Fluvoxamine: A Review of Its Mechanism of Action and Its Role in COVID-19
Vikas P Sukhatme, Angela M Reiersen, Sharat J Vayttaden, Vidula V Sukhatme
Frontiers in Pharmacology, doi:10.3389/fphar.2021.652688
Fluvoxamine is a well-tolerated, widely available, inexpensive selective serotonin reuptake inhibitor that has been shown in a small, double-blind, placebo-controlled, randomized study to prevent clinical deterioration of patients with mild coronavirus disease 2019 . Fluvoxamine is also an agonist for the sigma-1 receptor, through which it controls inflammation. We review here a body of literature that shows important mechanisms of action of fluvoxamine and other SSRIs that could play a role in COVID-19 treatment. These effects include: reduction in platelet aggregation, decreased mast cell degranulation, interference with endolysosomal viral trafficking, regulation of inositolrequiring enzyme 1α-driven inflammation and increased melatonin levels, which collectively have a direct antiviral effect, regulate coagulopathy or mitigate cytokine storm, which are known hallmarks of severe COVID-19.
Conflict of Interest: Author VVS was employed by the company GlobalCures, Inc. Author AR has received research support for clinical trials of fluvoxamine for COVID-19 from the Taylor Family Institute for Innovative Psychiatric Treatment at Washington University, Fast Grants, and the COVID-19 Early Treatment Fund, and she is an inventor on a patent application filed by Washington University in St. Louis, which is relevant to methods of treating COVID-19, including fluvoxamine. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Copyright © 2021 Sukhatme, Reiersen, Vayttaden and Sukhatme. This is an openaccess article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
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