- Fluvoxamine, an antidepressant approved for treating OCD, is being studied for use on COVID-19 patients.
- If approved for use, the drug would treat severe cases of COVID-19 rather than protecting uninfected people against transmission.
- The drug is affordable and widely available, which will help areas with low vaccination rates and fewer resources.
An antidepressant drug may reduce the risk of severe COVID-19, according to a recent study.
In a trial with around 1,500 COVID-19 patients in Brazil, researchers found that fluvoxamine, a common antidepressant, reduced the need for hospitalizations in patients who were at high risk of severe illness.
Around 11% of patients who received fluvoxamine required treatment in emergency rooms or hospitalizations, compared to 16% of placebo recipients, according to the study. Among the patients who received fluvoxamine, 17 deaths were recorded, compared to 25 in the placebo group.
Sold under its brand name Luvox, fluvoxamine is approved for mental health treatment by the Food and Drug Administration (FDA). If approved for treating COVID-19, the drug may help keep patients out of the hospital. However, it’s not a replacement for vaccination.
Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) typically used to treat obsessive compulsive disorder (OCD) and depression. Current research doesn’t detail how fluvoxamine works to treat COVID-19, but scientists have some theories.
Brian DeHaven, PhD, associate professor in biology at LaSalle University, told Get Meds Info that fluvoxamine doesn’t work the same way as antiviral drugs like Merck’s new COVID-19 pill. Most antiviral drugs block the entry of the virus or viral replication, he said, but fluvoxamine binds to the sigma-1 receptor, which helps regulate inflammation and immune signaling.
“One of the reasons you can get really, really sick when you have COVID and die from it is over-activation of your immune response,” DeHaven said.
The drug’s anti-inflammatory effects seem to help COVID-19 patients recover and prevent hospitalization and death, according to the study.
“It’s great if you know why something works, but knowing that it works is extremely useful, especially since we’re still in a pandemic,” DeHaven said.
Fluvoxamine is not currently FDA-approved to treat COVID-19 due to a lack of evidence of the efficacy and risks, according to the National Institutes of Health (NIH).
NIH’s reasoning is based on a 2020 study that evaluated fluvoxamine use in 80 patients, compared to 72 patients who were given a placebo. The study did not show a significant difference in outcomes between the placebo and control groups, nor did it have a large enough sample size to inspire a recommendation had the results shown promise.
Could Other Antidepressants Treat COVID-19 Too?
Several anti-depression medications that target inflammation could potentially treat COVID-19 symptoms as well, DeHaven said. But it’s hard to judge whether they’d produce the same results without trials.
“A number of these older antidepressants bind to the sigma-1 receptor, and so it’s possible that we might find some other medications that are useful in viral infections like COVID-19,” DeHaven said.
Other antidepressants have been repurposed to treat physical conditions. For instance, Elavil and Prozac are among many of the antidepressants that can be prescribed to treat irritable bowel syndrome.
Kelly McClure, PhD, a psychology professor at LaSalle University, told Get Meds Info that some of the early psychotherapy drugs were discovered by accident when they were meant to treat physical conditions. For example, calcium blockers and anti-diabetic drugs have been repurposed to treat major depressive disorder.
“It’s not uncommon for drugs to affect different systems of your body at the same time,” McClure said.
What Will It Mean if Fluvoxamine Is Approved for COVID-19?
Fluvoxamine is low in cost and high in supply. Researchers in the new study noted the drug’s safety and widespread availability may influence international guidelines on treating COVID-19.
“Although safe and effective vaccines for COVID-19 have been developed and distributed, there remain, particularly in low resource settings, major challenges regarding their production, allocation, and affordability,” the researchers wrote.
DeHaven added that repurposing an existing drug like fluvoxamine will be very cheap. But it’s unlikely that the drug would be approved for people who aren’t hospitalized with COVID-19. Vaccines are still the first line of defense against the virus, he said.
“This is not going to be as useful as a vaccine because this is only going to work if you’re already infected,” DeHaven said. “But for someone that is in the hospital already, it’s too late for the vaccine. This can make the difference between being really sick and possibly even dying versus a moderately bad case.”
What This Means For You
Fluvoxamine may help prevent severe cases of COVID-19, but it’s not a replacement for preventive tools like vaccination and mask wearing.
The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.