Fluvoxamine: A Review of Its Mechanism of Action and Its effectiveness for treating COVID-19.

Key Messages

A review of published evidence that indicates fluvoxamine, which is a well-tolerated and inexpensive antidepressant, is also an effective drug for treating COVID-19.

Potential mechanisms of action include reduced blood clotting, anti-inflammatory effects, antiviral activity, and increased melatonin levels.

Given the multiple physiological effects of fluvoxamine, it is likely to have a major impact on the progression of COVID-19, especially if used to treat patients who are in the early stages of the disease.

Early treatment of COVID-19 with fluvoxamine may reduce the number of hospitalizations, the persistence of symptoms, the risk for requiring ventilation, and the COVID-19 death rate.

Frontiers in Pharmacology

Publication Date: April 20, 2021
Peer Reviewed: Yes
Publication Type: Review/Commentary/Letter
DOI: https://www.doi.org/10.3389/fphar.2021.652688

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

Abstract

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 (COVID-19). 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 inositol-requiring 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.