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Overview of the potential use of fluvoxamine for COVID-19 and long COVID

Hashimoto, K., Discover Mental Health, doi:10.1007/s44192-023-00036-3
Mar 2023  
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27th treatment shown to reduce risk in November 2021, now with p = 0.00014 from 21 studies, recognized in 3 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 112 treatments. c19early.org
Review of the potential benefits of fluvoxamine for COVID-19 treatment and minimizing long COVID symptoms.
Reviews covering fluvoxamine for COVID-19 include1-7.
Hashimoto et al., 21 Mar 2023, peer-reviewed, 1 author. Contact: hashimoto@faculty.chiba-u.jp.
This PaperFluvoxamineAll
Overview of the potential use of fluvoxamine for COVID-19 and long COVID
Kenji Hashimoto
Discover Mental Health, doi:10.1007/s44192-023-00036-3
Coronavirus disease 2019 (COVID-19) has presented a serious worldwide threat to public health since its emergence in late 2019. From a safety point of view, drug repurposing has received particular attention. Several clinical studies have demonstrated that the use of fluvoxamine, a selective serotonin reuptake inhibitor with potent sigma-1 receptor agonism, in the early-stage of infection might be associated with the prevention of clinical deterioration in individuals with SARS-CoV-2 infection, although several reports have shown that a low dose of fluvoxamine may be ineffective. There is increasing evidence that SARS-CoV-2 can cross the blood-brain barrier, resulting in a number of psychiatric and neurologic symptoms in COVID-19 survivors. Importantly, about half of COVID-19 survivors experience a variety of longterm sequelae, including psychiatric and neurologic symptoms, known as long COVID. In this priority review, the author presents an overview of the potential use of fluvoxamine in the treatment of COVID-19 and long COVID.
Author contributions KH did the reference search and wrote the manuscript. The author read and approved the final manuscript. Declarations Competing interests Dr. Hashimoto is the inventor of filed patent applications on "The use of R-Ketamine in the treatment of psychiatric diseases", "(S)-norketamine and salt thereof as pharmaceutical", "R-Ketamine and derivative thereof as prophylactic or therapeutic agent for neurodegeneration disease or recognition function disorder", "Preventive or therapeutic agent and pharmaceutical composition for inflammatory diseases or bone diseases", and "R-Ketamine and its derivatives as a preventive or therapeutic agent for a neurodevelopmental disorder" by the Chiba University. Dr. Hashimoto has also received speakers' honoraria, consultant fee, or research support from Abbott, Boehringer-Ingelheim, Daiichi-Sankyo, Meiji Seika Pharma, Seikagaku Corporation, Dainippon-Sumitomo, Taisho, Otsuka, Murakami Farm and Perception Neuroscience. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons..
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Several clinical studies ' 'have demonstrated that the use of fluvoxamine, a selective serotonin reuptake inhibitor with ' 'potent sigma-1 receptor agonism, in the early-stage of infection might be associated with the ' 'prevention of clinical deterioration in individuals with SARS-CoV-2 infection, although ' 'several reports have shown that a low dose of fluvoxamine may be ineffective. There is ' 'increasing evidence that SARS-CoV-2 can cross the blood–brain barrier, resulting in a number ' 'of psychiatric and neurologic symptoms in COVID-19 survivors. Importantly, about half of ' 'COVID-19 survivors experience a variety of long-term sequelae, including psychiatric and ' 'neurologic symptoms, known as long COVID. 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' 'https://doi.org/10.1001/jamapsychiatry.2021.0500.', 'journal-title': 'JAMA Psychiat'}, { 'issue': '3', 'key': '36_CR88', 'doi-asserted-by': 'publisher', 'first-page': '1850', 'DOI': '10.1007/s12035-021-02696-0', 'volume': '59', 'author': 'TC Theoharides', 'year': '2022', 'unstructured': 'Theoharides TC. Could SARS-CoV-2 spike protein be responsible for ' 'long-COVID syndrome? Mol Neurobiol. 2022;59(3):1850–61. ' 'https://doi.org/10.1007/s12035-021-02696-0.', 'journal-title': 'Mol Neurobiol'}, { 'issue': '10', 'key': '36_CR89', 'doi-asserted-by': 'publisher', 'DOI': '10.1001/jamanetworkopen.2021.28568', 'volume': '4', 'author': 'D Groff', 'year': '2021', 'unstructured': 'Groff D, Sun A, Ssentongo AE, Ba DM, Parsons N, Poudel GR, et al. ' 'Short-term and long-term rates of postacute sequelae of SARS-CoV-2 ' 'infection: a systematic review. JAMA Netw Open. 2021;4(10): e2128568. 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' 'https://doi.org/10.1038/s41380-022-01546-2.', 'journal-title': 'Mol Psychiatry'}, { 'issue': '5', 'key': '36_CR96', 'doi-asserted-by': 'publisher', 'first-page': '1315', 'DOI': '10.4269/ajtmh.21-1310', 'volume': '106', 'author': 'CM Guo', 'year': '2022', 'unstructured': 'Guo CM, Harari O, Chernecki C, Thorlund K, Forrest JI. Fluvoxamine for ' 'the early treatment of COVID-19: a meta-analysis of randomized clinical ' 'trials. Am J Trop Med Hyg. 2022;106(5):1315–20. ' 'https://doi.org/10.4269/ajtmh.21-1310.', 'journal-title': 'Am J Trop Med Hyg'}, { 'issue': '3', 'key': '36_CR97', 'doi-asserted-by': 'publisher', 'first-page': 'e298', 'DOI': '10.1097/MJT.0000000000001496', 'volume': '29', 'author': 'S Bhuta', 'year': '2022', 'unstructured': 'Bhuta S, Khokher W, Kesireddy N, Iftikhar S, Beran A, Mhanna M, et al. ' 'Fluvoxamine in nonhospitalized patients with acute COVID-19 infection ' 'and the lack of efficacy in reducing rates of hospitalization, ' 'mechanical ventilation, and mortality in placebo-controlled trials: a ' 'systematic review and meta-analysis. Am J Ther. 2022;29(3):e298–304. ' 'https://doi.org/10.1097/MJT.0000000000001496.', 'journal-title': 'Am J Ther'}, { 'issue': '4', 'key': '36_CR98', 'doi-asserted-by': 'publisher', 'DOI': '10.1001/jamanetworkopen.2022.6269', 'volume': '5', 'author': 'TC Lee', 'year': '2022', 'unstructured': 'Lee TC, Vigod S, Bortolussi-Courval É, Hanula R, Boulware DR, Lenze EJ, ' 'et al. Fluvoxamine for outpatients management of COVID-19 to prevent ' 'hospitalization: a systematic review and meta-analysis. JAMA Netw Open. ' '2022;5(4): e226269. https://doi.org/10.1001/jamanetworkopen.2022.6269.', 'journal-title': 'JAMA Netw Open'}, { 'issue': '6', 'key': '36_CR99', 'doi-asserted-by': 'publisher', 'first-page': '702', 'DOI': '10.1016/j.jinf.2022.10.012', 'volume': '85', 'author': 'HA Cheema', 'year': '2022', 'unstructured': 'Cheema HA, Jafar U, Elrashedy AA, Shahid A, Awan RU, Ehsan M, et al. ' 'Efficacy and safety of fluvoxamine for the treatment of COVID-19 ' 'patients. J Infect. 2022;85(6):702–69. ' 'https://doi.org/10.1016/j.jinf.2022.10.012.', 'journal-title': 'J Infect'}, { 'issue': '11', 'key': '36_CR100', 'doi-asserted-by': 'publisher', 'first-page': '1259', 'DOI': '10.1016/j.jiph.2022.10.010', 'volume': '15', 'author': 'LC Lu', 'year': '2022', 'unstructured': 'Lu LC, Chao CM, Chang SP, Lan SH, Lai CC. Effect of fluvoxamine on ' 'outcomes of nonhospitalized patients with COVID-19: a systematic review ' 'and meta-analysis. J Infect Public Health. 2022;15(11):1259–64. ' 'https://doi.org/10.1016/j.jiph.2022.10.010.', 'journal-title': 'J Infect Public Health'}, { 'issue': '2', 'key': '36_CR101', 'doi-asserted-by': 'publisher', 'first-page': '154', 'DOI': '10.1016/j.jinf.2022.11.011', 'volume': '86', 'author': 'R Marcec', 'year': '2023', 'unstructured': 'Marcec R, Dodig VM, Likic R. A meta-analysis regarding fluvoxamine and ' 'hospitalization risk of COVID-19 patients: TOGETHER making a difference. ' 'J Infect. 2023;86(2):154–225. ' 'https://doi.org/10.1016/j.jinf.2022.11.011.', 'journal-title': 'J Infect'}, { 'issue': '2', 'key': '36_CR102', 'doi-asserted-by': 'publisher', 'first-page': '154', 'DOI': '10.1016/j.jinf.2022.11.016', 'volume': '86', 'author': 'V Trkulja', 'year': '2023', 'unstructured': 'Trkulja V. There is no reasonable evidence to support efficacy of ' 'fluvoxamine in prevention of disease deterioration in COVID-19 ' 'outpatients: a comment on two recent meta-analyses advocating its use. J ' 'Infect. 2023;86(2):154–225. https://doi.org/10.1016/j.jinf.2022.11.016.', 'journal-title': 'J Infect'}, { 'issue': '2', 'key': '36_CR103', 'doi-asserted-by': 'publisher', 'first-page': '321', 'DOI': '10.1007/s00228-022-03447-3', 'volume': '79', 'author': 'V Trkulja', 'year': '2023', 'unstructured': 'Trkulja V. Why we should not recommend or offer fluvoxamine to COVID-19 ' 'patients? Eur J Clin Pharmacol. 2023;79(2):321–2. ' 'https://doi.org/10.1007/s00228-022-03447-3.', 'journal-title': 'Eur J Clin Pharmacol'}, { 'key': '36_CR104', 'doi-asserted-by': 'publisher', 'author': 'J Deng', 'year': '2023', 'unstructured': 'Deng J, Rayner D, Ba Ramaraju H, Abbas U, Carcia C, Heybati K, et al. ' 'Efficacy and safety of selective serotonin reuptake inhibitors in ' 'COVID-19 management: a systematic review and meta-analysis. Clin ' 'Microbiol Infect. 2023. https://doi.org/10.1016/j.cmi.2023.01.010.', 'journal-title': 'Clin Microbiol Infect', 'DOI': '10.1016/j.cmi.2023.01.010'}, { 'key': '36_CR105', 'doi-asserted-by': 'publisher', 'unstructured': 'Kirenga BJ, Mugenyi L, Sánchez-Rico M, Kyobe H, Muttamba W, Mugume R, et ' 'al. Association of fluvoxamine with mortality and symptom resolution ' 'among inpatients with COVID-19 in Uganda: a prospective interventional ' 'open-label cohort study. Mol Psychiatry. 2023;1–8. ' 'https://doi.org/10.1038/s41380-023-02004-3.', 'DOI': '10.1038/s41380-023-02004-3'}, { 'issue': '7', 'key': '36_CR106', 'doi-asserted-by': 'publisher', 'first-page': '3812', 'DOI': '10.3390/ijms23073812', 'volume': '23', 'author': 'M Mahdi', 'year': '2022', 'unstructured': 'Mahdi M, Hermán L, Réthelyi JM, Bálint BL. Potential role of the ' 'antidepressants fluoxetine and fluvoxamine in the treatment of COVID-19. 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' 'https://doi.org/10.4269/ajtmh.22-0106.', 'journal-title': 'Am J Trop Med Hyg'}], 'container-title': 'Discover Mental Health', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://link.springer.com/content/pdf/10.1007/s44192-023-00036-3.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/article/10.1007/s44192-023-00036-3/fulltext.html', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/content/pdf/10.1007/s44192-023-00036-3.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2023, 3, 21]], 'date-time': '2023-03-21T14:09:07Z', 'timestamp': 1679407747000}, 'score': 1, 'resource': {'primary': {'URL': 'https://link.springer.com/10.1007/s44192-023-00036-3'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2023, 3, 21]]}, 'references-count': 107, 'journal-issue': {'issue': '1', 'published-online': {'date-parts': [[2023, 12]]}}, 'alternative-id': ['36'], 'URL': 'http://dx.doi.org/10.1007/s44192-023-00036-3', 'relation': {}, 'ISSN': ['2731-4383'], 'container-title-short': 'Discov Ment Health', 'published': {'date-parts': [[2023, 3, 21]]}, 'assertion': [ { 'value': '25 January 2023', 'order': 1, 'name': 'received', 'label': 'Received', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '2 March 2023', 'order': 2, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '21 March 2023', 'order': 3, 'name': 'first_online', 'label': 'First Online', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, {'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Declarations'}}, { 'value': 'Dr. Hashimoto is the inventor of filed patent applications on “The use of ' '<i>R</i>-Ketamine in the treatment of psychiatric diseases”, ' '“(<i>S</i>)-norketamine and salt thereof as pharmaceutical”, “<i>R</i>-Ketamine ' 'and derivative thereof as prophylactic or therapeutic agent for ' 'neurodegeneration disease or recognition function disorder”, “Preventive or ' 'therapeutic agent and pharmaceutical composition for inflammatory diseases or ' 'bone diseases”, and “<i>R</i>-Ketamine and its derivatives as a preventive or ' 'therapeutic agent for a neurodevelopmental disorder” by the Chiba University. ' 'Dr. Hashimoto has also received speakers’ honoraria, consultant fee, or ' 'research support from Abbott, Boehringer-Ingelheim, Daiichi-Sankyo, Meiji Seika ' 'Pharma, Seikagaku Corporation, Dainippon-Sumitomo, Taisho, Otsuka, Murakami ' 'Farm and Perception Neuroscience.', 'order': 2, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Competing interests'}}], 'article-number': '9'}
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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment 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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