What Is Fluvoxamine? OCD Drug Could Be Used to Treat COVID

An anti-depressant medication used to treat obsessive-compulsive disorder (OCD) may also be effective at treating some COVID cases, scientists say.

The drug fluvoxamine, commonly sold under the brand name Luvox, has emerged as a candidate for early treatment of the disease, with studies suggesting it could prevent some people's symptoms progressing to the point of needing hospitalization.

Fluvoxamine is a type of selective serotonin reuptake inhibitor (SSRI) which alters how chemicals used by nerves in the human brain communicate.

These chemicals, known as neurotransmitters, are released by the body's nerves before attaching to other nerves. Experts believe an imbalance of neurotransmitters can cause psychiatric disorders such as depression.

Fluvoxamine was approved for treatment of OCD by the Food and Drug Administration (FDA) in 1994, but has also been used to treat patients suffering from social anxiety, post-traumatic stress, binge eating disorders and pathological gambling.

A 2005 analysis published in the journal Neuropsychiatric Disease and Treatment said it is "well tolerated," with the most frequently-reported side effect being nausea. It had no significant impact on body weight or cardiovascular performance, the study said.

Most recently, scientists have theorized the drug could also be useful for treating people with COVID who are at risk of suffering from severe symptoms of the disease.

Last November, the results of a two week randomized clinical trial from scientists at the Washington University in St. Louis suggested dozens of COVID patients who were treated with fluvoxamine did not show deterioration—unlike those administered a placebo.

In that research, led by Eric Lenze of the School of Medicine's Department of Psychiatry, 115 people in total completed the trial. Clinical deterioration occurred in none of 80 patients in the fluvoxamine group and in six of 72 patients in the placebo group.

The fluvoxamine group had one serious adverse event and 11 other adverse events, the placebo group had six serious adverse events and 12 other adverse events. Findings were published in the The Journal of the American Medical Association.

The research was cited as inspiration for a more recent trial, the results of which were published in the Open Forum Infectious Diseases journal on February 1, 2021.

Those results were based on a real-world test using patients who contracted COVID at a mass outbreak at the Golden Gate Fields horse racing track in Berkeley, California, in November last year. Of those who took fluvoxamine, none were hospitalized.

In the trial, led by racetrack physician David Seftel and University of Minnesota Medical School scientist David Boulware, 65 people took fluvoxamine and 48 declined.

None of the 65 in the fluvoxamine group were hospitalized, unlike six of 48 people who were being observed without being given the drug. After two weeks, none of the 65 people with fluvoxamine had residual symptoms, unlike 29 of the 48 who did not take the drug.

The authors concluded: "Fluvoxamine seems to be promising as an early treatment for COVID to prevent clinical deterioration requiring hospitalization and to prevent possible long haul symptoms persisting beyond 2 weeks. Further randomized trial evidence is needed."

Now, building on his earlier small-scale experiment, Lenze is conducting broader research to try and determine the effectiveness of fluvoxamine for early COVID treatment.

Running under the title of the "STOP COVID Trial," it will aim to find out if fluvoxamine can be used to prevent more serious issues—such as shortness of breath.

According to its website, the study will randomize about 880 participants aged 30 and older who have tested positive for COVID and are experiencing mild symptoms.

"Fluvoxamine may benefit COVID-19 patients by slowing the progression of symptoms. It is safe, inexpensive, and FDA-approved," a website FAQ says.

"Using FDA-approved medicines for a new purpose, drug repurposing, is used to test new treatments more quickly compared to developing new medicines."

On February 9, McMaster University in Canada announced a new trial on multiple drugs, ivermectin, metformin and fluvoxamine, would take place to judge the effectiveness on COVID disease progression. The results could come out in three months.

Dr. Francis Collins, director of the National Institutes of Health (NIH), told CBS show 60 Minutes in a segment about new potential treatments aired on March 7 that fluvoxamine
"looks as if it has the promise to reduce the likelihood of severe illness."

The NIH director stated: "It's the FDA who will have the job of figuring out whether to give approval, for this use of that drug. And it will be about benefit and risk. And the benefit is maybe even a reduction of 20 percent of the chance that you're gonna end up in the hospital, that's probably a good thing. That should be added to the mix."