Table 2.

Antivirals with their associated neuropsychiatric effects and drug-drug interactions (DDIs).

Proposed antiviral treatment	Contraindications	Common Adverse effects	Neuropsychiatric side effects	Drug-drug interactions	Sources
LPV/RTV	Hypersensitivity	Diarrhoea, vomiting, nausea, hypercholesterolemia, hypertriglyceridemia, pancreatitis	–	Drugs requiring high CYP3A dependence for clearance, CYP3A inducers	[22]
Oseltamivir	Hypersensitivity	Nausea, vomiting, diarrhoea, abdominal pain	Increased risk of confusion, abnormal behaviour, delirium, delusion, hallucination	Not a substrate nor does it affect CYP450 isoenzymes	[[11], [12], [13]].
Zanamivir	Hypersensitivity	Sinusitis, bronchitis, dyspnea, fever or chills, diarrhoea, arthralgia, and articular rheumatism	Headache and dizziness in adults Seizures, confusion, abnormal behaviour among the pediatric age group	Not a substrate nor does it affect CYP450 isoenzymes	[129]
Peramivir	Hypersensitivity	Skin reactions	Depression, hallucinations, confusion, delirium, restlessness, abnormal behaviour, anxiety, and nightmares	Can alter the efficacy of live attenuated influenza vaccines.	[[130], [131], [132]]
Remdesivir	Hypersensitivity	Increased transaminase levels	–	Chloroquine/Hydroxychloroquine co-administration may reduce the anti-viral activity	[58,133]
Ribavirin	Monotherapy: Hypersensitivity, pregnancy, haemoglobinopathies heart disease Combination therapy with pegylated interferon alfa-2a: autoimmune hepatitis, hepatic decompensation, pancreatitis, organ transplant	Monotherapy: Itching and rash Combination therapy with pegylated interferon alfa-2a: autoimmune and infectious disorders, suppression of bone marrow function, haemolytic anaemia, diabetes, pulmonary dysfunction, pancreatitis, dyspnoea, pulmonary infiltrates, sarcoidosis, pneumonitis	Depression, suicidal ideation, dizziness, confusion, somnolence, insomnia	does not inhibit CYP450 enzymes. -Zidovudine -Stavudine -Didanosine	[134,135]
Darunavir	Acute/cytolytic hepatitis, skin reactions, sulfonamide allergy	–	–	Alfuzosin, dihydroergotamine, ergonovine, ergotamine, methylergonovine, cisapride, pimozide, oral midazolam, triazolam, St. John's Wort, lovastatin, simvastatin, rifampin and sildenafil (for treatment of pulmonary arterial hypertension)	[82]
Favipiravir	Pregnancy	Hyperuricemia, diarrhoea, reduced neutrophil count	Abnormal behaviour, anxiety, insomnia, so on (Very rare)	Pyrazinamide, Pyrazinamide, Theophylline, Famciclovir, sulindac, Acyclovir	[102,136]
Amantadine	Hypersensitivity, Pregnancy	Cardiotoxicity, arrhythmias, tachycardia, Acute respiratory failure, pulmonary edema, hypersexuality, elevated serum creatinine, alkaline phosphatase, bilirubin, etc.	Delirium, seizures, hypokinesia, delusions, aggressive behaviour, blurred vision, depression, agitation, hallucinations, etc.	Anticholinergic drugs, Acetaminophen Can alter the efficacy of live attenuated influenza vaccines.	[105,137,138]