Clinical Question
Is fluvoxamine a promising treatment for COVID-19?
Bottom line
This small randomized trial finds some benefit with fluvoxamine in the treatment of COVID-19. 2b
Reference
Study design: Randomized controlled trial (double-blinded)
Funding:
Setting: Outpatient (any)
Synopsis
Research Brief #74: Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) primarily used to treat obsessive-compulsive disorder. It is also is a strong agonist for the sigma-1 receptor that regulates cytokine production, and a French cohort study found an association between SSRI use and a reduced likelihood of intubation or death. In the current study, 181 outpatients with PCR-confirmed COVID-19 who had been symptomatic for fewer than 7 days were randomized to receive fluvoxamine or placebo in a double-blind manner. Patients who were hospitalized at any time or who had an oxygen saturation at baseline of less than 92% were excluded. Fluvoxamine was given as 50 mg once on day 1, then 100 mg twice daily on days 2 and 3, and increased if tolerated to 100 mg 3 times daily through day 15. The primary outcome was clinical deterioration, defined as the development of dyspnea or the need for hospitalization plus an oxygen saturation of less than 92%, and was available for 84% of participants. This outcome occurred in 0 of 80 patients in the fluvoxamine group and in 6 of 72 patients in the placebo group (0% vs 8.3%; P = .009; number needed to treat = 12). The secondary outcome was clinical deterioration on a 7-point ordinal scale ranging from none (0 points) through stages of increasing oxygen requirements, to the need for mechanical ventilation, and ultimately death (6 points). Of the 6 patients in the placebo group who deteriorated on this scale, 4 were hospitalized and one required mechanical ventilation, but after 30 days none had died. Based on this one small trial, fluvoxamine is a promising treatment for symptomatic outpatients with COVID-19, but these results require confirmation.
Reviewer
Mark H. Ebell, MD, MS
Professor
University of Georgia
Athens, GA
Comments
Tiny trial with fluvoxine? Present useful studies please.
I have yet to see a single POEM with numerous IVERMECTIN trials EACH one showing benefit. Zero trials showing no benefit. Present that data please.
fluvoxamine
Repurposing of an old antidepressant. I wonder if it will be used as well in the next pandemic. Would it help for influenza?
? Accuracy of Reference??...Possibly another FRENCH study
Re FRENCH study ?French. The investigators and study subjects were from United States. Please confirm if this was a mistake,or if there is another study involved. Thanks
Fluvoxamine vs Placebo and Clinical Deterioration in Outpatients With Symptomatic COVID-19: A Randomized Clinical Trial
Eric J Lenze 1, Caline Mattar 2, Charles F Zorumski 1, Angela Stevens 1, Julie Schweiger 1, Ginger E Nicol 1, J Philip Miller 3, Lei Yang 1, Michael Yingling 1, Michael S Avidan 4, Angela M Reiersen 1
Affiliations collapse
Affiliations
1Department of Psychiatry, School of Medicine, Washington University in St Louis, St Louis, Missouri.
2Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Washington University in St Louis, St Louis, Missouri.
3Division of Biostatistics, Informatics Institute, School of Medicine, Washington University in St Louis, St Louis, Missouri.
4Department of Anesthesiology, School of Medicine, Washington University in St Louis, St Louis, Missouri.
. One hundred fifty-two participants were enrolled from the St Louis metropolitan area (Missouri and Illinois)
https://medicine.wustl.edu/news/fluvoxamine-may-prevent-serious-illness…
Covid 19
There is lots people on some kind SSRI an epidemiologic can find out if people on SSRI have less incident covide
One can consider prescribing fluvoxamine by phone to patient
Interesting finding. So is Vitamin D in the role of preventing and treating COVID patients. Why these are not more broadly announced to the medical provider communities and to the general public?
good information
Relevant subject
Fluvoxamine for Covid
This is promising but needs further studies.
fluvox for covid
too small a study and needs more patients
Outpatient Covid Therapies.
Nice to know there is a growing List of Cytokine focused therapies for Covid -19
Interesting
This is interesting that it does seem to have a physiologic basis for effect