Inexpensive Generic Antidepressant May Reduce Serious COVID-19 Illness, Study Finds

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(CNN) – A cheap, generically available antidepressant could reduce the risk of severe COVID-19 illness by nearly a third in people at high risk, researchers reported on Wednesday.

A trial of around 1,500 patients in Brazil showed that those who took the drug, known as fluvoxamine, were less likely to develop serious illness and require hospitalization.

The drug, sold under the brand name Luvox, is a selective serotonin reuptake inhibitor (SSRI) most often used to treat obsessive-compulsive disorder (OCD) and depression. But it can affect inflammation, said Dr. Angela Reiersen, associate professor of psychiatry at Washington University in St. Louis who worked on the study, published in The Lancet Global Health.

“Fluvoxamine can reduce the production of inflammatory molecules called cytokines, which can be triggered by infection with SARS-CoV-2,” Reiersen said in a statement. The drug can also reduce blood platelets, which can affect the clotting effects of coronavirus infection.

Reierson and his colleagues gave 741 volunteers with Covid-19 100 mg of fluvoxamine twice daily for 10 days while 756 volunteers received a placebo.

Of the patients who received fluvoxamine, 79 – or about 11% – needed treatment in an emergency room or hospital room, compared with almost 16% of those who received placebos. This was a 5% decrease in absolute risk and a 32% decrease in relative risk.

More studies are needed to see if the drug could be added to treatments given to patients with coronavirus, but it is inexpensive. “A 10-day course of fluvoxamine costs around $ 4, even in well-heeled backgrounds,” the researchers wrote.

It’s not a cure, but if the drug can help keep patients out of the hospital, it would help.

“Given the safety, tolerability, ease of use, low cost and widespread availability of fluvoxamine, these findings could influence national and international guidelines on the clinical management of COVID-19,” said they concluded.

A related drug, Prozac, or fluoxetine, is also cheap and even more widely available, and the researchers said the drug should be studied to see if it might help.

“It is now crucial to establish whether there is a class effect and whether these drugs can be used interchangeably for COVID-19,” they wrote.

It wasn’t a perfect study, they noted. This was done in Brazil, and patients had a higher hospitalization rate than Covid-19 patients in other clinical trials.

“There is no standard of care for the early treatment of COVID-19 and various advocacy groups are promoting different interventions, including some of those evaluated in this trial and in our previous trials. In addition, it is difficult to understand who is most at risk of disease progression of this disease because some patients with many risk factors recover quickly while others with less established risk factors may not do so ”, have they wrote.


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