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Fluvoxamine for COVID-19
19 studies from 451 scientists
37,033 patients in 10 countries
Statistically significant lower risk for mortality, hospitalization, progression, and cases.
12 studies from 12 independent teams in 7 countries show statistically significant improvements.
COVID-19 Fluvoxamine studies. Sep 2023.
0 0.5 1 1.5+ All studies 38% Mortality 41% Hospitalization 26% Recovery 67% Cases 25% RCTs 31% RCT mortality 27% Prophylaxis 27% Early 42% Late 48% Favorsfluvoxamine Favorscontrol
Fluvoxamine has been officially adopted in all or part of 3 countries (5 including non-government medical organizations). Submit updates/corrections.
Sep 23
Covid Analysis Fluvoxamine for COVID-19: real-time meta analysis of 19 studies
Statistically significant lower risk is seen for mortality, hospitalization, progression, and cases. 12 studies from 12 independent teams in 7 countries show statistically significant improvements. • Meta analysis using the most serious..
Sep 13
Naggie et al., medRxiv, doi:10.1101/2023.09.12.23295424 Effect of Higher-Dose Fluvoxamine vs Placebo on Time to Sustained Recovery in Outpatients with Mild to Moderate COVID-19: A Randomized Clinical Trial
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
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
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
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
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
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
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
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. Other arms of this trial show many critical issues [Re..
Apr 11
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
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
51% lower PASC (p=0.06). 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
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
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
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
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 14
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
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
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
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
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
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
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
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
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
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
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 ..
Jun 21
Wannigama et al., NCT05087381 Randomized-controlled Trial of the Effectiveness of COVID-19 Early Treatment in Community With Fluvoxamine, Bromhexine, Cyproheptadine, and Niclosamide in Decreasing Recovery Time
1,200 patient fluvoxamine early treatment RCT with results not reported over 1 year after completion.
May 20
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
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
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
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
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
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
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
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 [].
Nov 15
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
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
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
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
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..
Aug 20
Reiersen et al., Open Forurm 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
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
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
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
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
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
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
Kirsch, S. COVID FAQ
COVID FAQ from the founder of the COVID-19 Early Treatment Fund [], including an extensive analysis of the fluvoxamine trials and other supporting evidence.
Feb 1
Seftel et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofab050 Prospective cohort of fluvoxamine for early treatment of COVID-19
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
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
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
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..
Please send us corrections, updates, or comments. Vaccines and treatments are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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