Fluvoxamine , sold under the brand name Luvox among others, is a drug used primarily for the treatment of obsessive-compulsive disorder (OCD), and is also used to treat major depressive disorders and anxiety disorders such as panic disorder and post-traumatic stress disorder. Fluvoxamine CR (controlled release) is approved to treat social anxiety disorders. This is selective serotonin reuptake inhibitor (SSRI) and? 1 agonist receptor.
The FDA has added a black box warning for this drug in reference to increasing the risk of suicidal thinking and behavior in young adults and children.
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Medical use
The only FDA-approved indication by Fluvoxamine is in OCD treatment, although in other countries (eg Australia, UK, and Russia) it also has indications for major depressive disorders. Fluvoxamine has been found to be useful in the treatment of major depressive disorders, anxiety disorders such as panic disorder, social anxiety disorder, and post-traumatic stress disorder, and other obsessive-compulsive spectrum disorders. Fluvoxamine is indicated for children and adolescents with OCD. It works long-term, and retains its therapeutic properties for at least a year. It was also found to have some analgesic properties in line with other SSRIs and tricyclic antidepressants.
Some evidence suggests fluvoxamine may be helpful in addition to the treatment of schizophrenia, improving depression, negative, and cognitive symptoms of the disorder. His actions on sigma receptors can give him a unique advantage among antidepressants in treating the cognitive symptoms of schizophrenia.
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Adverse effects
Gastrointestinal side effects are more common in those receiving fluvoxamine compared with other SSRIs. Otherwise, the side effects profile of fluvoxamine is very similar to other SSRIs.
- Common side effects (1-10% incident)
- Rarely (0.1-1% incident) side effects
- Hallucinations
- Confusing conditions
- Extrapyramidal side effects (eg dystonia, parkinsonism, tremor, etc.)
- Orthostatic hypotension
- Skin hypersensitivity reactions (eg edema [tissue buildup], rashes, pruritus)
- Arthralgia
- Rare (0.01-0.1% incident) side effects
- Mania
- Seizures
- Abnormal liver function (heart)
- Photosensitivity (sensitive to abnormal light)
- Galactorrhoea (expulsion of breast milk unrelated to pregnancy or breastfeeding)
- Unknown frequency effects
Interactions
Fluvoxamine inhibits the following P450 cytochrome enzymes:
- CYP1A2 (strong) that metabolizes agomelatine, amitriptyline, caffeine, clomipramine, clozapine, duloxetine, haloperidol, imipramine, phenacetin, tacrine, tamoxifen, theophylline, olanzapine, etc.
- CYP3A4 (weak) that metabolizes alprazolam, aripiprazole, clozapine, haloperidol, quetiapine, ziprasidone, etc.
- CYP2D6 (weak) that metabolizes aripiprazole, chlorpromazine, clozapine, codeine, fluoxetine, haloperidol, olanzapine, oxycodone, paroxetine, perphenazine, pethidine, risperidone, sertraline, thioridazine, zuclopenthixol.
- CYP2C9 (enough) to metabolize nonsteroidal anti-inflammatory drugs, phenytoin, sulfonylureas, etc.
- CYP2C19 (very) that metabolizes clonazepam, diazepam, phenytoin, etc.
- CYP2B6 (weak) that metabolizes bupropion, cyclophosphamide, sertraline, tamoxifen, valproate, etc.
By doing so, fluvoxamine can increase the serum concentration of substrate from these enzymes.
Fluvoxamine has been observed to increase serum mirtazapine concentrations, which are mainly metabolized by CYP1A2, CYP2D6, and CYP3A4, by 3 to 4-fold in humans. The attention and adjustment of the necessary doses are justified when combining fluvoxamine and mirtazapine.
Pharmacology
Fluvoxamine is a potent selective serotonin reuptake inhibitor with approximately 100-fold affinity for the serotonin transporter through the norepinephrine transporter. It has a negligible affinity for dopamine transporters or other sites, with the sole exception of receptors? 1 . It behaves as a powerful agonist at this receptor and has the highest affinity (36 nM) of each SSRI to do so. It may contribute to its antidepressant and anxiolytic effects and may also provide some efficacy in treating the symptoms of cognitive depression.
History
Fluvoxamine was developed by Kali-Duphar, part of Solvay Pharmaceuticals, Belgium, now Abbott Laboratories, and was introduced as Floxyfral in Switzerland and Solvay in West Germany in 1983. It was approved by the FDA on December 5, 1994 and was introduced as Luvox at WE. In India, it is available, among several other brands, such as Uvox by Abbott. This is one of the first SSRI antidepressants to be launched, and is prescribed in many countries for patients with severe depression. It was the first SSRI, a non-TCA drug, approved by the US FDA specifically for OCD treatment. By the end of 1995, more than ten million patients worldwide had been treated with fluvoxamine. Fluvoxamine was the first SSRI registered for the treatment of obsessive-compulsive disorder in children by the FDA in 1997. In Japan, fluvoxamine was the first SSRI approved for the treatment of depression in 1999 and then in 2005 the first drug was approved for the treatment of social anxiety disorders. Fluvoxamine is the first SSRI approved for clinical use in the UK. The largest producer of fluvoxamine, a drug substance, is Synthon BV (Netherlands).
See also
- Clovoxamine, a chemical drug similar to a chlorine atom that replaces the substituent CF 3
- Caproxamine
- Demexiptiline, a tricyclic antidepressant with the same ketoxime cessation chain as fluvoxamine
References
External links
- Fluvoxamine consumer information from Drugs.com
Source of the article : Wikipedia
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