Fluvoxamine Reduces Long COVID Fatigue in Trial
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- Fluvoxamine significantly reduced fatigue and improved quality of life in 399 adults with long COVID versus placebo in the REVIVE-TOGETHER trial, with statistical analysis showing a 99 percent probability the drug outperformed placebo.
- Metformin, the common diabetes medication tested in the same trial, showed no meaningful improvement for established long COVID fatigue, despite earlier research suggesting it could lower long COVID risk when taken during acute infection.
- McMaster University co-led the study with researchers from the University of British Columbia, Stanford, the University of Pittsburgh, Duke, and Georgetown, with all clinical sites located in Belo Horizonte and Minas Gerais, Brazil; results were published in the Annals of Internal Medicine.
- The trial used a Bayesian adaptive design, allowing researchers to end individual treatment groups early once evidence became clear, producing conclusions more efficiently than a conventional trial design.
- Long COVID affects an estimated 65 million people worldwide, and current medical recommendations for the condition focus mainly on supportive strategies like activity pacing and individual symptom management because proven therapies remain scarce.
- The trial was funded by The Latona Foundation; participants were randomized to receive fluvoxamine (brand name Luvox), metformin, or placebo for 60 days after fatigue lasting at least 90 days following a confirmed SARS-CoV-2 infection.
Why it matters: Patients with long COVID — estimated at 65 million worldwide — now have the first strong clinical evidence for a medication specifically targeting their most disabling symptom. Because fluvoxamine is already inexpensive, widely used, and well-understood for other conditions, the finding has a clearer path to clinical prescribing than a novel drug would, though researchers caution it addresses fatigue rather than the full spectrum of long COVID symptoms.
