Federal University of Santa Maria, Postgraduate Program in Pharmaceutical Sciences, Santa Maria, RS, Brazil.
Department of Clinical and Toxicological Analysis, Federal University of Santa Maria, UFSM, Building 26, Room 1201, Santa Maria, RS, 97015-900, Brazil.
Eur J Clin Pharmacol. 2022 Oct;78(10):1601-1611. doi: 10.1007/s00228-022-03372-5. Epub 2022 Aug 9.
The absence of specific treatments for COVID-19 leads to an intense global effort in the search for new therapeutic interventions and better clinical outcomes for patients. This review aimed to present a selection of accepted studies that reported the activity of antidepressant drugs belonging to the selective serotonin receptor inhibitor (SSRI) class for treating the novel coronavirus.
A search was performed in PubMed and SciELO databases using the following search strategies: [(coronavirus) OR (COVID) OR (SARS-CoV-2) AND (antidepressant) OR (serotonin) OR (selective serotonin receptor inhibitors)]. In the end, eleven articles were included. We also covered information obtained from ClinicalTrials.gov in our research.
Although several clinical trials are ongoing, only a few drugs have been officially approved to treat the infection. Remdesivir, an antiviral drug, despite favorable preliminary results, has restricted the use due to the risk of toxicity and methodological flaws. Antidepressant drugs were able to reduce the risk of intubation or death related to COVID-19, decrease the need for intensive medical care, and severely inhibit viral titers by up to 99%. Among the SSRIs studied so far, fluoxetine and fluvoxamine have shown to be the most promising against SARS-CoV-2.
If successful, these drugs can substantially reduce hospitalization and mortality rates, as well as allow for fully outpatient treatment for mild-to-moderate infections. Thus, repositioning SSRIs can provide benefits when faced with a rapidly evolving pandemic such as COVID-19.
由于目前缺乏针对 COVID-19 的特效治疗方法，全球正在努力寻找新的治疗干预措施，以改善患者的临床结局。本综述旨在介绍一系列已被认可的研究，这些研究报告了选择性 5-羟色胺再摄取抑制剂（SSRIs）类抗抑郁药治疗新型冠状病毒的活性。
在 PubMed 和 SciELO 数据库中使用以下搜索策略进行检索：[（冠状病毒）或（COVID）或（SARS-CoV-2）和（抗抑郁药）或（血清素）或（选择性 5-羟色胺再摄取抑制剂）]。最终，纳入了 11 篇文章。我们的研究还涵盖了 ClinicalTrials.gov 上获得的信息。
尽管有几项临床试验正在进行，但仅有少数几种药物被正式批准用于治疗这种感染。尽管瑞德西韦作为一种抗病毒药物，初步结果有利，但由于存在毒性风险和方法学缺陷，其使用受到限制。抗抑郁药能够降低与 COVID-19 相关的插管或死亡风险，减少对重症监护的需求，并能将病毒滴度降低多达 99%。在迄今为止研究的 SSRIs 中，氟西汀和氟伏沙明对 SARS-CoV-2 显示出最有前途的效果。
如果成功，这些药物可以显著降低住院率和死亡率，并允许对轻度至中度感染进行完全门诊治疗。因此，SSRIs 的重新定位在面对 COVID-19 等快速演变的大流行时可以带来益处。
