As vaccination campaigns start around the world, the race to find treatments for the coronavirus continues.
And one of the strategies is based on the drug repositioning. It is in fact to seek an antiviral activity from products already marketed for another therapeutic indication. The advantage is that their toxicity (adverse effects) has already been evaluated..
What if certain antidepressants could prevent severe forms? Uteam of researchers and doctors from the psychiatry and addictology department of the Corentin-Celton hospital (AP-HP)studied the association between taking certain antidepressant treatments and reducing the risk of intubation or death in patients hospitalized for COVID-19.
It all started with the observation of psychiatrist Nicolas Hoertel, who coordinates the study, that few patients Covid presented with psychiatric disorders. “I immediately thought of anti-depressants and said to myself that there could be a link “, he explains to our colleagues from France Inter.
Following their intuition, the researchers then collected health data frompatients hospitalized in AP-HP hospitals between January and April last. All the data medical including theongoing patient treatmentsare so been crossed to identify links.
Taking fluoxetine (Prozac) and other antidepressants lowers your risk
Their results are published in the journal Molecular Psychiatry, February 4, 2021. What are they? Out of 7,230 patients studied, 345 patients only (nearly 5%) had a prescription for antidepressant treatment within the first 48 hours after admission, which confirms the under-representation of Covid patients with psychiatric disorders. But above all, interesting data, these patients had too a risk of intubation or death reduced by more than 40% compared to patients who had not taken such treatment. “The study suggests a reduction in this risk for certain serotonin reuptake inhibitor antidepressants (SSRIs) (fluoxetine, paroxetine, escitalopram) and some non-SSRI antidepressants (venlafaxine and mirtazapine), with a risk reduction of between 42% and 78% depending on the molecule, “said a press release from AP-HP.
THE‘study further emphasizes that antidepressants (SSRIs and non-SSRIs) are more or less effective depending on the molecule.The fluoxetine, marketed under the name Prozac, would be of particular interest.
Researchers hypothesize that antidepressant treatments may inhibit the activity of Acid sphingomyelinase, an enzyme that appears to influence the intracellular penetration of the SARS-CoV-2 virus.
A clinical trial will start in France
It should be noted that this is an observational study whose main limitation is that one cannot conclude that there is a causal link. But hope remains. Indeed, a randomized clinical trial versus placebo set up in the United States after the publication of the first results of the AP-HP in July 2020 seems to confirm the unexpected effect of antidepressants to limit severe forms. Thereby, the study, published in the Journal of the American Medical Association in November 2020, shows that none of the 80 patients with Covid-19 treated with an antidepressant, the fluvoxamine, was clinically worsening, compared to 6 of 72 patients receiving placebo.
Next step, in order to confirm these promising data, the AP-HP will launch a large-scale trial on hundreds of patients.
Sources:
- “Hoertel N et al. Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study “, Molecular Psychiatry, February 4, 2021.
- “Fluvoxamine vs Placebo and Clinical Deterioration in Outpatients With Symptomatic COVID-19”, JAMA, November 12, 2020.
- “Association between the use of certain antidepressant treatments and the reduced risk of intubation or death in patients hospitalized for COVID-19”, AP-HP, February 5, 2021.
Read also:
- Covid-19: will colchicine keep its promises?
- Covid-long: causes, symptoms, risk profiles … What we know one year after the start of the epidemic
- Covid-19: should you drink wine to protect yourself against the virus?