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The skeletal formula of fluvoxamine.

Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) which is being trialed for possible therapeutic use in COVID-19.

Fluvoxamine showed promise in a randomized, placebo-controlled trial of 152 COVID-19 positive outpatients.  In a paper published in November, 2020 in the Journal of the American Medical Association:

Clinical deterioration occurred in 0 of 80 patients in the fluvoxamine group and in 6 of 72 patients in the placebo group (absolute difference, 8.7% [95% CI, 1.8%-16.4%] from survival analysis; log-rank P = .009). The fluvoxamine group had 1 serious adverse event and 11 other adverse events, whereas the placebo group had 6 serious adverse events and 12 other adverse events. -JAMA

Fluoxetine has also shown anti-SARS-CoV-2 activity in vitro in Vero and Calu-3 cells.

Mechanism of possible benefit?

Sigma-1 receptor

Mechanisms of potential benefit in COVID-19 may include sigma-1 receptor agonism.  See "Fluvoxamine alleviates ER stress via induction of Sigma-1 receptor" and "Modulation of the sigma-1 receptor–IRE1 pathway is beneficial in preclinical models of inflammation and sepsis".

As SSRI

An observational study of 7,345 hospitalized COVID-19 patients hinted at possible benefit of prior SSRI usage.

As an anti-viral

In an October, 2020 preprint, fluoxetine showed in vitro anti-SARS-CoV-2 activity in Vero and Calu-3 cells.

News coverage

See also

The skeletal formula of fluvoxamine.

Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) which is being trialed for possible therapeutic use in COVID-19.

COVID-19 clinical trials

Fluvoxamine showed promise in a randomized, placebo-controlled trial of 152 COVID-19 positive outpatients.  In a paper published in November, 2020 in the Journal of the American Medical Association:

Clinical deterioration occurred in 0 of 80 patients in the fluvoxamine group and in 6 of 72 patients in the placebo group (absolute difference, 8.7% [95% CI, 1.8%-16.4%] from survival analysis; log-rank P = .009). The fluvoxamine group had 1 serious adverse event and 11 other adverse events, whereas the placebo group had 6 serious adverse events and 12 other adverse events. -JAMA

Trials in progress

Mechanism of possible benefit?

Sigma-1 receptor

Mechanisms of potential benefit in COVID-19 may include sigma-1 receptor agonism.  See "Fluvoxamine alleviates ER stress via induction of Sigma-1 receptor" and "Modulation of the sigma-1 receptor–IRE1 pathway is beneficial in preclinical models of inflammation and sepsis".

As SSRI

An observational study of 7,345 hospitalized COVID-19 patients hinted at possible benefit of prior SSRI usage.

As an anti-viral

In an October, 2020 preprint, fluoxetine, a related SSRI, showed in vitro anti-SARS-CoV-2 activity in Vero and Calu-3 cells.

News coverage

See also