An inexpensive, commonly used antidepressant called fluvoxamine may significantly relieve the persistent fatigue associated with long COVID, according to a global clinical trial co-led by McMaster University. Researchers found the drug, also known as Luvox, reduced fatigue and improved quality of life in adults battling the condition.
Fatigue is one of the most common and debilitating symptoms reported by those experiencing long COVID, sometimes to the extent that it impacts work, family duties, and daily life. Despite the widespread nature of this issue, evidence-based treatments remain limited. "This is an important step forward for patients who have been desperate for evidence-based options," stated Edward Mills, a senior author and professor at McMaster University. "Fluvoxamine showed consistent and meaningful benefits, and because it's already widely used and well understood, it has clear potential for clinical use."
The REVIVE-TOGETHER trial, conducted across Canada, Brazil, and the United States, involved 399 adults in Brazil who had suffered from fatigue for at least 90 days after a confirmed SARS-CoV-2 infection. Participants were randomly assigned to receive either fluvoxamine, metformin (a diabetes medication), or a placebo for 60 days.
Fluvoxamine demonstrated superior results compared to the placebo in reducing fatigue, with a 99 percent probability of being more effective. Patients taking fluvoxamine also reported notable improvements in their overall quality of life. However, metformin did not yield similar benefits in this trial, although earlier research suggested it might help lower the risk of developing long COVID if taken during the initial infection phase.
The study employed a Bayesian adaptive trial design, allowing for the early conclusion of individual treatment arms once sufficient evidence was gathered. This method enables faster, reliable results while maintaining scientific rigor. "The trial used a sophisticated adaptive design that allowed it to reach conclusions more efficiently than traditional trials, stopping early when the evidence was clear enough," explained lead author Gilmar Reis, a researcher at Cardresearch and part-time professor at McMaster.
With an estimated 65 million people worldwide affected by long COVID, the lack of proven therapies makes this finding significant. While supportive strategies like pacing and symptom management are current recommendations, researchers caution that fluvoxamine appears to be a promising specific treatment for fatigue rather than a cure-all for the complex condition. Further studies are needed to identify ideal patient candidates, understand the drug's mechanism, and explore its potential use with other emerging treatments.
