Infectious Disease

In a small research, antidepressant prevents medical deterioration in sufferers with COVID-19

December 06, 2020

1 min read

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Disclosure:
Lenze reports having received grants from Acadia, Alkermes, Janssen, Takeda, the Barnes Jewish Hospital Foundation, and the Patient-Centered Outcomes Research Institute Foundation. Lenze also claims to have received consulting fees from Janssen and Jazz Pharmaceuticals. In the study you will find all relevant financial information from all other authors.

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The use of the antidepressant fluvoxamine in patients with COVID-19 was associated with a slightly lower likelihood of clinical deterioration over 15 days in a small study according to results published in JAMA.

“Fluvoxamine is a safe, widely available drug that is inexpensive and easy to use.” Eric Lenze, MD, Professor of psychiatry at Washington University School of Medicine, said Healio. “If it prevents COVID-19 from getting worse, patients who develop symptoms and test positive could take this medicine and reduce their risk of dyspnoea and hypoxia – signs of lung injury that often lead to hospitalizations.”

Fluvoxamine Infographic

Source: Lenze EJ et al. JAMA. 2020; doi: 10.1001 / jama.2020.22760.

Lenze and colleagues conducted a double-blind, randomized, contactless clinical trial to determine the effect of fluvoxamine versus placebo in 152 outpatients with COVID-19. The primary outcome was clinical deterioration within 15 days of randomization. The researchers defined clinical deterioration as breathlessness or hospitalization for dyspnoea or pneumonia and oxygen saturation below 92%, or the need for additional oxygen to reach saturation of 92% or more.

This included patients who were not hospitalized and who lived in the community who had COVID-19 symptoms within 7 days and had an oxygen saturation level of 92% or more. All participants were from the St. Louis area and were recruited between April 10, 2020 and August 5, 2020.

Eric Lenze

A total of 80 participants received 100 mg fluvoxamine three times a day and 72 three times placebo for 15 days. None of the patients in the treatment arm showed clinical deterioration compared to six patients in the placebo arm.

“Fluvoxamine prevented it from getting worse, but did not reduce symptoms any faster than placebo. We are not sure why not. Perhaps the symptoms of COVID-19 are so heterogeneous that it is difficult to use them as a result, ”said Lenze.

Regarding how an antidepressant would benefit patients with COVID-19, the researchers said a “possible mechanism for immune modulation is sigma-1 receptor (S1R) agonism”.

“If fluvoxamine is found to be effective in treating COVID-19, the underlying mechanism needs further clarification,” they write. “The study was triggered by a hypothesis that the influence of fluvoxamine on the S1R[inositol-requiring enzyme 1-sigma] Path. Anti-inflammatory (cytokine reduction) effects resulting from S1R activation would be in line with recent evidence on the benefits of other anti-inflammatory drugs such as colchicine and corticosteroids for COVID-19. “

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