• Give a brief and critical explanation of the rationale for using fluvoxamine (a selective serotonin reuptake inhibitor (SSRI) in the treatment of Covid patients. Your answer should include appropriate references as well as in-text references.

Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) used in a study to investigate clinical deterioration in patients with mild to moderate coronavirus disease. (Reiersen et al., 2021) Fluvoxamine also has affinity for the α1 agonist receptor. (Narita et al., 1996) It controls inflammation. The effects that fluvoxamine or other SSRI products have that can help with kovid-19 patients are decreased platelet aggregation, regulation of inositol enzyme, 1a-driven inflammation, and elevated melatonin levels, which have a direct antiviral effect. It also regulates coagulopathy or a mild cytokine storm, which is very dangerous in severe covid 19 cases. (Reiersen et al., 2021) Inflammatory cytokine activity and no expression are regulated by Fluvoxamine in both human and animal models of inflammation (Taler et al. al., 2007) The potential of fluvoxamine on the cytokine storm in covid 19 patients is there. The severity of the covid 19 infection is due to how the inflammation in the body increases as well as the cytokines and chemokines (Reiersen et al., 2021) Platelet aggregation is also a problem is covid 19 patients. Platelets do not possess the enzyme that synthesizes serotonin (Ni and Watts, 2006). If thrombosis occurs, serotonin will be released through platelet aggregation using hemostasis (Reiersen, 2021). As a result, the SSRI can reduce the bleeding time, which indirectly means a reduced platelet adhesion (Ni and Watts, 2006).

 Narita, N., Hashimoto, K., Tomitaka, S.I., and Minabe, Y. (1996). Interactions of selective serotonin reuptake inhibitors with subtypes of σ receptors in rat brain._ _Eur. J. Pharmacol. 307 (1), 117–119. doi:10.1016/0014-2999(96)00254-3 

Ni, W., and Watts, S. W. (2006). 5-hydroxytryptamine in the cardiovascular system: focus on the serotonin transporter (SERT). Clin. Exp. Pharmacol. Physiol. 33 (7), 575–583. doi:10.1111/j.1440-1681.2006.04410.x 

Reiersen, AM., Sukhatme, VP., Sukhatme, VV., and Vayttaden, SJ. (2021) Fluvoxamin: A Review of its Mechanism of Acion and Its Role in Covid-19. Frontiers in Pharmacology https://doi.org/10.3389/fphar.2021.652688

Taler, M., Gil-Ad, I., Korob, I., and Weizman, A. (2011). The immunomodulatory effect of the antidepressant sertraline in an experimental autoimmune encephalomyelitis mouse model of multiple sclerosis. Neuroimmunomodulation 18 (2), 117–122. doi:10.1159/000321634