Antidepressant flames out against COVID-19

Q: A year or two ago, there was a “60 Minutes” show about repurposed drugs for COVID-19. It suggested that an old antidepressant medication, fluvoxamine, might be helpful.

I have not heard anything more about fluvoxamine. Could you see where in development this drug is for treating COVID-19?

A: Other readers have also wondered what happened to research on fluvoxamine for treating COVID-19. This chemical cousin of fluoxetine (Prozac) was marketed in Switzerland as an antidepressant in 1984. The Food and Drug Administration approved it for treating OCD (obsessive compulsive disorder) in 1994 as Luvox (fluvoxamine).

A pilot study involving 152 COVID-19 patients suggested that this drug might be beneficial against SARS-CoV-2 (JAMA, Dec. 8, 2020). A much larger trial involving 1,288 COVID-19 patients recently reported that fluvoxamine “did not improve time to sustained recovery” (JAMA, Jan. 12, 2023). The authors concluded that the data do not support the use of this medication against COVID-19.

Q: I am a pharmacist and had taken lisinopril for over 12 years before I had an angioedema attack. About 8 p.m., I started having allergic symptoms. By 10 p.m., my face was swelling, and I couldn’t talk.

I rushed to the nearest hospital emergency room and was immediately diagnosed with angioedema.

They started a steroid IV, and about midnight, I was on my way to recovery. I was discharged the next morning after being in the ICU overnight.

Despite my pharmacy education, I couldn’t imagine that such a delayed reaction (12 years!) could occur. This must be emphasized during patient counseling.

A: Thank you for sharing your scary story. ACE inhibitors, such as lisinopril, are the most frequently prescribed blood pressure drugs in the U.S. At last count, nearly 20 million Americans swallow lisinopril daily.

Health professionals should always warn about angioedema (swelling of the mouth, lips and throat). It can also occur in the digestive tract and cause bloating, abdominal pain and obstruction. As you discovered, such complications can occur unexpectedly after years of treatment.

To learn more about this complication, the ACEi cough and other options for controlling high blood pressure, you may wish to read our “eGuide to Blood Pressure Solutions.” This online resource is available under the Health eGuides tab at PeoplesPharmacy.com.

Q: My first hearing aids, low-cost units, made a huge difference in my ability to hear. For the last four years, I have used higher-quality devices I get through Veterans Affairs. They have some nice features, but they still aren’t useful in noisy places like restaurants or parties.

Recently, I bought a pair of over-the-counter hearing aids online. I can wear them at the beach or the park without worrying about losing them. Also, I can wear them when my ears are sore from wearing COVID-19 masks.

Are they great? No! Do they work? Yes! I suspect they are programmed to enhance vocal frequencies so they will be helpful for seniors. If you can’t afford thousands of dollars for a state-of-the-art pair, OTC aids are better than missing out on the conversation.

A: Hearing aids can make a big difference. A research letter in JAMA found that older people with hearing loss are more vulnerable to dementia (JAMA, Jan. 10, 2023). The authors report that using hearing aids reduces the risk for dementia.

Matt Detrich/Associated Press A study of the medication fluvoxamine failed to show that its use could speed recovery from COVID-19.