Fluvoxamine shows promise for long COVID fatigue in clinical trial
A global clinical trial suggests the antidepressant fluvoxamine may relieve the disabling fatigue associated with long COVID, a condition affecting an estimated 65 million people. The study found a 99% probability that fluvoxamine was more effective than a placebo in reducing fatigue and improving quality of life. In contrast, the diabetes drug metformin showed no benefit for established long COVID fatigue. Researchers call the finding an important step forward but caution more study is needed.
Fluvoxamine trial results
▪A global clinical trial found the antidepressant fluvoxamine may provide relief for persistent fatigue from long COVID.
▪A statistical analysis indicated a 99% probability that fluvoxamine was more effective than a placebo for long COVID fatigue.
▪Fluvoxamine, sold under the brand name Luvox, reduced fatigue and improved quality of life in adults with long COVID in the trial.
Long COVID fatigue burden
▪For some patients, long COVID exhaustion is severe enough to interfere with employment, family responsibilities, and daily activities.
▪Long COVID is estimated to affect about 65 million people worldwide, yet few treatments are supported by strong clinical evidence.
▪Fatigue is one of the most frequent and disabling symptoms reported by people with long COVID.
Bayesian adaptive trial design
▪Participants were randomly assigned to receive fluvoxamine, metformin, or a placebo for 60 days.
▪The study used a Bayesian adaptive trial design, allowing researchers to end treatment groups early once evidence became sufficiently clear.
▪The REVIVE-TOGETHER trial included 399 adults in Brazil with fatigue for at least 90 days after a confirmed SARS-CoV-2 infection.
Metformin comparison findings
▪The trial also tested metformin, a common diabetes medication, but it provided no meaningful improvement for established long COVID fatigue.
▪Earlier research found that taking metformin during an initial COVID-19 infection could lower the risk of later developing long COVID.
Clinical limitations
▪The medication appears specifically promising for fatigue management, and additional studies are needed to determine which patients benefit most.
▪Researchers caution that fluvoxamine is not a complete solution for long COVID, which can involve many different symptoms.
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