Selective serotonin reuptake inhibitor (SSRI) antidepressants reduce COVID-19 infection: prospects for use

Eur J Clin Pharmacol. 2022 Oct;78(10):1601-1611. doi: 10.1007/s00228-022-03372-5. Epub 2022 Aug 9.

Abstract

Purpose: The absence of specific treatments for COVID-19 leads to an intense global effort in the search for new therapeutic interventions and better clinical outcomes for patients. This review aimed to present a selection of accepted studies that reported the activity of antidepressant drugs belonging to the selective serotonin receptor inhibitor (SSRI) class for treating the novel coronavirus.

Methods: A search was performed in PubMed and SciELO databases using the following search strategies: [(coronavirus) OR (COVID) OR (SARS-CoV-2) AND (antidepressant) OR (serotonin) OR (selective serotonin receptor inhibitors)]. In the end, eleven articles were included. We also covered information obtained from ClinicalTrials.gov in our research.

Results: Although several clinical trials are ongoing, only a few drugs have been officially approved to treat the infection. Remdesivir, an antiviral drug, despite favorable preliminary results, has restricted the use due to the risk of toxicity and methodological flaws. Antidepressant drugs were able to reduce the risk of intubation or death related to COVID-19, decrease the need for intensive medical care, and severely inhibit viral titers by up to 99%. Among the SSRIs studied so far, fluoxetine and fluvoxamine have shown to be the most promising against SARS-CoV-2.

Conclusion: If successful, these drugs can substantially reduce hospitalization and mortality rates, as well as allow for fully outpatient treatment for mild-to-moderate infections. Thus, repositioning SSRIs can provide benefits when faced with a rapidly evolving pandemic such as COVID-19.

Keywords: Antidepressants; COVID-19; Coronavirus; Pandemic; Redirection; Repositioning.

Publication types

  • Review

MeSH terms

  • Antidepressive Agents / therapeutic use
  • Antiviral Agents / therapeutic use
  • COVID-19 Drug Treatment*
  • Fluoxetine
  • Fluvoxamine
  • Humans
  • Receptors, Serotonin
  • SARS-CoV-2
  • Selective Serotonin Reuptake Inhibitors* / therapeutic use
  • Serotonin

Substances

  • Antidepressive Agents
  • Antiviral Agents
  • Receptors, Serotonin
  • Serotonin Uptake Inhibitors
  • Fluoxetine
  • Serotonin
  • Fluvoxamine