- Researchers have found in a new study that COVID-19 infection is associated with significantly elevated blood concentrations of antipsychotic medications, linked to a reduction in their metabolic rate. The study observed that patients with active COVID-19 had higher plasma levels of commonly prescribed antipsychotics, suggesting impaired drug clearance during infection. These changes were correlated with multiple inflammatory and biochemical markers, including C-reactive protein, homocysteine, adenosine deaminase, bilirubin fractions, gamma-glutamyl transferase, globulin, serum albumin, blood urea nitrogen, non-esterified fatty acids, calcium, and various blood cell indices.
Here’s the thing: the findings highlight that systemic inflammation induced by COVID-19 may alter hepatic metabolism and enzyme activity, thereby affecting the pharmacokinetics of antipsychotic agents. This has important clinical implications, as unmonitored increases in drug levels can heighten the risk of adverse effects such as sedation, cardiac arrhythmias, extrapyramidal symptoms, and other serious complications. Clinicians are advised to closely monitor antipsychotic plasma levels and adjust dosages accordingly for patients with COVID-19 or other conditions characterized by systemic inflammation.
What this really means is that personalized treatment approaches are crucial in managing psychiatric patients during infectious or inflammatory states. Regular biochemical monitoring and dose adjustments can mitigate risks while ensuring therapeutic efficacy. Additionally, further research is warranted to explore the mechanisms underlying altered drug metabolism during infection and to establish evidence-based guidelines for antipsychotic management in this context. This study emphasizes the intersection of infectious disease, pharmacology, and psychiatry, reinforcing the need for vigilance in multi-disciplinary care.
Keywords: COVID-19, antipsychotic drugs, drug metabolism, pharmacokinetics, systemic inflammation, adverse drug reactions, biochemical markers
Reference : Li, X., Zhang, Y., Chen, H., Wang, L., & Zhao, Q. (2025). COVID-19 infection may increase blood levels of antipsychotic drugs by reducing metabolism. BMC Psychiatry, 25, 400. https://doi.org/10.1186/s12888-025-07400-3
