Internet and Psychiatry
  • Home
    • Editorials
    • Research news
    • Research papers
    • Interviews with eminent psychiatrists
    • Ten years ago
    • Fifteen years ago
  • Topics
    • Alcohol and Drug Abuse
    • Anxiety Disorders
    • Biomedical Science
    • Compulsive gambling
    • Disaster Medicine
    • Education
    • General Medicine
      • Acupuncture
      • Physical medicine and Rehabilitation
    • Human Rights
    • Interviews with eminent psychiatrists
    • Mood Disorders
      • Bipolar Disorder
      • Depression
      • Seasonal Affective Disorder
    • Neurological Disorders
    • Other Psychiatric Disorders
    • Posttraumatic Stress Disorder
    • Sexual Behavior
  • Books
    • Comorbidity of Depression and Alcohol Use Disorders
    • “Immigration and Mental Health” chapter abstracts
    • “Internet and Suicide” chapter abstracts
    • “Neurobiology of PTSD” chapter abstracts
    • “Suicidal Behavior in Alcohol…” chapter abstracts
    • “Suicide in the Military” chapter abstracts
    • “Terror and Suicide” chapter abstracts
    • “War and Suicide” chapter abstracts
  • Editors
    • Leo Sher, M.D.
    • Alexander Vilens, M.S.
  • Guests
    • Distinguished Guests
    • Our Contributors
  • Reflections
    • Poetry
    • Quotes

Editorials

Omicron spread and oral antiviral pills are big news. The advent of nirmatrelvir and ritonavir: called Paxlovid

January 3, 2022

Aya Allam, M.D., Steven Lippmann, M.D. 

We know lots about the current omicron spread. So, what is going on with this new antiviral drug, branded as Paxlovid and made by Pfizer? This pharmaceutical was just approved for early-on therapeutic prescribing to patients at high risk to SARS-Cov-2 virus infection yielding a serious COVID-19 disease. It is a dual medication containing nirmatrelvir and ritonavir, two established antiviral agents. It is the first oral agent available to attenuate coronavirus illnesses and is becoming available during this recent surge of omicron virus spread. What are details?

Nirmatrelvir is an antiviral drug that blocks the activity of SARS-CoV2 protease enzymes; that interferes at the RNA level with viral protein synthesis inside human cells, therefore attenuating virus particle replication in that host. Since antiviral medicines have a short half-life, the medication regimen always includes ritonavir, a cytochrome P450 3A4 enzyme inhibitor, that thus prolongs nirmatrelvir duration and at a higher blood level. This is the mechanism by which this pharmaceutical diminishes viral loads and coronavirus illness severity, including to omicron and/or delta infections.

Available only by prescription, nirmatrelvir and ritonavir should be taken at the earliest time that a person feels sick with a then confirmed with a coronavirus infection. It might be considered for someone with or without vaccination or past COVID-19 disease. Best administered in the first three symptomatic days, and with efficacy demonstrated within the initial five days. Each dosing pack comes with two 150 mg nirmatrelvir tablets and one ritonavir pill of 100mg; this whole triple-pack of medicine is self-administered, orally twice daily. A course of treatment involves five consecutive days.

One must be at least age 12 and weigh 88 pounds to be eligible for this medication. It is not authorized for prescription to patients sick enough to require hospitalization, oxygenation, or late in the course of disease – beyond the five days period. It is not indicated for someone having significant kidney and/or liver impairment. Adverse events are rare and side effects have been mild – and commonly may include an altered sense of taste and causing diarrhea. Our government is securing large quantities of this medication at a cost of approximately $530 per five-day dosing regimen.

Nirmatrelvir and ritonavir administration has proven efficacy early in the course of disease. Research documents it best at attenuating the degree of illness, need for hospitalization, or death when prescribed at within the first three symptomatic days. At five days, investigations substantiate an 88% reduction in the risk for hospitalization or death compared to controls receiving a placebo.

While this medicine is effective to attenuate COVID-19 disease, it is only a therapeutic intervention and does not replace vaccinations, that impart preventative coverage. Clearly, this medication is especially helpful for people with comorbidities like advanced age, obesity, and numerous other risk factors. It may also prove particularly beneficial for those with immune deficiencies, individuals who are unvaccinated, or someone having already recovered from an infection.

Nirmatrelvir and ritonavir is not indicated for pre-exposure or post-exposure illness prophylaxis, only for patients already evidencing an early infection, not recommended beyond five days of illness. This offers hope to people from becoming very sick due to delta and/or omicron variants; it should be widely disseminated in this country and to the rest of the world’s population. Clinical use will determine the true value and incidence of the medication-induced side effects In the meantime, immunity self-care is protective by weight control, health maintenance, exercise, proper diet (including zinc), light exposure (for vitamin D), and sleep.

Related Posts

Editorials /

Fluvoxamine attenuates COVID-19 disease

Editorials /

What? Botox injections can mitigate depressions?

Editorials /

Smoking, suicide risk, and the COVID-19 pandemic

‹ Suicide prevention in the era of COVID-19 › Cerebrospinal fluid monoamine metabolites and lethality of suicide attempts in depressed patients with alcohol use disorder

Editorials

  • Fluvoxamine attenuates COVID-19 disease
  • What? Botox injections can mitigate depressions?
  • Smoking, suicide risk, and the COVID-19 pandemic
  • Omicron spread and oral antiviral pills are big news. The advent of nirmatrelvir and ritonavir: called Paxlovid

Research Papers

  • COVID-19 mortality in Europe and the ’Iron Curtain’ between East and West
  • Examination of depressive signs and symptoms among 803 University students in seven Universities and Colleges. Hungary, Romania, Serbia.
  • Examination of spirituality and the dimensions of spirituality among 803 students in seven different Universities. Hungary, Romania and Serbia.
  • Examination of depressive signs and symptoms among 932 students in eight different secondary schools in Hungary

Research News

  • Thirty years of publications in the field of suicidology
  • Osteoporosis drugs are associated with depression and anxiety
  • A study of relation between the use of cannabis in adolescence and self-harm or suicide
  • Senior WISE intervention: Gender differences in bodily pain and trait anxiety

Latest News

  • Suicide mortality in the U.S. decreased from 2018 to 2020 after increasing since 2000
  • The World Federation of Societies of Biological Psychiatry (WFSBP) Task Force on Men’s Mental Health – January 2022 update
  • The Nobel Prize in Physiology or Medicine 2021
  • 2021 National Veteran Suicide Prevention Annual Report

Interviews with eminent psychiatrists

  • Interview with Professor Shih-Ku Lin
  • Interview with Professor Masahito Fushimi
  • Interview with Professor Maurizio Pompili
  • Interview with Professor Marco Sarchiapone

Ten Years Ago

  • Suicidal ideation in depressed patients with or without comorbid posttraumatic stress disorder treated with selective serotonin reuptake inhibitors
  • Treatment of suicide attempters with bipolar disorder: a randomized clinical trial
  • Posttraumatic stress disorder and the Neuroevolutionary Time-depth Principle
  • The role of endogenous opioids and monoamine neurotransmitters in non-suicidal self-injury

Back to Top

  • About
  • Contact
  • Privacy Policy
  • Terms and Conditions
Copyright © 2022 AVCalc LLC. All rights reserved worldwide.