Long COVID fatigue continues to affect millions worldwide. A new study suggests that the antidepressant Fluvoxamine may help reduce fatigue and improve quality of life.
The antidepressant Fluvoxamine may offer new hope for people living with long COVID-related fatigue, one of the condition’s most persistent and disabling symptoms.
A large randomized clinical trial published in the Annals of Internal Medicine found that the widely used and affordable drug reduced fatigue and improved quality of life in adults with long COVID, making it one of the strongest pieces of evidence yet for a medication targeting this condition. (1✔ ✔Trusted Source
The Effect of Fluvoxamine and Metformin for Fatigue in Patients With Long COVID: An Adaptive Randomized Trial
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How Effective Was Fluvoxamine for Long COVID Fatigue?
Researchers enrolled 399 adults in Brazil who had moderate-to-severe fatigue that persisted for at least 90 days after COVID-19 infection.
Participants were randomly assigned to receive Fluvoxamine, Metformin, or a placebo for 60 days, with fatigue measured using the validated Fatigue Severity Scale (FSS).
The trial found that people taking Fluvoxamine experienced significantly greater reductions in fatigue than those receiving a placebo by day 60, with the benefits continuing through day 90.
Participants were also more likely to achieve meaningful recovery from fatigue and reported better overall quality of life during follow-up.
In contrast, Metformin did not show a meaningful or sustained improvement in long COVID fatigue. The independent safety committee stopped the Metformin arm early because it was unlikely to provide benefit, while the Fluvoxamine arm was stopped after demonstrating superiority over placebo.
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Why Might Fluvoxamine Help People With Long COVID?
Long COVID continues to affect millions of people worldwide, with fatigue remaining one of its most common symptoms. Many patients also experience brain fog, poor concentration, disturbed sleep, and reduced quality of life, yet treatment options remain largely supportive.
Although Fluvoxamine is commonly prescribed for depression and obsessive-compulsive disorder (OCD), researchers believe its potential benefits in long COVID may extend beyond its antidepressant effects.
The drug activates the sigma-1 receptor, a pathway involved in regulating inflammation, immune responses, and cellular stress. It has also shown anti-inflammatory effects in previous COVID-19 studies, making it a promising candidate for treating persistent post-viral symptoms. However, researchers note that the exact biological mechanism behind its benefits in long COVID is still being investigated.
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Is Fluvoxamine Ready to Become a Long COVID Treatment?
The study found that adverse events occurred less frequently with Fluvoxamine than with either Metformin or placebo, while serious side effects were uncommon across all groups. The researchers concluded that Fluvoxamine may help reduce fatigue and improve quality of life in people with long COVID.
At the same time, they caution that the trial focused specifically on fatigue rather than the full range of long COVID symptoms, and participants were followed for only 90 days.
The researchers say larger and longer-term studies, including assessments of biological markers and different patient groups, are still needed before Fluvoxamine can become a standard treatment for long COVID. Until then, the medication should only be used under medical supervision.
Reference:
- The Effect of Fluvoxamine and Metformin for Fatigue in Patients With Long COVID: An Adaptive Randomized Trial. (https://www.acpjournals.org/doi/10.7326/ANNALS-25-03959)
Source-Medindia