Antidepressant cuts COVID-19 hospital cases 30% to 65%


The inexpensive antidepressant fluvoxamine reduced the need for a long emergency department (ED) observation or a hospital stay among high-risk, symptomatic COVID-19 outpatients treated within 7 days of symptom onset as much as 30% to 65%, finds a Brazilian platform clinical trial yesterday in The Lancet Global Health.

In the largest such trial to date, a team led by researchers in Brazil, the United States, and Canada randomly assigned 1,497 adult COVID-19 patients, most of them unvaccinated, in 11 cities to either 100 milligrams of fluvoxamine twice daily for 10 days or a placebo from Jan 20 to Aug 5, 2021.

Average patient age was 50 years, 58% were female, 95% were of mixed race, and all had at least one predisposing medical condition. Patients were followed for 28 days.

The study was part of the ongoing TOGETHER trial, which has evaluated eight possible COVID-19 treatments (eg, lopinavir-ritonavir, metformin). The fluvoxamine arm was stopped early because preliminary results showed that it was more effective than placebo.

Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) used since the 1990s to treat mental illnesses such as obsessive compulsive disorder and depression. Possible mechanisms of action in COVID-19 are its anti-inflammatory, antiplatelet, and possible antiviral properties. The cost of a 10-day course of fluvoxamine is about $4, regardless of world region.



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