Antidepressant fluvoxamine can save Covid-19 patients, McMaster research shows | Hacker News Reader

Antidepressant fluvoxamine can save Covid-19 patients, McMaster research shows

brighterworld.mcmaster.ca

37 pointsageitgey38 comments

Patrick Collison, one of the funders of this research via the Fast Grants program (https://fastgrants.org/), tweeted an excellent summary the results a few days ago:

https://twitter.com/patrickc/status/1427367934880469010

n=1,472 patients; ~1/3 reduction in hospitalization; now pursuing a larger scale trial to replicate the results

The actual research results are here:

https://www.frontiersin.org/articles/10.3389/fphar.2021.6526...

From the paper, dosage in the trial was:

" Participants received 50 mg FLV QD on day 1, then for 2 days 100 mg FLV BID, and then 100 mg FLV TID as tolerated through day 15 and then stopped. "

Fluvoxamine has been long off patent. Based on my slap-dash googling of online pharmacies, this treatment would cost under US$10 total.

The hypothesized mechanisms of action are the anti-inflammatory, anti-platelet, and potentially antiviral activities which are side effects of Fluvoxamine's psychoactive properties. These mechanisms would counter some of the more serious body responses to the more severe cases of covid.

All sigma 1 agonists in test for covid seem to work very well to prevent serious disease symptoms and death. They appear to modulate the immune system's response to the virus (including cytokine storm) which is what causes most of the damage.

This came out of the Together Trial project which has been looking at hundreds of existing drugs to see if any will work for COVID19:

https://www.togethertrial.com/

I'm going to be skeptical until the paper comes out. There was a lot of initial data on Hydroxychloroquine that looked good and it ended up being only noise (and bad study designs).

So far all I see is PR and nothing published or peer reviewed.

They are late to the party, fluvoxamine and it's effects on Covid was already investigated and published by a team at Washington University in St Louis a last year in JAMA [0]

It's not the only medicine that has a potential effect on Covid-19 infection. Colchicine [1] for instance.

[0] https://pubmed.ncbi.nlm.nih.gov/33180097/

[1] https://pubmed.ncbi.nlm.nih.gov/34051877/

Having taken SSRI's before, and experienced their withdrawal symptoms, I'd almost rather have COVID.

Brain zaps? Still better than benzo withdrawal though!

Brain zaps. Feeling like I was going to puke all day every day for a month. I somehow avoided one of the more common side-effects and withdrawal symptoms: panic and/or anxiety. The two reasons I was taking the SSRI's to begin with.

I should have done the research beforehand to know that the medication has the potential to make worse the symptoms it is supposed to remedy.

In the end, therapy did way more for me than those pills ever did.

You need to taper off. And I mean really gradually over weeks. Sadly, they don't even work for me, yet doctors are hellbent on me trying them and won't prescribe anything else. Guess I'll die lol

If fluvoxamine is used for COVID-19 treatment it will probably only be administered for a couple weeks so withdrawal symptoms should be minimal.

Having experienced both, I'd prefer to have COVID. The only reason why I'd take SSRI's for COVID is to prevent the multi month recovery of symptoms.

Currently on a selective norepinephrine reuptake inhibitor, side effects are wonky...

How long? Most side effects should be gone after ~1 month.

Side effects are starting to subside for me after a week, so I'm hopeful..

I had 0 issues when I've stopped, I've been on Voxra (bupropion) and Escitalopram. Meds that cause brain zaps like Voxra need to be stopped over a longer period of time, for me I got off them in a month after being on the max dose but for many that's way too fast as well.

FYI, bupropion is not an SSRI. Escitalopram is.

I had brain zaps with escitalopram, but not very bad. I went off over the course of 2-3 weeks.

It's usually SSRIs and SNRIs that are associated with brain zap withdrawal symptoms. Bupropion is an NDRI.

Taking an SSRI and it saved my life. I‘d rather be the happy motivated SSRI addict than be left with permanent lung damage etc

There was a similar result with fluoxetine (Prozac), another SSRI (and one that is generally considered safe).

I tried to find it and I found a much more recent study: https://www.nature.com/articles/s41380-021-01021-4#:~:text=I...

I had seen the original much earlier in the pandemic. There might be a link.

why was this article posted prior to the publication of their actual research paper?

Because "science by PR" is the new fashion. Back in my day, we waited for the peer reviewed publication, and tied onions to our belts, which was the style at the time.

I'd really like to see what effect Opipramol/Insidon has on COVID patients. If the results were similar to Fluvoxamine, that would very strongly suggest that the mechanism of action is via the σ1 receptor.

> “Fluvoxamine is the only treatment that, if administered early, can prevent COVID-19 from becoming a life-threatening illness,”

Actually many front-line doctors have been using a multidrug treatment based on existing medicines to successfully reduce hospitalization and death since very early on in the pandemic. One key aspect is treating patients early in the symptomatic phase with a combination of antiviral, corticosteroid, and antithrombotic medications. [1][2][3][4][5][6][7][8][9][10]

Many clinical trials have evaluated the suggested drugs in a single-drug treatment regime, but very few clinical trials have evaluated a multidrug treatment approach specifically focused on patients who are early in the symptomatic phase.

[1] Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection https://www.amjmed.com/article/S0002-9343(20)30673-2/fulltex...

[2] Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19) https://scholarlycommons.henryford.com/cgi/viewcontent.cgi?a...

[3] Clinical outcomes after early ambulatory multidrug therapy for high-risk SARS-CoV-2 (COVID-19) infection https://rcm.imrpress.com/EN/article/downloadArticleFile.do?a...

[4] Early multidrug treatment of SARS-CoV-2 infection (COVID-19) and reduced mortality among nursing home (or outpatient/ambulatory) residents https://www.sciencedirect.com/science/article/abs/pii/S03069...

[5] Multidrug treatment for COVID-19 https://www.jstage.jst.go.jp/article/ddt/advpub/0/advpub_202...

[6] A review of therapeutic agents and Chinese herbal medicines against SARS-COV-2 (COVID-19) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7237953/

[7] Clofazimine broadly inhibits coronaviruses including SARS-CoV-2 https://www.nature.com/articles/s41586-021-03431-4

[8] In Silico Exploration of the Molecular Mechanism of Clinically Oriented Drugs for Possibly Inhibiting SARS-CoV-2’s Main Protease https://pubs.acs.org/doi/pdf/10.1021/acs.jpclett.0c00994

[9] Identification of 14 Known Drugs as Inhibitors of the Main Protease of SARS-CoV-2 https://pubs.acs.org/doi/full/10.1021/acsmedchemlett.0c00521

[10] Repurposed Drugs, Molecular Vaccines, Immune‐Modulators, and Nanotherapeutics to Treat and Prevent COVID‐19 Associated with SARS‐CoV‐2, a Deadly Nanovector https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7645867/

It is criminal the way YouTube et al suppressed propagation of those facts.

YouTube suppresses multi drugs treatments ?

Brazil has become a big open air experiment on the efficacy of Hydroxychloroquine, Azithromycin and/or Ivermectin, separately and together. Those specific drugs don't seem to help that much, if at all. On the other hand, they may have severe side effects. (Dexamethasone do work in critically ill patients though)

It's a tough call. I really want to support science and probably some combination of drugs in the above studies work. It's just hard to know which ones.

> I really want to support science and probably some combination of drugs in the above studies work. It's just hard to know which ones

Agreed, and thanks for the reference. Here are some promising results from a well designed and recently completed RCT evaluating Ivermectin in combination with doxycycline [1].

[1] Ivermectin in combination with doxycycline for treating COVID-19 symptoms: a randomized trial https://pubmed.ncbi.nlm.nih.gov/33983065/

I would assume that most patients don’t seek medical care until they are having symptoms they can’t manage at home.

I don’t know how useful drugs are that have to be used in the early symptom phase. Does this require everybody to present themselves to a doctor every time they get upper respiratory symptoms?

I don’t think that’s the case. Most governments tell people to get a test if they have symptoms and the vast majority of tests are negative. This indicates that people are getting tests with mild symptoms of maybe-covid, in large numbers.

Will this be a required prophylactic soon?

Doubtful due to side effects. At most this will be a treatment for patients with confirmed infection. And then probably only after the results are reproduced in a larger clinical trial.

Yes. You will be force-fed antidepressants. /s

Can you explain more why you think this is a possibility?

Anything to slow the spread seems to be an option these days. Two years ago the idea of vaccine passports would be unimaginable by the gentry, yet here we are.

Yes, time to invest on Viagra-making companies.

"prophylactic" == "preventative"

Was anyone testing "vitamine B15" effect? It seems to improve oxygen utilisation so maybe could be helpful. I can't find many articles related to covid.

https://en.wikipedia.org/wiki/Mass_psychogenic_illness

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