Common antidepressant likely lowers risk of Covid hospitalization, study finds

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Fluvoxamine, a cheap and widely available pill used worldwide to treat mental illness, is highly likely to reduce the risk of being hospitalized with Covid-19, according to a new peer-reviewed study published in JAMA network open, to open up another possible treatment option for the disease with a drug that has been tried and tested for decades.

Important facts

Based on an analysis of data from three separate clinical trials, the researchers said there is a “high probability” that fluvoxamine has been associated with “at least a modest reduction in Covid-19-related hospital admissions.”

The studies, which involved a total of nearly 2,200 unvaccinated Covid-positive patients from the United States, Brazil and Canada, evaluated how well taking fluvoxamine 100 mg twice daily reduced the risk of being hospitalized with the disease.

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

However, they stressed that it is important for clinical trials investigating fluvoxamine to further substantiate the findings, particularly those investigating lower doses of the drug and how effective it is in vaccinated individuals.

A similar and widely used antidepressant, fluoxetine, should also be studied for its potential to treat Covid-19, the researchers said.

Researchers noted that circulating Covid variants varied between studies and all post-dated Omicron and Delta variants, which could impact baseline risk and any calculated reduction.

key background

While researchers have rushed to develop novel treatments and vaccines to combat Covid-19, supply is still tight and demand remains high, particularly for more affordable and accessible treatment options. Studies evaluating how existing drugs can be repurposed to fight Covid can help reduce development and production times. Fluvoxamine, a selective serotonin reuptake inhibitor (SSRI) FDA-approved to treat obsessive-compulsive disorder and widely used in other conditions such as depression, has shown remarkable promise. Experts aren’t sure why fluvoxamine and other SSRIs show promise against Covid, although they believe it may have something to do with their ability to fight inflammation, a key factor in serious Covid outcomes. Even so, the National Institutes of Health say there is insufficient evidence to recommend the drug for use against Covid. Other drugs, notably the antiparasitic ivermectin and the antimalarial hydroxychloroquine, have gained popularity as a treatment for Covid, although there is no strong evidence supporting their use.

What to look out for

change treatment guidelines. The World Health Organization is continually reviewing new evidence to update its treatment guidelines for Covid-19. In early March, the WHO expert panel responsible for the guidelines announced that it was reviewing fluvoxamine alongside several other drugs on recommendation. The agency said its guidelines will be updated when “sufficient new evidence warrants it.”

Further reading

Can antidepressant fluvoxamine prevent severe covid-19 caused by coronavirus? (Forbes)

Investigating the Surprising Effect of Antidepressants on COVID Deaths (Scientific American)

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