Fluvoxamine in the Treatment of Patients with COVID-19

COVID-19 aff ects central nervous system along with lungs and other internal organs. Infl ammatory
reactions, secretion of cytokines in brain cause anxiety and depressive symptoms, sleep disturbances
in most patients. Mental disorders are also associated with psychosocial factors of the pandemic. SSRI
antidepressants are often used to relieve psychopathological symptoms in COVID-19. Among them,
fl uvoxamine occupies a special place. Fluvoxamine, in addition to antidepressant and anti-anxiety
eff ects, exhibits clear anti-infl ammatory properties, which are realized through two mechanisms.
Fluvoxamine signifi cantly increases the level of nocturnal melatonin in blood plasma. Melatonin has
anti-infl ammatory, antioxidant and chronobiological normalizing eff ects. The second mechanism is
associated with the fact that fl uvoxamine in therapeutic dosages activates sigma-1 receptors, which
prevents secretion of cytokines and development of endoplasmic stress. Patients with COVID-19
taking fl uvoxamine did not report clinical complications of coronavirus infection.