Efficacy and safety of adding fluoxetine to the treatment regimen of hospitalized patients with non-critical COVID-19 pneumonia: A double-blind randomized, placebo-controlled clinical trial

Neuropsychopharmacol Rep. 2023 Jun;43(2):202-212. doi: 10.1002/npr2.12327. Epub 2023 Mar 20.

Abstract

Introduction: Selective serotonin reuptake inhibitors are considered the drugs, whose effectiveness in viral pandemics has been studied. The aim of this study was to evaluate of adding fluoxetine to the treatment regimen of patients with COVID-19 pneumonia.

Methods: This study was a double-blind randomized placebo controlled clinical trial .36 patients in the fluoxetine and 36 patients in the placebo group were enrolled. Patients in the intervention group were first treated with fluoxetine 10 mg for 4 days and then the dose of 20 mg was continued for 4 weeks. Data analysis was conducted using SPSS V. 22.0.

Results: There was no statistically significant difference between the two groups in terms of clinical symptoms at the beginning of the study and also the score of anxiety and depression, oxygen saturation at the time of hospitalization, mid-hospitalization and discharge periods. The need for mechanical ventilator support (p = 1.00), the need for admission in the intensive care unit (ICU) (p = 1.00), rate for mortality (p = 1.00), and discharge with relative recovery (p = 1.00) were not significantly different between the two groups. The distribution of CRP within the study groups showed a significant decrease during different time periods (p = 0.001), and although there was no statistically significant difference between the two groups on the first day (p = 1.00) and at discharge (p = 0.585), mid-hospital CRP showed a significant decrease in the fluoxetine group (p = 0.032).

Conclusion: Fluoxetine resulted in a faster reduction of patients' inflammation without association with depression and anxiety.

Keywords: COVID-19; anxiety; depression; drug regimens; fluoxetine.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Antidepressive Agents, Second-Generation / administration & dosage
  • Antidepressive Agents, Second-Generation / adverse effects
  • Antidepressive Agents, Second-Generation / therapeutic use
  • Anxiety / complications
  • C-Reactive Protein / analysis
  • COVID-19* / complications
  • COVID-19* / mortality
  • COVID-19* / therapy
  • Depression / complications
  • Double-Blind Method
  • Female
  • Fluoxetine* / administration & dosage
  • Fluoxetine* / adverse effects
  • Fluoxetine* / therapeutic use
  • Hospitalization*
  • Humans
  • Inflammation / complications
  • Inflammation / drug therapy
  • Intensive Care Units
  • Male
  • Middle Aged
  • Patient Discharge
  • Placebos
  • Pneumonia, Viral* / complications
  • Pneumonia, Viral* / mortality
  • Pneumonia, Viral* / therapy
  • Respiration, Artificial
  • SARS-CoV-2
  • Selective Serotonin Reuptake Inhibitors / administration & dosage
  • Selective Serotonin Reuptake Inhibitors / adverse effects
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Treatment Outcome

Substances

  • Antidepressive Agents, Second-Generation
  • C-Reactive Protein
  • Fluoxetine
  • Placebos
  • Selective Serotonin Reuptake Inhibitors