10 ms·

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

37 points by ageitgey 5y ago

captainredbeard 5y ago
Will this be a required prophylactic soon?
- nradov 5y ago
  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.
- aaaaaaaaaaab 5y ago
  Yes. You will be force-fed antidepressants. /s
- Tarucho 5y ago
  Yes, time to invest on Viagra-making companies.
  - captainredbeard 5y ago
    "prophylactic" == "preventative"
- kgin 5y ago
  Can you explain more why you think this is a possibility?
  - captainredbeard 5y ago
    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.
miej 5y ago
why was this article posted prior to the publication of their actual research paper?
- raphlinus 5y ago
  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.
Zelphyr 5y ago
Having taken SSRI's before, and experienced their withdrawal symptoms, I'd almost rather have COVID.
- aaaaaaaaaaab 5y ago
  Brain zaps? Still better than benzo withdrawal though!
  - Zelphyr 5y ago
    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.
- bserge 5y ago
  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
- nradov 5y ago
  If fluvoxamine is used for COVID-19 treatment it will probably only be administered for a couple weeks so withdrawal symptoms should be minimal.
- tsomctl 5y ago
  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.
- sergiomattei 5y ago
  Currently on a selective norepinephrine reuptake inhibitor, side effects are wonky...
thesausageking 5y ago
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/ 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).
- deleted 5y ago
  [deleted]
black6 5y ago
https://en.wikipedia.org/wiki/Mass_psychogenic_illness https://en.wikipedia.org/wiki/Mass_psychogenic_illness
criticaltinker 5y ago
> “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/fulltext 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?article=1139&context=infectiousdiseases_articles 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?attachType=PDF&id=5074 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/S0306987721001419 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_2021.01005/_pdf 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/ 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 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 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 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/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7645867/
worldvoyageur 5y ago
Patrick Collison, one of the funders of this research via the Fast Grants program (https://fastgrants.org/ https://fastgrants.org/), tweeted an excellent summary the results a few days ago: https://twitter.com/patrickc/status/1427367934880469010 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.2021.652688/full 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.
- chriscappuccio 5y ago
  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.
instagraham 5y ago
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=In%20this%20multicenter%20retrospective%20observational,risk%20of%20intubation%20or%20death%2C 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.
908B64B197 5y ago
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/ https://pubmed.ncbi.nlm.nih.gov/33180097/ [1] https://pubmed.ncbi.nlm.nih.gov/34051877/ https://pubmed.ncbi.nlm.nih.gov/34051877/
machiaweliczny 5y ago
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.
kaminar 5y ago
Is this medicine on the CDC approved list of expensive, experimental excrement with zero liability?
fourtrees 5y ago
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.

37 points by ageitgey 5y ago

captainredbeard 5y ago

Will this be a required prophylactic soon?

nradov 5y ago
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.
aaaaaaaaaaab 5y ago
Yes. You will be force-fed antidepressants. /s
Tarucho 5y ago
Yes, time to invest on Viagra-making companies.
- captainredbeard 5y ago
  "prophylactic" == "preventative"
kgin 5y ago
Can you explain more why you think this is a possibility?
- captainredbeard 5y ago
  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.

miej 5y ago

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

raphlinus 5y ago
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.

Zelphyr 5y ago

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

aaaaaaaaaaab 5y ago
Brain zaps? Still better than benzo withdrawal though!
- Zelphyr 5y ago
  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.
bserge 5y ago
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
nradov 5y ago
If fluvoxamine is used for COVID-19 treatment it will probably only be administered for a couple weeks so withdrawal symptoms should be minimal.
tsomctl 5y ago
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.
sergiomattei 5y ago
Currently on a selective norepinephrine reuptake inhibitor, side effects are wonky...

thesausageking 5y ago

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/ 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).

deleted 5y ago
[deleted]

black6 5y ago

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

criticaltinker 5y ago

> “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/fulltext 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?article=1139&context=infectiousdiseases_articles 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?attachType=PDF&id=5074 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/S0306987721001419 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_2021.01005/_pdf 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/ 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 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 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 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/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7645867/

worldvoyageur 5y ago

Patrick Collison, one of the funders of this research via the Fast Grants program (https://fastgrants.org/ https://fastgrants.org/), tweeted an excellent summary the results a few days ago: https://twitter.com/patrickc/status/1427367934880469010 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.2021.652688/full 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.

chriscappuccio 5y ago
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.

instagraham 5y ago

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=In%20this%20multicenter%20retrospective%20observational,risk%20of%20intubation%20or%20death%2C 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.

908B64B197 5y ago

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/ https://pubmed.ncbi.nlm.nih.gov/33180097/ [1] https://pubmed.ncbi.nlm.nih.gov/34051877/ https://pubmed.ncbi.nlm.nih.gov/34051877/

machiaweliczny 5y ago

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.

kaminar 5y ago

Is this medicine on the CDC approved list of expensive, experimental excrement with zero liability?

fourtrees 5y ago

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.