Common antidepressant likely reduces risk of hospitalization for Covid, study finds

Topline

Fluvoxamine, a cheap and widely available pill used around the world to treat mental illness, is highly likely to reduce the risk of being hospitalized with Covid-19, according to new peer-reviewed research published in Open JAMA Network, opening up another possible treatment option for the disease using a drug that has been proven for decades.

Highlights

Based on an analysis of data from three different clinical trials, the researchers said there is a “high probability” that fluvoxamine is associated with “at least a moderate reduction in hospitalizations for Covid-19”.

The trials, which recruited a total of nearly 2,200 unvaccinated Covid-positive patients from the United States, Brazil and Canada, assessed how well 100 mg of fluvoxamine taken twice daily reduced the risk of being hospitalized for the disease.

The analysis, coupled with the fact that fluvoxamine is “immediately available, safe and inexpensive” worldwide, makes the drug a “reasonable option for high-risk outpatients” who do not have access to other Covid treatments like antiviral drugs or monoclonal antibodies, the researchers said.

However, they stressed that it is important that clinical trials examining fluvoxamine continue to strengthen the results, especially those studying lower doses of the drug and its effectiveness in vaccinated people.

A similar, 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 previous omicron and delta variants, which could affect baseline risk levels and any calculated reductions.

Key context

While researchers have rushed to develop new treatments and vaccines to fight Covid-19, supply is still insufficient and demand is still high, especially for more affordable and accessible treatment options. Trials assessing how existing drugs can be repurposed to fight Covid can help reduce 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 remarkable promise. Experts aren’t sure why fluvoxamine and other SSRIs show promise against Covid, though they think it might have something to do with their ability to fight inflammation, a key driver of severe Covid outcomes. Despite this, the National Institutes of Health say there is not enough evidence to recommend the drug’s use against Covid. Other drugs, including the antiparasitic ivermectin and the antimalarial hydroxychloroquine, have gained popularity as treatments for Covid, despite a lack of strong evidence to support their use.

To monitor

Modification of treatment guidelines. The World Health Organization is constantly reviewing new evidence to update its treatment guidelines for Covid-19. In early March, the WHO expert group responsible for the guidance said it was evaluating fluvoxamine, along with several other drugs, for recommendation. The agency said its guidance will be updated if and when “sufficient new evidence warrants it.”

Further reading

Can the antidepressant drug Fluvoxamine prevent severe coronavirus Covid-19? (Forbes)

Survey of surprising effect of antidepressants on COVID deaths (Scientific American)

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