This cheap antidepressant could cut Covid hospitalisation risk

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A new study has suggested that early treatment of COVID-19 patients with the commonly prescribed antidepressant fluvoxamine can cut hospitalization by up to 30 percent and potentially save lives.

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Researchers in Brazil, the US, Canada and Australia said the cheap drug could provide low-cost protection against severe COVID infection or death in low-income countries that have not yet received adequate doses of vaccines.

In the largest clinical trial of the drug, conducted between January 15 and August 6, 739 randomly selected Brazilian COVID-19 patients were treated with fluvoxamine, while another 733 received a placebo.


Researchers tracked each patient receiving fluvoxamine for 28 days to determine their health and if they still needed hospital treatment. They found that hospitalizations were reduced by up to 30 percent in those who received 100 mg of fluvoxamine twice daily for ten days compared to those who received a placebo.

The drug, commonly used to treat mental health conditions such as depression and obsessive compulsive disorder, was chosen to study its COVID-19 healing potential because of its anti-inflammatory properties, the research noted, published in the Lancet magazine.

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Fluvoxamine was offered to patients in one arm of the “Together Trial” – a randomized adaptive platform trial to examine the efficacy of eight repurposing therapies for COVID-19 among high-risk adult outpatients.

Of the 741 patients who received fluvoxamine, the scientists found that 79 required an emergency setting or hospitalization for more than six hours, while 119 of the 756 participants received a placebo.

Costing around $4 per 10-day course, fluvoxamine could be a game-changer for low-income countries, which have low vaccination rates and lack access to more advanced COVID-19 treatments, scientists said.

Researchers say the drug may have the potential to reduce the severe immune response known as the cytokine storm seen in COVID-19 patients that can cause fatal organ damage.

Although reducing deaths was not a targeted focus area in the study, the scientists noted that patients taking at least 80 percent of drug doses had one death in the fluvoxamine group. In the placebo group, there were 12 deaths.

Bellow-based co-principal investigator Gilmour Rees said, “Given the safety, tolerability, ease of use, low cost and widespread availability of fluvoxamine, these findings are supported on national and international guidelines on the clinical management of COVID-19.” could have a significant impact.” Horizonte, Brazil said in a statement.

The researchers hope to further assess whether the closely related drug fluoxetine, which is part of the WHO essential medicines list, can be used interchangeably for COVID-19, and if combining fluvoxamine with other drugs is better. Treatment can provide results.

“Fluvoxamine, so far, is the only treatment that, if administered early, can prevent Covid-19 from becoming a life-threatening disease,” said co-principal investigator Edward Mills of the “Together Trial” from McMaster University in Canada.

“It may be one of our most powerful weapons against the virus and its effectiveness is one of the most important discoveries we have made since the pandemic began,” Dr. Mills said.

The scientists cautioned, however, that the use of interventions such as fluvoxamine to prevent COVID-19 disease progression and hospitalization is “severely dependent” on reliably identifying patients at highest risk of worsening in the early stages of infection. Is.

“The study strongly suggests that fluvoxamine is an effective, safe, inexpensive, and relatively well-tolerated option for the management of ambulatory patients with COVID-19, particularly for low-resource settings (but but not limited to) is useful,” the researchers wrote.

Because at least one factor for more severe disease was required to initiate fluvoxamine treatment in the patient population recruited for the study, the effect on more serious outcomes remains uncertain.

one in linked commentaryOttavio Berwanger of the Academic Research Organization of Hospital Israelita Albert Einstein in So Paulo, Brazil, said that some questions remain open regarding the efficacy and safety of fluvoxamine for COVID-19 patients, although the drug is more commonly prescribed for mental illnesses such as depression. Was.

“It remains to be determined whether fluvoxamine has an additive effect to monoclonal antibodies and other therapies such as budesonide, and what is the optimal fluvoxamine therapeutic plan,” he said.

According to Dr Barwanger, it is also unclear whether these findings extend to other outpatient populations with Covid-19, such as those without risk factors for disease progression, those who are fully vaccinated, and Those infected with recent variants.

“Going forward, it will be important to include patients with vaccine success infection in trials of community-based interventions, and trials to include this important subgroup with appropriate pre-treatment stratification and sample size adjustments to enable meaningful findings. Protocols should be amended. Accessible,” said Professor Penny Ward in Pharmaceutical Medicine at King’s College London.


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