Fluvoxamine is sold under the brand name "Luvox".
Fluvoxamine has the distinction of being the only SSRI that is not FDA approved for use in Major Depression.
Fluvoxamine, like its cousins, fluoxetine (Prozac), citalopram (Celexa), sertraline (Zoloft), escitalopram (Lexapro) and paroxetine (Paxil), reversibly blocks the recycling of serotonin from outside the nerve to inside the nerve. This increase in serotonin in the gap between nerves in the central nervous system (the synapse) leads to alterations in serotonin function that have been associated with improvements in depression and anxiety. Each of these serotonin reuptake inhibitors (SSRIs for short) has its own personality, if you will. Fluvoxamine, like paroxetine, often causes patients to feel lethargic and “numb”. It tends to slow people down and leave them feeling “blah” when used to treat Major Depression. It may be less prone to do so when treating anxiety disorders, however.
Fluvoxamine is processed for elimination from the body (“metabolized”) in the liver to an inactive compound that is in turn eliminated by the kidneys. The half life of fluvoxamine is about one day and consequently if stopped abruptly (not recommended) it is out of the body in about 5 days. It sometimes can also cause significant withdrawal symptoms that can include dizziness, shock-like feelings in the head, dysphoria and others.
Fluvoxamine in combination with a monoamine oxidase inhibitor can cause serotonin syndrome that in turn can be fatal.
Possible adverse effects can include sexual dysfunction, nausea, insomnia, agitation, diarrhea, difficulty thinking and others. Often, in common with other SSRIs, it may leave a person feeling a bit numb emotionally rather than really well and “perky”.
Fluvoxamine significantly inhibits enzyme systems in the liver (CYP3A4, 1A2, 2C6/2C19) that can increase the blood levels of other medications metabolized by those enzymatic systems. One must therefore be mindful of possible drug interactions when prescribing other medications with fluvoxamine.
Fluvoxamine carries a warning from the FDA, along with the other SSRIs, against neonatal pulmonary hypertension in neonates exposed to fluvoxamine in the final trimester of pregnancy.
All antidepressants have a warning from the FDA against new onset suicidal “thoughts and behaviors”. There is no evidence children taking antidepressants are suiciding; quite otherwise, there is very good evidence that children treated for depression suicide less often than children who are depressed who are not treated with antidepressants.
If you miss a dose of fluvoxamine do not add it to the next dose. As with all medications, it is important to take fluvoxamine regularly as prescribed.
