fluvoxamine and Obesity

Early treatment to prevent severe coronavirus disease 2019 (Covid-19) is an important component of the comprehensive response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic.. In this phase 3, double-blind, randomized, placebo-controlled trial, we used a 2-by-3 factorial design to test the effectiveness of three repurposed drugs - metformin, ivermectin, and fluvoxamine - in preventing serious SARS-CoV-2 infection in nonhospitalized adults who had been enrolled within 3 days after a confirmed diagnosis of infection and less than 7 days after the onset of symptoms. The patients were between the ages of 30 and 85 years, and all had either overweight or obesity. The primary composite end point was hypoxemia (≤93% oxygen saturation on home oximetry), emergency department visit, hospitalization, or death. All analyses used controls who had undergone concurrent randomization and were adjusted for SARS-CoV-2 vaccination and receipt of other trial medications.. A total of 1431 patients underwent randomization; of these patients, 1323 were included in the primary analysis. The median age of the patients was 46 years; 56% were female (6% of whom were pregnant), and 52% had been vaccinated. The adjusted odds ratio for a primary event was 0.84 (95% confidence interval [CI], 0.66 to 1.09; P = 0.19) with metformin, 1.05 (95% CI, 0.76 to 1.45; P = 0.78) with ivermectin, and 0.94 (95% CI, 0.66 to 1.36; P = 0.75) with fluvoxamine. In prespecified secondary analyses, the adjusted odds ratio for emergency department visit, hospitalization, or death was 0.58 (95% CI, 0.35 to 0.94) with metformin, 1.39 (95% CI, 0.72 to 2.69) with ivermectin, and 1.17 (95% CI, 0.57 to 2.40) with fluvoxamine. The adjusted odds ratio for hospitalization or death was 0.47 (95% CI, 0.20 to 1.11) with metformin, 0.73 (95% CI, 0.19 to 2.77) with ivermectin, and 1.11 (95% CI, 0.33 to 3.76) with fluvoxamine.. None of the three medications that were evaluated prevented the occurrence of hypoxemia, an emergency department visit, hospitalization, or death associated with Covid-19. (Funded by the Parsemus Foundation and others; COVID-OUT ClinicalTrials.gov number, NCT04510194.).

Topics: Adult; Aged; Aged, 80 and over; COVID-19; COVID-19 Drug Treatment; COVID-19 Vaccines; Double-Blind Method; Female; Fluvoxamine; Humans; Hypoxia; Ivermectin; Male; Metformin; Middle Aged; Obesity; Overweight; Pregnancy; Pregnancy Complications, Infectious; SARS-CoV-2

The effect of extended anti-depressant treatment on weight has been poorly investigated. Also unknown is whether different compounds have differential effects. The aim of the present study was to assess changes in weight in obsessive-compulsive disorder (OCD) patients treated for 2.5 years with clomipramine or selective serotonin reuptake inhibitors.. 138 DSM-IV OCD patients who responded to 6-month acute treatment at the Mood and Anxiety Disorders Unit, Department of Neuroscience, University of Turin, Italy, were followed-up for 2 years while receiving open-label clomipramine, citalopram, fluoxetine, fluvoxamine, paroxetine, or sertraline. Patients were consecutively recruited and followed from May 1998 to March 2003. The mean percentage change in weight was compared for each group, as was the proportion of patients who had a > or = 7% weight increase from baseline.. At the end of the 2.5-year study period, patients had gained a mean of 2.5% of their body weight with respect to baseline (1.58 kg); 14.5% of the total sample experienced a significant (> or = 7%) weight increase. Within each but the fluoxetine treatment group, paired t tests showed a significant increase in weight from baseline to final visit. Analysis of variance showed a significant difference between treatment groups (p = .009), with clomipramine being associated with the highest weight increase and fluoxetine and sertraline with the lowest. A higher proportion of clomipramine-treated patients (34.8%) gained > or = 7% in weight as compared with sertraline and fluoxetine, which accounted for the lowest percentage of patients with a significant weight gain (4.5% and 8.7%, respectively), although this difference was not statistically significant.. Risk of weight gain during extended serotonin reuptake inhibitor treatment for OCD differs depending on which compound is used. The differences among antiobsessive drugs may affect compliance with medication and health risks.

Topics: Adult; Ambulatory Care; Citalopram; Clomipramine; Female; Fluoxetine; Fluvoxamine; Follow-Up Studies; Humans; Male; Obesity; Obsessive-Compulsive Disorder; Paroxetine; Patient Compliance; Prospective Studies; Risk Factors; Selective Serotonin Reuptake Inhibitors; Sertraline; Weight Gain

The effect of fluvoxamine versus placebo on serum cholesterol levels in obese women undergoing behavior therapy for weight reduction was evaluated.. Forty obese female outpatients undergoing 13 weeks of a behaviorally oriented treatment program for weight reduction were randomly assigned to double-blind treatment with fluvoxamine 100 mg/day (N = 18) or placebo (N = 22). Total serum cholesterol levels were measured before and after the 13-week study period.. Patients of the two treatment groups did not differ in age, weight, body mass index, cholesterol levels before treatment, and the extent of weight reduction during treatment. Cholesterol levels were significantly lower after fluvoxamine treatment than before, whereas cholesterol levels remained unaltered after placebo administration. Patients with initially high total cholesterol levels (> or = 200 mg/dL) showed a significantly larger reduction than patients with desirable cholesterol levels. However, there was no interaction between treatment and initial cholesterol level.. The results might suggest a cholesterol-lowering effect of fluvoxamine.

Topics: Adult; Ambulatory Care; Behavior Therapy; Body Mass Index; Cholesterol; Comorbidity; Female; Fluvoxamine; Humans; Hypercholesterolemia; Middle Aged; Obesity; Regression Analysis; Weight Loss

Obesity and depression are common disorders which may co-exist. The management of the combination is complicated because some antidepressants cause weight gain fenfluramine, an effective antiobesity agent, may cause depression. Fluvoxamine is an antidepressant which, like fenfluramine, inhibits serotonin re-uptake within the brain. Forty obese female subjects with refractory obesity participated in a double-blind placebo controlled trial. During the twelve week study, those subjects receiving fluvoxamine achieved a mean weight loss greater than, but not significantly different from, that of the placebo group. The result suggests that fluvoxamine may be particularly useful in the management of obese patients requiring treatment with an antidepressant.

Topics: Adolescent; Adult; Antidepressive Agents; Body Weight; Dose-Response Relationship, Drug; Fluvoxamine; Humans; Middle Aged; Obesity; Oximes

The results of a small pilot study using Fluvoxamine (Faverin) in the treatment of non-vomiting bingeing female patients and women with bulimia nervosa is presented. Ten non-vomiting subjects and six with bulimia nervosa were treated on an open basis with Fluvoxamine 100-200 mg daily. Assessment was made using established questionnaires for severity of eating disorder and abnormality of mood. Five non-vomiting patients and three with bulimia nervosa completed the study. Non-vomiters showed a significant weight loss; a significant reduction in number of binges; a significant reduction in the scores on the BITE and the EAT; and a significant reduction in anxiety. Those with bulimia nervosa had a significant reduction in hunger and a reduction in depression which tended towards significance. Firm conclusions cannot be drawn from this study as it is an open pilot study of a small number of women. However, the results indicate that Fluvoxamine may have a role in the treatment of eating disorders where bingeing is a prominent symptom and that further research would be valuable. Comments are also made on the usefulness of various questionnaires designed to assess eating disorders.

Topics: Adolescent; Adult; Bulimia; Depression; Feeding and Eating Disorders; Female; Fluvoxamine; Humans; Obesity; Surveys and Questionnaires; Vomiting; Weight Loss