Among selective serotonin reuptake inhibitors (SSRIs), fluvoxamine shows high affinity for sigma-1 receptors (SIGMAR1). Binding (Ishikawa et al. 2007) and stimulation of SIGMAR1 by fluvoxamine elicits antidepressive effects in rats (Yagasaki et al. 2006, Fishback et al. 2010). The endogenous ligand for SIGMAR1 may be progesterone (Ganapathy et al. 1999). Small anecdotal studies suggest that ligands that target SIGMAR1 may be useful in treating central hypoventilation syndromes (Loiseau et al. 2018), suggesting a possible role for such drugs in treatment of COVID-19 symptoms. After several trials for the use of fluvoxamine the US FDA rejected an EmergencyUse Authorization of Fluvoxamine, giving a detailed summary of results (FDA, 2022).
Hayashi, T, Kunugi, H, Yagasaki, Y, Numakawa, T, Kumamaru, E, Su, TP
Zhang, HK, Gunosewoyo, H, Kozikowski, AP, Yu, LF
Food and Drug Administration, FDA
Ishii, K, Fujisaki, M, Hashimoto, K, Iyo, M, Shirayama, Y, Ishiwata, K, Naganawa, M, Ishikawa, M, Shimizu, E, Oda, K, Kimura, Y, Miyatake, R, Sakata, M
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