Fluvoxamine to Augment Olfactory Recovery For Long COVID-19 Parosmia

Exclusion Criteria

• •History of olfactory dysfunction prior to COVID-19 infection
• •Any use of concomitant therapies specifically for the treatment of olfactory dysfunction
• •History of olfactory dysfunction of longer than 12 months
• •History of bipolar disorder as SSRIs can theoretically destabilize bipolar disorder
• •Participants with symptoms of depression as evidenced by a score of 10 or greater on the Patient Health Questionnaire-9 (PHQ-9).95 The PHQ-9 is a nine-item questionnaire designed to assess and aid in diagnosing patients with depression in clinical and community settings.
• •History of neurodegenerative disease (i.e., Alzheimer's dementia, Parkinson's disease, Lewy body dementia, frontotemporal dementia)
• •History of chronic rhinosinusitis or sinus surgery
• •Pregnant or breastfeeding mothers.
• •Already enrolled in another COVID 19 medication trial or receipt of monoclonal antibody infusion.
• •Taking donepezil or fluoxetine (rationale: these drugs are S1R agonists) or sertraline (a S1R antagonist).
• •Participants taking theophylline, tizanidine, clozapine, or olanzapine (drugs with a narrow therapeutic index that are primarily metabolized by CYP 1A2, which is inhibited by fluvoxamine.
• •Taking another SSRI, unless at a low dose (e.g., escitalopram 5mg) such that adding fluvoxamine would not put patient at risk for serotonin syndrome.
• •Taking coumadin based on theoretical risk of increased bleeding with fluvoxamine.
• •Unable to provide informed consent.
• •Unable to perform the study procedures.