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Fluvoxamine COVID-19 studies. Treatment recommendations are available from Ontario. Recent:
Fluvoxamine has been officially adopted for early treatment in all or part of 2 countries (4 including non-government medical organizations). Submit updates/corrections.
Sep 29
Early, Late, PrEP, PEP Covid Analysis (Preprint) (meta analysis)
Fluvoxamine for COVID-19: real-time meta analysis of 9 studies
Details   • Statistically significant improvements are seen for mortality and recovery. 5 studies from 5 independent teams in 3 different countries show statistically significant improvements in isolation (1 for the most serious outcome). • Meta an..
Aug 22
PrEPPEP Fritz et al., Translational Psychiatry, doi:10.1038/s41398-022-02109-3
hosp./ER, ↓19.4%, p=0.69
Association between antidepressant use and ED or hospital visits in outpatients with SARS-CoV-2
Details   Retrospective 25,034 COVID+ outpatients showing significantly lower ER/hospitalization with antidepressants and FIASMA antidepressants, and a dose-dependent response.
Aug 18
Early Bramante et al., NEJM, doi:10.1056/NEJMoa2201662
death/hosp., ↑10.8%, p=0.88
Randomized Trial of Metformin, Ivermectin, and Fluvoxamine for Covid-19
Details   COVID-OUT remotely operated RCT, showing no significant difference in outcomes. Results for other treatments are listed separately - metformin , ivermectin . The "control" group includes patients receiving metformin, which is known to be ..
May 20
Early Valerio Pascua et al., Epidemiology International Journal, doi:10.23880/eij-16000234 Repurposing Drugs for Covid-19 by a Developing Country
Details   Review of a multiphasic multidrug early treatment protocol for COVID-19 in Honduras, showing one death from 415 patients, which was for a patient not receiving early treatment (presenting on the 5th day in need of hospitalization and supp..
May 6
PrEPPEP Nemani et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2022.10743
death, ↓97.5%, p=1.00
Association Between the Use of Psychotropic Medications and the Risk of COVID-19 Infection Among Long-term Inpatients With Serious Mental Illness in a New York State–wide Psychiatric Hospital System
Details   Retrospective 1,958 consecutive psychiatric patients in the USA, showing higher cases and lower mortality with fluvoxamine, without statistical significance. There was only 25 fluvoxamine patients.
Apr 16
Late Nakhaee et al., medRxiv, doi:10.1101/2022.04.11.22273709 (Preprint) The effect of antidepressants on severity of COVID-19 in hospitalized patients: A systematic review and meta-analysis
Details   Meta analysis of 12 studies concluding that evidence supports the use of antidepressants, mainly fluvoxamine, for COVID-19. Fluvoxamine significantly reduced severity, RR 0.75 [0.58-0.96].
Mar 29
PrEPPEP MacFadden et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofac156
cases, ↓14.0%, p=0.02
Screening Large Population Health Databases for Potential COVID-19 Therapeutics: A Pharmacopeia-Wide Association Study (PWAS) of Commonly Prescribed Medications
Details   Retrospective 26,121 cases and 2,369,020 controls ≥65yo in Canada, showing lower cases with chronic use of fluoxetine.
Mar 3
Early Seo et al., Infection & Chemotherapy, doi:10.3947/ic.2021.0142
progression, 0.0%, p=1.00
Fluvoxamine Treatment of Patients with Symptomatic COVID-19 in a Community Treatment Center: A Preliminary Result of Randomized Controlled Trial
Details   Early terminated RCT with 52 COVID+ patients in South Korea, showing no significant difference in progression with fluvoxamine treatment. There were only 2 events in each arm, and only one event for fluvoxamine in PP analysis. The trial w..
Feb 24
Review Kory et al., Journal of Clinical Medicine Research, doi:10.14740/jocmr4658 (Review)
“MATH+” Multi-Modal Hospital Treatment Protocol for COVID-19 Infection: Clinical and Scientific Rationale
Details   Review of the data supporting the MATH+ hospital treatment protocol for COVID-19.
Jan 7
Review Hashimoto et al., Molecular Psychiatry, doi:10.1038/s41380-021-01432-3 (Review)
Mechanisms of action of fluvoxamine for COVID-19: a historical review
Details   Review of the potential mechanisms of action of fluvoxamine for COVID-19.
Dec 21
Meta Lee et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2022.6269 (date from earlier preprint) (meta analysis)
Fluvoxamine for Outpatient Management of COVID-19 to Prevent Hospitalization: A Systematic Review and Meta-analysis
Details   Systematic review and meta analysis of outpatient RCTs, showing hospitalization RR 0.75 [0.57-0.97]. For discussion see .
Nov 15
PrEPPEP Oskotsky et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2021.33090
death, ↑57.9%, p=0.62
Mortality Risk Among Patients With COVID-19 Prescribed Selective Serotonin Reuptake Inhibitor Antidepressants
Details   Retrospective database analysis of 83,584 patients in the USA, showing lower mortality with existing fluoxetine use in PSM analysis. There were 11 fluvoxamine patients, showing non-statistically significant higher mortality.
Nov 1
Late Calusic et al., British Journal of Clinical Pharmacology, doi:10.1111/bcp.15126
death, ↓42.0%, p=0.03
Safety and efficacy of fluvoxamine in COVID-19 ICU patients: an open label, prospective cohort trial with matched controls
Details   Prospective PSM study of 51 COVID-19 ICU patients in Croatia and 51 matched controls, showing significantly lower mortality with treatment.
Oct 26
PrEPPEP Rauchman et al., medRxiv, doi:10.1101/2021.10.25.21265218 (Preprint)
death, ↓2.0%, p=0.83
Ongoing use of SSRIs and the hospital course of COVID-19 patients: a retrospective outcome analysis
Details   Retrospective 9,043 COVID-19+ patients in the USA, 832 with existing SSRI use, showing no significant difference in mortality. None of the patients were on fluvoxamine. Authors note that specific SSRIs such as fluvoxamine may be effective..
Sep 2
Review Hashimoto et al., European Archives of Psychiatry and Clinical Neuroscience, doi:10.1007/s00406-021-01326-z (Review)
Old drug fluvoxamine, new hope for COVID-19
Details   Review of research supporting the use of fluvoxamine for COVID-19. Authors note the favorable safety profiles, widespread availability, very low cost, and oral administration.
Aug 23
Late Reis et al., The Lancet Global Health, doi:10.1016/S2214-109X(21)00448-4 (date from earlier preprint)
death, ↓30.3%, p=0.24
Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised, platform clinical trial
Details   Together Trial showing significantly lower hospitalization/extended ER visits with fluvoxamine treatment. Adherence was only 73.2%. Symptom onset was unspecified or >= 4 days for 57% of patients. The schedule of study activities specifies..
Aug 20
Early Lenze, E. (News)
hosp., ↓7.3%, p=1.00
Fluvoxamine for Early Treatment of COVID-19: The STOP COVID Clinical Trials
Details   Presentation noting that STOP COVID 2 was terminated early for futility with only 30/551 cases of detioration and no significant treatment effect. The main results are not available yet, however partial results presented suggest that earl..
Aug 12
Late Németh et al., Ideggyógyászati szeml, doi:10.18071/ISZ.74.0389 (date from earlier preprint)
death, ↓58.4%, p=0.002
Fluoxetine use is associated with improved survival of patients with COVID-19 pneumonia: A retrospective case-control study
Details   Retrospective 269 hospitalized patients in Hungary, 110 treated with fluoxetine, showing lower mortality with treatment.
Aug 12
Review Hoertel et al., Molecular Psychiatry, doi:10.1038/s41380-021-01254-3 (Review)
Repurposing antidepressants inhibiting the sphingomyelinase acid/ceramide system against COVID-19: current evidence and potential mechanisms
Details   Review of the mechanisms of action and clinical studies for the treatment of COVID-19 with FIASMA antidepressants such as fluoxetine, fluvoxamine, paroxetine, escitalopram, or amitriptyline.
Jun 29
PrEPPEP Assanovich et al., Psychiatry, Psychotherapy and Clinical Psychology, doi:10.34883/PI.2021.12.2.007 Fluvoxamine in the Treatment of Patients with COVID-19
Details   Report on the use of fluvoxamine for COVID-19 noting that "patients with COVID-19 taking fluvoxamine did not report clinical complications of coronavirus infection". Only the abstract is currently available.
May 29
PrEPPEP Hoertel et al., Clinical Pharmacology & Therapeutics, doi:10.1002/cpt.2317
death/int., ↓42.0%, p<0.0001
Association Between FIASMAs and Reduced Risk of Intubation or Death in Individuals Hospitalized for Severe COVID-19: An Observational Multicenter Study
Details   Retrospective 2,846 severe COVID-19 patients in France, 277 taking a FIASMA medication, showing lower risk of intubation of death with FIASMA use.
Apr 20
Review Sukhatme et al., Front. Pharmacol., doi:10.3389/fphar.2021.652688 (Review)
Fluvoxamine: A Review of Its Mechanism of Action and Its Role in COVID-19
Details   Review of mechanisms of action of fluvoxamine and other SSRIs that could be beneficial for COVID-19 treatment, including lower platelet aggregation, decreased mast cell degranulation, interference with endolysosomal viral trafficking, reg..
Mar 7
PrEPPEP Darquennes et al., Pharmaceuticals, doi:10.3390/ph14030226
death, ↓41.3%, p=0.06
Association between Functional Inhibitors of Acid Sphingomyelinase (FIASMAs) and Reduced Risk of Death in COVID-19 Patients: A Retrospective Cohort Study
Details   Retrospective 350 COVID-19 hospitalized patients in Belgium, showing lower mortality with existing long-term FIASMA treatment, not quite reaching statistical significance for all FIASMA medications, but reaching statistical significance f..
Mar 6
Review Kirsch, S. (Review) (Preprint)
Details   COVID FAQ from the founder of the COVID-19 Early Treatment Fund , including an extensive analysis of the fluvoxamine trials and other supporting evidence.
Feb 1
Early Seftel et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofab050
death/ICU, ↓83.9%, p=0.15
Prospective cohort of fluvoxamine for early treatment of COVID-19
Details   Prospective quasi-randomized (patient choice) study with 125 outpatients, 77 treated with fluvoxamine, showing lower death/ICU admission (0 of 77 vs. 2 of 48), lower hospitalization (0 of 77 vs. 6 of 48), and faster recovery with treatmen..
Nov 12
Early Lenze et al., JAMA, doi:10.1001/jama.2020.22760
progression, ↓92.7%, p=0.009
Fluvoxamine vs Placebo and Clinical Deterioration in Outpatients With Symptomatic COVID-19: A Randomized Clinical Trial
Details   RCT 152 outpatients, 80 treated with fluvoxamine showing lower progression with treatment (0 of 80 versus 6 of 72 control). STOP COVID trial. NCT04342663.
Aug 17
Late Hoertel et al., Molecular Psychiatry, doi:10.1038/s41380-021-01021-4
death/int., ↓44.0%, p<0.0001
Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study
Details   Retrospective 7,230 hospitalized COVID-19 patients in France, 345 receiving an antidepressant medication within 48 hours of admission. There was a significant association between antidepressant use and reduced risk of intubation or death...
Jun 4
Theory Hooper, P., Cell Stress and Chaperones, doi:10.1007/s12192-020-01126-9 (Theory)
COVID-19 and heme oxygenase: novel insight into the disease and potential therapies
Details   Proposal that COVID-19 risk is related to low intracellular heme oxygenase (HO-1), and that therapies that raise HO-1 may be beneficial, which includes fluvoxamine, certain anesthetics (sevoflurane or isoflurane), hemin, estrogen, statins..
Please send us corrections, updates, or comments. Vaccines and treatments are both valuable and complementary. All practical, effective, and safe means should be used. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. Denying the efficacy of any method increases mortality, morbidity, collateral damage, and the risk of endemic status. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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