Brazilian study finds common anti-depressant may lower risk of hospitalization

by mcardinal

Lauren Dempsey, MS in Biomedicine and Law, RN, FISM News 


On Wednesday, promising results from a Brazilian study evaluating the effectiveness of a common anti-depressant against COVID-19 showed that the drug has potential to be a low-cost treatment for those who contract the virus.

The study published in the Lancet included about 1,500 participants in Brazil who were randomly selected to either receive 100mg of fluvoxamine twice a day for 10 days or a placebo. Those chosen for the study must have tested positive for COVID-19 and be symptomatic. The patients in this trial were also considered high risk due to age or having multiple co-morbidities and were mostly unvaccinated. 

The trial was conducted because recent evidence from smaller studies indicated that there was a potential therapeutic benefit when using fluvoxamine for COVID-19. In the TOGETHER trial for acutely ill and symptomatic  COVID-19 patients, researchers “aimed to assess the efficacy of fluvoxamine versus placebo in preventing hospitalization defined as either retention in a COVID-19 emergency setting or transfer to a tertiary hospital due to COVID-19”.

The TOGETHER Trial is a collaboration of international partners that are committed to research that will prevent death and improve patient outcomes for those impacted by COVID-19. The goal of this coordinated, global trial is “to identify effective repurposed therapies to prevent the disease progression of COVID-19.”

The data from the trial showed that treatment with fluvoxamine “among high-risk outpatients with early diagnosed COVID-19 reduced the need for hospitalization” and reduced patients risk by 32%. In the group of patients that received the medication, 11% went to a hospital or were seen in a COVID-19 emergency treatment center. This was compared to 16% in the group of patients who were not given the medication.

The medication even showed promising results when patients were not compliant in following the treatment regimen. Data revealed that when patients took only 80% of the doses prescribed, there was still a reduction in hospitalizations. In addition only one patient that received fluvoxamine died, compared to 12 patients who died in the placebo group. 

The research is still unclear on the mechanism of action of fluvoxamine for COVID-19 treatment. The authors of the study wrote that the drug appears to be effective against COVID-19 and that its anti-inflammatory properties could help coronavirus patients.

Ed Mills, a researcher at McMaster University said “one of the other aspects of this particular drug, for me, is that it has immunomodulatory effects. In particular, it has anti-inflammatory effects.” A 2019 study of fluvoxamine showed benefits in reducing inflammation and sepsis through this mechanism.

Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) that is FDA approved and been used as an antidepressant since the 1990s.  It is a commonly prescribed to treat depression, anxiety disorders, and obsessive-compulsive disorder. Research is still underway which will need to conclude before this medication is used in treating COVID-19 patients, but prescribing medication of off-label use is common practice. 

One promising aspect of fluvoxamine is that the medication is extremely cost-effective. A 10-day course of medication costs about $4. According to Mills, fluvoxamine could be a game-changer for poorer countries with low vaccination rates and lacking access to more advanced COVID-19 therapies.