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Revision as of 06:53, 9 August 2011 editBeetstra (talk | contribs)Edit filter managers, Administrators172,044 edits Script assisted update of identifiers for the Chem/Drugbox validation project (updated: 'ChEBI').← Previous edit		Latest revision as of 04:03, 12 January 2025 edit undoArthurfragoso (talk | contribs)Extended confirmed users, Template editors4,542 edits dark mode fix
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			{{Short description|SSRI antidepressant drug}}
	{{distinguish|Fluoxetine}}
			{{Distinguish|Fluoxetine}}
	{{Drugbox| verifiedrevid = 407829219
			{{Use dmy dates|date=December 2023}}
	|
			{{cs1 config|name-list-style=vanc|display-authors=6}}
	|IUPAC_name = (''E'')-5-methoxy-1-pentan-1-one ''O''-2-aminoethyl oxime
			{{Infobox drug
	| image = Fluvoxamine structure.svg
			| Verifiedfields = changed
	| width = 180px
			| Watchedfields = changed
	| CASNo_Ref = {{cascite|correct|CAS}}
			| verifiedrevid = 443824781
			| image = Fluvoxamine.svg
			| image_class = skin-invert-image
			| width =
			| alt =
			| caption =
			| image2 = Fluvoxamine 3D 4ENH.png
			| width2 =
			| alt2 =
			<!-- Clinical data -->
			| pronounce =
			| tradename = Luvox, others
			| Drugs.com = {{drugs.com|monograph|fluvoxamine-maleate}}
			| MedlinePlus = a695004
			| DailyMedID = Fluvoxamine
			| pregnancy_AU = C
			| pregnancy_AU_comment = <ref name="Drugs.com pregnancy">{{drugs.com|pregnancy|fluvoxamine}}</ref>
			| pregnancy_category =
			| routes_of_administration = ]
			| class = ] (SSRI)
			| ATC_prefix = N06
			| ATC_suffix = AB08
			| ATC_supplemental =
			<!-- Legal status -->
			| legal_AU = S4
			| legal_AU_comment =
			| legal_BR = C1
			| legal_BR_comment = <ref name="Anvisa-2023">{{cite web |author=Anvisa |author-link=Brazilian Health Regulatory Agency |date=31 March 2023 |title=RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial |trans-title=Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control|url=https://www.in.gov.br/en/web/dou/-/resolucao-rdc-n-784-de-31-de-marco-de-2023-474904992 |url-status=live |archive-url=https://web.archive.org/web/20230803143925/https://www.in.gov.br/en/web/dou/-/resolucao-rdc-n-784-de-31-de-marco-de-2023-474904992 |archive-date=3 August 2023 |access-date=16 August 2023 |publisher=] |language=pt-BR |publication-date=4 April 2023}}</ref>
			| legal_CA = Rx-only
			| legal_CA_comment =
			| legal_DE = <!--Anlage I, II, III or Unscheduled-->
			| legal_DE_comment =
			| legal_NZ = <!--Class A, B, C-->
			| legal_NZ_comment =
			| legal_UK = POM
			| legal_UK_comment =
			| legal_US = Rx-only
			| legal_US_comment =
			| legal_UN = <!--N I, II, III, IV / P I, II, III, IV-->
			| legal_UN_comment =
			| legal_status = <!--For countries not listed above-->
			<!-- Pharmacokinetic data -->
			| bioavailability = 53% (90% confidence interval: 44–62%)<ref name="LUVOX" />
			| protein_bound = 77–80%<ref name="LUVOX" /><ref name="vanHarten1993">{{cite journal | vauthors = van Harten J | title = Clinical pharmacokinetics of selective serotonin reuptake inhibitors | journal = Clinical Pharmacokinetics | volume = 24 | issue = 3 | pages = 203–220 | date = March 1993 | pmid = 8384945 | doi = 10.2165/00003088-199324030-00003 | s2cid = 84636672 }}</ref>
			| metabolism = ] (primarily O-])<ref name="AltamuraCaldiroliBuoli2015" /><br />Major: ] or ]<ref name="AltamuraCaldiroliBuoli2015" /><ref name="Wyska2019" /><ref name="LUVOX" /><br />Minor: ], ], and/or ]<ref name="Wyska2019" /><ref name="LUVOX" />
			| metabolites =
			| onset =
			| elimination_half-life = 12–13 hours (single dose), 22 hours (repeated dosing)<ref name="LUVOX" />
			| duration_of_action =
			| excretion = ] (98%; 94% as metabolites, 4% as unchanged drug)<ref name="LUVOX" />
			<!-- Identifiers -->
			| CAS_number_Ref = {{cascite|correct|??}}
			| CAS_number = 54739-18-3
			| CAS_supplemental =
			| PubChem = 5324346
			| IUPHAR_ligand = 7189
			| DrugBank_Ref = {{drugbankcite|changed|drugbank}}
			| DrugBank = DB00176
			| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
			| ChemSpiderID = 4481878
	| UNII_Ref = {{fdacite|correct|FDA}}		| UNII_Ref = {{fdacite|correct|FDA}}
	| UNII = O4L1XPO44W		| UNII = O4L1XPO44W
			| KEGG_Ref = {{keggcite|correct|kegg}}
	| InChI = 1/C15H21F3N2O2/c1-21-10-3-2-4-14(20-22-11-9-19)12-5-7-13(8-6-12)15(16,17)18/h5-8H,2-4,9-11,19H2,1H3/b20-14+
			| KEGG = D07984
	| smiles = FC(F)(F)c1ccc(\C(=N\OCCN)CCCCOC)cc1
			| ChEBI_Ref = {{ebicite|correct|EBI}}
	| InChIKey = CJOFXWAVKWHTFT-XSFVSMFZBL
			| ChEBI = 5138
	| ChEMBL_Ref = {{ebicite|correct|EBI}}		| ChEMBL_Ref = {{ebicite|correct|EBI}}
	| ChEMBL = 814		| ChEMBL = 814
			| NIAID_ChemDB =
			| PDB_ligand =
			| synonyms =
			<!-- Chemical and physical data -->
			| IUPAC_name = 2-<nowiki/>{ pentylidene}amino]oxy}ethanamine<ref name="ChemSpider-2013">{{cite web|title=Luvox|work=ChemSpider|publisher=Royal Society of Chemistry|access-date=21 October 2013|url=http://www.chemspider.com/Chemical-Structure.4481878|archive-url=https://web.archive.org/web/20131115055836/http://www.chemspider.com/Chemical-Structure.4481878|archive-date=15 November 2013|url-status=dead}}</ref>
			| C=15 | H=21 | F=3 | N=2 | O=2
			| SMILES = FC(F)(F)c1ccc(\C(=N\OCCN)CCCCOC)cc1
	| StdInChI_Ref = {{stdinchicite|correct|chemspider}}		| StdInChI_Ref = {{stdinchicite|correct|chemspider}}
	| StdInChI = 1S/C15H21F3N2O2/c1-21-10-3-2-4-14(20-22-11-9-19)12-5-7-13(8-6-12)15(16,17)18/h5-8H,2-4,9-11,19H2,1H3/b20-14+		| StdInChI = 1S/C15H21F3N2O2/c1-21-10-3-2-4-14(20-22-11-9-19)12-5-7-13(8-6-12)15(16,17)18/h5-8H,2-4,9-11,19H2,1H3/b20-14+
			| StdInChI_comment =
	| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}		| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}
	| StdInChIKey = CJOFXWAVKWHTFT-XSFVSMFZSA-N		| StdInChIKey = CJOFXWAVKWHTFT-XSFVSMFZSA-N
			| density =
	| CAS_number=54739-18-3
			| density_notes =
	| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
			| melting_point =
	| ChemSpiderID = 4481878
			| melting_high =
	| ATC_prefix=N06
			| melting_notes =
	| ATC_suffix=AB08
			| boiling_point =
	| ATC_supplemental=
			| boiling_notes =
	| ChEBI = 5138
			| solubility =
	| PubChem=5324346
			| sol_units =
	| DrugBank=APRD00425
			| specific_rotation =
	| KEGG_Ref = {{keggcite|correct|kegg}}
	| KEGG = D07984
	| C=15 | H=21 | F=3 | N=2 | O=2
	| molecular_weight = 318.335
	| bioavailability= 77%
	| metabolism = ]
	| elimination_half-life= 15.6 hours
	| excretion = ]
	| pregnancy_category = C
	| legal_US = Rx-only
	| legal_AU = S4
	| routes_of_administration= Oral
	}}		}}
			'''Fluvoxamine''', sold under the brand name '''Luvox''' among others, is an ] of the ] (SSRI) class.<ref name="U.S. Food and Drug Administration (FDA)-2015">{{cite web | title=Fluvoxamine Maleate Information | website=U.S. ] (FDA) | date=15 July 2015 | url=https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fluvoxamine-maleate-information | archive-url=https://web.archive.org/web/20191129061058/https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fluvoxamine-maleate-information | archive-date=29 November 2019 | url-status=live | access-date=28 November 2019}}</ref> It is primarily used to treat ] and, perhaps more-especially, ] (OCD),<ref name="pmid20140100">{{cite journal | vauthors = McCain JA | title = Antidepressants and suicide in adolescents and adults: a public health experiment with unintended consequences? | journal = P & T | volume = 34 | issue = 7 | pages = 355–378 | date = July 2009 | pmid = 20140100 | pmc = 2799109 }}</ref> but is also used to treat ]s<ref name="pmid11323729">{{cite journal | vauthors = | title = Fluvoxamine for the treatment of anxiety disorders in children and adolescents. The Research Unit on Pediatric Psychopharmacology Anxiety Study Group | journal = The New England Journal of Medicine | volume = 344 | issue = 17 | pages = 1279–1285 | date = April 2001 | pmid = 11323729 | doi = 10.1056/NEJM200104263441703 | doi-access = free }}</ref> such as ], ], and ].<ref name="pmid11085201">{{cite journal | vauthors = Figgitt DP, McClellan KJ | title = Fluvoxamine. An updated review of its use in the management of adults with anxiety disorders | journal = Drugs | volume = 60 | issue = 4 | pages = 925–954 | date = October 2000 | pmid = 11085201 | doi = 10.2165/00003495-200060040-00006 | s2cid = 265712201 }}</ref><ref name="pmid18568110"/><ref name="pmid11472786">{{cite journal | vauthors = Asnis GM, Hameedi FA, Goddard AW, Potkin SG, Black D, Jameel M, Desagani K, Woods SW | title = Fluvoxamine in the treatment of panic disorder: a multi-center, double-blind, placebo-controlled study in outpatients | journal = Psychiatry Research | volume = 103 | issue = 1 | pages = 1–14 | date = August 2001 | pmid = 11472786 | doi = 10.1016/S0165-1781(01)00265-7 | s2cid = 40412606 }}</ref>
	'''Fluvoxamine''' (brand name '''Luvox''') is an ] which functions as a ] (SSRI). Fluvoxamine was first approved by the ] (FDA) in 1993 for the treatment of ] (OCD).<ref>
	</ref> Fluvoxamine CR (controlled release) is approved to treat ].<ref name="Stahl, S. Stahl's Essential Psychopharmacology 2009. pp.215">Stahl, S. Stahl's Essential Psychopharmacology: The Prescriber's Guide. Cambridge University Press. New York, NY. 2009. pp.215</ref> Fluvoxamine is also prescribed to treat ] (MDD) and ], such as ] (GAD), ], and ] (PTSD).<ref>{{cite journal | first = David P. Figgitt | last = Karen J. McClellan | date = Drugs October 2000 | title = Fluvoxamine An Updated Review of its Use in the Management of Adults with Anxiety Disorders | journal = Adis Drug Evaluation | volume = 60 | issue = 4 | pages = 925–954}}</ref>
			Fluvoxamine's side-effect profile is similar to that of other SSRIs. Common adverse effects include ], ], ], ], ], ], ], ] and an increased risk of ] at the start of treatment. These effects appear to be significantly weaker than with other SSRIs, with the exception of gastrointestinal side-effects.<ref name="Vezmar-2009">Vezmar, S. et al., « Pharmacokinetics and Efficacy of Fluvoxamine and Amitriptyline in Depression », J Pharmacol Sci, vol. 110, no 1, 2009, p. 98 – 104 (ISSN 1347-8648)</ref>
	==History==
	Fluvoxamine was developed by ] and was the first non-] drug approved by the U.S. Food and Drug Administration (FDA) specifically for the treatment of OCD.<ref>.</ref> It was one of the first SSRI antidepressants to be launched (1984 in Switzerland), and following its FDA approval in 1993, it was launched in the U.S. in December 1994, Australia in February 1999 and Japan in June 1999.<ref>.</ref> At the end of 1995, more than 10 million patients worldwide had been treated with fluvoxamine.<ref>{{cite journal | first = | last = | year = 1999 | title = | journal = Fluvoxamine Product Monograph | volume = | issue = | pages = }}</ref> Fluvoxamine was the first SSRI to be registered for the treatment of obsessive compulsive disorder in children by the FDA in 1997.<ref>{{cite journal | first = | last = | date = | title = Luvox Approved For Obsessive Compulsive Disorder in Children and Teens | journal = Http://www.pslgroup.com/dg/2261a.htm | volume = | issue = | pages = }}</ref> Fluvoxamine was the first drug approved for the treatment of social anxiety disorder in Japan in 2005.<ref>{{cite journal | first = | last = | date = | title = Solvay’s Fluvoxamine maleate is first drug approved for the treatment of social anxiety disorder in Japan | journal = Http://www.solvaypress.com/pressreleases/0,,33713-2-83,00.htm | volume = | issue = | pages = }}</ref>
			Fluvoxamine appears to be more tolerable than other SSRIs, particularly with respect to cardiovascular complications.<ref name = "Westenberg_2006">{{cite journal | vauthors = Westenberg HG, Sandner C | title = Tolerability and safety of fluvoxamine and other antidepressants | journal = International Journal of Clinical Practice | volume = 60 | issue = 4 | pages = 482–491 | date = April 2006 | pmid = 16620364 | pmc = 1448696 | doi = 10.1111/j.1368-5031.2006.00865.x }}</ref> Compared to ] and ], fluvoxamine's gastrointestinal profile may be less intense,<ref name="Oliva Lippi Paci Del Fabro 2021 p. 110266">{{cite journal | vauthors = Oliva V, Lippi M, Paci R, Del Fabro L, Delvecchio G, Brambilla P, De Ronchi D, Fanelli G, Serretti A | title = Gastrointestinal side effects associated with antidepressant treatments in patients with major depressive disorder: A systematic review and meta-analysis | journal = Progress in Neuro-Psychopharmacology & Biological Psychiatry | volume = 109 | pages = 110266 | date = July 2021 | pmid = 33549697 | doi = 10.1016/j.pnpbp.2021.110266 | publisher = Elsevier BV | s2cid = 231809760 }}</ref> often being limited to ].<ref name="pmid18568110">{{cite journal | vauthors = Irons J | title = Fluvoxamine in the treatment of anxiety disorders | journal = Neuropsychiatric Disease and Treatment | volume = 1 | issue = 4 | pages = 289–299 | date = December 2005 | pmid = 18568110 | pmc = 2424117 | doi = }}</ref> ] has demonstrated efficacy in treating fluvoxamine-induced nausea.<ref name="Ueda Yoshimura Shinkai Terao 2001 pp. 259–264">{{cite journal | vauthors = Ueda N, Yoshimura R, Shinkai K, Terao T, Nakamura J | title = Characteristics of fluvoxamine-induced nausea | journal = Psychiatry Research | volume = 104 | issue = 3 | pages = 259–264 | date = November 2001 | pmid = 11728615 | doi = 10.1016/s0165-1781(01)00320-1 | publisher = Elsevier BV | s2cid = 38761139 }}</ref> It is also advised practice to divide total daily doses of fluvoxamine greater than 100 milligrams, with the higher fraction being taken in the evening (e.g., 50&nbsp;mg at the beginning of the waking day and 200&nbsp;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 increase the likelihood of nausea.<ref name="Ware 1997 pp. 15–23">{{cite journal |last=Ware |first=Michael R. |title=Fluvoxamine: A Review of the Controlled Trials in Depression |journal=The Journal of Clinical Psychiatry |publisher=Physicians Postgraduate Press, Inc. |volume=58 |issue=suppl 5 |date=1 March 1997 |issn=0160-6689 |url=https://www.psychiatrist.com/read-pdf/7342/ |access-date=1 December 2023 |pages=15–23 |pmid=9184623 |archive-date=6 December 2022 |archive-url=https://web.archive.org/web/20221206050356/https://www.psychiatrist.com/read-pdf/7342/ |url-status=live }}</ref>
	In 1999, fluvoxamine came under great public scrutiny after it was discovered that ], one of the two teenage shooters involved in the ], had been taking the drug. Many immediately pointed fingers at fluvoxamine and its manufacturer Solvay Pharmaceuticals.<ref name="DenverPost">{{cite news |url=http://www.denverpost.com/golf/ci_5094436 |title=Judge: Seal Columbine papers for 25 years |accessdate=2008-03-03 |date=January 26, 2007 |format= |work=The Denver Post |first=Howard |last=Pankratz}}</ref> Sales fell, and Solvay withdrew the medication from the U.S. market in 2002.<ref>{{cite journal | first = | last = | date = | title =Solvay Pharmaceuticals, Inc. Withdraws LUVOX | journal = Http://www.solvaypharmaceuticals-us.com/newsroom/pressreleases/0,,14517-2-0,00.htm | volume = | issue = | pages = }}</ref> In 2007, Solvay re-introduced Luvox to the U.S. market, which is now manufactured by Palo Alto, California-based Jazz Pharmaceuticals, Inc., with a generic version of Luvox available from ], Inc. On February 28, 2008, the FDA approved a controlled-release formulation of fluvoxamine for Solvay Pharmaceuticals, to be marketed as '''Luvox CR'''.<ref>{{cite web |url=http://www.jazzpharma.com/news.php?id=59 |title=Jazz Pharmaceuticals press release, February 28, 2008 – FDA APPROVES LUVOX CR (FLUVOXAMINE MALEATE) EXTENDED-RELEASE CAPSULES FOR THE TREATMENT OF SOCIAL ANXIETY DISORDER (SAD) AND OBSESSIVE COMPULSIVE DISORDER (OCD) |accessdate=2008-03-14 |format= |work= |archiveurl = http://web.archive.org/web/20080526082602/http://www.jazzpharma.com/news.php?id=59 <!-- Bot retrieved archive --> |archivedate = 2008-05-26}}</ref><ref>{{cite web |title=Luvox CR | Prescribing Info |url=http://www.luvoxcr.com/LUVOX-CR-PI.pdf |accessdate=2008-02-21}}</ref>
			It is on the ].<ref name="WHO23rd">{{cite book | vauthors = ((World Health Organization)) | title = The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023) | year = 2023 | hdl = 10665/371090 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MHP/HPS/EML/2023.02 | hdl-access=free }}</ref>
	==Indications==
	Fluvoxamine is widely prescribed to treat major depressive disorder (MDD), and anxiety disorders such as obsessive compulsive disorder (OCD), generalized anxiety disorder (GAD), panic disorder, social phobia, and post-traumatic stress disorder (PTSD). Fluvoxamine is indicated for children and adolescents with OCD<ref>{{cite journal | first = | last = | month = March | year = 2005 | title = US-FDA Fluvoxamine Product Insert | journal = | volume = | issue = | pages = }}</ref> and ].<ref name="Stahl, S. Stahl's Essential Psychopharmacology 2009. pp.215"/>
	==Side effects==		==Medical uses==
			In many countries (e.g., Australia,<ref name = AMH/><ref name="NPS-MedicineWise-2018">{{cite web|url=https://www.nps.org.au/medical-info/medicine-finder/luvox-tablets|title=Luvox Tablets|website=NPS MedicineWise|access-date=22 October 2018|archive-date=22 October 2018|archive-url=https://web.archive.org/web/20181022153450/https://www.nps.org.au/medical-info/medicine-finder/luvox-tablets|url-status=live}}</ref> the United Kingdom,<ref name = BNF/> and Russia<ref name="Drug Registry of Russia (RLS) Drug Compendium">{{cite web|title=Summary of Full Prescribing Information: Fluvoxamine|url=http://www.rlsnet.ru/mnn_index_id_307.htm|website=Drug Registry of Russia (RLS) Drug Compendium|access-date=21 March 2015|language=ru|archive-date=2 April 2015|archive-url=https://web.archive.org/web/20150402162017/http://www.rlsnet.ru/mnn_index_id_307.htm|url-status=live}}</ref>) it is commonly used for ]. Fluvoxamine is also approved in the United States for ] (OCD),<ref name = DailyMed/><ref name="pmid20140100" /> and ].<ref name="Luvox CR approved for OCD and SAD">{{cite web|url=https://www.empr.com/home/news/luvox-cr-approved-for-ocd-and-sad/|title=Luvox CR approved for OCD and SAD|date=29 February 2008|website=MPR|access-date=2 March 2019|archive-date=28 August 2021|archive-url=https://web.archive.org/web/20210828090440/https://www.empr.com/home/news/luvox-cr-approved-for-ocd-and-sad/|url-status=live}}</ref> In Japan, it is also approved to treat ], ] and major depressive disorder.<ref name="Astellas-Pharma-2018">{{cite web|url=https://www.astellas.com/en/corporate/news/detail/luvox-receives-approval-for-so.html|title=2005 News Releases|website=Astellas Pharma|access-date=16 September 2018|archive-date=16 September 2018|archive-url=https://web.archive.org/web/20180916235231/https://www.astellas.com/en/corporate/news/detail/luvox-receives-approval-for-so.html|url-status=dead}}</ref><ref name="www.medscape.com-2018">{{cite web|url=https://www.medscape.com/viewarticle/514804|title=International Approvals: Ebixa, Depromel/Luvox, M-Vax|website=www.medscape.com|access-date=16 September 2018|archive-date=29 October 2020|archive-url=https://web.archive.org/web/20201029173810/https://www.medscape.com/viewarticle/514804|url-status=live}}</ref> Fluvoxamine is indicated for children and adolescents with OCD.<ref name="Jazz Pharmaceuticals, Inc.-2005">{{cite web | date = March 2005 | title = Fluvoxamine Product Insert | url = https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/022235lbl.pdf | work = Jazz Pharmaceuticals, Inc. | publisher = U.S. Food and Drug Administration | access-date = 4 November 2022 | archive-date = 4 November 2022 | archive-url = https://web.archive.org/web/20221104055928/https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/022235lbl.pdf | url-status = live }}</ref> The ] guidelines in the United Kingdom have, as of 2005, authorized its use for ] in adults and adolescents of any age and children over the age of 7.{{medcn|date=April 2024}}
	] most commonly observed with fluvoxamine include nausea, vomiting, drowsiness, insomnia, dizziness, nervousness, feeling anxious, dry mouth, abdominal pain, constipation, diarrhea, heart burn, loss of appetite, muscle weakness, pins and needles, abnormal taste, headache, faster heart beat, sweating, weight gain, weight loss or unusual bruising. Other side effects which are observed more frequently in children include abnormal thoughts or behaviour, cough, increased period pain, nose bleeds, increased restlessness, infection and sinusitis.<ref></ref> Sexual side effects with fluvoxamine are less pronounced than with other SSRIs.<ref>{{cite journal | first = Waldinger MD | last = Hengeveld VW et al. | last2 = Hengeveld | year = 1998 | first2 = MW | last3 = Zwinderman | first3 = AH | last4 = Olivier | first4 = B | title = Effect of SSRI antidepressants on ***: a double blind, randomised, placebo-controlled study with fluoxetine, fluvoxamine, paroxetine and sertraline | journal = Journal of Clinical Psychopharmacology | volume = 18 | pmid = 9690692 | issue = 4| pages = 274–281 | doi = 10.1097/00004714-199808000-00004}}</ref>
			There is evidence that fluvoxamine is effective for ] in adults, although, as with other ]s, some of the results may be compromised by having been funded by pharmaceutical companies.<ref name="pmid29048739">{{cite journal | vauthors = Williams T, Hattingh CJ, Kariuki CM, Tromp SA, van Balkom AJ, Ipser JC, Stein DJ | title = Pharmacotherapy for social anxiety disorder (SAnD) | journal = The Cochrane Database of Systematic Reviews | volume = 10 | issue = 10 | pages = CD001206 | date = October 2017 | pmid = 29048739 | pmc = 6360927 | doi = 10.1002/14651858.CD001206.pub3 }}</ref><ref name="pmid29995828">{{cite journal |vauthors=Liu X, Li X, Zhang C, Sun M, Sun Z, Xu Y, Tian X |title=Efficacy and tolerability of fluvoxamine in adults with social anxiety disorder: A meta-analysis |journal=Medicine (Baltimore) |volume=97 |issue=28 |pages=e11547 |date=July 2018 |pmid=29995828 |pmc=6076099 |doi=10.1097/MD.0000000000011547 |url=}}</ref> Of the ]s, however, fluvoxamine, ] and ] do appear consistent as viable treatments for generalised social anxiety.<ref name="Williams-2020">Williams, T., McCaul, M., Schwarzer, G., Cipriani, A., Stein, D. J., & Ipser, J. (2020). Pharmacological treatments for social anxiety disorder in adults: a systematic review and network meta-analysis. Acta neuropsychiatrica, 32(4), 169–176. https://doi.org/10.1017/neu.2020.6 {{Webarchive|url=https://web.archive.org/web/20240907193632/https://www.cambridge.org/core/journals/acta-neuropsychiatrica/article/abs/pharmacological-treatments-for-social-anxiety-disorder-in-adults-a-systematic-review-and-network-metaanalysis/38FA011F8B7B205A8714F57528DF59A4 |date=7 September 2024 }}</ref><ref name="Davidson-2003">Davidson J. R. (2003). Pharmacotherapy of social phobia. Acta psychiatrica Scandinavica. Supplementum, (417), 65–71. https://doi.org/10.1034/j.1600-0447.108.s417.7.x {{Webarchive|url=https://web.archive.org/web/20240907193630/https://onlinelibrary.wiley.com/doi/10.1034/j.1600-0447.108.s417.7.x |date=7 September 2024 }}</ref> ],<ref name="Tancer-1997">Tancer, M. E., & Uhde, T. W. (1997). Role of serotonin drugs in the treatment of social phobia. The Journal of clinical psychiatry, 58 Suppl 5, 50–54.</ref><ref name="Aarre-2003"> Aarre T. F. (2003). Phenelzine efficacy in refractory social anxiety disorder: a case series. Nordic journal of psychiatry, 57(4), 313–315. https://doi.org/10.1080/08039480310002110</ref> ], ], ], ] and ] represent other viable options for the pharmacological treatment of generalised social anxiety.<ref name="pmid11801236">Blanco C, Antia SX, Liebowitz MR. Pharmacotherapy of social anxiety disorder. Biol Psychiatry. 2002 Jan 1;51(1):109-20. doi: 10.1016/s0006-3223(01)01294-x. PMID 11801236.</ref><ref name="pmid19238127">Westenberg HG. Recent advances in understanding and treating social anxiety disorder. CNS Spectr. 2009 Feb;14(2 Suppl 3):24-33. doi: 10.1017/s1092852900027267. PMID 19238127.</ref><ref name="pmid25284086">Davis ML, Smits JA, Hofmann SG. Update on the efficacy of pharmacotherapy for social anxiety disorder: a meta-analysis. Expert Opin Pharmacother. 2014 Nov;15(16):2281-91. doi: 10.1517/14656566.2014.955472. Epub 2014 Oct 5. PMID 25284086.</ref>
	==Pharmacology==
	Fluvoxamine is a potent and selective ] with approximately 100-fold affinity for the ] over the ]. It has negligible affinity for the ] or any other ], with the sole exception of the ]. It behaves as a potent ] at this receptor and has the highest affinity of any SSRI for doing so. This may contribute to its antidepressant and anxiolytic effects inside the brain. Indeed, other SSRIs which also act as ] agonists, such as ] and ] (not verified but likely to be), display enhanced antidepressant efficacy.<ref>{{cite journal | first = Narita N | last = Hashimoto K et al. | year = 1996 | title = Interactions of selective reuptake inhibitors with subtypes of sigma receptor in rat brain | journal = Eur J Pharmacol| volume = 307 | issue = 1| pages = 117–9 | doi = 10.1016/0014-2999(96)00254-3 | pmid = 8831113 | last2 = Hashimoto | first2 = K | last3 = Tomitaka | first3 = S | last4 = Minabe | first4 = Y}}</ref> suggesting that it may have particular benefits in the treatment of depressed patients who show features of anxiety/stress and for whom memory impairment is particularly undesirable (such as in depressed elderly patients, and also in treating psychotic depression).<ref>{{cite journal | first = Carrasco JL | last = C.Sandner | month = December | year = 2005 | title = Clinical effects of pharmacological variations in selective serotonin reuptake inhibitors: an overview | journal = International Journal of Clinical Practice | volume = 59 | issue = 12 | pages = 1428–1434 | doi = 10.1111/j.1368-5031.2005.00681.x | pmid = 16351675 | last2 = Sandner | first2 = C}}</ref> In fact, the TCA ], a σ<sub>1</sub> receptor agonist without effects on the serotonin, dopamine, or norepinephrine systems, has considerable antidepressant and ] efficacy in its own right.
			Fluvoxamine is also effective for treating a range of ]s in children and adolescents, including ], social anxiety disorder, panic disorder and ].<ref name="NIHR-Evidence-2022">{{cite journal |date=3 November 2022 |title=Antidepressants for children and teenagers: what works for anxiety and depression? |url=https://evidence.nihr.ac.uk/collection/antidepressants-for-children-and-teenagers-what-works-anxiety-depression/ |journal=NIHR Evidence |type=Plain English summary |publisher=National Institute for Health and Care Research |doi=10.3310/nihrevidence_53342 |s2cid=253347210 |url-access=subscription |access-date=7 November 2022 |archive-date=5 November 2022 |archive-url=https://web.archive.org/web/20221105153958/https://evidence.nihr.ac.uk/collection/antidepressants-for-children-and-teenagers-what-works-anxiety-depression/ |url-status=live }}</ref><ref name="pmid32982805">{{cite journal | vauthors = Boaden K, Tomlinson A, Cortese S, Cipriani A | title = Antidepressants in Children and Adolescents: Meta-Review of Efficacy, Tolerability and Suicidality in Acute Treatment | journal = Frontiers in Psychiatry | volume = 11 | pages = 717 | date = 2 September 2020 | pmid = 32982805 | pmc = 7493620 | doi = 10.3389/fpsyt.2020.00717 | doi-access = free }}</ref><ref name="pmid34002501">{{cite journal | vauthors = Correll CU, Cortese S, Croatto G, Monaco F, Krinitski D, Arrondo G, Ostinelli EG, Zangani C, Fornaro M, Estradé A, Fusar-Poli P, Carvalho AF, Solmi M | title = Efficacy and acceptability of pharmacological, psychosocial, and brain stimulation interventions in children and adolescents with mental disorders: an umbrella review | journal = World Psychiatry | volume = 20 | issue = 2 | pages = 244–275 | date = June 2021 | pmid = 34002501 | pmc = 8129843 | doi = 10.1002/wps.20881 }}</ref>
	==Pharmacokinetics==
	The oral ] of fluvoxamine is 53%. The plasma protein binding is about 80%.<ref name="drugs.com PI">{{cite web |url=http://www.drugs.com/pro/fluvoxamine.html |title=Fluvoxamine Official FDA information, side effects and uses |author=Barr Laboratories Inc |year=2010 |month=October |at=Subsection: Fluvoxamine - Clinical Pharmacology -> Pharmacokinetics |accessdate=2011-02-15}}</ref>
			The drug works long-term, and retains its therapeutic efficacy for at least one year.<ref name="pmid7507038">{{cite journal | vauthors = Wilde MI, Plosker GL, Benfield P | title = Fluvoxamine. An updated review of its pharmacology, and therapeutic use in depressive illness | journal = Drugs | volume = 46 | issue = 5 | pages = 895–924 | date = November 1993 | pmid = 7507038 | doi = 10.2165/00003495-199346050-00008 | s2cid = 195691900 }}</ref>
	===Metabolism===
	Fluvoxamine is strongly metabolized in the liver, mostly by the processes of ] ] (producing fluvoxamine acid and its N-] ]) and ] (producing fluvoxethanol). Only fluvoxamine acid has been shown to have ] inhibitor activity, roughly 1-2 ] less potent than the parent compound.<ref name="Rxlist Data">{{cite web |title=Luvox Tablets (Fluvoxamine Maleate) Drug Information: Uses, Side Effects, Drug Interactions and Warnings at RxList |url=http://www.rxlist.com/luvox-drug.htm |accessdate=2009-02-17 }}</ref>
			The average therapeutic dose for fluvoxamine is 100 to 300&nbsp;mg/day, with 300&nbsp;mg being the upper daily limit normally recommended. ], however, often requires higher doses; doses of up to 450&nbsp;mg/day may be prescribed in this case.<ref name="Seibell-2015">Seibell PJ, Hamblin RJ, Hollander E.
	] administration of a dose of fluvoxamine produced nine identifiable metabolites, constituting 85% of the absorbed dosage (thus 15% of the fluvoxamine remained unchanged). This isolate of metabolites was ]ly proven to contain 60% fluvoxamine acid and its N-acetyl analog, and 10% fluvoxethanol, with the other six metabolites making up 30%.<ref name="Rxlist Data" />
			Obsessive-compulsive disorder: Overview and standard treatment strategies. Psychiatric Annals. 2015 Jun 1;45(6):297-302.</ref><ref name="Rivas-1997">Rivas-Vazquez, R.A. and Blais, M.A., 1997. Selective serotonin reuptake inhibitors and atypical antidepressants: A review and update for psychologists. Professional Psychology: Research and Practice, 28(6), p.526.</ref><ref name="Middleton-2019">Middleton, R., Wheaton, M.G., Kayser, R. and Simpson, H.B., 2019. Treatment resistance in obsessive-compulsive disorder. Treatment resistance in psychiatry: risk factors, biology, and management, pp.165-177.</ref> The (off-label) upper daily limits for other serotonin-reuptake inhibitors used in the treatment of ], by analogy, are 400mg for ],<ref name="pmid16426083">Ninan PT, Koran LM, Kiev A, Davidson JR, Rasmussen SA, Zajecka JM, Robinson DG, Crits-Christoph P, Mandel FS, Austin C. High-dose sertraline strategy for nonresponders to acute treatment for obsessive-compulsive disorder: a multicenter double-blind trial. J Clin Psychiatry. 2006 Jan;67(1):15-22. doi: 10.4088/jcp.v67n0103. PMID 16426083.</ref> 100 mg for ], 120 mg for both ] and ], 60 mg for ] and 300 mg for ].<ref>{{Cite web|url=https://psychopharmacologyinstitute.com/section/adequate-treatment-trials-in-ocd-fda-approvals-and-maximal-dosing-2523-4887|title=Psychopharmacology Institute|website=psychopharmacologyinstitute.com}}</ref><ref name="pmid17849776">Koran LM, Hanna GL, Hollander E, Nestadt G, Simpson HB; American Psychiatric Association. Practice guideline for the treatment of patients with obsessive-compulsive disorder. Am J Psychiatry. 2007 Jul;164(7 Suppl):5-53. PMID 17849776.</ref>
	===Elimination===
	Fluvoxamine has the shortest ] ] of all SSRIs, with a mean of 15.6 hours.<ref>Center for Drug Evaluation and Research, (2000). Fluvoxamine Maleate Tablets. Application Number: 75901, Retrieved July 28, 2008, from http://www.fda.gov/cder/foi/anda/2000/75901_Fluvoxamine%20Maleate_Prntlbl.pdf</ref>
			In any case with fluvoxamine, treatment is generally begun at 50 mg and increased in 50 mg increments every 4 to 7 days until a therapeutic optimum is reached.<ref name="Figgitt-2000">Figgitt, D.P. and McClellan, K.J., 2000. Fluvoxamine: an updated review of its use in the management of adults with anxiety disorders. Drugs, 60, pp.925-954.</ref>
	==Drug interactions==
	Fluvoxamine has a low potential for the ]s which are based on inhibition of enzyme ] ]. Fluvoxamine shows the least interaction of the SSRIs, in regard to this specific enzyme.<ref>{{cite journal | first = Baumann | last = P. | year = 1996 | title = Pharmacokinetic-pharmacodynamic relationship of the Selective serotonin reuptake inhibitors | journal = Clinical Pharmacokinetics | volume = 31 | issue = 6| pages = 444–469 | doi = 10.2165/00003088-199631060-00004 | pmid = 8968657}}</ref><ref>{{cite journal | first = DeVane CL | last = Gill HS | year = 1997 | title = Clinical Pharmacokinetics of Fluvoxamine: applications to dosage regime design | journal = Journal of Clinical Psychiatry | volume = 58 | issue = Suppl 5 | pages = 7–14}}</ref><ref>{{cite journal | first = CL | last = DeVane| year = 1998 | title = Translational pharmacokinetics: current issues with newer antidepressants | journal = Depression and Anxiety | volume = 8 | issue = Suppl 1 | pages = 64–70 | doi = 10.1002/(SICI)1520-6394(1998)8:1+<64::AID-DA10>3.0.CO;2-S | pmid = 9809216}}</ref>
	Naturally the other SSRIs which are metabolized by CYP2D6 will have more CYP2D6-based interactions with ], ], ], ], ] and ].
			==Adverse effects==
	Fluvoxamine does, however, inhibit cytochrome P450 enzyme ], which metabolises ], ], ], ], ], ], ], and ]. These substances can cause increased serum levels when administered together with fluvoxamine. Of major concern is the fact that the ] found in ] are potent inducers of CYP1A2 so that smokers may require significant modification of medication dosage.<ref>{{cite journal| last = Kroom| first = Lisa A.| authorlink = | coauthors = | title = Drug Interactions With Smoking| journal = Am J Health-Syst Pharm.| volume = 64| issue = 18| pages = 1917–1921| publisher = American Society of Health-System Pharmacists| location = Medscape| date = 10-01-2007| url = http://www.medscape.com/viewarticle/562754_print| doi = 10.2146/ajhp060414| id = | accessdate = 2008-01-31| pmid = 17823102}}</ref> A recent warning has been published regarding potentially serious interaction with ], based on CYP1A2 metabolism.<ref>{{cite web| last = Waknine| first = Yael| authorlink = | coauthors = | title = Prescribers Warned of Tizanidine Drug Interactions| work = Medscape News| publisher = Medscape| date = April 13, 2007| url = http://www.medscape.com/viewarticle/555194_print| format = | doi = | accessdate = 2008-02-01}}</ref>
			Fluvoxamine's side-effect profile is very similar to other SSRIs. ] side effects are characteristic of those receiving treatment with fluvoxamine.<ref name=LUVOX>{{cite web |title=Product Information Luvox |work=TGA eBusiness Services |publisher=Abbott Australasia Pty Ltd |date=15 January 2013 |access-date=21 October 2013 |url=https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-PI-07140-3 |archive-date=9 October 2017|archive-url=https://web.archive.org/web/20171009014348/https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-PI-07140-3 |url-status=live}}</ref><ref name=DailyMed>{{cite web |title=Fluvoxamine Maleate tablet, coated prescribing information |work=] |publisher=U.S. National Library of Medicine |date=14 December 2018 |url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7ecd83ec-88f5-4f85-9cc2-9068375d8820 |access-date=28 November 2019 |archive-date=19 October 2020 |archive-url=https://web.archive.org/web/20201019235438/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7ecd83ec-88f5-4f85-9cc2-9068375d8820 |url-status=live}}</ref><ref name="AMH">{{cite book |veditors=Rossi S |isbn=978-0-9805790-9-3 |title=Australian Medicines Handbook |place=Adelaide |publisher=The Australian Medicines Handbook Unit Trust |year=2013 |edition=2013}}</ref><ref name="BNF">{{cite book |isbn=978-0-85711-084-8 |title=British National Formulary (BNF) |last1=Joint Formulary Committee |year=2013 |publisher=Pharmaceutical Press |location=London, UK |edition=65th |url-access=registration |url=https://archive.org/details/bnf65britishnati0000unse}}</ref><ref name="Maudsley">{{cite book |isbn=978-0-470-97948-8 |title=The Maudsley prescribing guidelines in psychiatry |vauthors=Taylor D, Paton C, Shitij K |year=2012 |publisher=Wiley-Blackwell |location=West Sussex}}</ref><ref name="electronic Medicines Compendium-2013">{{cite web |title=Faverin 100 mg film-coated tablets – Summary of Product Characteristics (SPC) |work=electronic Medicines Compendium |publisher=Abbott Healthcare Products Limited |date=14 May 2013 |access-date=21 October 2013 |url-status=live |url=http://www.medicines.org.uk/emc/medicine/22124/SPC/Faverin+100+mg+film-coated+tablets/ |archive-date=21 October 2013 |archive-url=https://web.archive.org/web/20131021042737/http://www.medicines.org.uk/emc/medicine/22124/SPC/Faverin+100+mg+film-coated+tablets/}}</ref>
			===Common===
	Fluvoxamine inhibits metabolism of ] and ] via ] and metabolism of ], ], ], ], ], ], ], ] and ] via ] as well as of ], ], ], ] and ] via ].<ref>{{cite journal| last = Bondy| first = Brigitta| authorlink =
			Common side effects occurring with 1–10% incidence:
	| coauthors = Illja Spellmann| title = Pharmacogenetics of Antipsychotics: Useful For the Clinician?
			{{div col |colwidth=20em}}
	| journal = Curr Opin Psychiatry| volume = 20| issue = 1| pages = 126–130| publisher = Lippincott Williams & Wilkins| location = Medscape| year = 2007| url = http://www.medscape.com/viewarticle/552100_print| doi = 10.1097/YCO.0b013e328017f69f
			* Abdominal pain
	| id = | accessdate = 2008-02-01| pmid = 17278909 }}</ref>
			* Agitation
			* Anxiety
			* ] (weakness)
			* ]
			* ]
			* Dizziness
			* ] (indigestion)
			* Headache
			* ] (excess sweating)
			* Insomnia
			* Loss of appetite
			* ]
			* Nausea
			* Nervousness
			* ]
			* Restlessness
			* ] (including delayed ejaculation, erectile dysfunction, decreased libido, etc.)
			* ] (drowsiness)
			* ] (high heart rate)
			* ]
			* Vomiting
			* Weight loss
			* ] (dry mouth)
			* Yawning
			{{div col end}}
			===Uncommon===
	The plasma protein binding of fluvoxamine is about 77%. Drugs with low protein binding are less likely to displace other protein bound drugs, and therefore have a lower potential to cause protein binding-related drug interactions.
			Uncommon side effects occurring with 0.1–1% incidence:
			{{div col |colwidth=30em}}
			* ]
			* Confusional state
			* Cutaneous hypersensitivity reactions (e.g. oedema , rash, pruritus)
			* Extrapyramidal side effects (e.g. dystonia, parkinsonism, tremor, etc.)
			* Hallucination
			* ]
			{{div col end}}
			===Rare===
	Fluvoxamine also inhibits ].<ref name="Rxlist Data" /><ref name="half-life">{{cite web |title=Brain Elimination Half-Life of Fluvoxamine |url=http://ajp.psychiatryonline.org/cgi/content/full/155/3/380 }}</ref>
			Rare side effects occurring with 0.01–0.1% incidence:
			{{div col |colwidth=32em}}
			* Abnormal hepatic (liver) function
			* Galactorrhoea (expulsion of breast milk unrelated to pregnancy or breastfeeding)
			* ]
			* Photosensitivity (being abnormally sensitive to light)
			* Seizures
			{{div col end}}
			===Unknown frequency===
	==Appearance in popular culture==
			{{div col |colwidth=30em}}
	The drug was given visibility in the American television series ] produced by ], in the second season, episode 10. Dr. ], the psychiatrist treating the character named ], is prescribed Luvox by her own psychiatrist, to treat a strong inclination toward alcohol.
			* ]{{snd}} a sense of inner restlessness that presents itself with the inability to stay still
			* Bed-wetting
			* ]s
			* ]
			* ]
			* ]
			* ]
			* ] (elevated plasma prolactin levels leading to galactorrhoea, amenorrhoea , etc.)
			* ]
			* ]
			* ] – practically identical presentation to serotonin syndrome except with a more prolonged onset
			* ]
			* ] – a potentially fatal condition characterised by abrupt onset muscle rigidity, hyperthermia (elevated body temperature), ], mental status changes (e.g. coma, hallucinations, agitation), etc.
			* Suicidal ideation and behaviour
			* ]
			* Urinary incontinence
			* Urinary retention
			* Violence towards others<ref name = LUVOXTIME>{{cite magazine |title=Top Ten Legal Drugs Linked to Violence |magazine=Time |date=7 January 2011 |access-date=10 September 2014 |url=https://healthland.time.com/2011/01/07/top-ten-legal-drugs-linked-to-violence/ |vauthors=Szalavitz M |archive-date=21 September 2014 |archive-url=https://web.archive.org/web/20140921052039/http://healthland.time.com/2011/01/07/top-ten-legal-drugs-linked-to-violence/ |url-status=live }}</ref>
			* Weight changes
			* Withdrawal symptoms
			{{div col end}}
			== Interactions ==
	"Stuttering" John Melendez, formerly of The Howard Stern Show, had taken Luvox for a period of time before his departure from the show.
			]
	==Synthesis==
	])]]
	]
			Fluvoxamine inhibits the following ] enzymes:<ref name=Pharm>{{cite book| vauthors = Ciraulo DA, Shader RI | veditors = Ciraulo DA, Shader RI | title=Pharmacotherapy of Depression|year=2011|publisher=Springer|isbn=978-1-60327-435-7|page=49 |edition= 2nd |doi=10.1007/978-1-60327-435-7}}</ref><ref name="GG">{{cite book | isbn = 978-0-07-162442-8 | title = Goodman and Gilman's The Pharmacological Basis of Therapeutics | edition = 12th | vauthors = Brunton L, Chabner B, Knollman B | year = 2010 | publisher = McGraw-Hill Professional | location = New York | title-link = Goodman and Gilman's The Pharmacological Basis of Therapeutics }}</ref><ref name="pmid8968657">{{cite journal | vauthors = Baumann P | title = Pharmacokinetic-pharmacodynamic relationship of the selective serotonin reuptake inhibitors | journal = Clinical Pharmacokinetics | volume = 31 | issue = 6 | pages = 444–469 | date = December 1996 | pmid = 8968657 | doi = 10.2165/00003088-199631060-00004 | s2cid = 31923953 }}</ref><ref name="pmid9184622">{{cite journal | vauthors = DeVane CL, Gill HS | title = Clinical pharmacokinetics of fluvoxamine: applications to dosage regimen design | journal = The Journal of Clinical Psychiatry | volume = 58 | issue = Suppl 5 | pages = 7–14 | year = 1997 | pmid = 9184622 }}</ref><ref name="pmid9809216">{{cite journal | vauthors = DeVane CL | title = Translational pharmacokinetics: current issues with newer antidepressants | journal = Depression and Anxiety | volume = 8 | issue = Suppl 1 | pages = 64–70 | year = 1998 | pmid = 9809216 | doi = 10.1002/(SICI)1520-6394(1998)8:1+<64::AID-DA10>3.0.CO;2-S | s2cid = 22297498 | doi-access = free }}</ref><ref name="pmid17278909">{{cite journal | vauthors = Bondy B, Spellmann I | title = Pharmacogenetics of antipsychotics: useful for the clinician? | journal = Current Opinion in Psychiatry | volume = 20 | issue = 2 | pages = 126–130 | date = March 2007 | pmid = 17278909 | doi = 10.1097/YCO.0b013e328017f69f | s2cid = 23859992 }}</ref><ref name="pmid17823102">{{cite journal | vauthors = Kroon LA | title = Drug interactions with smoking | journal = American Journal of Health-System Pharmacy | volume = 64 | issue = 18 | pages = 1917–1921 | date = September 2007 | pmid = 17823102 | doi = 10.2146/ajhp060414 }}</ref><ref name="Waknine-2007">{{cite web| vauthors = Waknine Y| title = Prescribers Warned of Tizanidine Drug Interactions| work = Medscape News| publisher = Medscape| date = 13 April 2007| url = http://www.medscape.com/viewarticle/555194_print| access-date = 1 February 2008| archive-date = 21 February 2013| archive-url = https://web.archive.org/web/20130221020721/http://www.medscape.com/viewarticle/555194_print| url-status = live}}</ref><ref name="Mayo-Clinic-2018">{{cite web|url=https://www.mayoclinic.org/drugs-supplements/fluvoxamine-oral-route/precautions/drg-20066874?p=1|title=Fluvoxamine (Oral Route) Precautions|website=Mayo Clinic|access-date=2 November 2018|archive-date=6 March 2019|archive-url=https://web.archive.org/web/20190306043631/https://www.mayoclinic.org/drugs-supplements/fluvoxamine-oral-route/precautions/drg-20066874?p=1|url-status=live}}</ref>{{Excessive citations inline|date=April 2024}}<!--there should be citations near the relevant enzymes/substances rather than the whole list of citations with unknown relevance-->
	Fluvoxamine is one of only two SSRIs (along with ]<ref>{{cite journal |title=Alaproclate acts as a potent, reversible and noncompetitive antagonist of the NMDA receptor coupled ion flow |author=A Wilkinson, M Courtney, A Westlind-Danielsson, G Hallnemo and K E Akerman |journal=JPET |date=December |year=1994 |volume=271 |issue=3 |pages=1314–1319}}</ref><ref>{{cite journal |title=Evaluation of the phencyclidine-like discriminative stimulus effects of novel NMDA channel blockers in rats |author=K L Nicholson and R L Balster |journal=Psychopharmacology |date= 23 April |year=2003}}</ref>) to have a monocyclic structure.
			* ] (strongly) which metabolizes ], ], ], ], ], ], ], ], ], ], ], ], ], etc.
			* ] (moderately) which metabolizes ], ], ], ], ], ], ], etc.<ref name="pmid11876575">{{cite journal | vauthors = Hemeryck A, Belpaire FM | title = Selective serotonin reuptake inhibitors and cytochrome P-450 mediated drug-drug interactions: an update | journal = Current Drug Metabolism | volume = 3 | issue = 1 | pages = 13–37 | date = February 2002 | pmid = 11876575 | doi = 10.2174/1389200023338017 }}</ref>
			* ] (weakly) which metabolizes ], ], ], ], ], ], ], ], ], ], ], ], ], ], ], etc.<ref name="FDA_drug_development">{{cite journal|title=Drug Development and Drug Interactions: Table of Substrates, Inhibitors and Inducers|journal=FDA|date=26 May 2021|url=https://www.fda.gov/drugs/drug-interactions-labeling/drug-development-and-drug-interactions-table-substrates-inhibitors-and-inducers|access-date=25 December 2020|archive-date=4 November 2020|archive-url=https://web.archive.org/web/20201104173036/https://www.fda.gov/drugs/drug-interactions-labeling/drug-development-and-drug-interactions-table-substrates-inhibitors-and-inducers|url-status=live}}</ref>
			* ] (moderately) which metabolizes ], ], ], etc.
			* ] (strongly) which metabolizes ], ], ], etc.
			* ] (weakly) which metabolizes ], ], ], ], ], etc.
			By so doing, fluvoxamine can increase serum concentration of the substrates of these enzymes.<ref name = Pharm/>
	==See also==
	*]
	*]
			Fluvoxamine may also elevate plasma levels of olanzapine by approximately two times.<ref name="pmid17214606">{{cite journal | vauthors = Spina E, de Leon J | title = Metabolic drug interactions with newer antipsychotics: a comparative review | journal = Basic & Clinical Pharmacology & Toxicology | volume = 100 | issue = 1 | pages = 4–22 | date = January 2007 | pmid = 17214606 | doi = 10.1111/j.1742-7843.2007.00017.x | doi-access = free }}</ref> Combined olanzapine and fluvoxamine, which may cause increased sedation,<ref name="pmid11063782">{{cite journal | vauthors = Bogetto F, Bellino S, Vaschetto P, Ziero S | title = Olanzapine augmentation of fluvoxamine-refractory obsessive-compulsive disorder (OCD): a 12-week open trial | journal = Psychiatry Research | volume = 96 | issue = 2 | pages = 91–98 | date = October 2000 | pmid = 11063782 | doi = 10.1016/s0165-1781(00)00203-1 | s2cid = 43395897 }}</ref> should be used cautiously and controlled clinically and by therapeutic drug monitoring to avoid olanzapine induced adverse effects and/or intoxication.<ref name="pmid12352274">{{cite journal | vauthors = Hiemke C, Peled A, Jabarin M, Hadjez J, Weigmann H, Härtter S, Modai I, Ritsner M, Silver H | title = Fluvoxamine augmentation of olanzapine in chronic schizophrenia: pharmacokinetic interactions and clinical effects | journal = Journal of Clinical Psychopharmacology | volume = 22 | issue = 5 | pages = 502–506 | date = October 2002 | pmid = 12352274 | doi = 10.1097/00004714-200210000-00010 | s2cid = 38073367 }}</ref><ref name="NPS MedicineWise-2020">{{cite web |date=23 November 2020 |title=Movox |url=https://www.nps.org.au/medicine-finder/movox-tablets |access-date=4 November 2022 |website=NPS MedicineWise |archive-date=4 November 2022 |archive-url=https://web.archive.org/web/20221104034758/https://www.nps.org.au/medicine-finder/movox-tablets |url-status=live }}</ref>
	==References==
	{{reflist|1}}
			The plasma levels of oxidatively metabolized ]s (e.g., ], ], ] and ]) are likely to be increased when co-administered with fluvoxamine. However, the clearance of ]s metabolized by ] (e.g., ]; ], which is coincidentally a metabolite of diazepam;<ref name="pmid28903606">{{cite journal | vauthors = Dinis-Oliveira RJ | title = Metabolic profile of oxazepam and related benzodiazepines: clinical and forensic aspects | journal = Drug Metabolism Reviews | volume = 49 | issue = 4 | pages = 451–463 | date = November 2017 | pmid = 28903606 | doi = 10.1080/03602532.2017.1377223 | s2cid = 4528255 }}</ref> ])<ref name="Raouf-2016">{{cite web|url=http://paindr.com/wp-content/uploads/2015/10/Revised-BZD_-9-30.pdf|title=Benzodiazepine Metabolism and Pharmacokinetics|vauthors=Raouf M|date=2016|veditors=Fudin J|access-date=16 September 2018|archive-date=12 July 2018|archive-url=https://web.archive.org/web/20180712232038/http://paindr.com/wp-content/uploads/2015/10/Revised-BZD_-9-30.pdf|url-status=live}}</ref><ref name="pmid8700792">{{cite journal | vauthors = Peppers MP | title = Benzodiazepines for alcohol withdrawal in the elderly and in patients with liver disease | journal = Pharmacotherapy | volume = 16 | issue = 1 | pages = 49–57 | date = 1996 | pmid = 8700792 | doi = 10.1002/j.1875-9114.1996.tb02915.x | s2cid = 1389910 }}</ref> are not affected by fluvoxamine and may be safely taken alongside fluvoxamine should concurrent treatment with a benzodiazepine be necessary.<ref name="fluvoxamine maleate-2016">{{cite web|url=http://www.mylan.ca/-/media/mylanca/documents/english/product%20pdf/pdfs%20dec%202015/luvox-pm-2016.01.08.pdf|title=fluvoxamine maleate: PRODUCT MONOGRAPH|date=2016|access-date=16 September 2018|archive-date=16 September 2018|archive-url=https://web.archive.org/web/20180916130322/http://www.mylan.ca/-/media/mylanca/documents/english/product%20pdf/pdfs%20dec%202015/luvox-pm-2016.01.08.pdf|url-status=live}}</ref> Additionally, it appears that benzodiazepines metabolized by nitro-reduction (], ]) may also, in a somewhat similar vein, be unlikely to be affected by fluvoxamine.<ref name="Medsafe, New Zealand-2017">{{cite web|url=http://www.medsafe.govt.nz/profs/datasheet/l/luvoxtab.pdf|title=Luvox Data Sheet|date=2017|publisher=Medsafe, New Zealand|access-date=16 September 2018|archive-date=29 March 2018|archive-url=https://web.archive.org/web/20180329045516/http://www.medsafe.govt.nz/profs/datasheet/l/luvoxtab.pdf|url-status=dead}}</ref><ref name="NPS MedicineWise-2022">{{cite web |title=Faverin Tablets |url=https://www.nps.org.au/medicine-finder/faverin-tablets |access-date=4 November 2022 |website=NPS MedicineWise |date=July 2022 |archive-date=4 November 2022 |archive-url=https://web.archive.org/web/20221104201934/https://www.nps.org.au/medicine-finder/faverin-tablets |url-status=live }}</ref>
			Using fluvoxamine and ] together can increase ] plasma concentrations.<ref name="pmid12698310">{{cite journal | vauthors = Suzuki Y, Shioiri T, Muratake T, Kawashima Y, Sato S, Hagiwara M, Inoue Y, Shimoda K, Someya T | title = Effects of concomitant fluvoxamine on the metabolism of alprazolam in Japanese psychiatric patients: interaction with CYP2C19 mutated alleles | journal = European Journal of Clinical Pharmacology | volume = 58 | issue = 12 | pages = 829–833 | date = April 2003 | pmid = 12698310 | doi = 10.1007/s00228-003-0563-9 | s2cid = 32559753 }}</ref> If ] is coadministered with fluvoxamine, the initial ] dose should be reduced to the lowest effective dose.<ref name="Gerlach-2014">{{cite book|url=https://books.google.com/books?id=AmQlBAAAQBAJ&pg=PA131|title=Psychiatric Drugs in Children and Adolescents: Basic Pharmacology and Practical Applications|vauthors=Gerlach M, Warnke A, Greenhill L|publisher=Springer-Verlag Wien|year=2014|isbn=978-3-7091-1500-8|pages=131|access-date=21 May 2020|archive-date=10 January 2023|archive-url=https://web.archive.org/web/20230110041817/https://books.google.com/books?id=AmQlBAAAQBAJ&pg=PA131|url-status=live}}</ref><ref name="pmid8005185">{{cite journal | vauthors = Fleishaker JC, Hulst LK | title = A pharmacokinetic and pharmacodynamic evaluation of the combined administration of alprazolam and fluvoxamine | journal = European Journal of Clinical Pharmacology | volume = 46 | issue = 1 | pages = 35–39 | date = 1994 | pmid = 8005185 | doi = 10.1007/bf00195913 | s2cid = 2161450 }}</ref>
			Fluvoxamine and ] coadministration is not indicated.<ref name="pmid20478852">{{cite journal | vauthors = Obach RS, Ryder TF | title = Metabolism of ramelteon in human liver microsomes and correlation with the effect of fluvoxamine on ramelteon pharmacokinetics | journal = Drug Metabolism and Disposition | volume = 38 | issue = 8 | pages = 1381–1391 | date = August 2010 | pmid = 20478852 | doi = 10.1124/dmd.110.034009 | s2cid = 8421997 }}</ref><ref name="pmid23861638">{{cite journal | vauthors = Pandi-Perumal SR, Spence DW, Verster JC, Srinivasan V, Brown GM, Cardinali DP, Hardeland R | title = Pharmacotherapy of insomnia with ramelteon: safety, efficacy and clinical applications | journal = Journal of Central Nervous System Disease | volume = 3 | pages = 51–65 | date = 12 April 2011 | pmid = 23861638 | pmc = 3663615 | doi = 10.4137/JCNSD.S1611 }}</ref>
			Fluvoxamine has been observed to increase serum concentrations of ], which is mainly metabolized by CYP1A2, CYP2D6, and CYP3A4, by three- to four-fold in humans.<ref name="AnttilaRasanen2001">{{cite journal | vauthors = Anttila AK, Rasanen L, Leinonen EV | title = Fluvoxamine augmentation increases serum mirtazapine concentrations three- to fourfold | journal = The Annals of Pharmacotherapy | volume = 35 | issue = 10 | pages = 1221–1223 | date = October 2001 | pmid = 11675851 | doi = 10.1345/aph.1A014 | s2cid = 44807359 }}</ref> Caution and adjustment of dosage as necessary are warranted when combining fluvoxamine and ].<ref name="AnttilaRasanen2001" />
			Fluvoxamine seriously affects the ] of ] and increases the intensity and duration of its effects. Because of the potentially hazardous consequences, the concomitant use of ] with fluvoxamine, or other potent inhibitors of ], should be avoided.<ref name="pmid15060511">{{cite journal | vauthors = Granfors MT, Backman JT, Neuvonen M, Ahonen J, Neuvonen PJ | title = Fluvoxamine drastically increases concentrations and effects of tizanidine: a potentially hazardous interaction | journal = Clinical Pharmacology and Therapeutics | volume = 75 | issue = 4 | pages = 331–341 | date = April 2004 | pmid = 15060511 | doi = 10.1016/j.clpt.2003.12.005 | s2cid = 25781307 }}</ref>
			When a beta-blocker is required, ],<ref name="pmid7988100">{{cite journal | vauthors = Perucca E, Gatti G, Spina E | title = Clinical pharmacokinetics of fluvoxamine | journal = Clinical Pharmacokinetics | volume = 27 | issue = 3 | pages = 175–190 | date = September 1994 | pmid = 7988100 | doi = 10.2165/00003088-199427030-00002 | s2cid = 22472247 }}</ref> ]<ref name="pmid11543734">{{cite journal | vauthors = Zanardi R, Serretti A, Rossini D, Franchini L, Cusin C, Lattuada E, Dotoli D, Smeraldi E | title = Factors affecting fluvoxamine antidepressant activity: influence of pindolol and 5-HTTLPR in delusional and nondelusional depression | journal = Biological Psychiatry | volume = 50 | issue = 5 | pages = 323–330 | date = September 2001 | pmid = 11543734 | doi = 10.1016/s0006-3223(01)01118-0 | s2cid = 22692759 }}</ref><ref name="Sluzewska-1996">{{cite journal | vauthors = Sluzewska A, Szczawinska K | title = The effects of pindolol addition to fluvoxamine and buspirone in chronic mild stress model of depression. | journal = Behavioural Pharmacology | date = May 1996 | volume = 7 | pages = 105 }}</ref><ref name="pmid9817627">{{cite journal | vauthors = Mundo E, Guglielmo E, Bellodi L | title = Effect of adjuvant pindolol on the antiobsessional response to fluvoxamine: a double-blind, placebo-controlled study | journal = International Clinical Psychopharmacology | volume = 13 | issue = 5 | pages = 219–224 | date = September 1998 | pmid = 9817627 | doi = 10.1097/00004850-199809000-00005 | s2cid = 23946424 }}</ref> and, possibly, ]<ref name="pmid9681670">{{cite journal | vauthors = Belpaire FM, Wijnant P, Temmerman A, Rasmussen BB, Brøsen K | title = The oxidative metabolism of metoprolol in human liver microsomes: inhibition by the selective serotonin reuptake inhibitors | journal = European Journal of Clinical Pharmacology | volume = 54 | issue = 3 | pages = 261–264 | date = May 1998 | pmid = 9681670 | doi = 10.1007/s002280050456 | s2cid = 28105445 }}</ref><ref name="pmid8904628">{{cite journal | vauthors = Xu ZH, Xie HG, Zhou HH | title = In vivo inhibition of CYP2C19 but not CYP2D6 by fluvoxamine | journal = British Journal of Clinical Pharmacology | volume = 42 | issue = 4 | pages = 518–521 | date = October 1996 | pmid = 8904628 | pmc = 2042705 | doi = 10.1046/j.1365-2125.1996.45319.x | doi-broken-date = 9 December 2024 }}</ref><ref name="pmid11876575"/><ref name="Belpaire-1997">{{cite journal | vauthors = Belpaire FM, Wijnant P, Tammerman A, Bogaert M, Rasmussen B, Brosen K | title = Inhibition of the oxidative metabolism of metoprolol by selective serotonin reuptake inhibitors in human liver microsomes. | journal = Fundamental and Clinical Pharmacology | date = 1997 | volume = 2 | issue = 11 | pages = 147 }}</ref> may be safer choices than ], as the latter's metabolism is seriously, potentially dangerously, inhibited by fluvoxamine.<ref name="pmid8846617">{{cite journal | vauthors = van Harten J | title = Overview of the pharmacokinetics of fluvoxamine | journal = Clinical Pharmacokinetics | volume = 29 | issue = Suppl 1| pages = 1–9 | date = 1995 | pmid = 8846617 | doi = 10.2165/00003088-199500291-00003 | s2cid = 71812133 }}</ref> Indeed, fluvoxamine may increase propranolol blood-levels by five-fold.<ref name="pmid22311403">{{cite journal | vauthors = Muscatello MR, Spina E, Bandelow B, Baldwin DS | title = Clinically relevant drug interactions in anxiety disorders | journal = Human Psychopharmacology | volume = 27 | issue = 3 | pages = 239–253 | date = May 2012 | pmid = 22311403 | doi = 10.1002/hup.2217 | s2cid = 11592004 }}</ref>
			] increases fluvoxamine levels and, conversely-likewise, fluvoxamine increases ] levels (thereby its serotoninergic potential) and inhibits its metabolism to its strongly-noradrenergic metabolite, ].<ref name="pmid8666564">{{cite journal | vauthors = Szegedi A, Wetzel H, Leal M, Härtter S, Hiemke C | title = Combination treatment with clomipramine and fluvoxamine: drug monitoring, safety, and tolerability data | journal = The Journal of Clinical Psychiatry | volume = 57 | issue = 6 | pages = 257–264 | date = June 1996 | pmid = 8666564 | doi = }}</ref><ref name="pmid34777510">{{cite journal | vauthors = Hardy NE, Walkup JT | title = Clomipramine in Combination with Fluvoxamine: A Potent Medication Combination for Severe or Refractory Pediatric OCD | journal = Journal of the Canadian Academy of Child and Adolescent Psychiatry | volume = 30 | issue = 4 | pages = 273–277 | date = November 2021 | pmid = 34777510 | pmc = 8561855 | doi = }}</ref>
			==Pharmacology==
			===Pharmacodynamics===
			{| class="wikitable floatright"
			|+Receptor affinity profile<ref name="pmid17662961">{{cite journal | vauthors = Ishikawa M, Ishiwata K, Ishii K, Kimura Y, Sakata M, Naganawa M, Oda K, Miyatake R, Fujisaki M, Shimizu E, Shirayama Y, Iyo M, Hashimoto K | title = High occupancy of sigma-1 receptors in the human brain after single oral administration of fluvoxamine: a positron emission tomography study using SA4503 | journal = Biological Psychiatry | volume = 62 | issue = 8 | pages = 878–883 | date = October 2007 | pmid = 17662961 | doi = 10.1016/j.biopsych.2007.04.001 | s2cid = 728565 }}</ref><ref name="Schatzberg-2009">{{cite book |title=The American Psychiatric Publishing textbook of psychopharmacology | vauthors = Schatzberg AF, Nemeroff CB |publisher= American Psychiatric Pub. |year=2009 |isbn=978-1-585-62386-0 |edition=4th |location=Arlington, VA |pages=354 |oclc=320111564}}</ref><ref name="pmid28501470">{{cite journal | vauthors = Yahata M, Chiba K, Watanabe T, Sugiyama Y | title = Possibility of Predicting Serotonin Transporter Occupancy From the In Vitro Inhibition Constant for Serotonin Transporter, the Clinically Relevant Plasma Concentration of Unbound Drugs, and Their Profiles for Substrates of Transporters | journal = Journal of Pharmaceutical Sciences | volume = 106 | issue = 9 | pages = 2345–2356 | date = September 2017 | pmid = 28501470 | doi = 10.1016/j.xphs.2017.05.007 | doi-access = free }}</ref>
			|-
			! Site !! K<sub>i</sub> (nM)
			|-
			| {{abbrlink|SERT|Serotonin transporter}} || 2.5
			|-
			| {{abbrlink|NET|Norepinephrine transporter}} || 1,427
			|-
			| ] || 5,786
			|-
			| ] || 1,288
			|-
			| ] || 36
			|}
			Fluvoxamine is a potent ] with around 100-fold affinity for the ] over the ].<ref name = GG/> It has negligible affinity for the ] or any other site, with the sole exception of the ].<ref name = sig>{{cite journal | vauthors = Hashimoto K | title = Sigma-1 receptors and selective serotonin reuptake inhibitors: clinical implications of their relationship | journal = Central Nervous System Agents in Medicinal Chemistry | volume = 9 | issue = 3 | pages = 197–204 | date = September 2009 | pmid = 20021354 | doi = 10.2174/1871524910909030197 }}</ref><ref name = "Westenberg_2006" /> It behaves as a potent ] at this receptor and has the highest affinity (36&nbsp;nM) of any SSRI for doing so.<ref name = sig/> This may contribute to its antidepressant and ] effects and may also afford it some efficacy in treating the cognitive symptoms of depression.<ref name = cog>{{cite journal | vauthors = Hindmarch I, Hashimoto K | title = Cognition and depression: the effects of fluvoxamine, a sigma-1 receptor agonist, reconsidered | journal = Human Psychopharmacology | volume = 25 | issue = 3 | pages = 193–200 | date = April 2010 | pmid = 20373470 | doi = 10.1002/hup.1106 | s2cid = 26491662 }}</ref> It increases concentrations of the ] ], which may also contribute to its anxiolytic effects.<ref name="pmid9501247">{{Cite journal |last=Uzunova |first=V |date=March 17, 1998 |title=Increase in the cerebrospinal fluid content of neurosteroids in patients with unipolar major depression who are receiving fluoxetine or fluvoxamine |journal=Proceedings of the National Academy of Sciences of the United States of America |volume=95 |issue=6 |pages=3239–3244 |doi=10.1073/pnas.95.6.3239 |doi-access=free |pmid=9501247 |pmc=19726 |bibcode=1998PNAS...95.3239U }}</ref> Unlike some other SSRIs, fluvoxamine's metabolites are pharmacologically neutral.<ref name="pmid1931931">{{cite journal | vauthors = Hrdina PD | title = Pharmacology of serotonin uptake inhibitors: focus on fluvoxamine | journal = Journal of Psychiatry & Neuroscience | volume = 16 | issue = 2 Suppl 1 | pages = 10–18 | date = July 1991 | pmid = 1931931 | pmc = 1188307 }}</ref>
			===Pharmacokinetics===
			]s have stated that fluvoxamine is ] primarily by ] and to a minor extent by ].<ref name="AltamuraCaldiroliBuoli2015">{{cite journal | vauthors = Altamura AC, Caldiroli A, Buoli M | title = Pharmacokinetic evaluation of fluvoxamine for the treatment of anxiety disorders | journal = Expert Opin Drug Metab Toxicol | volume = 11 | issue = 4 | pages = 649–660 | date = April 2015 | pmid = 25728382 | doi = 10.1517/17425255.2015.1021331 | url = }}</ref><ref name="Wyska2019">{{cite journal | vauthors = Wyska E | title = Pharmacokinetic considerations for current state-of-the-art antidepressants | journal = Expert Opin Drug Metab Toxicol | volume = 15 | issue = 10 | pages = 831–847 | date = October 2019 | pmid = 31526279 | doi = 10.1080/17425255.2019.1669560 | url = }}</ref> However, CYP2D6 ]s do not have considerably higher fluvoxamine levels than ]s.<ref name="AltamuraCaldiroliBuoli2015" /> The ]n ] (TGA) label (last revised 2023) states that the specific ]s involved in fluvoxamine are not definitively known and that '']'' data suggest that it is mainly metabolized by CYP1A2 and may also be metabolized by ] and ] to a much lesser extent.<ref name="LUVOX" />
			==History==
			Fluvoxamine was developed by Kali-Duphar,<ref name="Sittig"/> part of ], Belgium, now ], and introduced as Floxyfral in Switzerland in 1983.<ref name=Sittig>{{cite book|title=Sittig's Pharmaceutical Manufacturing Encyclopedia|year=2008|publisher=William Andrew|isbn=978-0-8155-1526-5|page=1699|url=http://www.armchairpatriot.com/Encyclopedias/Encyclopedia-Pharmaceutical%20Manufacturing%20%283rd%20edition%29/15265_v02_04.pdf|edition=3rd|access-date=17 October 2013|archive-date=14 October 2013|archive-url=https://web.archive.org/web/20131014042521/http://www.armchairpatriot.com/Encyclopedias/Encyclopedia-Pharmaceutical%20Manufacturing%20%283rd%20edition%29/15265_v02_04.pdf|url-status=dead}}</ref> It was approved by the U.S. ] (FDA) in 1994, and introduced as Luvox in the US.<ref name="pmid15995053">{{cite journal | vauthors = Leslie LK, Newman TB, Chesney PJ, Perrin JM | title = The Food and Drug Administration's deliberations on antidepressant use in pediatric patients | journal = Pediatrics | volume = 116 | issue = 1 | pages = 195–204 | date = July 2005 | pmid = 15995053 | pmc = 1550709 | doi = 10.1542/peds.2005-0074 }}</ref> In India, it is available, among several other brands, as Uvox by Abbott.<ref name=India>{{cite web|title=Brand Index―Fluvoxamine India |url=http://www.drugsupdate.com/brand/showavailablebrands/184 |access-date=18 October 2013 |archive-url=https://web.archive.org/web/20131019151123/http://www.drugsupdate.com/brand/showavailablebrands/184 |archive-date=19 October 2013 |url-status=dead }}</ref> It was one of the first SSRI antidepressants to be launched, and is prescribed in many countries to patients with major depression.<ref name="Cochrane 2010/2013">{{cite journal | vauthors = Omori IM, Watanabe N, Nakagawa A, Cipriani A, Barbui C, McGuire H, Churchill R, Furukawa TA | title = Fluvoxamine versus other anti-depressive agents for depression | journal = The Cochrane Database of Systematic Reviews | issue = 3 | pages = CD006114 | date = March 2010 | volume = 2013 | pmid = 20238342 | pmc = 4171125 | doi = 10.1002/14651858.CD006114.pub2 }}</ref> It was the first SSRI, a non-] drug, approved by the U.S. FDA specifically for the treatment of OCD.<ref name="OCD Medication">{{cite web|title=OCD Medication |url=http://www.brainphysics.com/medications.php |access-date=17 October 2013 |archive-url=https://web.archive.org/web/20131014072454/http://www.brainphysics.com/medications.php |archive-date=14 October 2013 |url-status=dead }}</ref> At the end of 1995, more than ten million patients worldwide had been treated with fluvoxamine.<ref name="Fluvoxamine Product Monograph-1999">{{cite web | year = 1999 | title = Fluvoxamine Product Monograph | url = https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/021519s003lbl.pdf | access-date = 15 September 2018 | archive-date = 27 October 2020 | archive-url = https://web.archive.org/web/20201027214646/https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/021519s003lbl.pdf | url-status = live }}</ref>{{failed verification|reason=no discussion of ten million patients|date=November 2019}} Fluvoxamine was the first SSRI to be registered for the treatment of obsessive compulsive disorder in children by the FDA in 1997.<ref name="Luvox Approved For Obsessive Compulsive Disorder in Children and Teens-2009">{{cite web | title = Luvox Approved For Obsessive Compulsive Disorder in Children and Teens | url = http://www.pslgroup.com/dg/2261a.htm | access-date = 8 February 2014 | archive-url = https://web.archive.org/web/20090116004424/http://www.pslgroup.com/dg/2261a.htm | archive-date = 16 January 2009 | url-status = dead }}</ref> In Japan, fluvoxamine was the first SSRI to be approved for the treatment of depression in 1999<ref name="pmid19300537">{{cite journal | vauthors = Higuchi T, Briley M | title = Japanese experience with milnacipran, the first serotonin and norepinephrine reuptake inhibitor in Japan | journal = Neuropsychiatric Disease and Treatment | volume = 3 | issue = 1 | pages = 41–58 | date = February 2007 | pmid = 19300537 | pmc = 2654524 | doi = 10.2147/nedt.2007.3.1.41 | doi-access = free }}</ref><ref name="Wishart">{{cite HMDB|author1-link=David S. Wishart|url=http://www.hmdb.ca/metabolites/HMDB0014322|title=Showing metabocard for Fluvoxamine (HMDB0014322)}}</ref> and was later in 2005 the first drug to be approved for the treatment of social anxiety disorder.<ref name="Solvay-2018">{{cite web | title = Solvay's Fluvoxamine maleate is first drug approved for the treatment of social anxiety disorder in Japan | url = https://www.fdanews.com/articles/81585-solvay-s-fluvoxamine-maleate-is-first-drug-approved-for-treatment-of-social-anxiety-disorder-in-japan | access-date = 15 September 2018 | archive-date = 15 September 2018 | archive-url = https://web.archive.org/web/20180915122310/https://www.fdanews.com/articles/81585-solvay-s-fluvoxamine-maleate-is-first-drug-approved-for-treatment-of-social-anxiety-disorder-in-japan | url-status = live }}</ref> Fluvoxamine was the first SSRI approved for clinical use in the United Kingdom.<ref name="Churchill Livingstone Elsevier-2007">{{cite book | isbn = 978-0-7020-4293-5 | title = Clinical Pharmacy and Therapeutics | year = 2007 | orig-year = 1994 | publisher = Churchill Livingstone Elsevier | location = Edinburgh | edition = 4th | veditors = Walker R, Whittlesea C }}</ref> Manufacturers include BayPharma, ], and ], among others.<ref name="www.drugbank.ca-2019">{{cite web |title=Fluvoxamine |url=https://www.drugbank.ca/drugs/DB00176 |website=www.drugbank.ca |access-date=22 October 2019 |archive-date=4 November 2019 |archive-url=https://web.archive.org/web/20191104161742/https://www.drugbank.ca/drugs/DB00176 |url-status=live }}</ref>
			== Research directions ==
			While early studies have suggested potential benefits for fluvoxamine as an anti-inflammatory agent and a possible impact on reducing cytokine storms, further studies did not confirm this expected benefit on COVID-19 patients.<ref name="pmid35383578">{{cite journal | vauthors = Bhuta S, Khokher W, Kesireddy N, Iftikhar S, Beran A, Mhanna M, Patel NJ, Patel M, Burmeister C, Assaly R | title = Fluvoxamine in Nonhospitalized Patients With Acute COVID-19 Infection and the Lack of Efficacy in Reducing Rates of Hospitalization, Mechanical Ventilation, and Mortality in Placebo-Controlled Trials: A Systematic Review and Meta-Analysis | journal = American Journal of Therapeutics | volume = 29 | issue = 3 | pages = e298–e304 | date = 2022 | pmid = 35383578 | doi = 10.1097/MJT.0000000000001496 | s2cid = 247978477 | doi-access = free }}</ref><ref name="pmid36532776">{{cite journal | vauthors = Asadi Anar M, Foroughi E, Sohrabi E, Peiravi S, Tavakoli Y, Kameli Khouzani M, Behshood P, Shamshiri M, Faridzadeh A, Keylani K, Langari SF, Ansari A, Khalaji A, Garousi S, Mottahedi M, Honari S, Deravi N | title = Selective serotonin reuptake inhibitors: New hope in the fight against COVID-19 | journal = Frontiers in Pharmacology | volume = 13 | issue = | pages = 1036093 | date = 2022 | pmid = 36532776 | pmc = 9748354 | doi = 10.3389/fphar.2022.1036093 | doi-access = free }}</ref> A cytokine storm refers to an excessive immune response characterized by a release of large amounts of pro-inflammatory cytokines.<ref name="pmid32592501">{{cite journal | vauthors = Hu B, Huang S, Yin L | title = The cytokine storm and COVID-19 | journal = Journal of Medical Virology | volume = 93 | issue = 1 | pages = 250–256 | date = January 2021 | pmid = 32592501 | pmc = 7361342 | doi = 10.1002/jmv.26232 }}</ref>
			In May 2022, based on a review of available scientific evidence, the U.S. ] (FDA) chose not to issue an ] covering the use of fluvoxamine to treat COVID-19, saying that, at the time, the data was not sufficient to conclude that fluvoxamine may be effective in treating non-hospitalized people with COVID-19 to prevent serious illness or hospitalization. The agency stated that study results suggest that further clinical trials may be warranted.<ref name="Reuters-2022">{{cite news |title=FDA declines to authorize common antidepressant as COVID treatment |url=https://www.reuters.com/business/healthcare-pharmaceuticals/fda-declines-authorize-common-antidepressant-covid-treatment-2022-05-16/ |access-date=18 May 2022 |work=Reuters |date=16 May 2022 |archive-date=17 May 2022 |archive-url=https://web.archive.org/web/20220517202625/https://www.reuters.com/business/healthcare-pharmaceuticals/fda-declines-authorize-common-antidepressant-covid-treatment-2022-05-16/ |url-status=live }}</ref><ref name="Food and Drug Administration-2022">{{cite tech report |type=Memorandum |title=Memorandum Explaining Basis for Declining Request for Emergency Use Authorization of Fluvoxamine Maleate |id=4975580 |institution=Food and Drug Administration |date=16 May 2022 |url=https://www.accessdata.fda.gov/drugsatfda_docs/nda/2020/EUA%20110%20Fluvoxamine%20Decisional%20Memo_Redacted.pdf |archive-url=https://web.archive.org/web/20220517001646/https://www.accessdata.fda.gov/drugsatfda_docs/nda/2020/EUA%20110%20Fluvoxamine%20Decisional%20Memo_Redacted.pdf |archive-date=17 May 2022 |url-status=live}} {{PD-notice}}</ref>
			A large double-blind randomized controlled trial called ACTIV-6, published in 2023 in '']'', revealed that taking 200&nbsp;mg of fluvoxamine every day for about two weeks was not significantly better than placebo at shortening the duration of mild or moderate COVID-19 symptoms.<ref name="Ingram-2023">{{cite web |last=Ingram |first=Ian |date=17 November 2023 |title=Higher-Dose Fluvoxamine Fails for COVID Outpatients |website=] |url=https://www.medpagetoday.com/infectiousdisease/covid19/107439 |access-date=4 December 2023 |url-status=live |archive-url=https://web.archive.org/web/20231117222854/https://www.medpagetoday.com/infectiousdisease/covid19/107439 |archive-date=17 November 2023}}</ref>{{med cn|date=December 2023}}
			There is tentative evidence that fluvoxamine may reduce the overall morbidity of ] and complications thereof.<ref name="pmid36103313">{{cite journal |vauthors=Nyirenda JL, Sofroniou M, Toews I, Mikolajewska A, Lehane C, Monsef I, Abu-Taha A, Maun A, Stegemann M, Schmucker C |title=Fluvoxamine for the treatment of COVID-19 |journal=The Cochrane Database of Systematic Reviews |volume=2022 |issue=9 |pages=CD015391 |date=September 2022 |pmid=36103313 |pmc=9473347 |doi=10.1002/14651858.CD015391 |type=Systematic review}}</ref><ref name="pmid38516100">{{cite journal |vauthors=Wannigama DL, Hurst C, Phattharapornjaroen P, Hongsing P, Sirichumroonwit N, Chanpiwat K, ((Rad S. M. AH)), Storer RJ, Ounjai P, Kanthawee P, Ngamwongsatit N, Kupwiwat R, Kupwiwat C, Brimson JM, Devanga Ragupathi NK, Charuluxananan S, Leelahavanichkul A, Kanjanabuch T, Higgins PG, Badavath VN, Amarasiri M, Verhasselt V, Kicic A, Chatsuwan T, Pirzada K, Jalali F, Reiersen AM, Abe S, Ishikawa H |title=Early treatment with fluvoxamine, bromhexine, cyproheptadine, and niclosamide to prevent clinical deterioration in patients with symptomatic COVID-19: a randomized clinical trial |journal=eClinicalMedicine |volume=70 |issue= |pages=102517 |date=April 2024 |pmid=38516100 |pmc=10955208 |doi=10.1016/j.eclinm.2024.102517}}</ref>
			==Environment==
			Fluvoxamine is a common finding in waters near human settlement.<ref name="Runoff" /> Christensen ''et al.'' 2007 finds it is "very toxic to aquatic organisms" by ] standards.<ref name="Runoff">
			{{Unbulleted list citebundle
			|{{*}} {{cite journal | vauthors = Chia MA, Lorenzi AS, Ameh I, Dauda S, Cordeiro-Araújo MK, Agee JT, Okpanachi IY, Adesalu AT | title = Susceptibility of phytoplankton to the increasing presence of active pharmaceutical ingredients (APIs) in the aquatic environment: A review | journal = Aquatic Toxicology | volume = 234 | pages = 105809 | date = May 2021 | pmid = 33780670 | doi = 10.1016/j.aquatox.2021.105809 | publisher = ] | bibcode = 2021AqTox.23405809C | s2cid = 232419482 }}
			|{{*}} {{cite journal | vauthors = Christensen AM, Faaborg-Andersen S, Ingerslev F, Baun A | title = Mixture and single-substance toxicity of selective serotonin reuptake inhibitors toward algae and crustaceans | journal = Environmental Toxicology and Chemistry | volume = 26 | issue = 1 | pages = 85–91 | date = January 2007 | pmid = 17269464 | doi = 10.1897/06-219R.1 | publisher = ] (] (SETAC)) | s2cid = 6562531 | doi-access = free | bibcode = 2007EnvTC..26...85C }}
			}}
			</ref>
			== References ==
			{{Reflist}}
	{{Antidepressants}}		{{Antidepressants}}
	{{Anxiolytics}}		{{Anxiolytics}}
			{{OCD pharmacotherapies}}
	{{Serotonergics}}
			{{Monoamine reuptake inhibitors}}
			{{Sigma receptor modulators}}
	==External links==
			{{Portal bar | Medicine}}
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