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Other Treatments Global Adoption
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Lenze (DB RCT) 93% 0.07 [0.00-1.28] progression 0/80 6/72 Improvement, RR [CI] Treatment Control Seftel (QR) 84% 0.16 [0.01-3.29] death/ICU 0/77 2/48 Tau​2 = 0.00; I​2 = 0.0% Early treatment 89% 0.11 [0.01-0.85] 0/157 8/120 89% improvement Reis (DB RCT) 30% 0.70 [0.37-1.26] death 17/741 25/756 Improvement, RR [CI] Treatment Control Calusic (PSM) 42% 0.58 [0.36-0.94] death 30/51 39/51 Tau​2 = 0.00; I​2 = 0.0% Late treatment 40% 0.60 [0.47-0.77] 47/792 64/807 40% improvement Oskotsky (PSM) -58% 1.58 [0.42-5.93] death 2/11 19/165 Improvement, RR [CI] Treatment Control Tau​2 = 0.00; I​2 = 0.0% Prophylaxis -58% 1.58 [0.42-5.93] 2/11 19/165 -58% improvement All studies 38% 0.62 [0.42-0.93] 49/960 91/1,092 38% improvement 5 fluvoxamine COVID-19 studies Dec 3, 2021 Tau​2 = 0.05; I​2 = 22.4%; Z = 2.29 Effect extraction pre-specified, see appendix Favors fluvoxamine Favors control
Database of all fluvoxamine COVID-19 studies. Submit updates/corrections.
Restrict:    All    Early    Late    Prophylaxis
Nov 15
PrEPPEP Oskotsky et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2021.33090 (Peer Reviewed)
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 (Peer Reviewed)
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) (Peer Reviewed)
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 (preprint 8/23/2021) (Peer Reviewed)
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 12
Late Németh et al., SSRN, doi:10.2139/ssrn.3896539 (Preprint)
death, ↓67.0%, p=0.003
Fluoxetine May Improve 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) (Peer Reviewed)
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 (Peer Reviewed) 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.
Apr 20
Review Sukhatme et al., Front. Pharmacol., doi:10.3389/fphar.2021.652688 (Review) (Peer Reviewed)
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 6
Review Kirsch, S. (Review) (Preprint)
Details   COVID FAQ from the founder of the COVID-19 Early Treatment Fund [1], including an extensive analysis of the fluvoxamine trials and other supporting evidence.
Mar 7
PrEPPEP Darquennes et al., Pharmaceuticals, doi:10.3390/ph14030226 (Peer Reviewed)
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..
Feb 1
Early Seftel et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofab050 (Peer Reviewed)
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 (Peer Reviewed)
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).
Aug 17
Late Hoertel et al., Molecular Psychiatry, doi:10.1038/s41380-021-01021-4 (Peer Reviewed) 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 ..
Please send us corrections, updates, or comments. Vaccines and treatments are both extremely valuable and complementary. All practical, effective, and safe means should be used. Elimination of COVID-19 is a race against viral evolution. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. Denying the efficacy of any method increases the risk of COVID-19 becoming endemic; and increases mortality, morbidity, and collateral damage. 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. Treatment protocols for physicians are available from the FLCCC.
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Thanks for your feedback! Please search before submitting papers and note that studies are listed under the date they were first available, which may be the date of an earlier preprint.