Olanzapine, risperidone and quetiapine: Do these atypical antipsychotics have a protective effect for SARS-CoV-2?

Abstract

It was proposed that antipsychotics drugs (APDs) could have anti SARS-CoV-2 properties and different mechanisms were described to explain this antiviral effect (Gordon et al., 2020b; Javelot et al., 2020; Plaze et al., 2020). Two articles using the comparative viral-human protein-protein interaction map revealed that the sigma-1 receptor (SIGMA1R), located in the endoplasmic reticulum, caused reductions in SARS-CoV-2 replication, and proposed haloperidol as a potential anti SARS-CoV-2 for its effect on this receptor (Gordon et al., 2020, Gordon et al., 2020). Another mechanism proposed by which antipsychotics could have antiviral properties is through the inhibition of clathrin-mediated endocytosis (de Pellón Santamaría, 2020; Villoutreix et al., 2020). Also, it was described that cationic amphiphilic drugs (CAD), like numerous APDs, may have antiviral effects (Vaugeois, 2020). On the other side, antipsychotics suppress the expression of pro-inflammatory cytokines and these anti-inflammatory effects are elicited through the reduction of pro-inflammatory cytokines production, like IL-1A, IL-6, and TNF-α (Obuchowicz et al., 2017). Growing evidence suggests that antipsychotics have anti-inflammatory properties that may attenuate the normal defensive function of the immune system and possibly reduce the uncontrolled inflammatory responses, such as seen in severe SARS-CoV-2 (Juncal-Ruiz et al., 2018).