Fluvoxamine, a cheap and widely available pill used around the world to treat mental illness, is very likely to reduce the risk of being hospitalized with Covid-19, according to new peer reviewed research published in JAMA Network Open, opening up another possible treatment option for the disease using a medicine with a decades-long track record.
Based on an analysis of data from three different clinical trials, the researchers said there is a “high probability” fluvoxamine was associated with “at least a moderate reduction in Covid-19 hospitalizations.”
The trials, which enrolled a total of nearly 2,200 unvaccinated Covid-positive patients from the U.S., Brazil and Canada, evaluated how well 100mg of fluvoxamine taken twice a day reduced the risk of being hospitalized with the disease.
The analysis, coupled with the fact that fluvoxamine is “immediately available, safe and inexpensive” around the world, makes the drug a “reasonable option for high-risk outpatients” who don’t have access to other Covid treatments like antiviral drugs or monoclonal antibodies, the researchers said.
However, they stressed it is important clinical trials examining fluvoxamine continue to bolster the results, especially those studying lower doses of the drug and how effective it is in vaccinated individuals.
A similar and widely available antidepressant, fluoxetine, should also be studied for its potential to treat Covid-19, the researchers said.
The researchers noted that circulating Covid variants varied between studies and all predated omicron and delta variants, which could affect the baseline levels of risk and any reduction calculated.
While researchers have rushed to develop novel treatments and vaccines to tackle Covid-19, supply is still short and demand is still high, especially for more affordable and accessible treatment options. Trials evaluating how existing medicines can be repurposed to fight Covid can help slash development and production times. Fluvoxamine, a selective serotonin reuptake inhibitor (SSRI) approved by the FDA to treat obsessive compulsive disorder and widely used for other conditions like depression, has shown notable promise. Experts are not certain why fluvoxamine and other SSRIs show promise against Covid, though they believe it may have something to do with their ability to fight inflammation, a key driver of serious Covid outcomes. Despite this, the National Institutes of Health says there is insufficient evidence to recommend the drug for use against Covid. Other drugs, notably the antiparasitic ivermectin and antimalarial hydroxychloroquine, have surged in popularity as a treatment for Covid, despite no strong evidence supporting their use.
What To Watch For
Changing treatment guidelines. The World Health Organization continually reviews new evidence to update its treatment guidelines for Covid-19. In early March, the WHO’s expert panel responsible for the guidance said it is evaluating fluvoxamine, alongside several other medicines, for recommendation. The agency said its guidelines will be updated if and when “sufficient new evidence warrants this.”
Can Antidepressant Medication Fluvoxamine Prevent Severe Covid-19 From Coronavirus? (Forbes)
Investigating Antidepressants’ Surprising Effect on COVID Deaths (Scientific American)
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