OCD drug shows promise against COVID-19

A cheap antidepressant commonly used to treat obsessive-compulsive disorder (OCD) significantly decreased the risk of COVID-19 patients becoming hospitalized in a large trial.

The results come from a randomized, controlled trial of fluvoxamine in unvaccinated people in Brazil who had recently become infected with SARS-CoV-2 and who had at least one preexisting condition that made them more likely to develop severe COVID-19. The study, published yesterday in The Lancet Global Health, involved 1500 participants who had COVID-19 symptoms and tested positive for the virus. Half received the drug, a so-called selective serotonin reuptake inhibitor, within 7 days of their symptoms’ onset, and half got a placebo. Those who received a fluvoxamine pill twice a day were 32% less likely to be hospitalized or need prolonged observation in an emergency room than those in the placebo group.

The results were stronger in a smaller group that excluded patients in the treatment arm who failed to follow through and take the full course of the drug. In the group that largely followed doctors’ orders—taking the pills at least 80% of the time—the risk of hospitalization was 66% less than in those in the placebo group. Just one of the treated patients died, compared with 12 who received the placebo.

“That’s really good,” David Boulware, an infectious disease scientist at the University of Minnesota, Twin Cities, told The New York Times.

The results are “promising, particularly as this product is inexpensive and could be made widely available,” Penny Ward, a drug company consultant and visiting professor in pharmaceutical medicine at King’s College London, told the Science Media Centre. But she cautioned that the trial did not include vaccinated people with “breakthrough” SARS-CoV-2 infections, who make up an increasing proportion of COVID-19 patients as more and more people are vaccinated.

Although its mechanism of action in the COVID-19 context is uncertain, fluvoxamine was examined as a possible treatment because of its antiviral and anti-inflammatory effects; it also has antiplatelet activity that could potentially reduce the widespread clotting that can complicate severe COVID-19.

By Meredith Wadman