To find a treatment for COVID-19, researchers and healthcare practitioners around the world are leaving no stone unturned. From the malaria drug hydroxychloroquine to the Ebola drug remdesivir, several medications are either under trial or are being used for the symptomatic management of the novel coronavirus disease.
Now researchers at the Institute of Virology and Immunobiology, Germany say that fluoxetine, an antidepressant drug, can suppress the replication of SARS-CoV-2, the causative agent of COVID-19, when used at the dose taken for depression treatment: 0.8 µg/mL.
The study is not peer-reviewed yet and is still in the pre-print stage. As per the study, the patent of fluoxetine (more commonly called Prozac) has long since expired and so anybody can make it now. If this drug indeed proves to be effective against the COVID-19 causing virus, it may be made available easily, quickly and at a very reasonable cost.
Fluoxetine is an FDA-approved serotonin reuptake inhibitor that is used as oral tablets for the management of conditions like anxiety, depression, obsessive-compulsive disorder (OCD), panic disorder and bulimia nervosa (an eating disorder).
Serotonin is commonly called the happy hormone in the body; low levels of serotonin have been noted in patients with depression. It is also a neurotransmitter, meaning it helps pass signals within brain cells. When a brain cell releases serotonin and it is not taken up by the next cell, the first cell retakes it: serotonin reuptake. However, fluoxetine inhibits this reuptake, letting more brain cells to take up serotonin.
In the case of COVID-19, however, experts suggest that fluoxetine can suppress cytokine storm – a life-threatening condition in COVID-19 patients.
As per the FDA, fluoxetine has various side effects including an increase in suicidal tendencies in children, anxiety and insomnia, increased bleeding to name a few. Also, no one should take fluoxetine without speaking to a doctor, especially pregnant and breastfeeding women.
Not the first study
There are various studies that suggest the antiviral effects of fluoxetine. This drug has shown effects against enterovirus (causes various diseases in both adults and children), coxsackievirus (causes hand foot and mouth disease and various diseases of the lungs and heart), and dengue virus.
On April 13, researchers at the Washington University School of Medicine in St. Louis announced that they were starting a clinical trial to study the efficiency of fluoxetine in the treatment of non-hospitalised COVID-19 patients. The decision was taken on the basis of a previous study done by a group of researchers at the University of Virginia that indicated that fluoxetine reduces the negative effects of inflammation in mice.
Another clinical trial is currently underway to study the effect of fluoxetine in reducing intubation and death in COVID-19 patients. The trial funded by the University of Toledo Health Science Campus, US, will enrol about 2,000 patients. Half of the enrolled patients will get fluoxetine (20 to 60 mg daily from two weeks to two months) and the other half will get the standard treatment.
For more information, read our article on Drugs that are being repurposed for COVID-19.
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