Does fluvoxamine reduce inflammation? (3+ insights)

This article will answer the question of the possibility of fluvoxamine’s ability to reduce inflammation. We will also discuss the mechanism that is responsible for it to act as an anti-inflammatory agent and dive into the potential role in the future and side effects associated with its anti-inflammatory properties.

Does fluvoxamine reduce inflammation?

Yes, fluvoxamine (Luvox) is known to reduce inflammation. This is not its primary mechanism of action but it has been reported to act on the sigma-1 receptor as an agonist which in turn is responsible for the anti-inflammatory actions.

This area of fluvoxamine is under research and was brought to light during the COVID-19 pandemic. Extensive research is being conducted on the possibility of fluvoxamine being used in various inflammatory diseases such as irritable bowel syndrome and neurodegenerative diseases such as Parkinson’s.

What is the anti-inflammatory effect of fluvoxamine compared to other compounds?

Several other anti-inflammatory agents are present in the market. This table shows a brief comparison of the anti-inflammatory effect of fluvoxamine with other anti-inflammatory agents.

More research is being done to understand the anti-inflammatory effect of fluvoxamine in various conditions involving the S1R receptor.

What mechanism is used by fluvoxamine to reduce inflammation?

Fluvoxamine is an antidepressant which belongs to the class of selective serotonin reuptake inhibitor (SSRI). Its primary mechanism of action is to regulate the levels of serotonin neurotransmitters by blocking the reuptake of serotonin by the receptors. This results in increased levels of serotonin in the brain.

It has been reported that fluvoxamine also acts on the sigma-1 receptor agonistically. It has the strongest affinity for this receptor among all other SSRIs. The sigma-1 receptor (S1R) is present at the endoplasmic reticulum and is responsible for the modulation of calcium signalling. (1)

Sigma-1 receptors (S1R) are responsible for the modulation of innate and adaptive immune responses. The anti-inflammatory effects of fluvoxamine are likely to stem from its effect on the S1R receptor.

What does research say?

The preclinical impact of fluvoxamine on inflammation was studied. Fluvoxamine increased the survival of mice in inflammatory models caused by IRE1 (inositol-requiring enzyme) and peritonitis induced by faeces. Normal mice were protected from death caused by endotoxic shock when given fluvoxamine. However, this protective effect was not present in mice who lacked S1R receptors. This indicated that the anti-inflammatory effect of fluvoxamine was linked with the S1R receptor. (1)

A study was aimed at identifying the anti-inflammatory effect of fluvoxamine in an in-vitro model using  U937 macrophages and human epithelial cells as well as in an in-vivo rat model with carrageenan-induced paw oedema. Fluvoxamine decreased the concentration of inflammatory genes (ICAM1, VCAM2, COX2, iNOS) in both models. It was suggested that the anti-inflammatory effect may have been due to the downregulation of inflammatory genes. (2)

Further research needs to be performed to fully understand the complex mechanisms that are underlying the immunomodulatory effect of fluvoxamine.

What are the potential benefits of fluvoxamine in reducing inflammation?

Fluvoxamine has been used for the treatment of COVID-19 due to its anti-inflammatory properties. In a prospective study for the early use of fluvoxamine for COVID-19 patients, the incidence was reported to be 0% (0/65) whereas 12.5% (6/48) for the group which was under observation only. After 14 days, 0% (0/65) of the patients treated with fluvoxamine had no persistent symptoms as compared to 60% (29/48) of the patients who opted for no therapy. (1)

This study shows that fluvoxamine could have a major impact on the early treatment of COVID-19 patients in terms of stopping the disease progression.

Research is also being conducted on animal models in terms of fluvoxamine being used for inflammatory conditions such as irritable bowel syndrome (IBS) and other neurodegenerative disorders such as Parkinson’s disease.

How would fluvoxamine benefit Parkinson’s patients?

In Parkinson’s disease, microglial cells are responsible for causing neuroinflammation and contribute to neurodegeneration. This neurodegeneration can lead to further neuroinflammation.

S1Rs are expressed in the microglial cells and modulate the activity of these cells. Research has suggested that fluvoxamine’s anti-inflammatory effects are related to its relation with the S1R receptor.

Therefore, an S1R agonist (fluvoxamine) will result in the release of anti-inflammatory cytokines which will block the action of inflammatory cytokines. This will provide relief from the neuroinflammation caused by the microglial cells. (3)

Should fluvoxamine be used as an anti-inflammatory drug?

Yes, fluvoxamine should be used as an anti-inflammatory drug because, with its current studied profile, it has been known to be well-tolerated without posing any serious side effects.

The research studies have shown that fluvoxamine was beneficial as an anti-inflammatory agent for COVID patients in comparison to placebo. Its use was also suggested for other inflammatory conditions such as Parkinson’s and irritable bowel syndrome.

As an antidepressant, it has been suggested that the anti-inflammatory effects of the SSRI/SNRI also aid in the treatment of depression.

The side effect profile of fluvoxamine, if used as an anti-inflammatory agent, has not yet been studied and therefore would require more research to be done for it to be included in the scientific literature.

Conclusion

In this article, we discussed that fluvoxamine can reduce inflammation by acting on the sigma-1 receptor. Although the anti-inflammatory effect of fluvoxamine is not fully understood, research is being conducted to evaluate the possibility of its use in neuro and other inflammatory diseases.

In my opinion, fluvoxamine will be a valuable asset with its dual function if the anti-inflammatory mechanism can be fully understood in the field of neurodegenerative disorders especially Parkinson’s.

References