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fluvoxamine [2022/01/14 18:49]
brian 		fluvoxamine [2022/05/27 18:11] (current)
pamela
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 Fluvoxamine (FLV) is a Selective Serotonin Reuptake Inhibitor (SSRI) that’s been used as an anti-depressant and treatment for obsessive compulsive disorder(OCD). It was first discovered in 1983 and approved by the US FDA in 1994.  Fluvoxamine (FLV) is a Selective Serotonin Reuptake Inhibitor (SSRI) that’s been used as an anti-depressant and treatment for obsessive compulsive disorder(OCD). It was first discovered in 1983 and approved by the US FDA in 1994. 
  
-[[Angela Reiersen]] was the first to propose Fluvoxamine as a treatment for Covid-19 in March 2020.+ 
 +=== Fluvoxamine for Covid 19 Treatment ===  
 + 
 +==Mechanism of Action== 
 +  * stabilize platelets to prevent clotting and serotonin release.  
 +  * increases endogenous levels of melatonin, which has anti-inflammatory effects at higher concentrations.  
 +  * inhibits inflammatory cytokines and sepsis by activating the anti-inflammatory Sigma-1 receptor, and it may even block entry of COVID-19 into human cells.  
 + 
 +==Story of Discovery== 
 +[[Angela Reiersen]] was the first to propose Fluvoxamine as a treatment for Covid-19 in March 2020. Reierson remembered learning about the ability of FLV to protect mice from lethal septic shock and dampen the inflammatory response in human blood leukocytes from a 2019 journal article in //Science Translational Medicine//.((https://www.science.org/doi/10.1126/scitranslmed.aau5266)) 
  
 The first published paper that proposed FLV's S1R agonist mechanism of action against Covid-19 was //"What Were You Before the War?" Repurposing Psychiatry During the COVID-19 Pandemic//.((https://www.psychiatrist.com/jcp/covid-19/repurposing-psychiatry-during-covid/)) The first published paper that proposed FLV's S1R agonist mechanism of action against Covid-19 was //"What Were You Before the War?" Repurposing Psychiatry During the COVID-19 Pandemic//.((https://www.psychiatrist.com/jcp/covid-19/repurposing-psychiatry-during-covid/))
  
 +==Trials==
 The [[COVID-19 Early Treatment Fund]] (CETF) funded the first randomized control trial(RCT) for Fluvoxamine for Covid-19.((https://medicine.wustl.edu/news/study-to-evaluate-antidepressant-as-potential-covid-19-treatment/)) The [[COVID-19 Early Treatment Fund]] (CETF) funded the first randomized control trial(RCT) for Fluvoxamine for Covid-19.((https://medicine.wustl.edu/news/study-to-evaluate-antidepressant-as-potential-covid-19-treatment/))
  
-The first RCT of fluvoxamine (FLV) was published in JAMA on November 12, 2020 and concluded that "Clinical deterioration occurred in 0 of 80 patients in the fluvoxamine group and in 6 of 72 patients in the placebo group." ((https://jamanetwork.com/journals/jama/fullarticle/2773108))+The first RCT results of fluvoxamine (FLV) against Covid-19 was published in JAMA on November 12, 2020 and found that "Clinical deterioration occurred in 0 of 80 patients in the fluvoxamine group and in 6 of 72 patients in the placebo group." ((https://jamanetwork.com/journals/jama/fullarticle/2773108))
  
 A large observational analysis (n=7345) of hospitalized French patients found that those on SSRI's had a substantially reduced risk of death from COVID. (([[https://www.medrxiv.org/content/10.1101/2020.07.09.20143339v2|Association between SSRI Antidepressant Use and Reduced Risk of Intubation or Death in Hospitalized Patients with Coronavirus Disease 2019: a Multicenter Retrospective Observational Study]]))  A large observational analysis (n=7345) of hospitalized French patients found that those on SSRI's had a substantially reduced risk of death from COVID. (([[https://www.medrxiv.org/content/10.1101/2020.07.09.20143339v2|Association between SSRI Antidepressant Use and Reduced Risk of Intubation or Death in Hospitalized Patients with Coronavirus Disease 2019: a Multicenter Retrospective Observational Study]])) 
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 The Lancet published results in October 27, 2021 of the Together RCT. The trial concluded that "Treatment with fluvoxamine ...  reduced the need for hospitalisation"(([[https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00448-4/fulltext|Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised, platform clinical trial]])) The Lancet published results in October 27, 2021 of the Together RCT. The trial concluded that "Treatment with fluvoxamine ...  reduced the need for hospitalisation"(([[https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00448-4/fulltext|Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised, platform clinical trial]]))
  
-[[https://www.medrxiv.org/content/10.1101/2021.12.17.21268008v1.full.pdf|Fluvoxamine for Outpatient COVID-19 to Prevent Hospitalization: A Systematic Review and Meta-Analysis]]+A pre-print Meta-Analysis posted on December 21, 2021 concluded that FLV has a high probability of preventing hospitalization from Covid-19(([[https://www.medrxiv.org/content/10.1101/2021.12.17.21268008v1|Fluvoxamine for Outpatient COVID-19 to Prevent Hospitalization: A Systematic Review and Meta-Analysis]]))
  
 +==Presentations==
 +[[https://www.youtube.com/watch?v=7xWbY7HVZUM|The TOGETHER Study Shows that Fluvoxamine Reduces Risk of Prolonged Hospitalization]] by Certara
 +
 +Dr. [[Eric Lenze]] gave a presentation on FLV for Covid on 20 Aug 2021(([[https://dcricollab.dcri.duke.edu/sites/NIHKR/KR/GR-Slides-08-20-21.pdf|New treatments for mental disorders Why we’ve failed…and how we will succeed.]]))
 +
 +=== Related News ===
 [[https://www.instagram.com/p/CXo0DhBD8z9/|Dr. Pater Attia's instagram post on fluvoxamine]] [[https://www.instagram.com/p/CXo0DhBD8z9/|Dr. Pater Attia's instagram post on fluvoxamine]]
 Dr. Peter Attia describes how one of the physicians in his practice tried to prescribe fluvoxamine for a patient who had just gotten COVID. They called in the prescription to a CVS in California, and the pharmacist told them they would not fill it because it was not part of the “official COVID guideline.” Dr. Peter Attia describes how one of the physicians in his practice tried to prescribe fluvoxamine for a patient who had just gotten COVID. They called in the prescription to a CVS in California, and the pharmacist told them they would not fill it because it was not part of the “official COVID guideline.”
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 Finding a possible early treatment for COVID-19 in a 40-year-old antidepressant]]** Finding a possible early treatment for COVID-19 in a 40-year-old antidepressant]]**
  
-===Presentations=== 
-[[https://www.youtube.com/watch?v=7xWbY7HVZUM|The TOGETHER Study Shows that Fluvoxamine Reduces Risk of Prolonged Hospitalization]] by Certara 
  
-Dr. [[Eric Lenze]] gave a presentation on FLV for Covid on 20 Aug 2021(([[https://dcricollab.dcri.duke.edu/sites/NIHKR/KR/GR-Slides-08-20-21.pdf|New treatments for mental disorders Why we’ve failed…and how we will succeed.]]))+==== The TOGETHER Study on Fluvoxamine Was Not Free of Errors, Either ==== 
 +A First Look at the Numbers by Alexandros Marinos  
 + 
 +This article is part of a series on the [[:TOGETHER trial]]. More articles from this series here.((https://doyourownresearch.substack.com/p/together-trial-index-of-articles?s=w)) 
 + 
 +Today, I'll show you one more example of how the TOGETHER trial outputs seem quite willing to blur various boundaries, and always in ways in which help them promote their desired outcome. This particular example is from the fluvoxamine arm of the study. 
 + 
 +In a way, you can see this as a demonstration of how tugging at a fairly small thing that looks strange can unearth a whole world of concerning issues about a trial. So let’s see ((https://doyourownresearch.substack.com/p/the-together-study-on-fluvoxamine?s=w)) 
  
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