luvox drug information
Fluvoxamine (Depromel), a selective serotonin reuptake inhibitor (SSRI), was launched in May 1999 in Japan with more than 10 years' delay from the marketing in Europe and the United States. Fluvoxamine has been approved in about 80 countries as the indication to "depression" since 1983. As the indication to obsessive-compulsive disorder (OCD), fluvoxamine was first approved in the United States in 1994 and then in about 30 countries. Efficacy of the drug on "depression and depressed state" was found to be comparable to traditional tricyclic antidepressants (TCAs) by the clinical studies in Japan. Indication to OCD was first approved for fluvoxamine in Japan. The antidepressant and the anti-OCD action are considered the result of the serotonin reuptake inhibition at the serotonergic neurons. Fluvoxamine has little affinity for muscarinic, adrenergic alpha 1- and histamine H1-receptors, which TCAs have. Therefore, fluvoxamine possesses less side effects such as dry mouse, disuria, dizziness, orthostatic hypotension and drowsiness, etc.; and it is useful for elderly patients and long-term treatments for depression and OCD.
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Obsessive-compulsive disorder (OCD) is a chronic debilitating condition that requires long-term treatment. The selective serotonin reuptake inhibitors (SSRIs) appear to be associated with similar levels of efficacy to clomipramine in short-term treatment, but to have significant tolerability advantages. The results of the long-term controlled studies on clomipramine, fluvoxamine, fluoxetine and sertraline are reviewed. They demonstrate a significantly better outcome for anti-obsessional drugs than placebo. The absence of adequate long-term controlled studies on pharmacotherapy strengthen the grounds for recommending pharmacotherapy as the optimal approach for long-term treatment of OCD. The SSRIs would appear to be the treatment of choice in OCD in view of their tolerability and safety advantages compared with clomipramine.
luvox drug class
To provide an update of literature on the safety of using selective serotonin reuptake inhibitors (SSRIs) during pregnancy.
We have studied the effect of serotonin on synaptic transmission in rat hippocampal subiculum slices. Electrical stimulation of the alveus induced a field potential in the subiculum. The non-NMDA glutamate receptor antagonist, NBQX (3 x 10(-6) mol/l) suppressed the response by 78%, indicating that the signal involves glutamatergic neurons. Application of serotonin suppressed (EC50 = 3.6 x 10(-6) mol/l) the amplitude of the evoked potentials in a reversible, concentration-dependent manner. The responses to 5-HT were not altered after pretreatment with the 5-HT uptake blocker, fluvoxamine (10(-5) mol/l) or a combination of the MAO inhibitor pargyline (10(-5) mol/l) and ascorbic acid (10(-4) mol/l). The responses to 5-HT were also unaffected by pretreatment with the 5-HT1A selective antagonist NAN-190 (10(-6) mol/l), the 5-HT2A antagonist ketanserin (10(-6) mol/l) or the 5-HT3/5-HT4 antagonist ICS 205-930 (10(-6) mol/l). The 5-HT1B selective agonist CP 93,129 mimicked the effects of serotonin, but was more potent (EC50 4.1 x 10(-7) mol/l). The 5-HT1B receptor antagonist, (+/-)21-009 (3 x 10(-7) mol/l), antagonized the response to 5-HT and CP 93,129 with a pKB value of 7.1 and 7.2, respectively. These results suggest that the effect of 5-HT in the rat subiculum is mediated by 5-HT1B receptors.
luvox starting dose
The effects of a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist dizocilpine ((+)-MK-801) and a competitive NMDA antagonist, (+/-)-3-2-carboxypiperazin-4-yl-propyl-1-phosphonic acid (CPP) were compared in electrically evoked 5-HT release in the brain slices incorporating the substantia nigra pars reticulata (SNr) or the dorsal raphé nucleus (DRN) using fast cyclic voltammetry (FCV). Electrical stimulation of either the SNr or the DRN with 50 pulses at frequencies greater than 10 Hz generated signals that were indistinguishable from 5-HT. In the SNr, 0.6-60 microM MK-801 concentration dependently potentiated stimulated 5-HT release. CPP 20 microM or NMDA 100 microM had no effect on 5-HT release evoked by electrical stimulation. In the SNr, 1 microM fluvoxamine or 0.6-60 microM MK-801 potentiated electrically evoked release of 5-HT. Pre-exposure to 20 microM MK-801 inhibited the enhancing effects of 1 microM fluvoxamine on electrically evoked 5-HT release in the SNr. In the DRN, the presence of 1 microM fluvoxamine or 20 microM MK-801 weakly potentiated 5-HT release. In the presence of 1 microM methiothepin (a nonselective 5-HT1-2 antagonist), 1 microM fluvoxamine or 20 microM MK-801 were equipotent in potentiating the concentration of 5-HT released in response to electrical stimulation. The T1/2 values for 5-HT release following MK-801 or fluvoxamine administration were significantly increased. Potentiation of 5-HT release by MK-801 in the SNr and the DRN and lack of effect of either CPP or NMDA on 5-HT release or uptake argues against a role for NMDA receptors in modulation of 5-HT release. Inhibition of fluvoxamine induced potentiation of 5-HT signal in the presence of MK-801 suggests that MK-801 and fluvoxamine may interact at the level of the 5-HT transporter.
Selected parameters of central nervous system function have been examined in rabbits and mice given ethyl alcohol (ET) in combination with antidepressant drugs with different pharmacological profiles. A significant prolongation of the ET-induced loss of righting reflex was observed in mice treated with amitriptyline, 3 mg/kg, or trazodone, 8 mg/kg, injected intraperitoneally. The same drugs failed to cause narcosis when given alone to mice at doses up to 40 (amitriptyline) and 100 (trazodone) mg/kg. Rabbits given single 5 mg/kg IV doses of amitriptyline or trazodone exhibited a synchronous EEG pattern with an increase in spectrum total power that became more pronounced after IV injection of a low dose of ET (0.2 g/kg). The increase in the spectrum total power after ET was significantly greater in rabbits given trazodone than in those given amitriptyline. No significant interactive effects were observed in animals receiving combinations of ET with viloxazine, bupropion or fluvoxamine.
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The discontinuation of many pharmacologic agents is associated with characteristic withdrawal symptoms. Antidepressants, particularly the tricyclic antidepressants (TCAs), are known to be associated with a group of common symptoms upon discontinuation. Serotonin reuptake inhibitors (SRIs) are also taking their respective place in the literature with reports of discontinuation symptoms. This review summarizes case reports and reports that allow systematic assessment of discontinuation symptoms following SRI discontinuation.
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Recognized since the Middle Ages, and clearly described for more than 100 years, obsessive-compulsive disorder (OCD) continues to intrigue and challenge mental health professionals. Recent evidence has implicated dysfunctional serotonergic neurotransmission in OCD. This review summarizes the evidence favoring a serotonergic hypothesis for OCD followed by a more detailed discussion of the implications the hypothesis holds for treatment.
luvox 450 mg
We report the case of a 19-year-old woman who had developed obsessive-compulsive disorder after a hemorrhagic infarct in the left caudate nucleus after neurosurgery. Four years after the operation, her obsessive-compulsive disorder symptoms showed a remarkable reduction within a week of starting low-dose fluvoxamine, without any behavioral or psychological treatment.
luvox dose forms
In the logistic regression analysis, we detected an association of the phenotypes (MDD or controls) with rs1800866 genotype. However, we did not detect an association between rs1800866 and SSRI therapeutic response in Japanese MDD. In addition, remission with SSRI was not associated with rs1800866. Also, we did not detect a novel polymorphism in SIGMAR1 when we performed a mutation search using MDD treated by SSRIs samples.
luvox 200 mg
Both drug groups showed significant amelioration of depressive symptomatology over the trial period lasting for 8 weeks. Statistical analyses revealed no significant between-group differences regarding the efficacy assessed by either HAM-D or CGI scores; however, the efficacy of nortriptyline tended to appear earlier than that of fluvoxamine. Moreover, no significant differences were obtained for the factor scores, representing 'depressed mood', 'physical symptoms' or 'sleep disturbances', although 'sleep disturbances' appeared to improve earlier in the nortriptyline group than in the fluvoxamine group. As for the safety profiles, the nortriptyline group scored a significantly higher incidence of adverse events such as dysarthria or orthostatic dizziness, as well as increased heart rate.