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.

Our advice is constantly reviewed as the pandemic situation evolves.

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.

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

Last updated 4 November 2020 [Text updated 9 November 2020]

  • Information aimed at patients, who are reminded to keep taking their prescribed medication for any existing conditions.
  • In terms of accessing their medication:
    • they might be able to order repeat prescriptions by phone, or online using an app or website if their doctor’s surgery offers this.
    • they should continue to order repeat prescriptions in the usual timeframe; there is no need to order for a longer duration or larger quantities.
    • their pharmacy may be able to deliver their medication if they are isolating; or they should think about who might be able to collect their medication on their behalf.
    • their GP practice (or clinical team) may move their prescriptions to repeat dispensing arrangements, so they only have to contact your pharmacy to get a repeat of your medicine rather than the practice.
    • they must be careful about buying medication online, and should only buy from registered pharmacies; pharmacy registration can be checked on the General Pharmaceutical Council website.
    • they can contact NHS 111 in England if they’re worried about accessing their medication.

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

Last updated 16 October 2020 [Text updated 9 November 2020]

  • Information aimed at parents and carers.
  • In terms of accessing medication for their child or young person:
    • they might be able to order their child or young person’s repeat prescriptions by phone, or online using an app or website if their doctor’s surgery offers this.
    • they should continue to order their child or young person’s repeat prescriptions in the usual timeframe; there is no need to order for a longer duration or larger quantities.
    • their child or young person’s pharmacy may be able to deliver the medication if they are unable to collect it; or they should think about who might be able to collect the medication.
    • their child or young person’s GP practice may move their prescriptions to repeat dispensing arrangements, so you only have to contact their pharmacy to get a repeat of the medicine rather than the practice.
    • they must be careful about buying medication for their child or young person online, and should only buy from registered pharmacies; pharmacy registration can be checked on the General Pharmaceutical Council website.
    • they should consider making arrangements for their child or young person if they (the parent or carer) become unwell; for example, making sure a partner, friend, family member or neighbor is aware of important information including their care plan, medications and emergency numbers.

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

Last updated 5 November 2020 [Text updated 9 November 2020]

  • Arrangements for prescribing and dispensing of medicines used in drug and alcohol treatment were changed to take account of service and pharmacy closures, staff unavailability, patients having to maintain social distance or self-isolate. These arrangements should be reviewed and returned to compliance with national drug and alcohol clinical guidance, and to meet service user needs, as soon as circumstances allow.
  • Measures 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 e-cigarettes, should all be increased where possible.
  • Commissioners, managers and staff need to consider contingency plans for situations such as: reduced or interrupted supply of medicines, or access to medicines when pharmacies are closed; reduced access to, or interrupted supply of, illicit drugs or alcohol; risk of exacerbation of breathing impairment from COVID-19 due to use of drugs such as opioids, benzodiazepines and pregabalin, and alcohol.
  • Advice is given with respect to: access to opioid substitution treatment (including depot buprenorphine); drug detoxification; alcohol harm reduction and detoxification, including community alcohol detoxification.

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, medication for attention deficit hyperactivity disorder (ADHD), valproate and prescribing psychotropic medicines for children and adolescents while working remotely.
  • Also provides links to guidance from other NHS organisations, e.g. North East London NHS Foundation Trust, South London & the European ADHD Guidelines Group.

Royal College of Psychiatrists: COVID-19: Accessing medication for mental health [Added 29 September 2020]

  • Information for patients to help address any concerns about taking their medication, getting supplies of their medication, appointments for monitoring or review of medications, whether their medication places them at increased risk if they get COVID-19 and how to distinguish between side effects of medications and COVID-19 symptoms.

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: Alcohol [Added 29 September 2020]

  • A resource for patients providing information on cutting down or stopping drinking alcohol, including advice on risk of withdrawal symptoms, planning how to cut down or stop drinking and links to further help.

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

Last updated 4 May 2020

  • 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.
  • Includes information on monitoring and supply of clozapine, managing febrile patients and managing patients unable to attend appointments [Added 9 November 2020].

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.
  • Includes information on signs of lithium toxicity, managing patients with confirmed or suspected COVID-19, managing patients who are self-isolating, managing patients unable to attend blood tests [Added 9 November 2020].

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 15 October 2020

  • Emergency guidance for all health and social care staff 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.
  • The MHRA will publish updated information once these temporary recommendations are no longer considered necessary [Added 9 November 2020].
  • Reminds healthcare professionals, patients and caregivers to submit all suspected side effect reports using the Yellow Card scheme electronically [Added 9 November 2020].

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.
  • Includes advice, such as how to manage self-isolating patients, how to manage potential pharmacy closures (including on-going considerations) and how to manage disruption to the supply chain [Added 9 November 2020].

Society for the Study of Addiction: COVID-19 national guidance links

Last updated 6 November 2020

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

Administration update (9th November 2020): resources updated on the page as indicated