Antidepressant Drug Helps Prevent Deterioration in Patients With COVID-19

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Researchers at Washington University School of Medicine in St. Louis discovered in a preliminary study¹ that the drug fluvoxamine may prevent some of COVID-19’s most serious complications. Treatment with fluvoxamine may make hospitalization and supplemental oxygen usage less likely.

“The patients who took fluvoxamine did not develop serious breathing difficulties or require hospitalization for problems with lung function,” Eric J. Lenze, MD, the Wallace and Lucille Renard Professor of Psychiatry, and the paper's first author, said to the press. “Most investigational treatments for COVID-19 have been aimed at the very sickest patients, but it's also important to find therapies that prevent patients from getting sick enough to require supplemental oxygen or to have to go to the hospital. Our study suggests fluvoxamine may help fill that niche.”²

Fluvoxamine, a selective serotonin-reuptake inhibitor (SSRI), is used commonly to treat obsessive-compulsive disorder (OCD), social anxiety disorder, and depression. Unlike other SSRIs, fluvoxamine interacts strongly with a protein called the sigma-1 receptor, which helps regulate inflammation.

“There are several ways this drug might work to help COVID-19 patients, but we think it most likely may be interacting with the sigma-1 receptor to reduce the production of inflammatory molecules,” said senior author Angela M Reiersen, MD, an associate professor of psychiatry, to the press. "Past research has demonstrated that fluvoxamine can reduce inflammation in animal models of sepsis, and it may be doing something similar in our patients.”²

Study supplies were delivered to the self-quarantined participants via a package left at their door. These materials included the study medication, an oxygen saturation monitor, a blood pressure monitor, and a thermometer. Participants used the equipment to confirm vital signs and oxygen saturation of 92% or greater. Data was collected via twice-daily surveys, sent by email, with phone call collection as an alternative for those without internet access.

The study involved 152 randomized participants with mild-to-moderate cases of COVID-19 who were recovering in their homes. The mean age was 46 years and 72% of these participants were women. Of the 152 patients, 76% of them completed the trial. Researchers broke the participants into 2 groups: those treated with fluvoxamine (80 participants) and those given an inactive placebo (72 participants). None of the 80 patients receiving fluvoxamine became seriously ill, whereas 6 of the 72 receiving the placebo experienced serious clinical deterioration, with 4 hospitalized.

“Our goal is to help patients who are initially well enough to be at home and to prevent them from getting sick enough to be hospitalized,” Caline Mattar, MD, an assistant professor of medicine in the Division of Infectious Diseases, reported to the press. “What we’ve seen so far suggests that fluvoxamine may be an important tool in achieving that goal.”²

References

1. Lenze EJ, Mattar C, Zorumski CF, et al. Fluvoxamine vs Placebo and Clinical Deterioration in Outpatients With Symptomatic COVID-19: A Randomized Clinical Trial. JAMA. Published online November 12, 2020. https://jamanetwork.com/journals/jama/fullarticle/2773108

2. Dryden J. Fluvoxamine may prevent serious illness in COVID-19 patients, study suggests. ScienceDaily. November 12, 2020. https://www.sciencedaily.com/releases/2020/11/201112113127.htm