What is Fluvoxamine? Uses, Dosage, and Side Effects
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Key takeaways:
Fluvoxamine (Luvox) is a selective serotonin reuptake inhibitor (SSRI) that’s used to treat obsessive-compulsive disorder (OCD).
Fluvoxamine is also used to treat several other mental health conditions, and it has a number of possible side effects.
If you have questions about fluvoxamine, please talk with a pharmacist or healthcare provider.
Many people may like to double-check things every now and then. But rituals and habits related to distressing thoughts or feelings might be a sign of obsessive-compulsive disorder (OCD) for some people. OCD is a medical condition that affects more than 2 million U.S. adults. For one-third of these adults, OCD began during childhood.
About half of adults with OCD have severe symptoms, but many people delay receiving treatment by an average of 11 years. If you have OCD, there are available treatment options. One potential option is fluvoxamine (Luvox).
In this article, we’ll discuss what fluvoxamine is, how you should use it, and possible side effects to be aware of.
What is fluvoxamine?
Fluvoxamine belongs to a medication class called selective serotonin reuptake inhibitors (SSRIs). Similar to other SSRIs, fluvoxamine works by raising the amount of serotonin — a naturally-occurring chemical — in the brain.
But unlike other SSRIs, fluvoxamine isn’t FDA-approved for the treatment of depression. Let’s talk a little bit more about the medical conditions that fluvoxamine is used to treat.
What conditions does fluvoxamine commonly treat?
In addition to depression, SSRIs are a first-choice option to treat OCD. Within the SSRI class, only a few medications are FDA-approved to treat OCD — one is fluvoxamine. Other SSRIs that can treat OCD include fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft).
Although fluvoxamine isn’t FDA-approved for the treatment of depression, healthcare providers have used this medication to treat depression and other mental health conditions, including social anxiety disorder (SAD), posttraumatic stress disorder (PTSD), panic disorder (PD), and certain eating disorders.
How is fluvoxamine dosed and given?
Fluvoxamine is available as an immediate-release (IR) tablet and extended-release (ER) capsule. You can take both forms by mouth, with or without food. Fluvoxamine is usually taken once daily at bedtime, but sometimes higher doses are divided throughout the day. Your healthcare provider can tell you when and how much fluvoxamine to take.
The ER capsule might not be appropriate for children who haven’t taken fluvoxamine before. A healthcare provider might start children — between 8 to 17 years of age — on a low dose of fluvoxamine IR. Adults can start with either the IR or ER capsule.
Then, depending on symptoms, the healthcare provider might slowly raise the dose until symptoms are adequately controlled. According to experts, higher doses might be appropriate for some people with OCD.
How long does it take fluvoxamine to start working?
When starting fluvoxamine, many people with OCD will not notice any improvement in their symptoms for about 4 to 6 weeks. In fact, some people might need 10 to 12 weeks to notice any difference in their symptoms.
In other words, patience is key — don’t suddenly stop fluvoxamine. Abruptly stopping fluvoxamine can lead to discontinuation symptoms that include nausea, sleeping troubles, and anxiety. If you don’t experience enough improvement in your symptoms within 4 weeks, talk with your healthcare provider. They can help you find reasons why your medication may not be working.
Can you use fluvoxamine to treat COVID-19?
Even though it’s a medication that treats OCD, some studies have looked at whether fluvoxamine has any effects on COVID-19.
During a COVID-19 infection, some people have strong inflammatory reactions. Inflammation is one of the body’s responses to infections. Studies show that fluvoxamine may attach to receptors (chemical binding sites) that could play a role in inflammation. By influencing inflammation, fluvoxamine might prevent lung damage, hospital visits, and ventilator use.
There are some promising results from a couple of small studies. But more research and larger studies are needed. Currently, experts don’t have a recommendation for or against fluvoxamine in the treatment of COVID-19.
If you have questions about fluvoxamine and its use in the treatment of COVID-19, please talk with a healthcare provider.
What are the most common side effects of fluvoxamine?
Like all medications, fluvoxamine has potential side effects. Except for sexual side effects, many of the following common side effects will go away within a few weeks:
Appetite and taste changes
Dry mouth
Diarrhea
Nausea and vomiting
Nervousness
Difficulty falling asleep
Tiredness
Sweating
Weakness
Headache
Children may also experience the following side effects:
Agitation and restlessness
Depression
Excess gas
Heavy periods in adolescents who menstruate
Skin rash
Coughing
If you’re concerned about any of these side effects, please talk with a pharmacist or healthcare provider.
What are the most serious side effects of fluvoxamine?
Fluvoxamine also has serious side effects. Although rare, these side effects include bleeding, changing or worsening mental health conditions, suicidal thoughts, and serotonin syndrome. Symptoms of serotonin syndrome may include fever, stiff muscles, and confusion. Other SSRIs also have these side effects.
Additional serious but rare side effects of fluvoxamine include the following:
Appetite and weight changes: A change in appetite and weight is a common side effect. But these changes can be excessive or severe in children.
Eye problems: There’s a structure in the eye that helps drain fluid from the eye. People with a narrow angle structure — which impacts fluid drainage from the eye — might have a higher risk of narrow-angle glaucoma with fluvoxamine. Some symptoms of this type of glaucoma include eye pain, vision changes, and swelling or redness in or around your eye.
Low sodium: Some SSRIs — like fluvoxamine — can lower the amount of sodium (salt) in your body. If you have low sodium in your body, you might notice headaches, weakness, and confusion. Older adults — people over 65 years of age — may have a higher risk of this serious side effect.
Seizures: Fluvoxamine might increase your risk of seizures — especially if you have unstable seizures.
If you experience any of these serious side effects, please seek medical attention.
Who shouldn’t take fluvoxamine?
Fluvoxamine is FDA-approved for kids between 8 to 17 years of age. But there isn’t any available data on safety and effectiveness for younger children. So, fluvoxamine isn’t recommended for children under 8 years of age.
People who take certain medications should also avoid fluvoxamine. We’ll discuss this next.
Does fluvoxamine interact with any medications?
Fluvoxamine interacts with a few other medications. If you’re taking fluvoxamine, you should avoid the following medications in particular:
Alosetron (Lotronex): Lotronex is a medication used to treat severe diarrhea related to irritable bowel syndrome (IBS). When taken with fluvoxamine, fluvoxamine slows the breakdown of Lotronex. So, a higher amount of Lotronex will be in the body. This might lead to overdose symptoms, which may include breathing difficulties and seizures.
Monoamine oxidase inhibitors (MAOIs): As noted, serotonin syndrome is a serious side effect of fluvoxamine. Although it’s potentially life-threatening, this medical condition is rare. However, the risk is higher when you combine fluvoxamine with MAOIs. Some examples of MAOIs are isocarboxazid (Marplan), linezolid (Zyvox), and selegiline (Eldepryl, Emsam).
Pimozide (Orap): Pimozide is a medication that decreases muscle and speech tics from Tourrette’s syndrome. Fluvoxamine interacts with pimozide by slowing down the body’s ability to clear out pimozide. With a higher amount of pimozide in the body, the risk is also higher for an abnormal heart rhythm, which may include symptoms of fast heartbeat, weakness, lightheadedness, fainting, and blurred vision.
Thioridazine: Thioridazine is a medication used to treat schizophrenia, a mental health condition. When taken with fluvoxamine, there’s a higher amount of thioridazine in the body. This can raise the risk of an abnormal heart rhythm.
Tizanidine: Tizanidine is a medication that helps relax the muscles. When taken with fluvoxamine, there is a higher amount of tizanidine in the body. This can drastically lower blood pressure and make you feel tired.
Does fluvoxamine interact with alcohol?
If you combine fluvoxamine with alcohol, you might experience worsening OCD symptoms and fluvoxamine side effects. To be safe, avoid drinking alcohol with fluvoxamine.
The bottom line
Fluvoxamine is a go-to medication used to treat OCD. But it usually takes weeks to work. Although SSRIs are generally safe, fluvoxamine has a number of potential side effects.
At the moment, there isn’t enough effectiveness and safety data for experts to recommend fluvoxamine as an option in the treatment of COVID-19. More research is necessary.
If you have any questions about fluvoxamine’s effectiveness, side effects, and interactions, please talk with a pharmacist or healthcare provider.
ABOUT THE AUTHOR:
Ross earned her doctorate in pharmacy (PharmD) at The University of Texas at Austin (UT Austin). Her years of experience practicing in various pharmacy settings also lead to multiple board certifications, including ambulatory care, geriatrics, and pharmacotherapy. She currently serves as the director of the PharmacyChecker international verification program.
Ross also founded Off Script Consults, a pharmacy consulting business. She strives to combine her passion for pharmacy, education, and writing to improve the quality of life and financial outcomes for people with chronic medical conditions, caregivers, and healthcare providers.
She particularly enjoys creating relatable and helpful content for her readers and viewers. For writing samples, please visit her Muck Rack portfolio. For videos, please visit her “Off Script Consults” YouTube channel.
Ross currently resides with her husband and two dogs in her home state of Texas to be closer to family. She also tries to find time for hobbies, which include rock climbing, running, and playing pickle ball.
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