https://doi.org/10.1177/02698811211064648 Journal of Psychopharmacology 2021, Vol. 35(12) 1439–1440 © The Author(s) 2021 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/02698811211064648 journals.sagepub.com/home/jop The COVID-19 pandemic which has plagued the world for almost 2 years has taught us many unexpected lessons, with undoubtedly many more to be yet fully realised. While many of these are still to be fully comprehended, the benefits of governments, other funding agencies and charities, and industry (liaising closely with regulatory agencies) working together to develop new treatments seem clear. Much of the acclaim so far has rightly gone to the vac- cine developers, but there has also been significant work done establishing the benefits and harms of other treatments for this viral infection. Of particular interest to psychopharmacologists will be the ‘Together’ trial (Reis et al., 2021). This was a placebo- controlled, randomised, adaptive platform trial done among high-risk symptomatic Brazilian adults confirmed positive for SARS-CoV-2 and included eligible patients from 11 clinical sites in Brazil with a known risk factor for progression to severe dis- ease. Patients were randomly assigned (1:1) to either fluvoxamine (100 mg twice daily for 10 days) or placebo. The primary outcome was a composite endpoint of hospitalisation defined as either retention in a COVID-19 emergency setting or transfer to tertiary hospital due to COVID-19 up to 28 days post-random assignment based on intention to treat; 741 patients were allocated to fluvox- amine and 756 to placebo. In short, it was found that this dose of fluvoxamine when given to high-risk outpatients with early diag- nosed COVID-19 reduced the need for hospitalisation defined as retention in a COVID-19 emergency setting or transfer to a ter- tiary hospital. Although some questions regarding the use of flu- voxamine for COVID-19 infection remain to be answered (Berwanger, 2021), this is an interesting example of a psychiatric treatment being ‘repurposed’. It also raises the possibility of informing future studies of this treatment in psychiatric disorders. As Berwanger (2021) notes, fluvoxamine was investigated in COVID-19 because of preclinical evidence of anti-inflammatory properties. Fluvoxamine is of course an SSRI (Selective Serotonin Reuptake Inhibitor) which is licenced for treatment in major depression and obsessive-compulsive disorder. Given that an ‘immune-metabolic’ subtype of depression has been identified (Milaneschi et al., 2020) perhaps trials should be done to establish if fluvoxamine confers extra benefits particular to this group. Such feedback to psychopharmacology from repurposing of an antidepressant would be pleasing indeed. Elsewhere in the current edition of the Journal, we see articles on a diverse range of topics. Garcia et al. (2021) compared differ- ent β-adrenoceptor antagonists for the risk of reporting night- mares. In this large pharmacovigilance study, nightmares were more frequently reported for pindolol and metoprolol and among β-adrenoceptor antagonists with high lipid solubility and high 5-HT1A receptor affinity. Dopaminergic and noradrenergic mod- ulation of stress-induced alterations in brain activation associated with goal-directed behaviour were examined by Van Ruitenbeek et al. (2021). Their neuroimaging (but not behavioural) data sug- gested that induced increases in dopamine and noradrenaline reverse stress-induced changes in key brain regions associated with goal-directed behaviour. These effects may be relevant for preventing stress-induced maladaptive behaviours. Faulkner et al. (2021) report on the relationship between depression, prefrontal creatine and grey matter volume. Their results provide support for previous findings which indicate that increasing creatine concentrations in the prefrontal cortex may improve mood and well-being. Also, about depression, Dawson et al. (2021) article suggests that accuracy in recognising happy facial expressions is associated with antidepressant response to an NOP (nociceptin opioid peptide receptor) receptor antagonist but not placebo treatment. In keeping with much of their previous work, these data suggest that emotional processing biomarkers may be sensitive to early effects of antidepressant treatment indic- ative of later clinical response. Clearly, further studies in this area may be useful in developing new treatments and clinical trial designs for predicting response to antidepressant treatment. Also from Oxford, De Giorgi et al. report an experimental medicine study which examined the effects of atorvastatin on emotional processing, reward learning, verbal memory and inflammation in healthy volunteers. Their results show an influence of atorvastatin on emotional cognition by increasing the processing of anxiety- related stimuli (i.e. increased recognition, discriminability and misclassifications of fearful facial expression) in healthy volun- teers, in the absence of more general effects on negative affective bias (De Giorgi et al., 2021). Statins are of course widely used to treat elevated lipids, and the prospect of them being ‘repurposed’ for depression is intriguing. Repurposing psychopharmacology: A two-way street? Allan H Young 1,2 1 Department of Psychological Medicine, Academic Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, London, UK 2 Bethlem Royal Hospital, South London and Maudsley NHS Foundation Trust, Beckenham, UK Corresponding author: Allan H Young, Bethlem Royal Hospital, South London and Maudsley NHS Foundation Trust, Monks Orchard Road, Beckenham BR3 3BX, Kent, UK. Email: allan.young@kcl.ac.uk 1064648JOP 0 0 10.1177/02698811211064648Journal of PsychopharmacologyYoung editorial 2021 Editorial