Overview
Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) antidepressant primarily used to treat obsessive-compulsive disorder (OCD) and various anxiety disorders. It works by increasing serotonin levels in the brain, which helps regulate mood and behavior.
Mechanism of Action
Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) that potently and selectively inhibits serotonin reuptake at the presynaptic neuronal membrane. It has minimal effects on norepinephrine and dopamine reuptake. By blocking serotonin reuptake, it increases serotonin concentration in the synaptic cleft, enhancing serotonergic neurotransmission.
Indications
- Obsessive-compulsive disorder (OCD)
- Social anxiety disorder (social phobia)
- Panic disorder
- Depression (in some countries)
Dosage
For OCD: Initial dose 50 mg once daily at bedtime, may increase to maximum 300 mg daily. For social anxiety disorder: Initial dose 50 mg once daily, may increase to maximum 300 mg daily. Doses should be titrated gradually based on clinical response and tolerability.
Contraindications
- Hypersensitivity to fluvoxamine or any component
- Concomitant use with monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing MAOIs
- Concomitant use with thioridazine
- Concomitant use with pimozide
- Concomitant use with alosetron
Side Effects
- Nausea
- Headache
- Insomnia
- Somnolence
- Dry mouth
- Dizziness
- Constipation
- Asthenia
- Sweating
- Anorexia
- Nervousness
- Sexual dysfunction
- Weight changes
Interactions
- MAO inhibitors (serotonin syndrome risk)
- Thioridazine (QT prolongation)
- Pimozide (QT prolongation)
- Tizanidine (increased effects)
- Theophylline (increased levels)
- Warfarin (increased anticoagulation)
- Benzodiazepines (increased effects)
- Tricyclic antidepressants (increased levels)
- Other serotonergic drugs
- NSAIDs (increased bleeding risk)