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Fluvoxamine for COVID-19
21 studies with >30,000 patients
Serious outcome risk
Fluvoxamine
Control
Significantly lower risk for mortality, hospitalization, progression, recovery, and cases.
14 studies from 14 independent teams in 8 countries show significant benefit.
COVID-19 Fluvoxamine studies · October 2026
Fluvoxamine was adopted in 2 countries. Recent:
Reis
Ibrahim
Reis.
Covid Analysis Fluvoxamine reduces COVID-19 risk: real-time meta-analysis of 21 studies (Version 39)
Significantly lower risk is seen for mortality, hospitalization, progression, recovery, and cases. 14 studies from 14 independent teams in 8 countries show significant benefit. Meta-analysis using the most serious outcome reported shows..
Oct 6
 Reis et al., Annals of Internal Medicine, doi:10.7326/ANNALS-26-02144 Effect of Fluvoxamine and Metformin for Fatigue in Patients With Long COVID
RCT 399 long COVID patients in Brazil showing reduced fatigue with fluvoxamine, and inconclusive results for metformin. This is a republication of a retracted paper [Reis]. Metformin was reduced from 750mg to 500mg bid in May 2024, and th..
Mar 31
 Reis et al., Annals of Internal Medicine, doi:10.7326/ANNALS-25-03959 RETRACTED: The Effect of Fluvoxamine and Metformin for Fatigue in Patients With Long COVID
RCT 399 adults with long COVID fatigue in Brazil showing significant benefit with fluvoxamine but not metformin for reducing fatigue severity. Authors hypothesize that fluvoxamine's σ-1 receptor agonism and immunomodulatory properties may..
Jul 21
2025
 Mabrouk et al., International Journal of Molecular Sciences, doi:10.3390/ijms26147002 Afucosylated IgG Promote Thrombosis in Mouse Injected with SARS-CoV-2 Spike Expressing Megakaryocytes
Mouse study showing that SARS-CoV-2 spike-expressing megakaryocytes induce afucosylated IgG antibodies leading to thrombosis, and identifying potential therapeutic targets. Inhibitors targeting FcγRIIa receptor, serotonin transporter..
Feb 24
2025
 Machado-Vieira et al., PLOS ONE, doi:10.1371/journal.pone.0310438 Protective effects of psychiatric medications against COVID-19 mortality before vaccines
Retrospective 366,937 COVID-19 patients in the US showing protective effects of certain psychiatric medications including SSRIs against COVID-19 severity.
Nov 19
2024
 Zhang et al., Journal of Virology, doi:10.1128/jvi.00754-24 SARS-CoV-2 NSP6 reduces autophagosome size and affects viral replication via sigma-1 receptor
In vitro study showing that the NSP6 protein from SARS-CoV-2 wild-type and Delta variant strains induces smaller autophagosomes and affects lysosome function in A549 cells. Authors find that NSP6 activates autophagy through the Akt-mTOR-U..
Jun 12
2024
 Prasanth et al., Scientific Reports, doi:10.1038/s41598-024-64260-9 A systematic review and meta-analysis, investigating dose and time of fluvoxamine treatment efficacy for COVID-19 clinical deterioration, death, and Long-COVID complications
78% lower mortality (p=0.001) and 64% lower progression (p=0.02). Systematic review and meta analysis of 14 studies showing significantly lower COVID-19 clinical deterioration and mortality with fluvoxamine treatment. Subgroup analysis indicated that higher doses (≥200mg/day) and earlier treatment (with..
May 16
2024
 Zhou et al., PLOS ONE, doi:10.1371/journal.pone.0300512 The efficacy and safety of fluvoxamine in patients with COVID-19: A systematic review and meta-analysis from randomized controlled trials
Meta analysis of 6 RCTs with 4,711 total participants showing significantly lower clinical deterioration and hospitalization with fluvoxamine treatment for COVID-19. Fluvoxamine doses ≥200mg daily were more effective than lower doses. The..
Apr 22
2024
 Scheim et al., Viruses, doi:10.3390/v16040647 Back to the Basics of SARS-CoV-2 Biochemistry: Microvascular Occlusive Glycan Bindings Govern Its Morbidities and Inform Therapeutic Responses
Review of the biochemical underpinnings of the severe morbidities of COVID-19, focusing on the binding of the SARS-CoV-2 spike protein (SP) to sialylated glycans on host cell surfaces. Authors highlight how the SP attaches particularly ti..
Mar 30
2024
 Thümmler et al., Viruses, doi:10.3390/v16040545 Fluoxetine and Sertraline Potently Neutralize the Replication of Distinct SARS-CoV-2 Variants
In vitro study showing that fluoxetine and sertraline potently neutralize the replication of distinct SARS-CoV-2 variants at subtoxic concentrations. Authors demonstrate that fluoxetine and sertraline inhibit infection with pseudotyped vi..
Mar 14
2024
 Wannigama et al., eClinicalMedicine, 10.1016/j.eclinm.2024.102517 Early treatment with fluvoxamine, bromhexine, cyproheptadine, and niclosamide to prevent clinical deterioration in patients with symptomatic COVID-19: a randomized clinical trial
98% lower ventilation (p<0.0001), 89% lower need for oxygen therapy (p<0.0001), 94% lower hospitalization (p<0.0001), and 40% lower long COVID (p<0.0001). RCT 995 outpatients showing significantly lower progression with early treatment within 48 hours using fluvoxamine, fluvoxamine+bromhexine, fluvoxamine+cyproheptadine, and niclosamide+bromhexine. 70% of patients received treatment within ..
Feb 20
2024
 Bonnet et al., Frontiers in Medicine, doi:10.3389/fmed.2024.1305184 Antidepressants for prevention of severe COVID-19, Long COVID and outlook for other viral diseases
Review of clinical studies on the potential benefits of antidepressants for prevention and treatment of COVID-19 and its sequelae. Authors summarize evidence from retrospective studies, randomized controlled trials, prospective studies, a..
Feb 6
2024
 Alkafaas et al., BMC Public Health, doi:10.1186/s12889-024-17747-z Molecular docking as a tool for the discovery of novel insight about the role of acid sphingomyelinase inhibitors in SARS- CoV-2 infectivity
In silico molecular docking analysis evaluating 71 functional inhibitors of acid sphingomyelinase (FIASMAs), showing that FIASMAs may prevent SARS-CoV-2 cell entry and infection via inhibiting ceramide platform formation that facilitates ..
Feb 6
2024
 Butzin-Dozier et al., BMC Medicine, doi:10.1186/s12916-024-03655-x SSRI use during acute COVID-19 and risk of Long COVID among patients with depression
N3C retrospective 302,626 COVID-19 patients with depression showing lower risk of long COVID with SSRI use during acute infection. In a subgroup analysis of new SSRI users with no prior history of use, a similar protective effect was obse..
Jan 18
2024
 Jittamala et al., eClinicalMedicine, doi:10.1016/j.eclinm.2024.103036 (date from preprint) Antiviral efficacy of fluoxetine in early symptomatic COVID-19: an open-label, randomised, controlled, adaptive platform trial (PLATCOV)
RCT 271 low-risk outpatients, showing improved viral clearance with fluoxetine in low-risk adult outpatients.
Dec 26
2023
 Deng et al., Reviews in Medical Virology, doi:10.1002/rmv.2501 Evaluating fluvoxamine for the outpatient treatment of COVID‐19: A systematic review and meta‐analysis
23% lower hospitalization (p=0.03). Systematic review and meta-analysis of 9 RCTs (N=5,861) evaluating fluvoxamine for the outpatient treatment of COVID-19, showing lower hospitalization with treatment, with improved results for higher doses. 100mg BID/TID showed lower hosp..
Nov 7
2023
 Avula et al., Journal of Clinical and Translational Science, doi:10.1017/cts.2023.668 Strategies used for the COVID-OUT decentralized trial of outpatient treatment of SARS-CoV-2
Report on the operation of the COVID-OUT trial noting several issues affecting the reliability of the results: - Use of home pulse oximeters for measuring oxygen saturation: authors note that the FDA warned about inaccuracies with home pu..
Nov 6
2023
 Tallaksen, E., Do Your Own Research TOGETHER Files 2: Lawsuit reveals FTX bought effective control of TOGETHER trial, part of SBF's dream of a pharma empire
Analysis of legal documents showing that a non-profit controlled by FTX's SBF and a former colleague invested >$50 million in the Together Trial and had the right to potentially control the company. Author notes that incorrect and mislead..
Oct 6
2023
 Siripongboonsitti et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2023.10.010 The Real-World Effectiveness of Fluvoxamine Therapy in Mild to Moderate COVID-19 Patients; a Historical Cohort Study (Fluvoxa Trial)
67% higher need for oxygen therapy (p=0.02), 42% lower progression (p=0.08), 34% improved recovery (p<0.0001), and 4% worse viral clearance (p=0.66). Retrospective 752 patients in Thailand showing mixed results with 50mg fluvoxamine bid. Authors note that trials showing benefit mostly used 100mg bid.
Sep 13
2023
 Stewart et al., JAMA, doi:10.1001/jama.2023.23363 (date from preprint) Higher-Dose Fluvoxamine and Time to Sustained Recovery in Outpatients With COVID-19
Late treatment low risk population RCT showing lower progression to hospitalization or urgent care/ER visits with fluvoxamine, without statistical significance. There was no mortality and only three hospitalizations. Authors provide no de..
Aug 12
2023
 Tsiakalos et al., Microorganisms, doi:10.3390/microorganisms11082073 Early Fluvoxamine Reduces the Risk for Clinical Deterioration in Symptomatic Outpatients with COVID-19: A Real-World, Retrospective, before–after Analysis
84% lower hospitalization (p=0.06) and 86% lower progression (p=0.02). Retrospective 103 outpatients in Greece, showing lower risk of progression with fluvoxamine 100mg bid for 10 days. 2 patients (4%) in the fluvoxamine group had clinical deterioration compared to 8 patients (16%) in the standard care group..
Aug 7
2023
 Abatematteo et al., Scientific Reports, doi:10.1038/s41598-023-39662-w A conformational rearrangement of the SARS-CoV-2 host protein sigma-1 is required for antiviral activity: insights from a combined in-silico/in-vitro approach
In vitro and in silico analysis supporting fluvoxamine for COVID-19. Authors investigated the mechanism of action of sigma-1 receptor (S1R) ligands for inhibiting SARS-CoV-2 replication, testing a series of S1R ligands and finding that so..
Aug 4
2023
 Hoertel et al., Pharmaceuticals, doi:10.3390/ph16081107 Medications Modulating the Acid Sphingomyelinase/Ceramide System and 28-Day Mortality among Patients with SARS-CoV-2: An Observational Study
Retrospective 72,105 COVID+ hospitalized patients in France, showing lower mortality with FIASMA medications.
Jun 29
2023
 Siripongboonsitti et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2023.06.018 Efficacy of Combination Therapy of Fluvoxamine and Favipiravir versus Favipiravir Monotherapy to Prevent Severe COVID-19 among Mild to Moderate COVID-19 Patients: Open-label Randomized Controlled Trial (EFFaCo Study)
2% higher need for oxygen therapy (p=1) and 22% higher hospitalization (p=0.77). RCT 327 outpatients in Thailand, showing no significant difference with 50mg fluvoxamine bid added to favipiravir. Authors note that trials showing benefit mostly used 100mg bid.
May 5
2023
 Stauning et al., Clinical Microbiology and Infection, doi:10.1016/j.cmi.2023.04.028 COVID-19 mortality among selective serotonin reuptake inhibitor users - Results from a nationwide cohort
58% lower mortality (p=0.39) and 45% lower progression (p=0.3). Retrospective 7,113 COVID+ SSRI users and 279,334 COVID+ non-SSRI users in Denmark, showing lower mortality with fluoxetine, without statistical significance, but higher mortality for other SSRIs.
Apr 23
2023
 Visos-Varela et al., European Neuropsychopharmacology, doi:10.1016/j.euroneuro.2023.03.011 Repurposing selective serotonin reuptake inhibitors for severity of COVID-19: A population-based study
395% higher ICU admission (p=0.24), 40% lower hospitalization (p=0.39), and 12% fewer cases (p=0.6). Retrospective 86,602 patients in Spain, showing lower COVID-19 risk SSRIs citalopram and paroxetine. There were no significant difference for fluvoxamine, which few patients were taking.
Apr 17
2023
 Reis et al., Annals of Internal Medicine, doi:10.7326/M22-3305 Oral Fluvoxamine With Inhaled Budesonide for Treatment of Early-Onset COVID-19
12% lower hospitalization (p=1) and 50% lower progression (p=0.04). Low-risk (1% hospitalization) outpatient RCT with 738 fluvoxamine + budesonide patients and 738 placebo patients, showing significantly lower hospitalization/ER visits with treatment.
Apr 11
2023
 Rahman et al., Interactive Journal of Medical Research, doi:10.2196/39455 Effects of Antidepressants on COVID-19 Outcomes: Retrospective Study on Large-Scale Electronic Health Record Data
N3C retrospective reporting that common antidepressants may increase the risk of COVID-19 complications, while certain antidepressants were associated with a lower risk of worse outcomes. Machine learning methods as used in this study can..
Mar 31
2023
 Farahani et al., BMC Infectious Diseases, doi:10.1186/s12879-023-08172-5 Effect of fluvoxamine on preventing neuropsychiatric symptoms of post COVID syndrome in mild to moderate patients, a randomized placebo-controlled double-blind clinical trial
25% lower long COVID (p=0.01). RCT 100 mild/moderate COVID-19 outpatients in Iran, showing lower post COVID symptoms 12 weeks after infection, statistically significant only for fatigue with the small sample size. All symptoms may occur for non-COVID-19 reasons, smell/..
Mar 21
2023
 Hashimoto, K., Discover Mental Health, doi:10.1007/s44192-023-00036-3 Overview of the potential use of fluvoxamine for COVID-19 and long COVID
Review of the potential benefits of fluvoxamine for COVID-19 treatment and minimizing long COVID symptoms.
Mar 20
2023
 Sedighi et al., Neuropsychopharmacology Reports, doi:10.1002/npr2.12327 Efficacy and safety of adding fluoxetine to the treatment regimen of hospitalized patients with non‐critical COVID‐19 pneumonia: A double‐blind randomized, placebo‐controlled clinical trial
11% shorter hospitalization (p=0.13). RCT 72 patients in Iran, showing faster reduction of inflammation with treatment. There was no significant difference in mortality, ventilation, or ICU admission (few events).
Mar 3
2023
 Kirenga et al., Molecular Psychiatry, doi:10.1038/s41380-023-02004-3 Association of fluvoxamine with mortality and symptom resolution among inpatients with COVID-19 in Uganda: a prospective interventional open-label cohort study
68% lower mortality (p<0.0001) and 53% improved recovery (p=0.04). Prospective study of 316 hospitalized patients in Uganda, 94 receiving fluvoxamine, showing significantly lower mortality and improved recovery with treatment.
Feb 27
2023
 Wang et al., The Lancet Regional Health - Western Pacific, doi:10.1016/j.lanwpc.2023.100716 Relationship between antidepressants and severity of SARS-CoV-2 Omicron infection: a retrospective cohort study using real-world data
PSM retrospective 60,903 hospitalized COVID-19 patients in Hong Kong, showing antidepressants associated with lower mortality, including for SSRIs, and for FIASMA antidepressants.
Jan 31
2023
 Fico et al., European Neuropsychopharmacology, doi:10.1016/j.euroneuro.2022.10.004 Psychotropic drug repurposing for COVID-19: A Systematic Review and Meta-Analysis
85% lower mortality (p=0.05). Systematic review and meta-analysis examining psychotropic drugs for COVID-19. Fluvoxamine showed significantly reduced mortality compared to placebo (OR 0.15, 95% CI 0.02-0.95).
Jan 31
2023
 Ibrahim et al., The Egyptian Journal of Chest Diseases and Tuberculosis, doi:10.4103/ecdt.ecdt_38_22 Treatment with fluvoxamine in nonhospitalized coronavirus disease 2019 patients
60% lower hospitalization (p=0.03). RCT of 162 nonhospitalized COVID-19 patients (mild and moderate) showing lower hospitalization with treatment. No multivariable adjustment: despite baseline imbalances in BMI, psychological disease, and other covariates, the primary outco..
Jan 14
2023
 Deng et al., Clinical Microbiology and Infection, doi:10.1016/j.cmi.2023.01.010 Efficacy and safety of selective serotonin reuptake inhibitors in COVID-19 management: A systematic review and meta-analysis
28% lower mortality (p<0.0001) and 21% lower hospitalization (p=0.03). Meta analysis of 6 fluvoxamine RCTs showing fluvoxamine associated with lower mortality and hospitalization. 100mg bid showed lower mortality and hospitalization, but 50mg bid did not. Authors use the Hartung-Knapp adjustment and they inc..
Dec 20
2022
 Glebov et al., BMC Medicine, doi:10.1186/s12916-023-02877-9 (date from preprint) Antidepressant drug prescription and incidence of COVID-19 in mental health outpatients: a retrospective cohort study
43% fewer cases (p=0.04). Retrospective 5,664 mental health patients in the UK, showing lower risk of COVID-19 cases with recent antidepressant prescriptions overall, and for the subset of patients receiving SSRIs.
Nov 17
2022
 Marcec et al., Journal of Infection, doi:10.1016/j.jinf.2022.11.011 A meta-analysis regarding fluvoxamine and hospitalization risk of COVID-19 patients: TOGETHER making a difference
43% lower hospitalization (p=0.03). Meta analysis of 7 fluvoxamine outpatient studies showing significantly lower hospitalization with treatment.
Nov 10
2022
 Sidky et al., medRxiv, doi:10.1101/2022.11.09.22282142 Assessing the Effect of Selective Serotonin Reuptake Inhibitors in the Prevention of Post-Acute Sequelae of COVID-19
N3C retrospective 17,933 COVID-19 patients in the USA, showing lower risk of PASC for SSRIs with or without S1R agonist activity.
Nov 7
2022
 Trkulja et al., European Journal of Clinical Pharmacology, doi:10.1007/s00228-023-03479-3 (date from preprint) Outpatients prescribed with fluvoxamine around the time of COVID-19 diagnosis are not at a reduced risk of subsequent hospitalization and death compared to their non-prescribed peers: population-based matched cohort study
27% lower mortality (p=0.41) and 37% higher hospitalization (p=0.5). Retrospective COVID+ patients in Croatia, showing no significant difference in outcomes with fluvoxamine prophylaxis.
Oct 18
2022
 McCarthy et al., JAMA, doi:10.1001/jama.2022.24100 (date from preprint) Effect of Fluvoxamine vs Placebo on Time to Sustained Recovery in Outpatients With Mild to Moderate COVID-19
4% worse recovery (p=0.45). RCT low-risk outpatients with very late treatment (median 5 days, 20% ≥8 days) in the USA, showing no significant differences with low-dose fluvoxamine treatment. Many of the issues noted for the ivermectin arm [ Naggie ] also apply to th..
Oct 13
2022
 Lu et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2022.10.010 Effect of fluvoxamine on outcomes of nonhospitalized patients with COVID-19: A systematic review and meta-analysis
31% lower hospitalization (p=0.02) and 41% fewer combined hospitalization/ER visits (p=0.0004). Systematic review and meta analysis of 4 fluvoxamine outpatient trials, showing lower hospitalization with treatment.
Oct 6
2022
 Diaz et al., The Primary Care Companion For CNS Disorders, doi:10.4088/PCC.22br03337 Protective Effect of Fluvoxamine for COVID-19 in Obsessive-Compulsive Disorder
28% fewer cases (p<0.0001). TriNetX PSM retrospective 82,069 OCD patients, showing lower risk of COVID-19 with fluvoxamine use.
Oct 4
2022
 Pineda et al., Frontiers in Pharmacology, doi:10.3389/fphar.2022.1054644 (date from preprint) Impact of fluvoxamine on outpatient treatment of COVID-19 in Honduras in a prospective observational real-world study
94% lower mortality (p=0.01), 73% lower need for oxygen therapy (p=0.0002), and 51% lower hospitalization (p=0.04). Prospective study of 657 COVID+ outpatients in Honduras, 594 accepting fluvoxamine treatment, showing significantly lower mortality and hospitalization with treatment.
Aug 22
2022
 Fritz et al., Translational Psychiatry, doi:10.1038/s41398-022-02109-3 Association between antidepressant use and ED or hospital visits in outpatients with SARS-CoV-2
Retrospective 25,034 COVID+ outpatients showing significantly lower ER/hospitalization with antidepressants and FIASMA antidepressants, and a dose-dependent response.
Aug 18
2022
 Bramante et al., NEJM, doi:10.1056/NEJMoa2201662 Randomized Trial of Metformin, Ivermectin, and Fluvoxamine for Covid-19
11% higher combined mortality/hospitalization (p=0.88), 16% higher progression (p=0.68), and 2% lower hospitalization (p=1). COVID-OUT remotely operated RCT, showing no significant difference in outcomes. Results for other treatments are listed separately - metformin , ivermectin . The "control" group includes patients receiving metformin, which is known to be ..
May 20
2022
 Valerio Pascua et al., Epidemiology International Journal, doi:10.23880/eij-16000234 Repurposing Drugs for Covid-19 by a Developing Country
Review of a multiphasic multidrug early treatment protocol for COVID-19 in Honduras, showing one death from 415 patients, which was for a patient not receiving early treatment (presenting on the 5th day in need of hospitalization and supp..
May 6
2022
 Nemani et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2022.10743 Association Between the Use of Psychotropic Medications and the Risk of COVID-19 Infection Among Long-term Inpatients With Serious Mental Illness in a New York State–wide Psychiatric Hospital System
30% more cases (p=0.16). Retrospective 1,958 consecutive psychiatric patients in the USA, showing higher cases and lower mortality with fluvoxamine, without statistical significance. There was only 25 fluvoxamine patients.
Apr 16
2022
 Nakhaee et al., PLOS ONE, doi:10.1371/journal.pone.0267423 (date from preprint) The effect of antidepressants on the severity of COVID-19 in hospitalized patients: A systematic review and meta-analysis
Meta analysis of 12 studies concluding that evidence supports the use of antidepressants, mainly fluvoxamine, for COVID-19. Fluvoxamine significantly reduced severity, RR 0.76 [0.60-0.97].
Mar 29
2022
 MacFadden et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofac156 Screening Large Population Health Databases for Potential COVID-19 Therapeutics: A Pharmacopeia-Wide Association Study (PWAS) of Commonly Prescribed Medications
14% fewer cases (p=0.02). Retrospective 26,121 cases and 2,369,020 controls ≥65yo in Canada, showing lower cases with chronic use of fluoxetine.
Mar 3
2022
 Seo et al., Infection & Chemotherapy, doi:10.3947/ic.2021.0142 Fluvoxamine Treatment of Patients with Symptomatic COVID-19 in a Community Treatment Center: A Preliminary Result of Randomized Controlled Trial
Early terminated RCT with 52 COVID+ patients in South Korea, showing no significant difference in progression with fluvoxamine treatment. There were only 2 events in each arm, and only one event for fluvoxamine in PP analysis. The trial w..
Feb 24
2022
 Kory et al., Journal of Clinical Medicine Research, doi:10.14740/jocmr4658 “MATH+” Multi-Modal Hospital Treatment Protocol for COVID-19 Infection: Clinical and Scientific Rationale
Review of the data supporting the MATH+ hospital treatment protocol for COVID-19.
Jan 7
2022
 Hashimoto et al., Molecular Psychiatry, doi:10.1038/s41380-021-01432-3 Mechanisms of action of fluvoxamine for COVID-19: a historical review
Review of the potential mechanisms of action of fluvoxamine for COVID-19.
Dec 21
2021
 Lee et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2022.6269 (date from preprint) Fluvoxamine for Outpatient Management of COVID-19 to Prevent Hospitalization: A Systematic Review and Meta-analysis
Systematic review and meta analysis of outpatient RCTs, showing hospitalization RR 0.75 [0.57-0.97]. For discussion see [web.archive.org].
Nov 15
2021
 Oskotsky et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2021.33090 Mortality Risk Among Patients With COVID-19 Prescribed Selective Serotonin Reuptake Inhibitor Antidepressants
Retrospective database analysis of 83,584 patients in the USA, showing lower mortality with existing fluoxetine use in PSM analysis. There were 11 fluvoxamine patients, showing non-statistically significant higher mortality.
Nov 1
2021
 Calusic et al., British Journal of Clinical Pharmacology, doi:10.1111/bcp.15126 Safety and efficacy of fluvoxamine in COVID-19 ICU patients: an open label, prospective cohort trial with matched controls
42% lower mortality (p=0.03). Prospective PSM study of 51 COVID-19 ICU patients in Croatia and 51 matched controls, showing significantly lower mortality with treatment.
Oct 26
2021
 Rauchman et al., medRxiv, doi:10.1101/2021.10.25.21265218 Ongoing use of SSRIs and the hospital course of COVID-19 patients: a retrospective outcome analysis
2% lower mortality (p=0.83). Retrospective 9,043 COVID-19+ patients in the USA, 832 with existing SSRI use, showing no significant difference in mortality. None of the patients were on fluvoxamine. Authors note that specific SSRIs such as fluvoxamine may be effective..
Sep 2
2021
 Hashimoto et al., European Archives of Psychiatry and Clinical Neuroscience, doi:10.1007/s00406-021-01326-z Old drug fluvoxamine, new hope for COVID-19
Review of research supporting the use of fluvoxamine for COVID-19. Authors note the favorable safety profiles, widespread availability, very low cost, and oral administration.
Aug 23
2021
 Reis et al., The Lancet Global Health, doi:10.1016/S2214-109X(21)00448-4 (date from preprint) Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised, platform clinical trial
30% lower mortality (p=0.24), 22% lower ventilation (p=0.33), 22% lower hospitalization (p=0.1), and 32% fewer combined hospitalization/ER visits (p=0.004). Together Trial showing significantly lower hospitalization/extended ER visits with fluvoxamine treatment. Adherence was only 73.2%. Symptom onset was unspecified or ≥4 days for 57% of patients. The schedule of study activities specifies t..
Aug 20
2021
 Reiersen et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofad419 (results 8/20/2021) The STOP COVID 2 study: Fluvoxamine vs placebo for outpatients with symptomatic COVID-19, a fully-remote randomized controlled trial
201% higher need for oxygen therapy (p=0.5), 9% lower hospitalization (p=1), and 12% lower progression (p=0.85). Remote RCT 547 outpatients a median of 5 days from onset, showing no significant differences with fluvoxamine. The trial was stopped early and underpowered due to low event rates. The trial does not report outcomes that may not be underpo..
Aug 12
2021
 Németh et al., Ideggyógyászati Szeml, doi:10.18071/ISZ.74.0389 (date from preprint) Fluoxetine use is associated with improved survival of patients with COVID-19 pneumonia: A retrospective case-control study
58% lower mortality (p=0.002). Retrospective 269 hospitalized patients in Hungary, 110 treated with fluoxetine, showing lower mortality with treatment.
Aug 12
2021
 Hoertel et al., Molecular Psychiatry, doi:10.1038/s41380-021-01254-3 Repurposing antidepressants inhibiting the sphingomyelinase acid/ceramide system against COVID-19: current evidence and potential mechanisms
Review of the mechanisms of action and clinical studies for the treatment of COVID-19 with FIASMA antidepressants such as fluoxetine, fluvoxamine, paroxetine, escitalopram, or amitriptyline.
Jun 29
2021
 Assanovich et al., Psychiatry, Psychotherapy and Clinical Psychology, doi:10.34883/PI.2021.12.2.007 Fluvoxamine in the Treatment of Patients with COVID-19
Report on the use of fluvoxamine for COVID-19 noting that "patients with COVID-19 taking fluvoxamine did not report clinical complications of coronavirus infection". Only the abstract is currently available.
May 29
2021
 Hoertel et al., Clinical Pharmacology & Therapeutics, doi:10.1002/cpt.2317 Association Between FIASMAs and Reduced Risk of Intubation or Death in Individuals Hospitalized for Severe COVID-19: An Observational Multicenter Study
42% lower combined mortality/intubation (p<0.0001). Retrospective 2,846 severe COVID-19 patients in France, 277 taking a FIASMA medication, showing lower risk of intubation of death with FIASMA use.
Apr 20
2021
 Sukhatme et al., Front. Pharmacol., doi:10.3389/fphar.2021.652688 Fluvoxamine: A Review of Its Mechanism of Action and Its Role in COVID-19
Review of mechanisms of action of fluvoxamine and other SSRIs that could be beneficial for COVID-19 treatment, including lower platelet aggregation, decreased mast cell degranulation, interference with endolysosomal viral trafficking, reg..
Mar 7
2021
 Darquennes et al., Pharmaceuticals, doi:10.3390/ph14030226 Association between Functional Inhibitors of Acid Sphingomyelinase (FIASMAs) and Reduced Risk of Death in COVID-19 Patients: A Retrospective Cohort Study
41% lower mortality (p=0.06). Retrospective 350 COVID-19 hospitalized patients in Belgium, showing lower mortality with existing long-term FIASMA treatment, not quite reaching statistical significance for all FIASMA medications, but reaching statistical significance f..
Mar 6
2021
 Kirsch, S. COVID FAQ
COVID FAQ from the founder of the COVID-19 Early Treatment Fund [treatearly.org], including an extensive analysis of the fluvoxamine trials and other supporting evidence.
Feb 1
2021
 Seftel et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofab050 Prospective cohort of fluvoxamine for early treatment of COVID-19
72% lower mortality (p=0.38), 84% lower combined mortality/ICU admission (p=0.15), 94% lower hospitalization (p=0.003), and 99% improved recovery (p<0.0001). Prospective quasi-randomized (patient choice) study with 125 outpatients, 77 treated with fluvoxamine, showing lower death/ICU admission (0 of 77 vs. 2 of 48), lower hospitalization (0 of 77 vs. 6 of 48), and faster recovery with treatmen..
Nov 12
2020
 Lenze et al., JAMA, doi:10.1001/jama.2020.22760 Fluvoxamine vs Placebo and Clinical Deterioration in Outpatients With Symptomatic COVID-19: A Randomized Clinical Trial
93% lower progression (p=0.009) and 82% lower hospitalization (p=0.009). RCT 152 outpatients, 80 treated with fluvoxamine showing lower progression with treatment (0 of 80 versus 6 of 72 control).
Aug 17
2020
 Hoertel et al., Molecular Psychiatry, doi:10.1038/s41380-021-01021-4 Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study
44% lower combined mortality/intubation (p<0.0001). Retrospective 7,230 hospitalized COVID-19 patients in France, 345 receiving an antidepressant medication within 48 hours of admission. There was a significant association between antidepressant use and reduced risk of intubation or death...
Jun 4
2020
 Hooper, P., Cell Stress and Chaperones, doi:10.1007/s12192-020-01126-9 COVID-19 and heme oxygenase: novel insight into the disease and potential therapies
Proposal that COVID-19 risk is related to low intracellular heme oxygenase (HO-1), and that therapies that raise HO-1 may be beneficial, which includes fluvoxamine, certain anesthetics (sevoflurane or isoflurane), hemin, estrogen, statins..