Our research aims to improve health outcomes by studying treatments that promote healthy minds and healthy bodies across the lifespan.

Healthy Mind Lab: Latest News

Fluvoxamine for Early Treatment of COVID-19: What You Should Know

What did we find?
  • Adults recently diagnosed with COVID-19 (less than 7 days) who took fluvoxamine for up to 15 days, did not show clinical deterioration.
  • Clinical deterioration is the combination of shortness of breath and hypoxia (decrease in oxygen), which are signs of damage to the lungs.
  • This is a common problem in about one in ten people who have initially mild illness.
  • This deterioration can lead to hospitalization and need for a ventilator.
  • Some studies show that people with initially mild COVID-19 develop lung damage because of inflammation (the body’s response to infection).  It was because of this effect that we tested the repurposing of fluvoxamine for COVID-19. Fluvoxamine has a strong effect on the sigma-1 receptor, which controls inflammation.

You can read more information about this study at JAMA: The Journal of the American Medical Association

What is fluvoxamine?

Fluvoxamine is a commonly-used medication worldwide since the 1990s.  It is used for depression and anxiety and belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs), which includes drugs like Prozac and Paxil.  Unlike these drugs, though, fluvoxamine has a strong effect on the sigma-1 receptor.

Is fluvoxamine safe?
Yes, when it is used correctly.  In this study, people started fluvoxamine at 50mg on the first night, then increased to 100mg twice daily.  Later in the 15-day course, some patients increased to 100mg three times daily as tolerated.  This rapid increase can cause side effects such as nausea, dizziness, and changes in sleep like insomnia.  However, these side effects are usually mild and go away.  Almost all patients in the study could take fluvoxamine for at least 5 days (and we don’t know if a 15-day course is needed).

Three safety issues are important:

  • First, fluvoxamine affects the metabolism of some drugs.  In particular, people taking theophylline, clozapine, olanzapine, or tizanidine should either avoid fluvoxamine or talk to their doctor about how to avoid a dangerous drug interaction.  Also, people using caffeine (like in coffee or tea) should greatly cut down on it.
  • Second, fluvoxamine has psychiatric effects.  We did not see any untoward effects from it (such as anxiety or loss of concentration), but people with psychiatric conditions such as bipolar disorder or who already take psychiatric medications such as antidepressants or mood stabilizers, should talk carefully with their doctor before adding fluvoxamine.
  • Third, patients taking drugs that promote bleeding such as coumadin may be at higher risk because fluvoxamine can also increase bleeding risk.  We don’t know how important this effect is, given how short is the course of fluvoxamine.

Should I be taking fluvoxamine if I get sick with COVID-19?

Unfortunately we cannot answer that yet.  This was the first study to demonstrate fluvoxamine’s effect, and we need to confirm the finding with a second study.

We have not studied fluvoxamine for people who test positive for the virus but have no symptoms, those who have not tested positive, or those who have had COVID-19 but are not in the early, or acute, phase of it.

Who funded this study?

COVID-19 Early Treatment Fund

Taylor Family Institute for Innovative Psychiatric Research

 

At the ISIRV Therapeutics for COVID-19 conference, Dr. Angela Reiersen and colleagues reported positive results from the STOP COVID Trial

October 6, 2020 | In this placebo-controlled trial, fluvoxamine prevented clinical deterioration in early COVID-19 illness. View abstract here: Fluvoxamine for prevention of clinical deterioration in early COVID-19: Results from a randomized placebo-controlled trial

Dr. Eric Lenze named Wallace and Lucille K. Renard Professor in Psychiatry

January 21, 2020  |  The Department of Psychiatry at Washington University School of Medicine in St. Louis is pleased to announce the appointment Dr. Eric Lenze as the fourth Lucille K. Renard Endowed Professor in Psychiatry. Dr. Lenze is an internationally recognized geriatric psychiatrist and independent investigator. At Washington University School of Medicine, Dr. Lenze has established a clinical training program for residents focused on evaluating, treating and studying neurocognitive disorders. Dr. Lenze’s research center, The Healthy Mind Lab, continually collaborates with leading researchers across the university and with a number of prestigious institutes including Columbia University, University of California Los Angeles, University of California San Diego, University of Pittsburgh and University of Toronto. With regular publications in leading medical journals, innovative and original clinical trials are at the center of his research on geriatric neurocognitive and mood concerns.

Previous Lucille K. Renard endowed professors include Drs. Edwin Gildea, Eli Robins, and C. Robert Cloninger. Between 1941 and 1955, Wallace and Lucille Renard made major gifts to support the missions of Washington University School of Medicine’s Department of Neuropsychiatry, to establish the Wallace and Lucille K. Renard Professorship in Psychiatry, and to help build Renard Hospital.

Read more about Department of Psychiatry Endowed Professorships

Read more about residency training in geriatric psychiatry with Dr. Eric Lenze at Washington University School of Medicine in St. Louis

Read more about Dr. Eric Lenze

 

Drs. Eric Lenze and Ginger Nicol lead establishment of new Research Core at Washington University School of Medicine: mHealth

January 2019  |  In collaboration with the Institute for Clinical and Translational Sciences, the Institute for Informatics, and the HealthCare Innovation Lab, Drs. Eric Lenze and Ginger Nicol are leading the newly established mHealth Core.

mHealth (mobile health) is widespread and understudied relative to its importance and potential. The mHealth Research Core is focused on measuring and improving health research and outcomes by incorporating the use of social media, smartphone devices, tablets, web sites, sensors, wearables and/or other remote technology. The mHealth Research Core also aims to provide guidance, consultative services and resources for investigators looking to study or incorporate mHealth into their research.

Find out the date of the next meeting and learn more about the new mHealth core

 

Department of Psychiatry Grand Rounds

Dr. Eric Lenze presents at Department of Psychiatry Grand Rounds: Getting to Precision Medicine in Psychiatry

January 21, 2020

Dr. Eric Lenze discusses:

  • The role of randomized controlled trials in the generation of evidence-based medicine,
  • Incorporation of biomarkers, such as genetics and neuroimaging, into clinical trials as an effort to bring psychiatry into precision medicine,
  • How design flaws in those trials have prevented progress to precision medicine,
  • How precision clinical trials are the solution to those flaws, and
  • How technology will be incorporated into clinical trials.

Click play to access full set of slides and audio of Dr. Lenze’s Grand Rounds talk.

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Healthy Mind Lab: In the News

 

Update on our study of an early treatment COVID-19

By November 12, 2020
Fluvoxamine vs Placebo and Clinical Deterioration in Outpatients With Symptomatic COVID-19 A Randomized Clinical Trial Eric J. Lenze, MD1; Caline Mattar, MD2; Charles F. Zorumski, MD1; Angela Stevens, BA1; Julie Schweiger1; Ginger E. Nicol, MD1; J. Philip Miller, AB3; Lei Yang, MPH, MSIS1; Michael Yingling, MS1; Michael S. Avidan, MBBCh4; Angela M. Reiersen, MD, MPE1 JAMA. Published online November 12, 2020. doi:10.1001/jama.2020.22760
Goal-oriented rehab improves recovery in older adults

Goal-oriented rehab improves recovery in older adults

SCHOOL OF MEDICINE NEWS RELEASEJuly 31, 2019
Goal-oriented, motivational physical and occupational therapy helps older patients recover more fully from broken hips, strokes and other ailments that land them in skilled nursing facilities for rehabilitation, according to new research at Washington University School of Medicine in St. Louis.

Read All Healthy Mind Lab News

Healthy Mind Lab Research is Funded by:

  • National Institutes of Health
  • Taylor Family Institute for Innovative Psychiatric Research
  • Center for Brain Research in Mood Disorders (at Washington University
  • FDA
  • McKnight Brain Research Foundation
  • Barnes Jewish Foundation
  • Takeda
  • Lundbeck
  • Janssen
  • Alkermes

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