$4 generic antidepressant significantly reduces COVID-19 hospitalizations, clinical trial finds

An inexpensive, generic antidepressant has been shown to significantly reduce the risk of severe COVID-19 in clinical trials.

Fluvoxamine — a readily available pill used to treat depression and obsessive-compulsive disorder — dramatically reduces serious illness and death from COVID-19 when prescribed early, according to a study published in the journal Lancet Global Health.

There were 1,497 COVID-positive patients in Brazil involved in the study; 741 patients were given fluvoxamine and 756 were given a placebo. The study — which was performed from Jan. 20 until Aug. 5 — found that patients who received fluvoxamine saw their hospitalizations or long-term medical observation rates decrease by nearly one-third.

The clinical trial found using the antidepressant for 10 days decreased the absolute risk by 5%, and there was a relative risk reduction of 32% compared to the control group.

"There was one death in the fluvoxamine group and 12 in the placebo group for the per-protocol population," the authors of the study wrote.

Researchers from the U.S., Canada, and Brazil believe fluvoxamine can effectively treat COVID-19 because of the drug's anti-inflammatory properties and may reduce blood platelets.

"Fluvoxamine may reduce the production of inflammatory molecules called cytokines, that can be triggered by SARS-CoV-2 infection," Dr. Angela Reiersen, an associate professor of psychiatry at Washington University in St. Louis who worked on the study, said.

The authors of the paper noted that more research is needed to understand how fluvoxamine will react to the COVID-19 vaccine since 94% of the people in the study were unvaccinated.

"Given fluvoxamine's safety, tolerability, ease of use, low cost, and widespread availability, these findings might influence national and international guidelines on the clinical management of COVID-19," researchers concluded.

The researchers shared the results of the study with the U.S. National Institutes of Health and the World Health Organization.

"If WHO recommends this, you will see it widely taken up," study co-author Dr. Edward Mills of McMaster University in Hamilton, Ontario, said, adding that the OCD drug is readily available in many poor countries. "We hope it will lead to a lot of lives saved."

The Associated Press noted that the antidepressant drug would be significantly cheaper than other COVID-19 treatments, "The pill, called fluvoxamine, would cost $4 for a course of COVID-19 treatment. By comparison, antibody IV treatments cost about $2,000 and Merck's experimental antiviral pill for COVID-19 is about $700 per course."

University of Minnesota infectious disease scientist Dr. David Boulware — who conducted his own study of the drug in COVID-19 patients — told the New York Times, "It's not a shiny new, expensive drug. The nice thing about this is it has a known safety profile."

Fluvoxamine is a selective serotonin reuptake inhibitor, or SSRI, that was first registered in Switzerland in 1983. Fluvoxamine was approved by the U.S. Food and Drug Administration in 1994.

The safety of fluvoxamine was "based on data from 17 years of global post-marketing surveillance in an estimated 28 million patients exposed to fluvoxamine."

The authors note that another SSRI – fluoxetine, commonly known as Prozac – could possibly be a COVID-19 treatment, and studies are needed to determine its effectiveness against coronavirus.

"It is now crucial to establish whether a class effect exists and whether these drugs can be used interchangeably for COVID-19," the researchers said.