A review of fluvoxamine’s mechanisms of action against COVID-19

Key Messages

This review study summarizes several anti-COVID mechanisms of action of fluvoxamine.

As a result of selective serotonin reuptake inhibition, fluvoxamine provides a strong anti-inflammatory effect and reduces blood clotting.

Fluvoxamine inhibits the acid sphingomyelinase (ASM)/ceramide system, thereby blocking the ability of the SARS-CoV-2 virus to infect cells.

Through activating the sigma-1 receptor, fluvoxamine suppresses SARS-CoV-2 replication, consequently reducing inflammatory events such as the cytokine storm.

Fluvoxamine intake increases melatonin levels which provides anti-inflammatory, immunomodulatory, and antioxidant effects.

Molecular Psychiatry

Publication Date: January 7, 2022
Peer Reviewed: Yes
Publication Type: Review/Commentary/Letter
DOI: https://www.doi.org/10.1038/s41380-021-01432-3

Mechanisms of action of fluvoxamine for COVID-19: a historical review

Yaeko Hashimoto, Takuji Suzuki, Kenji Hashimoto


The ongoing coronavirus disease 2019 (COVID-19) pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) accelerates the discovery of prophylactic and therapeutic drugs for persons infected with the virus. Drug repurposing for the COVID-19 pandemic has received particular attention. Increasing clinical data suggest that antidepressant use in early-stage subjects with COVID-19 might be associated with a reduced risk of intubation or death. Among the antidepressants, fluvoxamine is the most attractive drug for mild to moderate subjects with COVID-19. In this article, we review the mechanisms of action (i.e., serotonin transporter, sigma-1 receptor, and acid sphingomyelinase) of fluvoxamine for COVID-19. Furthermore, we discuss a possible link between maternal COVID-19 infection and a risk for neuropsychiatric disorders (i.e., autism spectrum disorder and schizophrenia) in offspring.