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IMO one of the most important drugs being examined is an oral antiviral pill, Molnupiravir. It has proven effective in Phase 2 clinical trials, and is being prepared for Phase 3 Clinical Trial. It uses a 5 day at home pill regimen, similar to Tamiflu.
This would be a game changer to have a prescription pill that can be taken at home. The problem with the current treatments is the need for infusion, which requires going to a medical center and can be impacted by capacity challenges.
I will be closely watch this. The SSRI in this thread would be a nice additional treatment in the armamentarium, but to have a target antiviral for COVID would be a game changer.
Potential users better consider the advantages/disadvantages. Once you start an SSRI, it's exceedingly difficult to stop.
Considering I'm in a high risk category, and the advantage could be saving my life (or potentially THOUSANDS of $ in hospital bills), that's one disadvantage I'll risk.
And a quick check shows that the people who have real problems stopping have been on them for a long time. This would likely be a 14 day course.
Considering I'm in a high risk category, and the advantage could be saving my life (or potentially THOUSANDS of $ in hospital bills), that's one disadvantage I'll risk.
You're making an informed decision, kudos. But there are more disadvantages than the one mentioned.
Quote:
Originally Posted by Bill790
And a quick check shows that the people who have real problems stopping have been on them for a long time. This would likely be a 14 day course.
True, but a layman (and even some prescribers) might start using higher doses, and/or for a longer term, thinking that would count as prophylaxis.
Potential users better consider the advantages/disadvantages. Once you start an SSRI, it's exceedingly difficult to stop.
I'm not sure I fully agree with this. I am internal medicine trained, and didn't prescribe this much during my residency; obviously Psych would prescribe most of these, but SSRI's aren't known to commonly cause addiction/dependence. And if they are being prescribed for short-term use, which presumably they would for an acute COVID infection, I don't think that would be a huge concern.
The bigger concern when these are being prescribed over a longer course is if a patient suddenly stops taking them. When you first start taking them they can be difficult for some patients too because they can cause pretty bad nausea and diarrheal/stomach issues in people (in addition to other general discomfort symptoms). These usually wane after a few days of getting used to them, and would be well worth it to treat COVID, but it is something to be aware of. When people abruptly stop taking SSRI, people can get the similar withdrawal symptoms that may intensify, so they are usually waned off of them. If there are any Psychiatrists on this board, they would likely be able to better speak to these impacts.
Again, assuming this SSRI would be taking over a short duration, I don't see much problem (in terms of any addiction).
I'm not sure I fully agree with this. I am internal medicine trained, and didn't prescribe this much during my residency; obviously Psych would prescribe most of these, but SSRI's aren't known to commonly cause addiction/dependence. And if they are being prescribed for short-term use, which presumably they would for an acute COVID infection, I don't think that would be a huge concern.
The bigger concern when these are being prescribed over a longer course is if a patient suddenly stops taking them. When you first start taking them they can be difficult for some patients too because they can cause pretty bad nausea and diarrheal/stomach issues in people (in addition to other general discomfort symptoms). These usually wane after a few days of getting used to them, and would be well worth it to treat COVID, but it is something to be aware of. When people abruptly stop taking SSRI, people can get the similar withdrawal symptoms that may intensify, so they are usually waned off of them. If there are any Psychiatrists on this board, they would likely be able to better speak to these impacts.
Again, assuming this SSRI would be taking over a short duration, I don't see much problem (in terms of any addiction).
According to the OP's link, the dosage during that trial was 100 mg 3 times a day for 15 days. Short duration, very high. Though it certainly varies, a maintenance dose of fluvoxamine to treat depression can start as low as 20 mg daily up to a maximum of 80 mg. According to drug info, taking it for more than 6 weeks raises the likelihood for withdrawal, but that's at much lower dosages.
Potential users better consider the advantages/disadvantages. Once you start an SSRI, it's exceedingly difficult to stop.
Not necessarily true. I was on Luvox, the subject of this thread, for seven years. Weaned myself off over a period of months, twelve years ago. It wasn't difficult.
It's not clear that it prevents infections from spreading, merely buys time for the body to fight the virus without a cytokine storm. It would require an antiviral.
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