Give a short and critical explanation of the rationale of using fluvoxamine (a selective serotonin reuptake inhibitor (SSRI) in the treatment of Covid patients.

Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) that was approved by the Food and Drug Administration (FDA) to be used to treat obsessive-compulsive disorder (OCD) and depression. It was, however not approved to be used as a treatment for infections (NIH, 2021). Sigma-1 agonism inhibits SARS-CoV-2 replication and modulates the inflammatory response in animals as well as potentially stop a large release of cytokines, which could be life-threatening, and acute respiratory distress syndrome in COVID-19 patients (Medical letter, 2021:63). Due to the fact that Fluvoxamine has a high affinity for the sigma-1 receptors, it can assist in preventing the health of SARS-CoV-2 patients from worsening (Hashimoto, 2021:2). There are no adverse effects of short courses of fluvoxamine, but it may inhibit enzymes such as CYP1A2, 2C9, and 3A4, which in turn will lower the metabolism and increase the concentrations of drugs that are metabolised by them. According to my research, Fluvoxamine is a safe drug to use in the treatment of COVID-19 and is also generically available however, there is not enough conclusive data and trials are still occurring (Medical letter, 2021:63).

Reference list:

Hashimoto K. 2021. Repurposing of CNS drugs to treat COVID-19 infection: targeting the sigma-1 receptor. Eur Arch Psychiatry Clin Neurosci, 271(2):249-258.

 Medical Letter on Drugs and Therapeutics. 2021. https://secure.medicalletter.org/sites/default/files/freedocs/w1623d.pdf Date of access: 18 Oct. 2021.

NIH (National Institute of health): COVID-19 Treatment Guidelines. 2021.  https://www.covid19treatmentguidelines.nih.gov/therapies/immunomodulators/fluvoxamine/ Date of access: 18 Oct. 2021.