Table 2.
Suggested clinically relevant options as adjunctive treatments during COVID-19 infection and associated psychopathology.
| Drug class | Psychiatric effects | Inflammatory-related effects | Antiviral-related effects |
|---|---|---|---|
| Antioxidants | |||
| α-lipoic acid | – | ↓ ROS, apoptosis [278,279,280] | ↓ gliotoxicity, viral replication and signalling [278,279] |
| Mangosteen pericarp | antidepressant [286,287] | – | ↓viral proteases [288] |
| Sceletium tortuosum | ↓ anxiety, depression [379] | anti-inflammatory [284] | ↓ viral enzymes and proteases [285] |
| Thymoquinone | ↑ spatial memory and slowdown of Alzheimer’s disease complications [289,380] | ↓ NO and ROS; modulating (inhibit) NF-κB and antioxidant enzyme nuclear factor 2 heme oxygenase‐1 (Nrf2/HO‐1) [289,290,381] | ↓ viral entry into host cell [291] |
| Alpha-2-AR modulators | |||
| Clonidine | ↓ psychosis, anxiety [298,299] | – | ↓ viral replication [297] |
| COX-II inhibitors | |||
| Celecoxib | ↑ mood [78] | ↓ IL-6, TNF-α [302] | ↓ viral transactivation of COX-2 [300,301] |
| Glucocorticoids | |||
| Dexamethasone | ↑ depression [78,305,306] | ↑ oxidative stress, inflammation [307,308,309] | – |
| Lithium | antidepressant [310] | ↓ NF-κB [311] ↑ pro-inflammatory activity [167] ↑ NO-cGMP pathway activity [316] |
– |
| MT-1 and -2 agonists | |||
| Agomelatine | anxiolytic, antidepressant [267,268] | ↓ CRP, IL-1β, IL-6 [264,265,268] | |
| Tetracyclines | |||
| Minocycline | ↑ mood [77,78] | ↓ inflammation [318] | ↓ viral replication and reactivation [321] |
| Mitochondrial rejuvenators and modulators | |||
| Methylene Blue | ↑ mood [147] | antioxidant [325] | Inactivates RNA viruses [326] ↑ MAVS [331] |
| N-acetyl cysteine | ↑ mood [382] | antioxidant [383] | ↑ MAVS [331] |
| mTOR inhibitors | |||
| Rapamycin | antidepressant [346,347] | ↓ oxidative stress, hyper-inflammation [345] | ↑ antiviral activity [343,344] |
| NF-κB inhibitors or antagonists | |||
| Ouabain | ↑ mood disorders [336] | ↓ NF-κB [334] | ↓ viral replication [335] |
| Digoxin | – | ↓ NF-κB [334] | ↓ viral replication [335] |
| PDE-4 inhibitors | |||
| Rolipram | – | ↓ cytokine storm [337] | – |
| Ibudilast | – | ↓ cytokine storm [337] | – |
| PDE-5 inhibitors | |||
| Sildenafil | anxiolytic, ↑ mood [172,238,340] | ↓ pro-inflammatory cytokines [338] | – |
| Tadalafil | – | – | ↓ cGMP [237] |
| PPAR-γ agonists | |||
| Pioglitazone | ↑ mood [78] | ↓ cytokine storm [342] | – |
| Tryptophan-kynurenine modulators | |||
| Allopurinol | ↓ inflammation-induced psychopathology [98] | ↓ inflammation [98] | – |