The race to find another treatment for COVID-19 reached a pinnacle this week. Scientists have found that fluvoxamine, a common antidepressant, effectively treats early COVID-19 infections. The evidence suggests that taking the drug on a regular basis for 10 days reduces the risk of a severe case. In effect, it also reduces the risk that Covid-19 patients will need emergency care or hospitalization.
The news comes from a research paper published in The Lancet Global Health Journal. From January to August of this year, researchers conducted a large clinical trial in 11 cities in Brazil. They recruited 9,803 adults who tested positive for COVID-19 and were experiencing symptoms. In addition, all participants had known health problems that made them likely to develop severe illness.
A Closer Look at the Research
The research team split the participants into two groups: 741 patients received fluvoxamine and 756 received a placebo. To make sure that the results were unbiased, the trial team, care staff, and patients themselves did not know who received fluvoxamine and who received the placebo. The patients had an average age of 50 years old and about 58 percent of them were women.
The researchers gave all the participants pills to take home, which were either fluvoxamine or a placebo. The team instructed them to take 100 milligrams twice daily for 10 days. Then, the participants were tracked for four weeks.
Upon careful analysis, the team noticed that the fluvoxamine group was less likely to need emergency care or get transferred to a hospital due to COVID-19. Only 11 percent of the group received emergency treatment. In contrast, 16 percent of the placebo group needed emergency care or hospital treatment.
This might not seem like a big difference at first. But when you think about the number of hospital beds available, those percentages become important. A reduction in severe cases could mean that more patients would have a bed available in the hospital if they needed it.
The risk of death was lower with the antidepressant drug as well: 25 patients in the placebo group died from the virus as compared to 17 in the fluvoxamine group.
“Treatment with fluvoxamine (100 mg twice daily for 10 days) among high-risk outpatients with early diagnosed COVID-19 reduced the need for hospitalization,” the study authors wrote.
Why Fluvoxamine May Work as a Treatment for COVID-19
At first, it’s strange to think that an antidepressant could reduce the severity of COVID-19. The National Institutes of Health defines fluvoxamine as a selective serotonin re-uptake inhibitor (SSRI). Doctors usually prescribe SSRIs to treat persistent or severe depression, generalized anxiety, obsessive compulsive disorder, and PTSD.
An SSRI like fluvoxamine works for depression by boosting serotonin levels in the brain, which may help a patient have a better mood, emotional regulation, and get better sleep. But that’s not all that fluvoxamine can do. New research suggests that this drug works as a treatment for COVID-19 because it reduces the chance of a cytokine storm.
According to the NIH, fluvoxamine binds to a specific receptor – known as the sigma-1 receptor – on immune cells. That sends a signal to the cells to stop producing inflammatory cytokines. Inflammatory cytokines are little proteins that act like messages between cells. Those messages tell cells to mount an immune response to invading pathogens like bacteria and viruses.
While an immune response to a pathogen is normally good thing, a strong response to COVID-19 is not. Too many cytokines can flood the blood stream too quickly, which may lead to life-threatening complications and multiple organ failure. So, think of fluvoxamine as a drug that may stop your immune system from going into overdrive.
The Importance of Finding New Drugs to Treat COVID-19
Fluvoxamine is also a very promising treatment for COVID-19 because it’s cheap. Traditional oral tablets of 100 mg each cost about $74.37 for 100 tablets. That means 20 tablets (which is the equivalent of a 10-day treatment) would cost $14.87. However, you can’t buy this drug on your own and self-medicate for a COVID-19 infection. Fluvoxamine requires a prescription in the U.S.
Regardless, the research is very promising for the future of COVID-19 treatments. It could level the playing field for poorer countries and communities that don’t have enough vaccines and have high rates of severe infections.
What does this mean for us? In the near future, patients with COVID-19 may receive fluvoxamine as a treatment. But this doesn’t mean that we should skip out on getting vaccinated. COVID-19 vaccines are still the most effective way to prevent severe illness, hospitalization, and death from the virus. Don’t wait to get your booster or your first dose!