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Fluvoxamine for COVID-19
13 studies from 133 scientists
34,828 patients in 5 countries
Statistically significant improvement for cases.
8 studies from 8 independent teams in 4 countries show statistically significant improvements in isolation.
COVID-19 Fluvoxamine studies. Dec 2022.
0 0.5 1 1.5+ All studies 31% Mortality 37% Hospitalization 28% Recovery 85% Cases 28% Viral clearance -49% RCTs 23% Prophylaxis 27% Early 56% Late 40% Favorsfluvoxamine Favorscontrol
Fluvoxamine COVID-19 studies. Treatment recommendations are available from Ontario. Recent:
Fluvoxamine has been officially adopted for early treatment in all or part of 3 countries (5 including non-government medical organizations). Submit updates/corrections.
Dec 2
Covid Analysis (Preprint) (meta analysis) Fluvoxamine for COVID-19: real-time meta analysis of 13 studies
Statistically significant improvement is seen for cases. 8 studies from 8 independent teams in 4 different countries show statistically significant improvements in isolation (4 for the most serious outcome). • Meta analysis using the mo..
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 (Preprint) 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., Research Square, doi:10.21203/ (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., medRxiv, doi:10.1101/2022.10.17.22281178 (Preprint) Fluvoxamine for Outpatient Treatment of COVID-19: A Decentralized, Placebo-controlled, Randomized, Platform Clinical Trial
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., medRxiv, doi:10.1101/2022.09.27.22280428 (Preprint) Impact of Fluvoxamine on outpatient treatment of COVID-19 in Honduras
96% lower mortality [p=0.005], 77% lower need for oxygen therapy [p=0.0004], and 54% 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 ..
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 earlier 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 (Review) “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 (Review) 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 earlier preprint) (meta analysis) 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 (Preprint) 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 (Review) 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 earlier 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
Lenze, E. (News) Fluvoxamine for Early Treatment of COVID-19: The STOP COVID Clinical Trials
7% lower hospitalization [p=1]. Presentation noting that STOP COVID 2 was terminated early for futility with only 30/551 cases of detioration and no significant treatment effect. The main results are not available yet, however partial results presented suggest that earl..
Aug 12
Németh et al., Ideggyógyászati szeml, doi:10.18071/ISZ.74.0389 (date from earlier 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 (Review) 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 (Review) 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. (Review) (Preprint) 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). STOP COVID trial. NCT04342663.
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 (Theory) 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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