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Doctors think this common antidepressant might treat COVID-19

BGR logo BGR 12/1/2020 Chris Smith
Coronavirus Treatment © Provided by BGR Coronavirus Treatment
  • Doctors found that antidepressant drug fluvoxamine that people can take at home can reduce respiratory complications after infection with the novel coronavirus.
  • The researchers found a significant difference between the group of people who took fluvoxamine and the placebo group. None of the people on fluvoxamine developed complications compared to 8% in the control cohort.
  • The drug requires further testing, with researchers planning a more ample study to verify the initial results.

With COVID-19 vaccines fast approaching, the world is one step closer to putting out the novel coronavirus. The process won’t be instant, and it will require a combined effort that includes widespread immunizations and the continued enforcement of health measures meant to prevent COVID-19 transmission. That’s to say, the world will wear masks and social distance for at least a year after the vaccination campaigns start. It could be even longer than that depending on vaccines’ success and the number of people who choose to be inoculated.

The world doesn’t have yet is an over-the-counter medicine that can treat COVID-19 at home from the moment it’s diagnosed. Drugs like remdesivir, dexamethasone, blood thinners, and monoclonal antibodies have specific uses, and they require a healthcare worker to administer it. The antibodies only work if administered early in the illness, just like blood plasma. Dexamethasone can save lives if given later in the course of COVID-19, once the immune response gets out of control. But researchers now think they may have found a drug that could be prescribed to COVID-19 patients who recover at home and could prevent severe respiratory complications requiring hospitalization.

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Fluvoxamine is an antidepressant that’s used to treat obsessive-compulsive disorder and anxiety. It’s part of a class of drugs called Selective serotonin reuptake inhibitors (SSRIs), which bind to receptors in the central nervous system. The drug binds to sigma-1 receptors, which can also affect the immune response that leads to lung damage in COVID-19. Lung damage, and the resulting respiratory distress, could lead to other organ issues resulting in death.

Researchers published the preliminary findings of a double-blind, placebo-controlled study of coronavirus patients in JAMA Network. Neither the doctors nor the 152 patients diagnosed with COVID-19 knew who was taking the drug or a placebo over the course of two weeks. The doctors observed the patients’ progress remotely, advising them on what steps to take in case of an increase in severity.

“We not only monitor people but if they are deteriorating, we let them know what to do,” Washington University, St. Louis, Dr. Eric Lenze told Star Tribune. “In the first study, it was quite often us … who told patients to get ahold of their primary care doctor or go straight to the emergency room because they were deteriorating.”

At the end of the study, the researchers found that nobody in the fluvoxamine group developed serious breathing problems. But 8% of the placebo group (6 people) developed shortness of breath and oxygen levels below 92%.

One of the advantages of repurposing a drug is that its safety and toxicity are known. Fluvoxamine side-effects can include headaches, nausea, diarrhea, restlessness, and fatigue. But if effective in COVID-19, these side-effects might be warranted. Also, the fluvoxamine therapy would only last 15 days, so the side effects might go away faster than in prolonged use of the drug.

Another advantage is the cost. A 15-day course of fluvoxamine for coronavirus would cost about $12.

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Only 20% of the volunteers for the first trial were accepted because the scientists had strict conditions. Hospitalized patients, patients who had symptoms for more than seven days, and asymptomatic individuals were excluded. Those people suffering from lung disease, heart failure, or immunocompromised conditions were also excluded.

“It was a well-done trial. But it’s still a relatively small number of patients, and that is the only concern,” Dr. David Boulware told Star Tribune. Boulware is the same University of Minnesota infectious disease physician who ran an outpatient trial that showed controversial drug hydroxychloroquine did not prevent COVID-19. He was an unpaid adviser on the fluvoxamine study design.

The final phase of the study will recruit people at risk of severe COVID-19 complications, including people who are over 40 or have at least one risk factor. The researchers look to include more than 800 people.

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