“Fluvoxamine, also known under its brand name Luvox, is an antidepressant that is often used to treat obsessive-compulsive disorder (OCD),” Diana Samuel, MD, a psychiatrist in New York City who was not involved with the study, tells Verywell.
The November study, published in JAMA, included non-hospitalized adults in the St. Louis metropolitan area with a confirmed COVID-19 diagnosis, COVID-19 symptoms, and oxygen saturation of 92% or higher. In other words, these patients did not have severe cases of COVID-19. Of the 152 patients, 76% finished the trial.
The findings showed that after 15 days, none of the 80 patients who had received the drug experienced serious deterioration, or worsening of their condition. Six of the 72 patients who were given a placebo (8.3%) became seriously ill, and four of them needed to be hospitalized.
Less Severe COVID-19 Symptoms
The study was conducted from April to August, with a final follow-up in September. At the beginning of the study, each participant was given the medication that they had been randomly assigned (either a dose of fluvoxamine or a placebo), oxygen and blood pressure monitors, and a thermometer. The participants were responsible for taking their own vital signs.
Participants took 50 milligrams (mg) of fluvoxamine for one day, then took 100 mg twice daily, as tolerated, for two days. After that, the dose increased to 100 mg three times daily, as tolerated, through day 15.
Only one serious adverse event was reported in the group that took the medication. In the placebo group, there were six serious adverse events and 12 other adverse events reported. Pneumonia and gastrointestinal distress occurred more often in the placebo group than in the group assigned a dose of fluvoxamine.
Overall, patients in the placebo group experienced more severe COVID-19 symptoms than those who were taking fluvoxamine.
How Does It Work?
Fluvoxamine is a selective serotonin-reuptake inhibitor (SSRI). Unlike other SSRIs, fluvoxamine reacts with the protein sigma-1 receptor, which helps control inflammation by regulating the body’s cytokine response.
“There are several ways this drug might work to help COVID-19 patients, but we think it most likely may be interacting with the sigma-1 receptor to reduce the production of inflammatory molecules,” senior author Angela M Reiersen, MD said in a press release. “Past research has demonstrated that fluvoxamine can reduce inflammation in animal models of sepsis, and it may be doing something similar in our patients.”
It’s thought that some COVID-19 patients experience an overwhelming immune system response, often leading to adverse effects that can leave a patient hospitalized. The researchers believe the drug’s effect on inflammation is potentially helping to prevent the immune system from developing this negative response.
Limitations of the Study
The authors note there were several limitations to the research. “The study is limited by a small sample size and short follow-up duration, and determination of clinical efficacy would require larger randomized trials with more definitive outcome measures,” the authors wrote.
The authors also noted that the differences in clinical deterioration among patients might have been attributable to “comparative baseline distributions of oxygen saturation rather than an effect of treatment.“
The editorial board also strongly emphasized that more data is needed from larger trials.
However, according to the study, the potential advantages of fluvoxamine for outpatient treatment of COVID-19 include its:
SafetyWidespread availabilityLow costOral administration
The researchers will begin a larger study in the next few weeks.
The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.
