Find information on thousands of medical conditions and prescription drugs.

Fluvoxamine

Fluvoxamine (sold as Luvox®, Faverin® and Fevarin®) is a selective serotonin reuptake inhibitor. It is used primarily to treat depression, anxiety and OCD. more...

Home
Diseases
Medicines
A
B
C
D
E
F
Captagon
Famohexal
Famotidine
Faslodex
Faslodex
Fasoracetam
Felbamate
Felbatol
Felodipine
Felypressin
Femara
Femara
Fempatch
Femring
Fenfluramine
Fenofibrate
Fentanyl
Fexofenadine
Filgrastim
Filipin
Finasteride
Fioricet
Fiorinal
Flagyl
Flarex
Flavoxate
Flecainide
Flexeril
Flomax
Flonase
Flovent
Floxuridine
Fluacizine
Flucloxacillin
Fluconazole
Flucytosine
Fludarabine
Fludrocortisone
Flumazenil
Flunisolide
Flunitrazepam
Fluocinonide
Fluohexal
Fluorometholone
Fluorouracil
Fluoxetine
Fluphenazine
Flurazepam
Flutamide
Fluticasone
Fluvastatin
Fluvoxamine
FML
Focalin
Folic acid
Follutein
Fomepizole
Formoterol
Fortamet
Fortovase
Fosamax
Fosinopril
Fosinoprilat
Fosmidomycin
Fosphenytoin
Frova
Frovatriptan
Frusehexal
Fulvestrant
Fumagillin
Furazolidone
Furosemide
Furoxone
Fusafungine
Fusidic acid
Fuzeon
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z

Although its effects are similar to other SSRIs, it acts on the body's neurochemistry differently. For this reason, fluvoxamine can be of benefit to patients who experience unusual or limiting side-effects from other antidepressants. Fluvoxamine also appears to cause fewer side-effects than other SSRIs, particularly in relation to loss of sex-drive.

Fluvoxamine has the shortest half-life of all the SSRIs. Its mean serum half-life is 15 hours after a single dose, and 17 to 22 hours after repeated doses.

Fluvoxamine causes many drug-drug interactions due to inhibition of metabolism mediated by several cytochrome P450 oxidases. Examples of substances that have higher serum levels when administered together with fluvoxamine include caffeine, clozapine, olanzapine, tricyclic antidepressants, diazepam, alprazolam, propranolol, warfarin and methadone.

Effective dosage

For depression and anxiety, dosage normally starts at 50 milligrams per day, rising to 100 milligrams after a few days. It may be raised after evaluation of the effects by a doctor.

Fluvoxamine is generally only effective for OCD at 150 milligrams and above, and dosages can reach 300 milligrams or more for some patients.

Historical Relevance

In 1999, fluvoxamine came under great public scrutiny after it was discovered that Eric Harris, one of the two teenaged shooters involved in the Columbine High School massacre, had been taking the drug as treatment for depression. Many immediately pointed fingers at fluvoxamine and its manufacturer Solvay Pharmaceuticals (which sells fluvoxamine under the widely known brandname Luvox), since Solvay's own clinical trials indicated the drug had the propensity to induce "mania" in 4% of the youth who took it. Solvay, while acknowledging the risks inherent in taking an SSRI medication like fluvoxamine, downplayed any role the drug may have had in the killings. The American Psychiatric Association (A.P.A.) took a similar stance; Rodrigo Munoz, M.D., President of the A.P.A., said: "Despite a decade of research, there is little valid evidence to prove a causal relationship between the use of anti-depressant medications and destructive behavior. On the other hand, there is ample evidence that undiagnosed and untreated mental illness exacts a heavy toll on those who suffer from these disorders as well as those around them." It was also pointed out by many that Luvox was often safer than the other SSRI medications available--for example, fluoxetine (Prozac) caused mania in 6% of youth tested on the drug (versus fluvoxamine's 4%). Nonetheless, the reputation of Luvox was irreparably damaged. Sales fell, and Solvay withdrew the medication from the U.S. market in 2002; the company maintains, however, that this move had nothing to do with the safety profile of the fluvoxamine, which they still sell in many countries around the world. In the United States, fluvoxamine can only be purchased generically.

Read more at Wikipedia.org


[List your site here Free!]


Is fluvoxamine safe and effective for treating anxiety disorders in children?
From Journal of Family Practice, 8/1/01 by John M. Burke

The Research Unit on Pediatric Psychopharmacology Anxiety Study Group. Fluvoxamine for the treatment of anxiety disorders in children and adolescents. N Engl J Med 2001; 344:1279-85.

* BACKGROUND Anxiety disorders are common psychiatric illnesses in children and may even precede the development of subsequent psychiatric illnesses in adulthood. Data are lacking to guide treatment decisions. Although commonly used for treating anxiety disorders in adults, selective serotonin reuptake inhibitors (SSRIs) are not well studied for anxiety in children, except for obsessive-compulsive disorder. Currently, only fluvoxamine and sertraline are approved by the US Food and Drug Administration for use in children (ages 6-8 years) with obsessive-compulsive disorder.

* POPULATION STUDIED Eligible subjects were aged 6 to 17 years, were recruited from 5 US university-based psychopharmacology department practices, and must have had either social phobia, separation anxiety, or generalized anxiety based on the criteria from the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. All patients had clinically important anxiety symptoms according to the Pediatric Anxiety Rating Scale (PARS) and impaired functioning (score [is less than] 60) on the Children's Global Assessment (CGA) scale. Each subject agreed to attend weekly visits with a parent. Children could not participate if they were treated with another psychoactive medication or had coexisting psychiatric disorders, conduct disorder, developmental delay, mental retardation, or attention-deficit/hyperactivity disorder. Most children were aged 6 to 12 years (74%) and had both parents at home (72%), but they had variable ethnic and socioeconomic backgrounds.

* STUDY DESIGN AND VALIDITY In this randomized double-blinded controlled trial, subjects received either fluvoxamine (n=63) or placebo (n=65) in conjunction with supportive psychotherapy (that did not include behavioral anxiety treatment) for 8 weeks. The authors did not state that allocation to treatment was concealed before entering patients into the study. The fluvoxamine dose was increased weekly in approximately 50-mg increments to a maximum daily dose of 300 mg in adolescents or 250 mg in children younger than 12 years unless the patient had resolution of symptoms or adverse effects. Intention-to-treat analysis was appropriately used, because the dropout rate approached 19% (24/128). To maintain inter-rater reliability, 16 subjects were rated by each clinician, and differences were resolved by discussion.

The study was limited by its short duration (2 months), given that the anxiety disorders studied are commonly chronic. Also, long-term treatment would be necessary to evaluate possible drug-related adverse cognitive effects. This study included a heterogeneous group of patients and did not provide a subgroup analysis of response within the various anxiety disorders. The extensive exclusion criteria limit the external validity in the more complex patients likely encountered in clinical practice.

* OUTCOMES MEASURED The 2 primary outcomes focused on the anxiety symptoms and functional impairment as measured by changes in the weekly PARS and the Clinical Global Impressions-Improvement Scale (CGIS).

* RESULTS From baseline to study completion, the PARS decreased from 18.7+2.9 to 9.0+7.0 in the fluvoxamine group and from 19.0 [+ or -] 3.0 to 15.9 [+ or -] 5.3 in the placebo group (P [is less than] .001). Significant differences were detectable by week 3 and peaked at week 6. Adequate response, as defined as improvement scores less than 4 on the CGIS, was achieved in 48 of 63 children (76%) in the fluvoxamine group and 19 of 65 children (29%) in the placebo group (P [is less than] .001). Treatment discontinuation was attributable to adverse events in 5 children (8%) treated with fluvoxamine and 1 child (2%) in the placebo group. Five patients in the placebo group withdrew because of lack of efficacy. Abdominal discomfort was reported more often in the fluvoxamine group (49% vs 28%, P=.02). The greater likelihood of an increase in motor activity in the fluvoxamine group (27% vs 12%) did not quite reach statistical significance (P=.06).

RECOMMENDATIONS FOR CLINICAL PRACTICE

Fluvoxamine appears to be superior to placebo for the short-term treatment of pediatric patients with anxiety disorders (social phobia, separation anxiety disorder, or generalized anxiety disorder). However, this study does not provide valuable information on the relative efficacy of psychotherapy and pharmacotherapy. Because questions regarding long-term use in children with anxiety disorders remain unanswered, psychotherapy should be considered a first-line option, particularly for less severely symptomatic patients.

COPYRIGHT 2001 Appleton & Lange
COPYRIGHT 2001 Gale Group

Return to Fluvoxamine
Home Contact Resources Exchange Links ebay