A randomized, placebo-controlled trial of 399 adults in Brazil found that the antidepressant fluvoxamine significantly reduced fatigue in people suffering from long COVID, offering the first strong evidence-based option for a symptom that has left patients desperate for relief.
The REVIVE-TOGETHER trial, led by researchers at McMaster University alongside teams from the University of British Columbia, Stanford, Duke, Georgetown and Brazilian institutions, tested fluvoxamine (100 mg twice daily), metformin (750 mg twice daily) and a placebo over 60 days in patients with fatigue lasting at least 90 days after confirmed SARS-CoV-2 infection. Fluvoxamine showed a 99% probability of outperforming placebo, with participants nearly 50% more likely to rate their fatigue as mild after 30 days, and the effect held through day 90. Metformin showed no meaningful benefit.
Long COVID fatigue affects an estimated 65 million people worldwide and ranks among the condition's most disabling symptoms. "This trial gives clinicians their first strong evidence for a medication that helps reduce long COVID fatigue," said corresponding author Jamie Forrest, while senior author Edward Mills called it "an important step forward for patients who have been desperate for evidence-based options."