Summary of COVID-19 medicines guidance: Mental health and illness

This page summarises and signposts to medicine related guidance we’re aware of from professional and government bodies relating to coronavirus and mental health and illness.

This page has been put together rapidly in relation to the COVID-19 pandemic.

Whilst we have tried to ensure that the information on this page is complete, please report a concern if you feel anything is omitted or inaccurate.

To see our professional guidance summaries for other clinical areas, click here

Advice in this area includes:

NHS England/NHS Improvement: Clinical guide for the management of people with alcohol dependence during the coronavirus pandemic

Last updated 8 April 2020

  • Specialty guide seeking to ensure proper management of patients with alcohol dependence in recognition of reduced availability of specialist advice and minimal provision of alcohol teams
  • Includes advice to continue to admit patients with complications of alcohol withdrawal requiring medical management to acute trusts, and for each acute and mental health trust to designate a COVID-19 alcohol lead to offer specialist support and guidance for current best practice for alcohol-dependent patients with COVID-19 at risk of respiratory depression during medically assisted alcohol withdrawal, or complicated alcohol withdrawal or comorbid opioid use.

NHS England/NHS Improvement: After-care needs of inpatients recovering from COVID-19

Last updated 5 June 2020

This guidance includes the following therapeutic areas: respiratory, cardiology, neurology, mental health, endocrinology and urology. There is no medication-related information within the neurology, mental health, endocrinology or urology sections.

  • Guidance for management of patients’ physical respiratory needs is given on pages 7-13.
  • Includes recommendations on anticoagulation for patients with pulmonary embolic disease.
  • Reference made to patients requiring cardiac assessment pre-discharge plus plan – with optimisation of medications listed on page 14.

Public Health England: Guidance for the public on the mental health and wellbeing aspect of coronavirus (COVID-19)

Last updated 31 March 2020

  • Includes advice for people taking medication for existing conditions, management of symptoms, where to seek further support, and advice for groups with specific mental health needs

Public Health England: Guidance for the parents and carers on supporting children and young people’s mental health and wellbeing during the coronavirus (COVID-19) outbreak

Last updated 21 April 2020

  • Includes advice for parents and carers on planning how to access medication

Public Health England: Guidance for commissioners and providers of services for people who use drugs or alcohol

Last updated 15 April 2020

  • Includes guidance for changes to arrangements for prescribing and dispensing medicines used in drug and alcohol services to take account of service and pharmacy closures, staff unavailability and patients having to social distance, self-isolate or be shielded.
  • Also includes guidance for increased measures where possible to reduce drug and alcohol-related harm, such as needle and syringe programmes (NSP), take-home naloxone, thiamine, advice on gradual reduction of alcohol consumption and use of e-cigarettes

Royal College of Psychiatrists: COVID-19: Providing medication

  • Guidance for clinicians on management of patients currently taking psychotropic medicines during the COVID-19 outbreak, with specific advice for benzodiazepines/rapid tranquilisation, lithium in febrile patients, clozapine (including advice on blood monitoring), depot injections, and medication for attention deficit hyperactivity disorder (ADHD).
  • Also provides links to guidance from other NHS organisations, e.g. North East London NHS Foundation Trust, South London & Maudsley NHS Trust

Royal College of Psychiatrists: COVID-19: Managing individuals with alcohol problems

  • Guidance primarily for addiction specialists and non-specialist community psychiatric teams
  • Includes advice on planning detoxification from alcohol including consideration of how much medication to issue and use of Pabrinex IM and/or oral thiamine for patients at risk of Wernicke’s encephalopathy
  • Provides information and links to further guidance on relapse prevention medication

Royal College of Psychiatrists: COVID-19: Working with vulnerable people

  • Guidance for healthcare professionals working with more vulnerable patients, such as older people, those who use drugs, people with alcohol dependence, people with intellectual disabilities, and pregnant women and those in the perinatal period
  • Includes advice where appropriate on non-pharmacological management of symptoms, as well as advice on pharmacological considerations for people using drugs, and on prescribing medications to people with intellectual disabilities
  • Provides a link to Faculty of Old Age Psychiatry Delirium management advice for patients with confirmed or suspected COVID-19 in acute trust settings.

British Geriatrics Society: Managing delirium in confirmed and suspected cases of COVID-19

Last updated 25 March 2020

  • Recommendations on reducing risk of delirium by avoiding or reducing known precipitants, e.g. constipation, pain, superadded infections, hypoxia, urinary retention and medication.
  • Recognition that it may be necessary to move to pharmacological management of behavioural disturbance earlier than would normally be considered
  • Signposts to suitable national guidance (e.g. SIGN, NICE) and provides advice on cautions with particular treatments and monitoring for adverse effects.
  • A table summarises medications that may be used in delirium, doses and cautions/contraindications.

College of Mental Health Pharmacy: Monitoring and Supply of Clozapine during the COVID-19 Pandemic

Last updated 31 March 2020

  • Guidance written for North East London NHS Foundation Trust endorsed by the CMHP and the Royal Pharmaceutical Society

College of Mental Health Pharmacy: Monitoring Lithium during the COVID-19 Pandemic

Last updated 31 March 2020

  • Guidance written for North East London NHS Foundation Trust endorsed by CMHP and the Royal Pharmaceutical Society

Department of Health and Social Care: The Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) during the coronavirus (COVID-19) pandemic

Last updated 9 April 2020

  • Emergency guidance for all decision-makers in England and Wales (e.g. hospitals, care homes and supervisory bodies) who are caring for or treating a person who lacks the relevant mental capacity

Medicines and Healthcare Products Regulatory Agency: Valproate Pregnancy Prevention Programme: temporary advice for management during coronavirus (COVID-19)

Last updated 6 May 2020

  • Guidance for specialists for initiation of valproate in female patients and for annual review and pregnancy testing to support adherence to pregnancy prevention requirements during the pandemic

Pharmaceutical Services Negotiating Committee: Shared-Care service provision for people being treated for substance use during the COVID-19 pandemic

Last updated 25 March 2020

  • Guidance to support community pharmacy teams in caring for shared-care substance use clients

Society for the Study of Addiction: Useful coronavirus (COVID-19) links

Last updated 13 May 2020

  • Repository of links to national guidance, treatment services, harm reduction advice, research, news and opinion and other resources