The antidepressant Fluvoxamine can keep patients with Covid-19 out of the hospital, the discovery of large studies

Blister pack of fluvoxamine, which is usually sold under the brand name Luvox.

Blister pack of fluvoxamine, which is usually sold under the brand name Luvox.
Photography: Editor182 / Wikimedia Commons

A cheap and widely available drug used as an antidepressant now also seems to be a life-saving drug for covid-19. In a recently published, great clinical in the study, fluvoxamine was shown to reduce the risk of prolonged hospitalization as well as death in high-risk patients treated in an emergency room. Along with the results of other promising trials, fluvoxamine appears poised to become part of the medical tool against a pandemic, which affects hundreds of thousands of people around the world every day.

Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) that has been around since the 1980s. It is commonly used to treat depression as well as obsessive-compulsive disorder. In addition to its antidepressant properties, fluvoxamine is known to reduce inflammation. And that is the latter attribute has led some researchers to wonder if it can be repurposed to fight or prevent severe covid-19, which is often characterized by an excessive immune response.

Fluvoxamine is far from the only older drug that scientists had hoped for during the pandemic. But unlike many other candidates, including hydroxychloroquine, seems to have withstood more rigorous tests. The results of the largest test of fluvoxamine on covid-19 so far were announced on Wednesday night published in the Lancet Global Health, and look very encouraging.

The investigation is part of the TOGETHER trial, a joint cooperation between Canadian and Brazilian researchers to test several older ones drugs that could be used early to prevent worsening of COVID-19. Fluvoxamine testing began in January 2021 and included about 1,400 Brazilian patients examined for Covid-19 as outpatients in the emergency room, all were rated as high risk for severe disease. These patients were randomized to receive fluvoxamine or placebo and then followed for 28 days.

Overall, 15.7% of placebo patients continued to need an extended stay in an emergency or later hospitalization, while the same was true for 10.6% of patients receiving fluvoxamine – an approximately 30% reduction in relative risk. This reduction rose to 65% for those taking the full course of fluvoxamine as directed, the authors said. Although the number of deaths was low in both groups, which means that the findings are not so definitive, fluvoxamine had an advantage here as well: only one patient among those taking at least 80% of fluvoxamine doses died, compared with 12 in the placebo group. . who were similarly attached to their treatment (a total of 17 died in the fluvoxamine group, versus 25 in the placebo group).

“Our results are consistent with earlier, smaller tests. Given the safety, tolerability, ease of use, low cost and wide availability of fluvoxamine, these findings may have an important impact on national and international guidelines for the clinical treatment of COVID-19,”Said Gilmar Reis, Brazilian researcher and principal investigator of the TOGETHER trial, in statement from McMaster University in Canada, one of the project partners.

Fluvoxamine has long since become generic and costs about $ 4 for 10-a daily course, indicating that it could be easily and easily distributed worldwide, especially in countries where access to more expensive covid-19 drugs such as monoclonal antibodies is limited. And if it had become the standard treatment for covid-19, it would have followed the rates of dexamethasone, a cheap steroid used to treat the most severe cases. However, unlike dexamethasone, it could be widely used as a kind of prophylaxis to prevent cases from ever becoming more serious. point.

Organizations like the WHO may need other major tests to confirm its widespread use, although there are several other upcoming studies, including in the US There are also important questions to be answered about the viability of covid-19, including its optimal dose, whether it would be used as a combination therapy with other promising drugs, and whether it would help. vaccinated persons which develop a penetrating infection. But the new results may be enough to force some doctors and countries to adopt the drug. Despite the pandemic subsiding in much of the world, including in The United States, some countries like Russia are struggling with waves of recovery, and many poorer countries still have little access to vaccination.

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Naveen Kumar

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