Fluoxetine (Prozac)

What is fluoxetine (Prozac)?

Most used for depression, fluoxetine belongs to a class of medication called selective serotonin reuptake inhibitors (SSRIs). Serotonin is a molecule in the body that aids in mood, sexual desire, sleep, digestion, wound healing, bone health, and blood clotting [1]. It is often referred to in psychology as the “happy” chemical. In conditions like depression, the brain is dealing with an imbalance of chemicals such as serotonin. SSRIs, like fluoxetine, work by keeping serotonin in the space where it can readily be available for bodily processes. 

What is the connection between fluoxetine and long-COVID?

In those diagnosed with long-COVID, many suffer from “brain fog”; decreased cognitive acuity, memory deficits, poor focus, reduced ability to multitask, and reduced concentration [2]. The proposed reason is that during a COVID-19 infection, the body’s immune response becomes activated, causing heavy amounts of inflammation.  This inflammation affects the central nervous system (CNS), brain, and spinal cord. To combat this problem, researchers have turned to already existing medication therapies in the hopes they may be able to help decrease “brain fog” symptoms.

Additionally, serotonin has been shown to have an effect against viral inflammation by blocking certain viruses (like HIV-1) from entering the cells. It can decrease the production of cytokines, which promotes the immune response. A trial conducted on 60 patients showed a decrease in depression when treated with an SSR like fluoxetine [2]. It was also observed that treatment with fluoxetine decreased COVID-19 levels, specifically in men, after a minimum of 10 days [3].

Researchers have begun clinical trials to test fluoxetine and its effect on serotonin and COVID-19 [4]. Results will not be available for quite some time; therefore, evidence is currently limited to support the use of SSRIs for inflammation-related long-COVID. However, for symptoms of depression associated with long-COVID, fluoxetine may be a viable option [5].

References:

¹ https://my.clevelandclinic.org/health/articles/22572-serotonin

²https://www.medtextpublications.com/open-access/long-covid-is-there-a-role-for-antidepressants-1249.pdf

³https://www.frontiersin.org/articles/10.3389/fphar.2022.1036093/full#h7

⁴https://www.nytimes.com/2023/10/16/health/long-covid-serotonin.html

⁵https://link.springer.com/article/10.1007/s40267-022-00975-x