Fluvoxamine is an inexpensive anti-depressant commonly used in mental healthcare. Evidence from the recently concluded clinical trial suggest that it can be repurposed to treat patients with COVID-19. It is found to reduce risk of severe COVID-19 symptoms, reduces need of emergency care and hospitalisation and reduce risk COVID-19 death.
COVID-19 pandemic has caused over half a million deaths so far and has caused unprecedented human suffering and economic damages worldwide and is still unabated as evidenced by recent upsurge of cases in the UK and Europea despite putting in place massive preventive measures (including vaccination) and therapeutic provisions at different levels. Therefore, there is an urgent need for new inexpensive and easily available treatment that could reduce severity of symptoms and reduce need for emergency care and hospitalisation thereby reduce COVID-19 mortality.
An earlier observational study had indicated that use of antidepressant is associated with the reduced risk of intubation or death. Results from a preliminary clinical trial with 152 adult participants with the symptoms of COVID-19 treated with fluvoxamine also indicated reduced likelihood of deterioration. Based on this, a larger clinical trial was conducted on out-patients in community in Brazil to evaluate efficacy of anti-depressant fluvoxamine in preventing clinical progression of COVID-19 cases to severity and hospitalisation. The results of the study were encouraging. It was found that relative risk of being transferred to tertiary care in hospitals was lower for fluvoxamine group than the group on placebo. Also, the number deaths in this group were lower by about 30%. This suggested treatment of early diagnosed COVID-19 patients with fluvoxamine reduced need of hospitalisation in due course.
The mechanism of action of fluvoxamine in treatment of COVID-19 cases is its anti-inflammatory and possibly, antiviral property. It dampens immune response and tissue damage.
This finding suggesting repurposing of fluvoxamine in treatment of COVID-19 is very significant especially for resource constrained settings because it is an inexpensive, easily available drug. The patients can be treated in community. So, it is just perfect in terms of affordability and accessibility.
Only caveat is that this study is conducted in a single geographic area so need to be tested in settings outside Brazil though it seems another study sponsored by Washington University School of Medicine has just been completed.
- Reis G., et al 2021. Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised, platform clinical trial. The Lancet Global Health. Published: October 27, 2021. DOI: https://doi.org/10.1016/S2214-109X(21)00448-4
- ClinicalTrial.gov ,. Repurposed Approved and Under Development Therapies for Patients With Early-Onset COVID-19 and Mild Symptoms. Identifier: NCT04727424. Available online at https://clinicaltrials.gov/ct2/show/NCT04727424
- ClinicalTrial.gov,. A Double-blind, Placebo-controlled Clinical Trial of Fluvoxamine for Symptomatic Individuals With COVID-19 Infection (STOP COVID). Identifier: NCT04342663. Available online at https://clinicaltrials.gov/ct2/show/results/NCT04342663?term=COVID&cond=Fluvoxamine&draw=2&rank=1
- Sidik S. 2021. Common antidepressant slashes risk of COVID death. Nature News 29 October 2021. DOI: https://doi.org/10.1038/d41586-021-02988-4