An antidepressant excluded by the health authorities from treatments against the disease

Fluvoxamine, an antidepressant, should not be used against Covid in the current state of knowledge, estimated this Tuesday the French health authorities, judging insufficient the few works going in the direction of a profit. “The data available to date, due to their methodological limitations, do not support a clinical benefit of fluvoxamine as a curative treatment for Covid-19 disease”, summarized in a press release the National Security Agency of medicine (ANSM).

Fluvoxamine, widely used as an antidepressant, is one of the few medications already existing which have given interesting results against severe forms of Covid. Unlike now discredited tracks like chloroquine or ivermectin, some credible studies suggest that it can reduce the risk of complications. Such a prospect is particularly interesting because the cost of such a treatment, which has long been in circulation, would be much lower than that of anti-Covid drugs developed specifically for this purpose, such as Pfizer’s Paxlovid pill.

“This position can completely evolve and be revised”

However, according to the ANSM, the current state of knowledge remains insufficient to support such use. “The data available today, and I mean today (…), are not sufficient to support a presumed favorable benefit-risk ratio in this indication”, summarizes Philippe Vella, specialist in antidepressants at the ANSM. Some of the available studies have observed after the fact that there were fewer complications in patients treated with fluvoxamine, but do not make it possible to ascertain a direct cause and effect link.

Others, rarer, have really sought to estimate the benefits of fluvoxamine, compared to a placebo, but, for the ANSM, they present too significant biases.

The largest study, conducted in Brazil and published at the end of 2021, has the particular defect of having mixed two evaluation criteria: the risk of staying more than a few hours in an emergency department, and that of being hospitalized. after several weeks. “We are not at the same level of severity in the criteria”, remarked Philippe Vella.

The ANSM also considers that these studies do not sufficiently detail the risk of adverse effects of fluvoxamine. Admittedly, its use as an antidepressant is well documented, but it would be given at very different doses and rhythm against the Covid. “This position, it can completely evolve and be revised if new data were to emerge”, however concluded Philippe Vella, wishing that larger studies be implemented.

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