News

Antidepressant fluvoxamine can keep COVID-19 patients out of the hospital

A 10-day course may work as an easy at-home treatment for early COVID-19, a clinical trial finds
Esther Landhuis, Science News
By Esther Landhuis, Science News
Dec. 4, 2021

An inexpensive, easy-to-take pill could be the next weapon in the arsenal against COVID-19. Taking the antidepressant fluvoxamine within days of showing symptoms of an infection can dramatically cut the risk of hospitalization and death, suggests the largest trial to date of this FDA-approved generic drug as a COVID-19 treatment.

In newly infected COVID-19 patients at high risk of complications, a 10-day course of the antidepressant fluvoxamine cut hospitalizations by two-thirds and reduced deaths by 91 percent in patients who tolerated the medicine, researchers report October 27 in the Lancet Global Health.

Editor182 on Wikimedia Commons
A decades-old antidepressant cut hospitalizations and deaths in COVID-19 outpatients, according to the largest trial to date testing the repurposed drug.

Fluvoxamine is commonly prescribed for obsessive-compulsive disorder and acts by increasing levels of the brain chemical serotonin between nerve cells. Aside from those effects, the drug has other biological properties that could quell inflammation triggered by COVID-19, says child psychiatrist Angela Reiersen of Washington University School of Medicine in St. Louis. She  stumbled onto the idea to test fluvoxamine as a COVID-19 treatment while scouring papers during her own bout of illness early in the pandemic.

“This is an existing medicine with two to three decades of clinical use — something millions of people have taken,” says David Boulware, an infectious disease physician and researcher at the University of Minnesota Medical School in Minneapolis. “It’s available at every pharmacy in the U.S., and [a 10-day course] costs $10.” By comparison, a five-day course of Merck’s antiviral molnupiravir — another oral drug that can protect people from serious COVID-19 — carries a $700 price tag. 

Boulware was not involved in the latest trial but helped analyze results from a smaller study showing fluvoxamine’s promise as an early COVID-19 treatment. That study tested real-world use of the antidepressant in workers who got infected during a COVID-19 outbreak at a California horse racing track last November.

The new analysis was conducted as part of TOGETHER — an international collaboration launched last year to test multiple repurposed medications in placebo-controlled experiments at the same time. The study’s adaptive design allows investigators to remove treatments from the study when statistical analyses show the drugs offer no benefit, as has been the case for the antimalarial drug hydroxychloroquine and for ivermectin, a drug commonly used against parasites.

For the new study, researchers at McMaster University in Hamilton, Canada, partnered with the research clinic Cardresearch in Brazil to recruit 1,497 unvaccinated, high-risk adults in their first week of flu-like symptoms from COVID-19. Patients at 11 clinical sites in Brazil entered the trial between January and August, and received either 100 milligrams of fluvoxamine or placebo pills twice a day for 10 days. Investigators monitored participants for another 28 days after treatment. 

In the placebo group, 119 of 756 patients, or 15.7 percent, developed complications requiring hospitalization or more than six hours of emergency care. In comparison, 79 of 741, or 10.7 percent, of fluvoxamine-treated patients got that sick. Taking fluvoxamine cut emergency visits and hospitalization by 32 percent, the trial found.

Among patients who took at least 80 percent of their doses, the benefits were even stronger. About three-fourths of patients fell into that group, with the most common reason for stopping the drug being gastrointestinal complaints. Fluvoxamine cut serious complications in that group by 66 percent and reduced mortality by 91 percent. In the placebo group, 12 patients died, compared with one who received the drug.  

Given the latest data and fluvoxamine’s long-standing safety record, Reiersen says, “we believe it should be used in COVID-19 for patients at high risk for morbidity and mortality from complications of the infection.” According to Boulware, the expert panel that develops U.S. COVID-19 treatment guidelines was briefed on the data in mid-September and could decide soon about recommending fluvoxamine as an early treatment.

This story was originally published by Science News, a nonprofit independent news organization.

Enjoy reading ASBMB Today?

Become a member to receive the print edition monthly and the digital edition weekly.

Learn more
Esther Landhuis, Science News
Esther Landhuis, Science News

Esther Landhuis is a freelance science journalist in the San Francisco Bay Area. Her stories have appeared in Scientific American, NPR, Nature, Science News, Alzheimer Research Forum, Cancer Discovery and elsewhere. She covers biomedicine, particularly neuroscience and immunology.

Get the latest from ASBMB Today

Enter your email address, and we’ll send you a weekly email with recent articles, interviews and more.

Latest in Science

Science highlights or most popular articles

Scientists use X-ray beams to determine role of zinc in development of ovarian follicles
Journal News

Scientists use X-ray beams to determine role of zinc in development of ovarian follicles

June 10, 2023

The study, conducted in part at Argonne’s Advanced Photon Source, could have implications for understanding human fertility.

Proteomic clues to oocyte development
Journal News

Proteomic clues to oocyte development

June 7, 2023

Researchers in Nanjing, China, have identified functions of critical proteins and pathways for female germ cell maturation.

Molecular basis for interaction between an essential protein complex and its regulator
News

Molecular basis for interaction between an essential protein complex and its regulator

June 4, 2023

Mutations in COPI are associated with multiple human diseases, including cancers and microcephalies.

UTSW researchers discover how food-poisoning bacteria infect the intestines
News

UTSW researchers discover how food-poisoning bacteria infect the intestines

June 3, 2023

Findings revealing efficient assembly of virulence machine could lead to development of treatments for diseases caused by gut pathogens.

'CoA as the central core'
Interview

'CoA as the central core'

June 2, 2023

ASBMB meeting on CoA and its derivatives will take place in Wisconsin in August and will feature sessions on metabolism, intracellular cross talk, proteostasis, autophagy and technological advances in mass spectrometry.

Study uncovers a unique, efficient method of copper delivery in cells
News

Study uncovers a unique, efficient method of copper delivery in cells

May 28, 2023

Discovery will help in treating Menkes disease, other copper deficiency disorders.