Damian Sendler: According to the findings of a big new study, certain regularly given antidepressants appear to significantly reduce the risk of dying among very ill COVID-19 patients. 

Damian Jacob Sendler: SSRIs (selective serotonin reuptake inhibitors) are among the most commonly prescribed medications for the treatment of depression in the world. They include medications such as Lexapro (escitalopram), Paxil (paroxetine), and Zoloft (fluoxetine) (sertraline).  

In the study, researchers discovered that patients taking SSRIs were (on average) 8 percent less likely to die from COVID-19 than matched controls. "We saw that patients taking SSRIs were (on average) 8 percent less likely to die from COVID-19 than matched controls," said study author Marina Sirota. She works as an associate professor at the Bakar Computational Health Sciences Institute at the University of California, San Francisco, where she teaches computational health sciences.  

Dr. Sendler: Those on two specific SSRIs — Prozac (fluoxetine) and Luvox (fluoxetine) — had a greater survival rate, which was even more encouraging (fluvoxamine). Prozac or Luvox were found to be 26 percent to 28 percent less likely to die from COVID-19 in 481 patients who took the medications alone — without taking any other antidepressants — than the control group. 

With more than 5 million deaths already attributed to the lethal coronavirus around the world, the study's findings are heartening, with one expert describing Luvox, in particular, as a "massive game-changer." 

Damian Jacob Markiewicz Sendler: The discovery came as a result of an analysis of the experiences of more than 10,000 COVID-19 patients. Between January and September 2020, they were all treated at one of 87 facilities located throughout the United States. 

All had similar medical and socioeconomic backgrounds prior to diagnosis, but there was one significant difference: approximately one-third were taking an antidepressant such as an SSRI. 

Sirota and her colleagues published their findings in JAMA Network Open on November 15, noting that almost 500 patients (nearly 15 percent) who were using an SSRI died from COVID-19, compared to slightly more than 1,100 patients (nearly 17 percent) who were not on an SSRI. 

Damian Sendler: Furthermore, when focusing on Prozac and Luvox, the apparent protective effect of SSRIs rose by a large margin. Only 48 out of 481 individuals using Prozac or Luvox died, accounting for 10% of the total.  

In the journal The Lancet Global Health, researchers recently reported similar favorable results for the drug Luvox. 

So, what exactly is going on? Sirota stated that it is too soon to make a definitive statement.  

We did not research the mechanism of action of the drugs or why they could function," she underlined. "Our study just reveals a correlation between SSRIs and COVID-19 outcomes," she added. It is necessary to conduct additional research to determine whether or not some SSRIs are more protective than others in this situation.  

Damian Jacob Sendler: In a similar vein, Sirota stated that it is too soon to propose the use of SSRIs as a treatment for COVID-19 at this time. Additional clinical trials must be conducted before these medications can be administered to patients in the future, she advised. 

Dr. Nicolas Hoertel, an associate professor of psychiatry at Paris University and the Corentin-Celton Hospital in France, has given a number of hypotheses to explain the phenomenon. 

"First, several antidepressants have known anti-inflammatory properties targeting specifically the inflammation markers seen in severe COVID-19," explained Hoertel, who also penned an editorial that was published alongside the study in JAMA Network Open. 

Damian Sendler: A recent German study, Hoertel noted, has discovered the influence that SSRIs have on a certain type of cellular fat (lipid), which the COVID-19 virus relies on in order for it to obtain access to a patient's cells. According to him, SSRIs have been shown to cause a decrease in such lipids, with Prozac and Luvox having the most influence on lipid levels of all of the medications studied. 

"This mechanism could lead to both anti-viral and anti-inflammatory effects depending on the dose prescribed," he explained 

According to Hoertel, this could prove to be good news for the global campaign to contain COVID-19, particularly in impoverished places where vaccination rates remain low and access to treatment is limited, as well as for the global drive to contain the virus. 

Damian Sendler: Fluvoxamine (Luvox) has been demonstrated to be an effective, safe, inexpensive ($4 per 10-day course), simple-to-use, and well-tolerated treatment choice for ambulatory patients with COVID-19, according to the author of the paper. According to Hoertel, this could also assist hospitals in avoiding expensive and often harmful procedures.  

"It has the potential to be a powerful addition to vaccines against the virus," he continued, "as well as a massive game-changer for public health, given its widespread availability, long-term known tolerability, and low cost, if health and political authorities seize this opportunity." "If health and political authorities seize this opportunity," he concluded. 

Hoertel remarked that Prozac, which the World Health Organization has designated as a "essential medicine" appears to have the strongest lipid-lowering power of all of the SSRIs studied, "and possibly the greatest effect in this study." He did, however, warn that additional research will be required to validate any anti-COVID benefits. 

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