Antidepressant fluvoxamine reduces fatigue in people with long COVID in the short term

A randomized trial of 399 adults with long COVID found fluvoxamine reduced self-reported fatigue at 30 and 60 days compared with placebo, though the benefit lessened by 90 days; a separate test of metformin showed no fatigue benefit.

A randomized clinical trial tested the antidepressant fluvoxamine against placebo for fatigue in people with long COVID. The study enrolled 399 adults who had new or worsening fatigue for at least 90 days and no more than one year. Participants took medication for 60 days and were assessed at 30, 60 and 90 days. The trial was conducted at outpatient clinics in Brazil and the findings were published in Annals of Internal Medicine. Key findings: - The trial included 399 adults with significant long-COVID fatigue and used a validated 7-point Fatigue Severity Scale to measure symptoms. - People assigned to fluvoxamine were nearly 50% more likely than placebo to rate fatigue as 3 or less at 30 days and showed about a half-point lower fatigue score at 60 days; the relative benefit declined by 90 days after treatment stopped. - Participants taking fluvoxamine also reported better quality of life and fewer adverse events than those on placebo. - Metformin did not reduce fatigue compared with placebo, and the authors noted the Brazil-based trial may not produce identical results in other settings. Summary: The study reports a short-term reduction in self-reported fatigue among people with long COVID who took fluvoxamine, with smaller relative benefits after treatment ended. Researchers described the findings as preliminary and called for further work to understand longer-term effects and generalizability. Undetermined at this time.