# Comparison of Antipsychotics in the Treatment of COVID-19-Induced First-Episode Psychosis: A Review of Case Studies

## TL;DR

This paper reviews case studies to compare antipsychotics used for treating psychosis caused by COVID-19, focusing on effectiveness and side effects.

## Contribution

The study provides a systematic review of antipsychotic treatment outcomes for first-episode psychosis linked to COVID-19.

## Key findings

- Olanzapine was the most commonly used antipsychotic in single-drug treatments.
- Combination therapy with haloperidol and aripiprazole was also frequently used.
- Atypical antipsychotics were preferred, with notable side effects and low relapse rates reported.

## Abstract

This study aims to systematically review COVID-19-associated first-episode psychosis cases, comparing antipsychotic selection, dosing strategies, treatment response timelines, adverse effects, and relapse rates to inform evidence-based pharmacological management.

We conducted a structured narrative review of published case reports and series describing COVID-19-Induced first-episode psychosis treated with antipsychotics. A comprehensive search of PubMed and Google Scholar (Jan 2020-Apr 2023) identified 42 eligible cases based on predefined inclusion/exclusion criteria. Data were extracted using a standardized template and summarized descriptively due to clinical heterogeneity. Variables included demographics, psychiatric features, antipsychotic(s) used, clinical course, and outcomes.

First-episode psychosis (FEP) was higher in males (24, 57.1%) and the 30-39 age group (10, 23.8%). Olanzapine was the most commonly used single antipsychotic (6, 28.6%), while the combination of haloperidol and aripiprazole was the most frequently used antipsychotic regimen (4, 19.0%).

Atypical antipsychotics were preferred (54.8%), with olanzapine (23, 54.8%) being the most commonly used at a mean dose of 10.9 mg/day. Reported side effects included fatigue, weight gain, akathisia, leukocytosis, and QT-interval prolongation (5, 11.9%), with a relapse rate of (2, 4.8%).

This review evaluates the treatment methods for COVID-19 FEP and develops a deeper understanding of various antipsychotics used in managing psychosis and its outcomes.