Antidepressants may prevent serious COVID complications

The antidepressant fluvoxamine appears to prevent some of the most serious complications of COVID-19, according to a study of patients with mild to moderate illness trying to recover at home.

Researchers also say the drug also seemed to reduce the need for hospitalization and oxygenation.

In a study of 152 patients infected with SARS-CoV-2, the virus that causes COVID-19, researchers found that the results of patients treated with fluboxamine were the results of patients who were given inactive placebo. Compared with. After 15 days, none of the 80 patients who received the drug experienced any serious clinical deterioration. Meanwhile, of the 72 patients who received placebo, 6 (8.3%) became seriously ill and 4 required hospitalization.

The study will be displayed in Journal of American Medical Association..

“Patients who took fluvoxamine did not develop severe dyspnea or require hospitalization due to lung function problems,” said Eric Lenze, a psychiatric professor at Washington University in St. Louis. say.

“Most clinical trial treatments for COVID-19 are aimed at very ill patients, but treatments that prevent them from getting sick enough to require oxygenation or to go to the hospital. It’s also important to find out. Our research suggests that fluboxamine may help fill that niche. “

New role of fluvoxamine

Fluvoxamine, commonly used to treat obsessive-compulsive disorder (OCD), social anxiety disorder, and depression, is a class of drugs known as selective serotonin reuptake inhibitors (SSRIs), but unlike other SSRIs. , Fluvoxamine is a sigma-1 receptor. Its receptors also help regulate the body’s inflammatory response.

“There are several ways this drug may work to help patients with COVID-19, but we say it may interact with the Sigma-1 receptor to reduce the production of inflammatory molecules. I think, “says senior author Angela M. Liarsen. Psychiatry. “Past studies have shown that fluvoxamine can reduce inflammation in animal models of sepsis, which may be the same in our patients.”

The effect of this drug on inflammation may prevent the immune system from reacting overwhelmingly. It is believed to occur in some COVID-19 patients who improve after several days of illness and then appear to worsen. Many of these patients will eventually be hospitalized and some will die.

Remote research

With an innovative twist on research during the pandemic, researchers conducted research remotely. When symptomatic patients were positive and enrolled in the study, research staff delivered the drug or inactive placebo to them, along with a thermometer, automatic blood pressure monitor, and fingertip oxygen sensor.

“Our goal is to help patients who are initially in good health to stay at home and prevent them from getting sick enough to be hospitalized,” said Caline Mattar, an assistant professor of medicine in the Department of Infectious Diseases. Says. “What we’ve seen so far suggests that fluvoxamine may be an important tool for achieving that goal.”

Subjects took either antidepressants or placebo sugar pills for two weeks, interacting daily with members of the research team over the phone or computer. This allowed patients to report on their symptoms, oxygen levels, and other vital signs. If the patient suffered from shortness of breath, went to the hospital because of pneumonia, or had oxygen saturation below 92%, the researchers thought the patient’s condition had deteriorated.

“The good news is that none of the people taking effective medications experienced any deterioration,” says Reiersen. “We believe this drug may be the reason, but we need to study more patients to make sure.”

Researchers will begin larger studies in the coming weeks. Lenze, director of Healthy Mind Lab in School of Medicine, is an expert in conducting clinical trials using mobile and internet technologies. He states that this first study targeted patients in the St. Louis region, but the next phase of the study will target patients from all over the country.

“We bring research to patients and provide them with tools to monitor their health at home,” says Lenze. “Our hope is that we can keep these patients in good health to avoid hospitalization.”

The study was funded by the Taylor Institute for Family Innovation Psychiatry, the Bantry Foundation, the University of Washington Center for Mood Disorder Brain Research, the COVID-19 Early Treatment Fund, and the National Institute of Health.

Source: Washington University in St. Louis