Fluvoxamine
Fluvoxamine, commonly sold under the brand names Luvox and Faverin, is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. It is primarily used to treat major depressive disorder and obsessive–compulsive disorder (OCD), but is also used to treat anxiety disorders such as panic disorder, social anxiety disorder, and post-traumatic stress disorder.
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| Trade names | Luvox, Faverin, others |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a695004 |
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| Routes of administration | By mouth |
| Drug class | Selective serotonin reuptake inhibitor (SSRI) |
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| Pharmacokinetic data | |
| Bioavailability | 53% (90% confidence interval: 44–62%) |
| Protein binding | 77–80% |
| Metabolism | Liver (primarily O-demethylation) Major: CYP1A2 Minor: CYP3A4 Minor: CYP2C19 |
| Elimination half-life | 12–13 hours (single dose), 22 hours (repeated dosing) |
| Excretion | Kidney (98%; 94% as metabolites, 4% as unchanged drug) |
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| ECHA InfoCard | 100.125.476 |
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| Formula | C15H21F3N2O2 |
| Molar mass | 318.340 g·mol−1 |
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Fluvoxamine's side-effect profile is very similar to other SSRIs: constipation, gastrointestinal problems, headache, anxiety, irritation, sexual problems, dry mouth, sleep problems and a risk of suicide at the start of treatment by lifting the psychomotor inhibition, but these effects appear to be significantly weaker than with other SSRIs (except gastrointestinal side-effects).
Although the many drug-drug interactions of fluvoxamine can be problematic (and may temper enthusiasm for its prescribing, advocation and usage to some), its tolerance-profile itself is actually superior in some respects to other SSRIs (particularly with respect to cardiovascular complications), despite its age. Compared to escitalopram and sertraline, indeed, fluvoxamine's gastrointestinal profile may be less intense, often being limited to nausea. Mosapride has demonstrated efficacy in treating fluvoxamine-induced nausea. It is also advised practice to divide total daily doses of fluvoxamine greater than 100 milligrams, with the higher fraction being taken at bedtime (e.g., 50 mg at the beginning of the waking day and 200 mg at bedtime). In any case, high starting daily doses of fluvoxamine rather than the recommended gradual titration (starting at 50 milligrams and gradually titrating, up to 300 if necessary) may predispose to nauseous discomfort.
It is on the World Health Organization's List of Essential Medicines.
Fluvoxamine is related to clovoxamine, a proposed SNRI which has been subject to a certain amount of investigative research but was never marketed.