Scientists test antidepressants for treatment of COVID-19

Fluvoxamine, a selective serotonin reuptake inhibitor (SSRI), is for the treatment of obsessive compulsive disorder and depression, among other disorders.

By ZACHARY KEYSER
Updated: AUGUST 11, 2020 09:48
Fluvoxamine sold under the brand name Luvox (photo credit: Wikimedia Commons)
Fluvoxamine sold under the brand name Luvox
(photo credit: Wikimedia Commons)
Researchers at the Washington University School of Medicine in St. Louis are currently testing the antidepressant fluvoxamine, recognized widely under the brand name Luvox, as a potential treatment for COVID-19. The new study follows work done by the University of Virginia School of Medicine, which determined that it "may prevent dangerous overreactions by the immune system."
Fluvoxamine, a selective serotonin reuptake inhibitor (SSRI), is for the treatment of obsessive compulsive disorder and depression, among other disorders. SSRIs include Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline), Lexapro (escitalopram) and Celexa (citalopram).
This family of drugs works on serotonin, a naturally occurring chemical messenger in the brain that controls mood. SSRIs block the reabsorption, or reuptake, of serotonin, making more of the chemical available to transmit messages between brain cells. This is what is thought to ease depression.
WU will be launching a clinical trial to determine the veracity of UVA's statement that the drug fluvoxamine can prevent "cytokine storms," which is when the body overproduces immune cells and their activating compounds (cytokines), causing dangerously high blood pressure, lung damage, respiratory distress syndrome and organ failure.
This is a common occurrence in some patients where the immune system's response to COVID-19 is extreme and goes into overdrive to fight the virus.
Accumulating evidence shows that many COVID-19 patients die because of the increase in the production of the inflammatory cytokine molecules, rather than the virus itself.
The UVA revelation piggy-backed off of a previous clinical study conducted by Alban Gaultier and Dorian A Rosen last year, in which they found that fluvoxamine may be able to stop sepsis – popularly but not accurately known as “blood poisoning” – a life-threatening condition that occurs when the immune system damages tissues and organs while fighting an infection.
The UVA trials showed success in mice. Now, WU will be testing the method on patients with coronavirus infections.
“I am excited to see the results from this clinical trial,” said Gaultier, of UVA’s Department of Neuroscience, the Center for Brain Immunology and Glia (BIG) and the Carter Immunology Center. “If proven effective in decreasing the symptoms of COVID-19, this treatment would be a safe and affordable option for fighting the pandemic. Further, this approach could also be applied to other inflammatory conditions driven by cytokine storms.”
The WU clinical trial will be carried out by Dr. Eric J. Lenze, who plans to test the effects of fluvoxamine on 152 COVID-19 patients across Missouri and Illinois. The experimental group will receive the antidepressant while the control group will receive a placebo, both while self-isolating in their homes.
Patients will each be given a thermometer, a fingertip oxygen sensor and automatic blood pressure monitors to track their progress, and they will report back to the team every day.
“Our hope is that by targeting patients who are well enough to be at home, we can give them fluvoxamine and prevent them from getting sicker and needing to go to the hospital,” said co-investigator Dr. Caline Mattar, of WU’s Division of Infectious Diseases.
“Using a psychiatric drug to treat COVID-19 may sound counterintuitive, but it’s no more counterintuitive than using a malaria drug,” Lenze said. “This drug has been around for decades, so we know how to use it safely. If effective, it could be an ideal drug to repurpose for outpatients with COVID.”
Reuters, Maayan Jaffe-Hoffman and Judy Siegel-Itzkovich contributed to this report.