Fluvoxamin

Fluvoxamin, more commonly known as fluvoxamine, is an antidepressant in the selective serotonin reuptake inhibitor (SSRI) class. It increases serotonin levels in the brain by inhibiting the serotonin transporter, and is primarily used to treat obsessive-compulsive disorder (OCD). In some countries it is also prescribed for social anxiety disorder, generalized anxiety disorder, and other anxiety-related conditions, with depression treatment when other options have not been adequate.

Administration and pharmacokinetics: Fluvoxamine is taken orally. It is extensively metabolized in the liver and has a half-life that generally ranges from about 15 to 20 hours, varying with formulation and individual factors. The drug can interact with many other medications because it inhibits several liver enzymes, notably those in the cytochrome P450 system, which can alter the levels of concomitant drugs.

Adverse effects and safety: Common adverse effects include nausea, sleep disturbances (insomnia or somnolence), dizziness, dry mouth, sweating, and sexual dysfunction. As with other SSRIs, there is a potential risk of increased suicidal thoughts in younger people and those with mood disorders, especially early in treatment. Serotonin syndrome can occur if fluvoxamine is combined with other serotonergic agents or monoamine oxidase inhibitors. Discontinuation should be gradual to minimize withdrawal symptoms.

Contraindications and interactions: It is contraindicated with concomitant use of monoamine oxidase inhibitors and requires caution with liver impairment and in pregnancy. Because of enzyme inhibition, fluvoxamine can raise levels and effects of various drugs, necessitating dose adjustments and monitoring.