Among these, the best-tolerated drugs with limited side effects could become encouraging prophylactic candidates to reduce the risk of SARS-CoV-2 infection in the general population. many older psychotropics [5], [6]. Pharmacochemical centered hypothesis There is some literature about the effectiveness of different pharmacotherapeutic classes on coronaviruses [6] which has been recently examined [3], [4]. This has allowed to designate the medicines which could have antiviral activity, and, more specifically, possible anti-SARS-CoV-2 effects [3], [4]. Based on the data provided by Dyall et al. [6] the class effect shared by phenothiazines (chlorpromazine, fluphenazine, promethazine, thiethylperazine, triflupromazine) could be extrapolated to additional substances, such as cyamemazine and alimemazine/trimeprazine, which are commonly prescribed in France, but also levomepromazine or periciazine [3], [4]. The 11 psychotropic medicines identified as potentially effective against coronaviruses by Dyall et al. [6] are antihistamines (anti-H1) and cationic amphiphilic medicines (CAD). The second option can cause intracellular trafficking disturbances, hence disrupting viral access and replication [3], [4]. From this standpoint, cationic amphiphilic medicines (CAD) could represent a preventive treatment against SARS-CoV-2. Cationic and amphiphilic represent important physicochemical characteristics of a newly proposed classification of medicines related to their ability of acid sphingomyelinase (ASM) inhibition and called Practical Inhibitors of Acid SphingoMyelinase (FIASMAs) [7]. This house could also be linked to the endolysosomal anti-SARS-CoV-2 activity and of the 11 medicines described above, 7 are indeed confirmed FIASMAs [6], [8], [9]. Antihistamine properties are present in all the substances mentioned above, as well as with standard antihistamines (astemizole, chlorphenoxamine), phenothiazines or structurally derived antipsychotics (thiothixene, fluspirilene), tricyclic antidepressants (clomipramine), and the anticholinergic (benztropine) [6]. Many antihistamine medicines will also be CAD and as such could take action on disease access while, also exerting a negative rules on IL-6 launch from human being lung macrophages which are secreted in great amounts during the cytokine-storm of COVID-19 [10], [11]. The most recent data indicate that antihistamines (anti-H1) medications in general and particularly phenothiazines and derivates could be a useful strategy against SARS-CoV-2 at multiple PKI 14-22 amide, myristoylated phases, from prophylaxis to avoiding complications of the illness itself [12], [13], [14], [15], [16], [17], [18], [19], [20], [21]. Moreover, in a large sample of 219,000 electronic health records, 3 antihistamine medications (azelastine, diphenhydramine and hydroxyzine) were associated with reduced incidence of SARS-CoV-2 in subjects above the age of 61 [17]. Two overlapping lists of psychoactive PKI 14-22 amide, myristoylated providers with potential prophylactic effects against SARS-CoV-2 have been recently proposed in the literature based on pharmaco-epidemiological and pharmacochemical/chemoinformatic data. Both include mostly substances with antihistamine and cationic amphiphilic characteristics [3], [4] (observe Table 1 ). Table 1 Substances with antihistamine and cationic amphiphilic characteristics, with potential (or confirmed) anti-SARS-CoV-2 activity [2], [3] thead th rowspan=”1″ colspan=”1″ Psychotropics with antihistamine and cationic amphiphilic properties and potential anti-SARS-CoV-2 activity (FIASMAs +/?) /th th rowspan=”1″ colspan=”1″ Initial data confirming anti-SARS-CoV-2 activity /th /thead Alimemazine/trimeprazine (??)[13]Amitriptyline (+)[8]Astemizole (+)Benz(a)tropine (+)[18]Cetirizine (?)Chlorphenoxamine (?)Chlorpromazine (+)[16], [18], [19]Citalopram* (?)Clomipramine (+)[19]Clozapine (?)?Cyamemazine (??)Escitalopram* (?)[8]Flupent(h)ixol (+)[13]Fluphenazine (+)[19]Fluspirilene*(?#)[19]Hydroxyzine (+)[17]Levomepromazine/methotrimeprazine (??)Mequitazine (??)Metopimazine (??)Penfluridol* (+)Pimozide* (+)[21]Pipamperone*(?)Pipotiazine (??)Promethazine (+)[19]Perici(y)azine/propericiazine (??)Quetiapine (?)Tiethylperazine (??)[19]Tiotixene (??)Triflupromazine (+)Zuclopenthixol (??) Open in a separate windowpane *Very fragile to fragile antihistamine effects. ?Very likely that all clinically used phenothiazines (and closely-related compounds) PKI 14-22 amide, myristoylated belong to the FIASMAs, but not tested almost all experimentally. #fluspirilene is definitely a diphenylbutylpiperidines related to pimozide, penfluridol and loperamide with FIASMA profile; not tested experimentally. ?Conflicting data in PPP1R49 Govind et al.[27]. It should be noted that this hypothesis was formulated based on the initial data concerning the evolution of the pandemic in psychiatry [1], [2], [22]. Some recent results, however, suggest that suffering from a psychiatric disorder could PKI 14-22 amide, myristoylated increase the risk of being affected by COVID-19 [23] of developing a severe form of it [1] and even of dying as a result of it [24] while psychotropic medicines may increase COVID-19 mortality in elderly individuals [25]. These data motivated us to make assumptions about what could have constituted a possible initial prophylactic factor in psychiatry settings. Like the conflicting data around tobacco and nicotine [26] it is necessary to assess whether the increased risk of aggravation in mental health individuals once hospitalized for COVID-19 could come from the possible reduction or cessation of all.