Paroxetine (Paxil)

What is paroxetine (Paxil)?

Most used for anxiety and depression, paroxetine 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 and anxiety, the brain is dealing with an imbalance of chemicals such as serotonin. SSRIs, like paroxetine, work by keeping serotonin in the space where it can readily be available for bodily processes. 

What is the connection between paroxetine and long-COVID?

Serotonin has been shown to have an effect against viral inflammation by blocking certain viruses (like HIV-1) into the cells. In addition, it can decrease cytokine production, promoting the immune response [2]. 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.

Researchers have begun looking at paroxetine as a potential agent to treat long-COVID and depression associated with long-COVID. A trial conducted on 60 patients showed a decrease in depression when treated with an SSRI, such as paroxetine [2]. In addition, a study looking at 95 patients found the addition of SSRIs, including paroxetine, led to an improvement in well-being in those with long-COVID [3].

More research needs to be conducted as there is currently limited evidence to support the use of SSRIs for inflammation-related long-COVID; however, for symptoms of depression associated with long-COVID, paroxetine may be a viable option [4]. Paroxetine is currently listed on long-COVID clinical guidelines for the treatment of depression. With further clinical studies, its indication could potentially expand to include the eradication of long-COVID [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.nature.com/articles/s41598-023-45072-9

⁴https://link.springer.com/article/10.1007/s40267-022-00975-x

⁵ https://www.ohsu.edu/sites/default/files/2021-04/Long-COVID-19-Clinical-Guidelines-English-April-21-2021.pdf

Active Clinical Trials: Long COVID, SSRI | Card Results | ClinicalTrials.gov