Fluvoxamine
Luvox
Selective Serotonin Reuptake InhibitorGeneric availableTDM data
The mechanism of action of fluvoxamine maleate tablets in obsessive-compulsive disorder is presumed to be linked to its specific serotonin reuptake inhibition in brain neurons. Fluvoxamine has been shown to be a potent inhibitor of the serotonin reuptake transporter in preclinical studies, both in-vitro and in-vivo .
Compare Fluvoxamine →FDA-Approved Indications
- Obsessive-compulsive disorder (adults; pediatric 8–17 years)
Common Off-Label Uses
- Social anxiety disorder
- PTSD
- Panic disorder
- Body dysmorphic disorder
- Generalized anxiety disorder
What Sets This Drug Apart
- Only SSRI with OCD as its sole FDA indication — not approved for MDD in the US
- Broadest CYP inhibition profile among SSRIs: strong inhibition of CYP1A2, CYP2C9, CYP3A4, and CYP2C19; relatively weak CYP2D6 inhibition
- 4 specific contraindicated drug combinations (tizanidine, thioridazine, alosetron, pimozide) due to CYP inhibition
- Shortest half-life among SSRIs (15.6 hours at steady state); requires twice-daily dosing above 100 mg
- Nonlinear pharmacokinetics: Cmax increases disproportionately at higher doses (88→283→546 ng/mL at 100/200/300 mg)
- Smoking increases metabolism by 25% (CYP1A2 substrate)
- Highest nausea rate among SSRIs (40% vs placebo 14%)
- Cipriani 2018 MDD response OR 1.69 (95% CrI 1.41–2.02) — second-highest among SSRIs (off-label for MDD in US)
- Henssler 2024 any-symptom discontinuation rate 0.38 (95% CI 0.08–0.81, k=3) — nominally high but very wide CI
- Montejo-Gonzalez 1997: less orgasm/ejaculation delay than paroxetine, fluoxetine, and sertraline (single prospective study, not NMA)
- Pediatric OCD labeled ages 8–17; pediatric concentrations 2–3x higher in children (6–11) than adolescents (12–17)
Boxed Warning
SUICIDALITY AND ANTIDEPRESSANT DRUGS
Boxed Warning
SUICIDALITY AND ANTIDEPRESSANTS