For laughs: antidepressants reduce COVID-19 mortality

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Taking antidepressants in hospitalized patients with COVID-19 reduces the likelihood of being ventilated and dying by an average of 20%, found out a team of foreign scientists. The drugs reduce plasma levels of inflammatory mediators, preventing the immune system from overreacting (cytokine storms), which often leads to complications. According to experts, antidepressants increase the motivation of patients: people are more actively involved in activities necessary for recovery. However, one should remember about the side effects of drugs and prescribe them individually, based on each specific case, the doctors warned.

Life has become more fun

Severe COVID-19 is often associated with elevated levels of inflammatory cells in the blood plasma. This leads to the development of acute respiratory syndrome, which often becomes the cause of death of the patient. The work of foreign experts has shown that antidepressants may be associated with a decrease in the levels of several inflammatory mediators, which are associated with mortality from this disease.

A team of scientists from several research centers and clinics in France and Spain, including the University of Paris, decided to test whether taking antidepressants actually improves patient survival.

They are examined the medical records of people with a confirmed diagnosis of COVID-19 from 39 hospitals… The data collected included patient demographics, selected health parameters, laboratory test results, drug intake data, diagnoses, discharges, as well as data on ventilator use and death certificates.

a patient with coronavirus on a ventilator

Photo: Izvestia / Pavel Bednyakov

The study included 7.2 thousand patients. 345 of them received an antidepressant within two days after admission to the hospital. Among the patients in this category, the majority received only one drug, and 16% took at least two. Mood stabilizers were on the list of antidepressants (lithium or mood-stabilizing antiepileptic drugs) and antipsychotic drugs.

Analysis showed an association between use of any antidepressant drug with a reduced risk of being ventilated or dying.… Average drugs reduced the likelihood such outcomes by 20%… The effect of the combination of drugs did not differ from the effect of one drug.

“These results should be interpreted with caution due to the observational study design. However, our results confirm the need for controlled randomized clinical trials of antidepressants for the treatment of COVID-19, ”the authors concluded.


Photo: Izvestia / Andrey Ershtrem

Scientists have provided several explanations for the link between taking antidepressants and a reduced risk of being ventilated or dying from coronavirus infection. Firstly, the mechanism of the drugs can prevent infection with SARS-CoV-2 of the epithelial cells of the lungs… Secondly, many antidepressants help prevent the cytokine storm (associated with an overly intense immune response) that often accompanies severe COVID-19… Drug use may be associated with decreased plasma levels of several inflammatory mediators associated with severe disease. Finally, some antidepressants may even have antiviral effects on SARS-CoV-2, according to the researchers.

Laugh and do no harm

Russian experts agreed that a number of drugs, in addition to the main antidepressant effect, have properties that, under certain conditions, can be regarded not as negative side effects, but as additional therapeutic effects

“However, two points must be taken into account. The first is that not every antidepressant has additional properties necessary for a particular patient. The second point is that the discovery and even the proof of useful therapeutic properties in the drug and their predominance over the possible risks does not allow prescribing the drug without officially introducing new indications into its instructions or issuing a special order of the regulatory authorities, – noted the head of the Department of Psychiatry, Psychotherapy and Psychosomatic Pathology of the Federal Medical Institute RUDN University Vladimir Medvedev.

doctor in the ward of patients with coronavirus

Photo: Izvestia / Zurab Javakhadze

He added that the risk of side effects from antidepressants, their severity, duration and impact on the overall effectiveness of treatment are individual in nature and depend on many factors: the initial state of the body, taking other drugs and their possible interactions, dosage. In each specific case, questions about the appointment of the time, timing, type of antidepressant to the patient should be resolved individually, said Vladimir Medvedev.

If the patient is depressed, they need to be prescribed antidepressants regardless of whether they have COVID-19. or another disease, – added an intensive therapist in the cardiac resuscitation department of the Russian Scientific Center for Surgery named after academician B.V. Petrovsky Roman Komnov. – The issue of reducing mortality with antidepressants should be discussed separately. But if, while taking such drugs, the patient will more actively help the medical staff (perform the prescribed exercises, monitor their performance, eat right), then he has more chances of a positive outcome… By the way, many antidepressants have cumulative response, and they do not act immediately.

Vladimir Medvedev also agrees that reducing “depression” decreases mortality. According to the expert, clinical practice shows that treatment of depression in patients with coronavirus and after it increases motivation, interest and involvement in therapy and the rehabilitation process, and reduces the likelihood of a severe course of the disease.