). The article presents international and national recommendations for the selection of the most effective therapy for mental disorders (antipsychotics, antidepressants, thymostabilizers, and anxiolytics) during acute COVID-19, indicating the doses and mode of administration. The recommendations for the management of the consequences of COVID-19 from the standpoint of evidence-based medicine are also given.