Escitalopram for COVID-19

Background: COVID-19, caused by SARS-CoV-2, remains a global health crisis with limited therapeutic options. Despite the availability of vaccines, the rapid evolution of viral variants necessitates the exploration of alternative treatments. Drug repositioning, the use of existing medications for new therapeutic indications, offers a promising approach. Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, sertraline, and escitalopram have shown potential antiviral properties due to their immunomodulatory effects. This study investigates the impact of these SSRIs on SARS-CoV-2-induced cytopathic effects (CPE) in Vero cells. Materials and Methods: Vero cells were cultured and treated with varying concentrations of fluoxetine, sertraline, and escitalopram. Ivermectin, was used as a positive control. The cytotoxicity of these drugs was assessed using the Neutral Red assay. After viral infection of the cells, cytopathic effects were measured to determine the antiviral activity of the drugs. IC50 (half-maximal inhibitory concentration) values were calculated for each drug, and the results were compared using statistical analysis. Results: Fluoxetine, sertraline, and escitalopram demonstrated dose-dependent inhibition of SARS-CoV-2- induced cytopathic effects, with escitalopram showing the highest efficacy (IC50 = 0.02557 µM, p < 0.03). The selectivity indices (SI) for fluoxetine, sertraline, and escitalopram were significantly higher than that of ivermectin, indicating their safety at higher doses. Escitalopram exhibited superior antiviral activity, with up to 38% inhibition of SARS-CoV-2-induced CPE, compared to ivermectin's 10%. Conclusion: Fluoxetine, sertraline, and escitalopram, particularly escitalopram, are promising candidates for treating SARS-CoV-2 infections. These SSRIs exhibit significant inhibition of virus-induced cytopathic effects in Vero cells, suggesting their potential use as therapeutic agents against COVID-19. Further studies are requiredto confirm their clinical efficacy and safety in human subjects.