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Fluoxetine: The Antidepressant Proving to Be a Surprising Contender in the Fight Against COVID-19

If that headline sounds like an antidepressant may be the cure to COVID-19, you interpreted incorrectly. Not just any antidepressant will work, nor is Fluoxetine a cure for the coronavirus. However, there is a new door opening to the possibility of some hope with this medication.

Since the spread of COVID-19 infections began, researchers and scientists worldwide quickly got to work in their laboratories, universities, and hospitals to investigate preventative and treatment methods which have gradually given way to vaccines and effective drugs. Although none of these is considered 100% effective, the progress achieved in record time is impressive.

Part of this accelerated progress is because the virus became massively contagious faster than previously expected, and in a more lethal way. In addition to seeking new ways to treat the virus’s effects, researchers had to resort to using existing products that could potentially benefit COVID patients. Among other discoveries, this led to the consideration of fluoxetine, which in small studies has shown to help reduce the virus's ability to multiply and help prevent its most serious symptoms.

What is fluoxetine?

Surprisingly, fluoxetine is an antidepressant used to treat various mental and eating disorders, approved by the FDA in the United States in 1987. In other parts of the world, fluoxetine has been used since the 1970s. It increases the production of serotonin, a substance in the brain that helps maintain emotional stability, reduce appetite, and create a sense of well-being, among other benefits.

Generically, it is an inexpensive product and unpopular in recent years now that more modern antidepressants have been favored. Some of these contain fluoxetine, such as Prozac, with more advanced formulas.

Why the sudden new fame?

  • Fluoxetine's renaissance is due to a recently reported clinical trial being conducted by scientists at Washington University in St. Louis, Missouri. With nearly 1100 volunteers in the early stages of the virus, fluvoxamine or Luvox, a fluoxetine-containing drug, has proven to help lessen the severity of symptoms and even reduce risk of death. Although the study is in preliminary stages, the outpatient results so far have been positive, showing reduced harm compared to the placebo in the first 15 days of treatment. (1)

  • Earlier research in 2020 had already set eyes on this particular drug, such as a pilot study conducted in Pennsylvania that showed fluoxetine can decrease the mechanisms leading to the so-called "cytokine storm" produced by COVID-19 (2), which causes the most severe symptoms, multisystemic failures, and even death. Participants took one 20-mg fluoxetine capsule daily, gradually increasing to 3 per day, over a total of 8 weeks. The results suggest that early use in COVID-19-infected patients may decrease risk of hospitalization, intubation, death, and the post-traumatic stress-related side effects of the disease, such as depression.

  • Although that study is very small and requires a great deal more research, it is not the only one. In mid-2020, another research trial conducted at the Institute of Virology and Immunology of the University Hospital in Würzburg, Germany also showed positive effects in the way fluoxetine manages to slow down the multiplication of the virus. (3)

  • Also in 2020, researchers from Egypt made a proposal to use fluoxetine to treat the effects of COVID-19 on the hypothesis that by decreasing immunity due to the stress and depression that occurs in patients, more serious symptoms are generated, leading even to death. They proposed the use of fluoxetine due to its ability to increase serotonin, its antiviral potential, and its effects on the immune system, among others.

There are also numerous previous studies on animals that refer to fluoxetine's anti-inflammatory capacity, which could also be key to its good performance in COVID-19 patients. Inflammation increases the possibility of developing complications such as clots and swelling of the toes, known as COVID toes. (2)

Does this mean that fluoxetine is an approved treatment?

It is not an official treatment for COVID-19. So far, all studies are only preliminary or in progress and therefore inconclusive enough to motivate the authorities to approve its widespread use. Perhaps more treatments can be made official in time, as has happened with other products such as remdesivir based on results shown thus far. Additionally, we must consider that even with officially approved drugs, everything depends on the individual circumstances of the patient and the treatment used by their supervising physicians. You can consult your own to know in advance what options are recommended in the case you become infected.

We already know the most important thing is to not stop taking care of ourselves while science continues to do its part. We can trust and hope for the best.

Let's continue to be healthier, together.

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