Common antidepressant may ease long COVID’s crushing fatigue

A decades-old antidepressant that costs only a few dollars a month may help millions of people struggling with the exhausting, life-altering fatigue that often lingers after a COVID-19 infection. A large international clinical trial, co-led by researchers at McMaster University, found that the drug fluvoxamine eased fatigue symptoms and boosted overall well-being in long COVID patients far more than a placebo did.

The findings, published in the journal Annals of Internal Medicine, come from a randomized, placebo-controlled study that enrolled 399 adults living with long COVID. Participants who took fluvoxamine reported notably less fatigue and a better quality of life than those given an inactive pill. Researchers described the result as one of the first times any medication has produced a clear, measurable improvement for this stubborn and often disabling condition.

Persistent exhaustion ranks among the most commonly reported and most debilitating effects of long COVID. Unlike ordinary tiredness, the fatigue tied to the syndrome can be severe enough to keep people from holding down jobs, caring for their families, or simply getting through routine daily tasks. For many patients, it has proven to be the single most limiting symptom of their recovery.

Long COVID has affected a substantial share of the global population since the pandemic began, with fatigue, brain fog and other lingering symptoms sometimes persisting for months or years after the initial infection clears. Despite how widespread the condition has become, doctors have had strikingly few tools to offer patients, since most treatments tested so far have failed to show a clear, reproducible benefit in rigorous trials.

Fluvoxamine itself is not new. Sold under the brand name Luvox, the drug belongs to a class of antidepressants known as selective serotonin reuptake inhibitors and has long been prescribed for depression, obsessive-compulsive disorder and related conditions. It first drew attention as a possible COVID-19 treatment earlier in the pandemic, when some researchers suggested its anti-inflammatory properties might help prevent severe illness in newly infected patients. The latest trial instead tested whether that same mechanism could help patients already dealing with the drawn-out aftereffects of infection.

Because fluvoxamine is an inexpensive, generic medication that is already approved and widely stocked by pharmacies, any move to recommend it for long COVID could be rolled out far more quickly and cheaply than a newly developed drug would allow. That accessibility is part of what has researchers optimistic, since it would not require new manufacturing or lengthy regulatory approval to reach patients who need relief now.

Scientists involved in the work cautioned that a single trial, however encouraging, is not the final word. Larger and longer follow-up studies are typically needed before medical guidelines shift to recommend a treatment broadly, and researchers noted that fluvoxamine addressed fatigue and quality of life specifically rather than curing long COVID or resolving its full range of symptoms, which can include cognitive difficulties, shortness of breath and heart-related complications. Even so, the trial adds rare, evidence-backed momentum to a field that has struggled to find any effective options, and it is expected to spur further research into whether repurposed, low-cost drugs can fill the treatment gap that has left long COVID patients waiting for answers.

Source: ScienceDaily