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Drugs

, Volume 60, Issue 4, pp 925–954 | Cite as

Fluvoxamine

An Updated Review of its Use in the Management of Adults with Anxiety Disorders
  • David P. FiggittEmail author
  • Karen J. McClellan
Adis Drug Evaluation

Summary

Abstract

Fluvoxamine is a potent and selective serotonin reuptake inhibitor (SSRI) that has little or no effect on other monoamine reuptake mechanisms. Relative to other SSRIs, fluvoxamine is a weak inhibitor of cytochrome P450 (CYP) 2D6, a moderate inhibitor of CYP2C19 and CYP3A4 and a potent inhibitor of CYP1A2.

In randomised, double-blind trials, fluvoxamine 100 to 300 mg/day for 6 to 10 weeks significantly reduced symptoms of obsessive-compulsive disorder (OCD) compared with placebo. Response rates of 38 to 52% have been reported with fluvoxamine, compared with response rates of 0 to 18% with placebo. In patients with OCD, fluvoxamine had similar efficacy to that of clomipramine and, in smaller trials, the SSRIs paroxetine and citalopram and was significantly more effective than desipramine. Maintenance therapy with fluvoxamine may reduce the likelihood of relapses in up to 67% of patients with OCD.

Fluvoxamine ≤300 mg/day for 6 to 8 weeks was as effective as imipramine in patients with panic disorder, and significantly more effective than placebo. In addition, treatment with fluvoxamine ≤300 mg/day for ≥8 weeks improved symptoms of social phobia (social anxiety disorder), post-traumatic stress disorder (PTSD), pathological gambling, compulsive buying, trichotillomania, kleptomania, body dysmorphic disorder, eating disorders and autistic disorder. Large trials comparing the efficacy of fluvoxamine and other SSRIs in patients with anxiety disorders are warranted.

Fluvoxamine is generally well tolerated; in postmarketing studies, nausea was the only adverse event occurring in >10% of patients with less commonly reported events including somnolence, asthenia, headache, dry mouth and insomnia. Fluvoxamine is associated with a low risk of suicidal behaviour, sexual dys-function and withdrawal syndrome. Fewer anticholinergic or cardiovascular events are associated with fluvoxamine than tricyclic antidepressants. Although comparative data are lacking, the tolerability profile of fluvoxamine appears to be broadly similar to those of other SSRIs.

Conclusion: Fluvoxamine has demonstrated short term efficacy in the treatment of OCD, panic disorder, social phobia, PTSD and in a range of obsessive-compulsive spectrum disorders. The drug is as effective as clomipramine in patients with OCD but appears to have a better tolerability profile. On the basis of current treatment guidelines, fluvoxamine, like other SSRIs, is recommended as first-line treatment for a number of anxiety disorders. It appears to offer some pharmacokinetic advantages and a different drug interaction profile to the other SSRIs with a broadly similar spectrum of adverse events. However, direct comparisons are required to assess the relative efficacy and tolerability of the different agents of this drug class.

Overview of Pharmacodynamic Properties

Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI). It has little or no effect on other monoamine reuptake mechanisms or monoamine neuronal function and has low affinity for other neurotransmitter receptors.

The drug has relatively few cardiovascular or anticholinergic effects, unlike tricyclic antidepressants (TCAs). Furthermore, fluvoxamine appears to have negligible proconvulsant or sedative effects, and has shown minimal effects on psychomotor and cognitive function in humans/animals.

Overview of Pharmacokinetic Properties

Fluvoxamine is almost completely absorbed from the gastrointestinal tract after oral administration: maximum plasma drug concentrations are reached within 2 to 8 hours and are not affected by the concomitant intake of food. Nonlinear pharmacokinetics are reported in volunteers after repeated administration of therapeutic dosages of fluvoxamine.

The drug is widely distributed throughout the body (25 L/kg) but has a relatively low level of protein binding (77%) compared with fluoxetine (94%), paroxetine (95%) and sertraline (98 to 99%). It has an absolute oral bioavailability of ≈50% because of extensive first-pass metabolism; the specific hepatic cytochrome P450 (CYP) isozymes involved remain to be identified.

Most of an oral fluvoxamine dose is excreted in the urine, but only 3% as unchanged drug. 11 pharmacologically inactive metabolites have been identified in urine after a radiolabelled dose. Excretion of fluvoxamine via breast milk is minimal.

Clearance of fluvoxamine may be slowed in the elderly and in patients with hepatic impairment, but the pharmacokinetic profile of the drug is not affected in patients with impaired renal function.

Evidence suggests that fluvoxamine is a weak inhibitor of CYP2D6 relative to other SSRIs, a moderate inhibitor of CYP2C19 and CYP3A4 and a potent inhibitor of CYP1A2 in hepatic microsomes. The drug is therefore likely to inhibit the metabolism and prolong the elimination of CYP1A2 substrates such as caffeine, clozapine, propranolol, tacrine, tertiary amine TCAs, theophylline and warfarin. Other drugs that potentially have their metabolic elimination impaired by fluvoxamine include those benzodiazepines which undergo oxidative metabolism by CYP3A4 (e.g. alprazolam and diazepam), methadone and thioridazine. There are no appreciable pharmacokinetic interactions between fluvoxamine and lithium, digoxin or ethanol (alcohol).

Therapeutic Efficacy

Obsessive-compulsive disorder: Oral administration of fluvoxamine at dosages of 100 to 300 mg/day for 6 to 10 weeks significantly reduced symptoms of obsessive-compulsive disorder (OCD) compared with placebo in randomised, double-blind trials. Significant reductions in the Yale-Brown Obsessive-Compulsive Scale and the National Institute of Mental Health Obsessive-Compulsive global rating scale occurred after 3 to 4 weeks, a delay similar to that seen with fluvoxamine in the treatment of depression. Most placebo-controlled studies reported a response rate (percentage of patients who were rated as ‘much improved’ or ‘very much improved’ on the Clinical Global Impression scale between 38 and 52% for fluvoxamine compared with 0 and 18% for placebo.

Evidence suggests that fluvoxamine has efficacy similar to that of the TCA clomipramine and the SSRIs paroxetine and citalopram in patients with OCD, and is significantly more effective than the noradrenaline uptake inhibitor desipramine.

Limited data suggest that maintenance therapy with fluvoxamine may reduce the likelihood of relapses in up to 67% of patients with OCD. Furthermore, treatment with fluvoxamine (up to 300 mg/day) may enhance the efficacy of behavioural therapy in this patient group.

Panic disorder: Placebo-controlled trials in patients with panic disorder found that 6 or 8 weeks’ treatment with fluvoxamine (≤300 mg/day) reduced the weekly number of full panic attacks by 54 to 100%; in comparison, the weekly number of full panic attacks in patients receiving placebo ranged from an increase of 10% to a reduction of 75%. Comparisons with placebo for this end-point were significant (p < 0.05) in most studies. Where evaluated, a higher proportion of fluvoxamine (47 to 81%) than placebo (22 to 61%) recipients were free from panic attacks in the final week of treatment, although not all studies showed a significant between-group difference.

Fluvoxamine also significantly reduced anxiety (assessed by the Hamilton Anxiety Scale or the Clinical Anxiety Scale) in these patients compared with placebo.

Limited comparative data in patients with panic disorder show that fluvoxamine ≤300 mg/day is as effective as the same dosage of the TCA imipramine (8-week study), but that a 150 mg/day dosage may be slightly less effective than the monoamine oxidase inhibitor (MAOI) brofaromine 150 mg/day (12-week study).

Limited evidence suggests that fluvoxamine ≤300 mg/day reduces anxiety levels significantly more effectively than cognitive therapy alone in patients with panic disorder; when coadministered with exposure or cognitive therapy the effects of fluvoxamine may be additive.

Other disorders: Results from small, generally noncomparative trials suggest that fluvoxamine (≤300 mg/day for 8 to 12 weeks) is effective in patients with post-traumatic stress disorder. Fluvoxamine was significantly more effective than placebo in 2 double-blind comparative studies in patients with eating disorders. In addition, limited data suggest that fluvoxamine has efficacy in the treatment of various other obsessive-compulsive spectrum disorders, including pathological gambling, body dysmorphic disorder, autistic disorder, trichotillomania, compulsive buying and kleptomania. Furthermore, the drug reduced symptoms of social phobia (social anxiety disorder) significantly more effectively than placebo in 2 double-blind studies.

Tolerability

Fluvoxamine is generally well tolerated in patients with non-depressive disorders. Approximately 42% of patients with or without depression who received fluvoxamine ≤300 mg/day for between 4 and 52 weeks in postmarketing studies reported ≥1 adverse event. Adverse events were generally transient, and mild to moderately severe. Nausea was the most frequently reported event (15.7%), with other less common events including somnolence (6.4%), asthenia (5.1%), headache (4.8%), dry mouth (4.8%) and insomnia (4.0%).

The risk of suicidal behaviour in fluvoxamine recipients is low, as is the likelihood of sexual dysfunction. A small portion of patients (≈0.4%) may experience a withdrawal syndrome 1 to 4 days after discontinuing fluvoxamine therapy; these symptoms are generally mild and resolve within 25 days.

The drug causes fewer anticholinergic or cardiovascular effects than TCAs, and its use is not associated with the increase in bodyweight, impairment of psychomotor performance or sexual function sometimes seen with these agents. The tolerability profile of fluvoxamine appears to be broadly similar to those of other SSRIs, although few directly comparative data are available.

Fluvoxamine is well tolerated in the elderly and in patients with mild cardiovascular disease. Because of limited isolated reports of fluvoxamine-induced seizures, the drug should be used with caution in patients at risk of seizures.

Dosage and Administration

Dosage recommendations for oral fluvoxamine in adults with anxiety disorders are currently only available for the treatment of OCD. In this patient group, the recommended fluvoxamine starting dosage is 50mg administered as a single daily dose at bedtime. In clinical trials in patients with OCD, fluvoxamine was generally titrated within a dosage range of 100 to 300 mg/day. As a result, it is recommended that the dosage of fluvoxamine should be titrated in 50mg increments every 4 to 7 days (depending on tolerability) until maximum therapeutic benefit is achieved. The daily dosage of fluvoxamine should not exceed 300mg; dosages >100 mg/day should be administered in 2 divided doses and, if the doses are not equal, the larger dose should be administered at bedtime. Similar dosage regimens have been used in clinical trials of fluvoxamine for the treatment of other anxiety disorders. It may be appropriate to modify the initial dose and subsequent dosage titrations in elderly patients and in patients with hepatic dysfunction.

Fluvoxamine is contraindicated in combination with MAOIs. According to US recommendations, administration of fluvoxamine is also contraindicated within 2 weeks of withdrawing an MAOI and vice versa. According to European recommendations, fluvoxamine treatment can be initiated 2 weeks after discontinuation of an irreversible MAOI or the following day after discontinuation of a reversible MAOI; at least 1 week should elapse between discontinuation of fluvoxamine and initiation of therapy with any MAOI.

It is recommended that fluvoxamine be used with caution and/or appropriate monitoring in patients taking other drugs with which it is known to interact, such as alprazolam, diazepam, theophylline and warfarin.

Keywords

Anxiety Disorder Fluvoxamine Social Phobia Bulimia Nervosa Pathological Gambling 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Costa e Silva JA. The public health impact of anxiety disorders: a WHO perspective. Acta Psychiatr Scand 1998; 98 Suppl. 393: 2–5CrossRefGoogle Scholar
  2. 2.
    Kessler RC, McGonagle KA, Zhao S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry 1994; 51: 8–19PubMedCrossRefGoogle Scholar
  3. 3.
    Rice DP, Miller LS. Health economics and cost implications of anxiety disorders and other mental disorders in the United States. Br J Psychiatry 1998; 173 Suppl. 34: 4–9Google Scholar
  4. 4.
    Sheehan DV. New treatments for anxiety disorders: clinical approaches for successful outcomes. J Clin Psychiatry 1999; 60 Suppl. 18: 3PubMedGoogle Scholar
  5. 5.
    Park LT, Jefferson JW, Greist JH. Obsessive-compulsive disorder: treatment options. CNS Drugs 1997; 7(3): 187–202CrossRefGoogle Scholar
  6. 6.
    Expert Consensus Panels for PTSD. Treatment of posttraumatic stress disorder. J Clin Psychiatry 1999; 60 Suppl. 16: 1–76Google Scholar
  7. 7.
    The Expert Consensus Panel for Obsessive-Compulsive Disorder. Treatment of obsessive-compulsive disorder. J Clin Psychiatry 1997; 58 Suppl. 4: 1–72Google Scholar
  8. 8.
    Ballenger JC, Davidson JRT, Lecrubier Y, et al. Consensus statement on panic disorder from the International Consensus Group on Depression and Anxiety. J Clin Psychiatry 1998; 59 Suppl. 8: 47–54PubMedGoogle Scholar
  9. 9.
    Ballenger JC, Davidson JRT, Lecrubier Y, et al. Consensus statement on social anxiety disorder from the International Consensus Group on Depression and Anxiety. J Clin Psychiatry 1998; 59 Suppl. 17: 54–60PubMedGoogle Scholar
  10. 10.
    Wilde MI, Plosker GL, Benfield P. Fluvoxamine: an updated review of its pharmacology, and therapeutic use in depressive illness. Drugs 1993 Nov; 46: 895–924PubMedCrossRefGoogle Scholar
  11. 11.
    Benfield P, Ward A. Fluvoxamine: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in depressive illness. Drugs 1986; 32: 313–34PubMedCrossRefGoogle Scholar
  12. 12.
    Palmer KJ, Benfield P. Fluvoxamine: an overview of its pharmacological properties and review of its therapeutic potential in non-depressive disorders. CNS Drugs 1994 Jan; 1(1): 57–87CrossRefGoogle Scholar
  13. 13.
    Claassen V. Review of the animal pharmacology and pharmacokinetics of fluvoxamine. Br J Clin Pharmacol 1983; 15 Suppl. 3: 349S–55SPubMedCrossRefGoogle Scholar
  14. 14.
    Claassen V, Davies JE, Hertting G, et al. Fluvoxamine, a specific 5-hydroxytryptamine uptake inhibitor. Br J Pharmacol 1977; 60: 505–16PubMedCrossRefGoogle Scholar
  15. 15.
    Hyttel J, Larsen J-J. Serotonin-selective antidepressants. Acta Pharmacol Toxicol 1985; 56(1): 146–53CrossRefGoogle Scholar
  16. 16.
    Constantinidis J, Dick P, Tissot R. Antidepressants and serotonin neurons of the raphe. Neuropsychobiology 1981; 7: 113–21PubMedCrossRefGoogle Scholar
  17. 17.
    Bel N, Artigas F. Fluvoxamine preferentially increases extracellular 5-hydroxytryptamine in the raphe nuclei: an in vivo microdialysis study. Eur J Pharmacol 1992; 229: 101–3PubMedCrossRefGoogle Scholar
  18. 18.
    Ortiz J, Artigas F Effects of monoamine uptake inhibitors on extracellular and platelet 5-hydroxytryptamine in rat blood: different effects of clomipramine and fluoxetine. Br J Pharmacol 1992; 105: 941–6PubMedCrossRefGoogle Scholar
  19. 19.
    Benfield P, Heel RC, Lewis SP. Fluoxetine: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in depressive illness. Drugs 1986; 32: 482–508Google Scholar
  20. 20.
    Dechant KL, Clissold SP. Paroxetine: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in depressive illness. Drugs 1991; 41: 225–53PubMedCrossRefGoogle Scholar
  21. 21.
    Murdoch D, McTavish D. Sertraline: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in depression and obsessive-compulsive disorder. Drugs 1992; 44: 604–24PubMedCrossRefGoogle Scholar
  22. 22.
    Alexander BS, Wood MD. [3H]8-OH-DPAT labels the 5-hydroxytryptamine uptake recognition site and the 5-HT1A binding site in the rat striatum. J Pharm Pharmacol 1988; 40: 888–91PubMedCrossRefGoogle Scholar
  23. 23.
    Jenck F, Moreau J-L, Mutel V, et al. Evidence for a role of 5-HT1C receptors in the antiserotonergic properties of some antidepressant drugs. Eur J Pharmacol 1993; 231: 223–9PubMedCrossRefGoogle Scholar
  24. 24.
    Thomas DR, Nelson DR, Johnson AM. Biochemical effects of the antidepressant paroxetine, a specific 5-hydroxytryptamine uptake inhibitor. Psychopharmacology 1987; 93: 193–200PubMedCrossRefGoogle Scholar
  25. 25.
    Wong DT, Bymaster FP, Reid LR, et al. Fluoxetine and two other serotonin reuptake inhibitors without affinity for neuronal receptors. Biochem Pharmacol 1983; 32: 1287–93PubMedCrossRefGoogle Scholar
  26. 26.
    Hall H, Sällemark M, Wedel I. Acute effects of atypical antidepressants on various receptors in the rat brain. Acta Pharmacol Toxicol 1984; 54: 379–84CrossRefGoogle Scholar
  27. 27.
    Heel RC, Morley PA, Brogden N, et al. Zimelidine: a review of its pharmacological properties and therapeutic efficacy in depressive illness. Drugs 1982; 24: 169–206PubMedCrossRefGoogle Scholar
  28. 28.
    Richelson E, Nelson A. Antagonism by antidepressants of neurotransmitter receptors of normal human brain in vitro. J Pharmacol Exp Ther 1984; 230: 94–102PubMedGoogle Scholar
  29. 29.
    Narita N, Hashimoto K, Tomitaka S-i, et al. Interactions of selective serotonin reuptake inhibitors with subtypes of σ receptors in rat brain. Eur J Pharmacol 1996 Jun 20; 307: 117–9PubMedCrossRefGoogle Scholar
  30. 30.
    Horton RW, Lowther S, Crompton MR, et al. The interaction of selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) with sigma (σ) binding sites in human brain tissue [abstract no. P13.21.21]. Can J Physiol Pharmacol 1994; 72 Suppl. 1:442Google Scholar
  31. 31.
    Flett SR, Szabadi E, Bradshaw CM. Acomparison of the effects of fluvoxamine and amitriptyline on autonomic functions in healthy volunteers. Eur J Clin Pharmacol 1992; 42: 529–33PubMedCrossRefGoogle Scholar
  32. 32.
    Wilson WH, Higano H, Papadatos Y, et al. A double-blind placebo-controlled study to compare the autonomic effects of fluvoxamine with those of amitriptyline and doxepin in healthy volunteers. Br J Clin Pharmacol 1983; 15 Suppl. 3: 385S–92SPubMedCrossRefGoogle Scholar
  33. 33.
    Robinson JF, Doogan DP. A placebo controlled study of the cardiovascular effects of fluvoxamine and clovoxamine in human volunteers. Br J Clin Pharmacol 1982; 14: 805–8PubMedCrossRefGoogle Scholar
  34. 34.
    Hewer W, Rost W, Gattaz WE Cardiovascular effects of fluvoxamine and maprotiline in depressed patients. Eur Arch Psychiatry Clin Neurosci 1995 Dec; 246: 1–6PubMedCrossRefGoogle Scholar
  35. 35.
    Hochberg HM, Kanter D, Houser VP. Electrocardiographic findings during extended clinical trials of fluvoxamine in depression: one years experience. Pharmacopsychiatry 1995 Nov; 28: 253–6PubMedCrossRefGoogle Scholar
  36. 36.
    Laird LK, Lydiard B, Morton A, et al. Cardiovascular effects of imipramine, fluvoxamine, and placebo in depressed outpatients. J Clin Psychiatry 1993 Jun; 54(6): 224–8PubMedGoogle Scholar
  37. 37.
    Krijzer F, Snelder M, Bradford D. Comparison of the (pro) convulsive properties of fluvoxamine and clomipramine with eight other antidepressants in an animal model. Neuropsychobiology 1984; 12: 249–54PubMedCrossRefGoogle Scholar
  38. 38.
    Saletu B, Grünberger J, Rajna P. Pharmaco-EEG profiles of antidepressants. Pharmacodynamic studies with fluvoxamine. Br J Clin Pharmacol 1983; 15 Suppl. 3: 369S–84SPubMedCrossRefGoogle Scholar
  39. 39.
    Linnoila M, Stapleton JM, George DT, et al. Effects of fluvoxamine, alone and in combination with ethanol, on psychomotor and cognitive performance and on autonomic nervous system reactivity in healthy volunteers. J Clin Psychopharmacol 1993; 13(3): 175–80PubMedCrossRefGoogle Scholar
  40. 40.
    Jenck F, Broekkamp CLE, van Delft AML. The effect of antidepressants on aversive periaqueductal gray stimulation in rats. Eur J Pharmacol 1990; 177: 201–4PubMedCrossRefGoogle Scholar
  41. 41.
    Olivier B, Bosch L, van-Hest A, et al. Preclinical evidence on the psychotropic profile of fluvoxamine. Pharmacopsychiatry 1993 May; 26 Suppl 1: 2–9PubMedCrossRefGoogle Scholar
  42. 42.
    Njung’e K, Handley SL. Effects of 5-HT uptake inhibitors, agonists and antagonists on burying of harmless objects by mice; a putative test for anxiolytic agents. Br J Pharmacol 1991; 104: 105–12PubMedCrossRefGoogle Scholar
  43. 43.
    Woods A, Smith C, Szewczak M, et al. Selective serotonin reuptake inhibitors decrease schedule-induced polydipsia in rats: a potential model for obsessive compulsive disorder. Psychopharmacology 1993 Sep; 112: 195–8PubMedCrossRefGoogle Scholar
  44. 44.
    Leonard BE, Faherty C. SSRIs and movement disorders: is serotonin the culprit? Hum Psychopharm 1996; 11: S75–82CrossRefGoogle Scholar
  45. 45.
    Leonard BE. Movement disorders and abuse potential of the selective serotonin reuptake inhibitors. Hum Psychopharm 1999; 14: 1–6CrossRefGoogle Scholar
  46. 46.
    van Harten J. Overview of the pharmacokinetics of fluvoxamine. Clin Pharmacokinet 1995; 29 Suppl. 1: 1–9PubMedCrossRefGoogle Scholar
  47. 47.
    Perucca E, Gatti G, Spina E. Clinical pharmacokinetics of fluvoxamine. Clin Pharmacokinet 1994 Sep; 27: 175–90PubMedCrossRefGoogle Scholar
  48. 48.
    Catterson ML, Preskorn SH. Pharmacokinetics of selective serotonin reuptake inhibitors: clinical relevance. Pharmacol Toxicol 1996 Apr; 78: 203–8PubMedCrossRefGoogle Scholar
  49. 49.
    Solvay Pharmaceuticals Inc. US prescribing information. Luvox (fluvoxamine maleate) tablets. Marietta, GA, USA, May 1999Google Scholar
  50. 50.
    Hartter S, Wetzel H, Hammes E, et al. Nonlinear pharmacokinetics of fluvoxamine and gender differences. Ther Drug Monit 1998 Aug; 20: 446–9PubMedCrossRefGoogle Scholar
  51. 51.
    Spigset O, Granberg K, Hägg S, et al. Non-linear fluvoxamine disposition. Br J Clin Pharmacol 1998 Mar; 45: 257–63PubMedCrossRefGoogle Scholar
  52. 52.
    Hurst M, Lamb HM. Fluoxetine: a review of its use in anxiety disorders and mixed anxiety and depression. CNS Drugs 2000 Jul; 14(1): 51–80CrossRefGoogle Scholar
  53. 53.
    De Vane CL, Gill HS. Clinical pharmacokinetics of fluvoxamine: applications to dosage regimen design. J Clin Psychiatry 1997; 58 Suppl. 5: 7–14Google Scholar
  54. 54.
    Overmars H, Scherpenisse PM, Post LC. Fluvoxamine maleate: metabolism in man. Eur J Drug Metab Pharmacokinet 1983; 8(3): 269–80PubMedCrossRefGoogle Scholar
  55. 55.
    Wright S, Dawling S, Ashford JJ. Excretion of fluvoxamine in breast milk. Br J Clin Pharmacol 1991; 31: 209PubMedCrossRefGoogle Scholar
  56. 56.
    De Vries MH, Raghoebar M, Mathlener IS, et al. Single and multiple oral dose fluvoxamine kinetics in young and elderly subjects. Ther Drug Monit 1992; 14: 493–8PubMedCrossRefGoogle Scholar
  57. 57.
    Brennan J, Hui J, Pullen R, et al. Steady state pharmacokinetics of fluvoxamine in young and elderly volunteers [abstract]. Clin Pharmacol Ther 1998 Feb; 63: 164Google Scholar
  58. 58.
    Raghoebar M, Roseboom H. Kinetics of fluvoxamine in special populations [poster]. Symposium on Variability in Pharmacokinetics and Drug Response; 1988 Oct 3–5; Gothenburg, SwedenGoogle Scholar
  59. 59.
    van Harten J, Duchier J, Devissaguet J-P, et al. Pharmacokinetics of fluvoxamine maleate in patients with liver cirrhosis after single-dose administration. Clin Pharmacokinet 1993; 24(2): 177–82PubMedCrossRefGoogle Scholar
  60. 60.
    Jeppesen U, Gram LF, Vistisen K, et al. Dose-dependent inhibition of CYP1A2, CYP2C19 and CYP2D6 by citalopram, fluoxetine, fluvoxamine and paroxetine. Eur J Clin Pharmacol 1996 Sep; 51: 73–8PubMedCrossRefGoogle Scholar
  61. 61.
    Xu Z-H, Xie H-G, Zhou H-H. In vivo inhibition of CYP2C19 but not CYP2D6 by fluvoxamine. Br J Clin Pharmacol 1996 Oct; 42: 518–21PubMedCrossRefGoogle Scholar
  62. 62.
    Jeppesen U, Rasmussen BB, Brøsen K. Fluvoxamine inhibits the CYP2C19-catalyzed bioactivation of chloroguanide. Clin Pharmacol Ther 1997 Sep; 62: 279–86PubMedCrossRefGoogle Scholar
  63. 63.
    Von Moltke LL, Greenblatt DJ, Court MH, et al. Inhibition of alprazolam and desipramine hydroxylation in vitro by paroxetine and fluvoxamine: comparison with other selective serotonin reuptake inhibitor antidepressants. J Clin Psychopharmacol 1995 Apr; 15: 125–31CrossRefGoogle Scholar
  64. 64.
    Fleishaker JC, Hulst LK. A pharmacokinetic and pharmacodynamic evaluation of the combined administration of alprazolam and fluvoxamine. Eur J Clin Pharmacol 1994; 46: 35–9PubMedCrossRefGoogle Scholar
  65. 65.
    Rasmussen BB, Maenpaa J, Pelkonen O, et al. Selective serotonin reuptake inhibitors and theophylline metabolism in human liver microsomes: potent inhibition by fluvoxamine. Br J Clin Pharmacol 1995 Feb; 39: 151–9PubMedCrossRefGoogle Scholar
  66. 66.
    Brøsen K, Skjelbo E, Rasmussen BB, et al. Fluvoxamine is a potent inhibitor of cytochrome P4501A2. Biochem Pharmacol 1993; 45: 1211–4PubMedCrossRefGoogle Scholar
  67. 67.
    Pastrakuljic A, Tang BK, Roberts EA, et al. Distinction of CYP1A1 and CYP1A2 activity by selective inhibition using fluvoxamine and isosafrole. Biochem Pharmacol 1997 Feb 21; 53: 531–8PubMedCrossRefGoogle Scholar
  68. 68.
    Kashuba ADM, Nafziger AN, Kearns GL, et al. Effect of fluvoxamine therapy on the activities of CYP1A2, CYP2D6, and CYP3A [abstract]. Clin Pharmacol Ther 1998 Feb; 63: 153CrossRefGoogle Scholar
  69. 69.
    Spigset O. Are adverse drug reactions attributed to fluvoxamine caused by concomitant intake of caffeine? Eur J Clin Pharmacol 1998 Oct; 54: 665–6PubMedCrossRefGoogle Scholar
  70. 70.
    Rasmussen BB, Nielsen TL, Brosen K. Fluvoxamine is a potent inhibitor of the metabolism of caffeine in vitro. Pharmacol Toxicol 1998 Dec; 83: 240–5PubMedCrossRefGoogle Scholar
  71. 71.
    Jeppesen U, Loft S, Poulsen HE, et al. A fluvoxamine-caffeine interaction study. Pharmacogenetics 1996 Jun; 6: 213–22PubMedCrossRefGoogle Scholar
  72. 72.
    Armstrong SC, Stephans JR. Blood clozapine levels elevated by fluvoxamine: potential for side effects and lower clozapine dosage [letter]. J Clin Psychiatry 1997 Nov; 58: 499PubMedCrossRefGoogle Scholar
  73. 73.
    Dequardo JR, Roberts M. Elevated clozapine levels after fluvoxamine initiation [letter; comment]. Am J Psychiatry 1996 Jun; 153:840–1PubMedGoogle Scholar
  74. 74.
    Heeringa M, Beurskens R, Schouten W, et al. Elevated plasma levels of clozapine after concomitant use of fluvoxamine. Pharm World Sci 1999; 21(5): 243–4PubMedCrossRefGoogle Scholar
  75. 75.
    Hiemke C, Weigmann H, Hartter S, et al. Elevated levels of clozapine in serum after addition of fluvoxamine [letter]. J Clin Psychopharmacol 1994 Aug; 14: 279–81PubMedCrossRefGoogle Scholar
  76. 76.
    Olesen OV, Linnet K. Fluvoxamine-clozapine drug interaction: inhibition in vitro of five cytochrome P450 isoforms involved in clozapine metabolism. J Clin Psychopharmacol 2000 Feb; 20(1): 35–42PubMedCrossRefGoogle Scholar
  77. 77.
    Wetzel H, Anghelescu I, Szegedi A, et al. Pharmacokinetic interactions of clozapine with selective serotonin reuptake inhibitors: differential effects of fluvoxamine and paroxetine in a prospective study. J Clin Psychopharmacol 1998 Feb; 18: 2–9PubMedCrossRefGoogle Scholar
  78. 78.
    Markowitz JS, Gill HS, Lavia M, et al. Fluvoxamine-clozapine dose-dependent interaction [letter]. Can J Psychiatry 1996 Dec; 41: 670–1PubMedGoogle Scholar
  79. 79.
    DuMortier G, Lochu A, Colen-de-Melo P, et al. Elevated clozapine plasma concentrations after fluvoxamine initiation [letter]. Am J Psychiatry 1996 May; 153: 738–9PubMedGoogle Scholar
  80. 80.
    Koponen HJ, Leinonen E, Lepola U. Fluvoxamine increases the clozapine serum levels significantly. Eur Neuropsychopharmacol 1996 Mar; 6: 69–71PubMedCrossRefGoogle Scholar
  81. 81.
    Becquemont L, Le Bot MA, Riche C, et al. Influence of fluvoxamine on tacrine metabolism in vitro: potential implication for the hepatotoxicity in vivo. Fundam Clin Pharmacol 1996; 10: 156–7PubMedCrossRefGoogle Scholar
  82. 82.
    Becquemont L, Ragueneau I, Le Bot MA, et al. Influence of the CYP1A2 inhibitor fluvoxamine on tacrine pharmacokinetics in humans. Clin Pharmacol Ther 1997 Jun; 61: 619–27PubMedCrossRefGoogle Scholar
  83. 83.
    Conus P, Bondolfi G, Eap CB, et al. Pharmacokinetic fluvoxamine-clomipramine interaction with favorable therapeutic consequences in therapy-resistant depressive patient. Pharmacopsychiatry 1996 May; 29: 108–10PubMedCrossRefGoogle Scholar
  84. 84.
    Xu ZH, Huang SL, Zhou HH. Inhibition of imipramine N-demethylation by fluvoxamine in Chinese young men. Chung Kuo Yao Li Hsueh Pao 1996 Sep; 17: 399–402PubMedGoogle Scholar
  85. 85.
    Spina E, Pollicino AM, Avenoso A, et al. Fluvoxamine-induced alterations in plasma concentrations of imipramine and desipramine in depressed patients. Int J Clin Pharmacol Res 1993; 13(3): 167–71PubMedGoogle Scholar
  86. 86.
    Seifritz E, Holsboer-Trachsler E, Hemmeter U, et al. Increased trimipramine plasma levels during fluvoxamine comedication. Eur Neuropsychopharmacol 1994 Mar; 4: 15–20PubMedCrossRefGoogle Scholar
  87. 87.
    Vandel P, Bonin B, Bertschy G, et al. Observations of the interaction between tricyclic antidepressants and fluvoxamine in poor metabolizers of dextromethorphan and mephenytoin [letter]. Therapie 1997 Jan–Feb; 52: 74–6PubMedGoogle Scholar
  88. 88.
    van den Brekel AM, Harrington L. Toxic effects of theophylline caused by fluvoxamine. Can Med Assoc J 1994 Nov 1; 151: 1289–90Google Scholar
  89. 89.
    Rasmussen BB, Jeppesen U, Gaist D, et al. Griseofulvin and fluvoxamine interactions with the metabolism of theophylline. Ther Drug Monit 1997 Feb; 19: 56–62PubMedCrossRefGoogle Scholar
  90. 90.
    De Vane CL, Markowitz JS, Hardesty SJ, et al. Fluvoxamine-induced theophylline toxicity [letter]. Am J Psychiatry 1997 Sep; 154: 1317–8Google Scholar
  91. 91.
    Hemeryck A, De Vriendt C, Belpaire FM. Inhibition of CYP2C9 by selective serotonin reuptake inhibitors: in vitro studies with tolbutamide and (S)-warfarin using human liver microsomes. Eur J Clin Pharmacol 1999 Feb; 54: 947–51PubMedCrossRefGoogle Scholar
  92. 92.
    Perucca E, Gatti G, Cipolla G, et al. Inhibition of diazepam metabolism by fluvoxamine: a pharmacokinetic study in normal volunteers. Clin Pharmacol Ther 1994 Nov; 56: 471–6PubMedCrossRefGoogle Scholar
  93. 93.
    Alderman CP, Frith PA. Fluvoxamine-methadone interaction. Aust N Z J Psychiatry 1999 Feb; 33: 99–101PubMedCrossRefGoogle Scholar
  94. 94.
    Bertschy G, Baumann P, Eap CB, et al. Probable metabolic interaction between methadone and fluvoxamine in addict patients. Ther Drug Monit 1994 Feb; 16: 42–5PubMedCrossRefGoogle Scholar
  95. 95.
    Carrillo JA, Ramos SI, Herraiz AG, et al. Pharmacokinetic interaction of fluvoxamine and thioridazine in schizophrenic patients. J Clin Psychopharmacol 1999; 19: 494–9PubMedCrossRefGoogle Scholar
  96. 96.
    Miljkovic BR, Pokrajac M, Timotijevic I, et al. The influence of lithium on fluvoxamine therapeutic efficacy and pharmacokinetics in depressed patients on combined fluvoxaminelithium therapy. Int Clin Psychopharmacol 1997 Jul; 12: 207–12PubMedCrossRefGoogle Scholar
  97. 97.
    Ochs HR, Greenblatt DJ, Verburg-Ochs B, et al. Chronic treatment with fluvoxamine, clovoxamine, and placebo: interaction with digoxin and effects on sleep and alertness. J Clin Pharmacol 1989; 29: 91–5PubMedGoogle Scholar
  98. 98.
    van Harten J, Stevens LA, Raghoebar M, et al. Fluvoxamine does not interact with alcohol or potentiate alcohol-related impairment of cognitive function. Clin Pharmacol Ther 1992; 52: 427–35PubMedCrossRefGoogle Scholar
  99. 99.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Fourth ed. Washington DC: American Psychiatric Association, 1994Google Scholar
  100. 100.
    Mundo E, Bianchi L, Bellodi L. Efficacy of fluvoxamine, paroxetine, and citalopram in the treatment of obsessive-compulsive disorder: a single-blind study. J Clin Psychopharmacol 1997 Aug; 17: 267–71PubMedCrossRefGoogle Scholar
  101. 101.
    Goodman WK, Kozak MJ, Liebowitz M, et al. Treatment of obsessive-compulsive disorder with fluvoxamine: a multi-centre, double-blind, placebo-controlled trial. Int Clin Psychopharmacol 1996 Mar; 11: 21–9PubMedCrossRefGoogle Scholar
  102. 102.
    Greist JH, Jenike MA, Robinson D, et al. Efficacy of fluvoxamine in obsessive-compulsive disorder: results of a multicentre, double blind, placebo-controlled trial. Eur J Clin Res 1995; 7: 195–204Google Scholar
  103. 103.
    Jenike MA, Hyman S, Baer L, et al. A controlled trial of fluvoxamine in obsessive-compulsive disorder: implications for a serotonergic theory. Am J Psychiatry 1990 Sep; 147: 1209–15PubMedGoogle Scholar
  104. 104.
    Mallya GK, White K, Waternaux C, et al. Short- and long-term treatment of obsessive-compulsive disorder with fluvoxamine. Ann Clin Psychiatry 1992 Jun; 4: 77–80CrossRefGoogle Scholar
  105. 105.
    Mundo E, Maina G, Uslenghi C, et al. Multicentre, double-blind, comparison of fluvoxamine and clomipramine in the treatment of obsessive-compulsive disorder. Int Clin Psychopharmacol 2000 Mar; 15: 69–76PubMedCrossRefGoogle Scholar
  106. 106.
    Freeman CPL, Trimble MR, Deakin JFW, et al. Fluvoxamine versus clomipramine in the treatment of obsessive compulsive disorder: a multicenter, randomized, double-blind, parallel group comparison. J Clin Psychiatry 1994 Jul; 55: 301–5PubMedGoogle Scholar
  107. 107.
    Rouillon F. A double-blind comparison of fluvoxamine and clomipramine in OCD [abstract]. Eur Neuropsychopharmacol 1998 Nov; 8 Suppl. 2: S260–261CrossRefGoogle Scholar
  108. 108.
    Koran LM, McElroy SL, Davidson JRT, et al. Fluvoxamine versus clomipramine for obsessive-compulsive disorder: a double-blind comparison. J Clin Psychopharmacol 1996 Apr; 16: 121–9PubMedCrossRefGoogle Scholar
  109. 109.
    Milanfranchi A, Ravagli S, Lensi P, et al. A double-blind study of fluvoxamine and clomipramine in the treatment of obsessive-compulsive disorder. Int Clin Psychopharmacol 1997 May; 12: 131–6PubMedCrossRefGoogle Scholar
  110. 110.
    Goodman WK, Price LH, Rasmussen SA, et al. Efficacy of fluvoxamine in obsessive-compulsive disorder: a double-blind comparison with placebo. Arch Gen Psychiatry 1989 Jan; 46: 36–44PubMedCrossRefGoogle Scholar
  111. 111.
    Goodman WK, Price LH, Delgado PL, et al. Specificity of serotonin reuptake inhibitors in the treatment of obsessive-compulsive disorder. Comparison of fluvoxamine and desi-pramine. Arch Gen Psychiatry 1990 Jun; 47: 577–85PubMedCrossRefGoogle Scholar
  112. 112.
    Nakajima T, Kudo Y, Yamashita I, et al. Clinical usefulness of fluvoxamine maleate (SME3110), a selective serotonin reuptake inhibitor, in the treatment of obsessive compulsive disorder: a double-blind, placebo-controlled study investigating the therapeutic dose range and the efficacy of SME3110 [in Japanese]. Rinsho Iyaku 1998; 14(3): 589–616Google Scholar
  113. 113.
    Perse TL, Greist JH, Jefferson JW, et al. Fluvoxamine treatment of obsessive-compulsive disorder. Am J Psychiatry 1987 Dec; 144(12): 1543–8PubMedGoogle Scholar
  114. 114.
    George MS, Trimble MR, Robertson MM. Fluvoxamine and sulpiride in comorbid obsessive-compulsive disorder and Gilles de la Tourette syndrome. Hum Psychopharm 1993 Sep–Oct; 8: 327–34CrossRefGoogle Scholar
  115. 115.
    Ravizza L, Barzega G, Bellino S. Drug treatment of obsessive-compulsive disorder (OCD): long-term trial with clomipramine and selective serotonin reuptake inhibitors (SSRIs). Psychopharmacol Bull 1996; 32(1): 167–73PubMedGoogle Scholar
  116. 116.
    Mundo E, Bareggi SR, Pirola R, et al. Long-term pharmacotherapy of obsessive-compulsive disorder: a double-blind controlled study. J Clin Psychopharmacol 1997 Feb; 17: 4–10PubMedCrossRefGoogle Scholar
  117. 117.
    Hohagen F, Winkelmann G, Rasche-Räuchle H, et al. Combination of behaviour therapy with fluvoxamine in comparison with behaviour therapy and placebo: results of a multicentre study. Br J Psychiatry 1998 Aug; 173 Suppl. 35: 71–8Google Scholar
  118. 118.
    Cottraux J, Mollard E, Bouvard M, et al. Exposure therapy, fluvoxamine, or combination treatment in obsessive-compulsive disorder: one-year follow-up. Psychiatry Res 1993 Oct; 49: 63–75PubMedCrossRefGoogle Scholar
  119. 119.
    Hoehn-Saric R, McLeod DR, Hipsley PA. Effect of fluvoxamine on panic disorder. J Clin Psychopharmacol 1993; 13(5): 321–6PubMedCrossRefGoogle Scholar
  120. 120.
    Sandmann J, Lörch B, Bandelow B, et al. Fluvoxamine or placebo in the treatment of panic disorder and relationship to blood concentrations of fluvoxamine. Pharmacopsychiatry 1998 Jul; 31: 117–21PubMedCrossRefGoogle Scholar
  121. 121.
    Den Boer JA, Westenberg HGM. Effect of a serotonin and nor-adrenaline uptake inhibitor in panic disorder; a double-blind comparative study with fluvoxamine and maprotiline. Int Clin Psychopharmacol 1988; 3: 59–74CrossRefGoogle Scholar
  122. 122.
    Sharp DM, Power KG, Simpson RJ, et al. Fluvoxamine, placebo, and cognitive behaviour therapy used alone and in combination in the treatment of panic disorder and agoraphobia. J Anxiety Disord 1996 Jul–Aug; 10: 219–42CrossRefGoogle Scholar
  123. 123.
    Black DW, Wesner R, Bowers W, et al. A comparison of fluvoxamine, cognitive therapy, and placebo in the treatment of panic disorder. Arch Gen Psychiatry 1993 Jan; 50: 44–50PubMedCrossRefGoogle Scholar
  124. 124.
    van Vliet IM, den Boer JA, Westenberg HGM, et al. A doubleblind comparative study of brofaromine and fluvoxamine in outpatients with panic disorder. J Clin Psychopharmacol 1996; 16(4): 299–306PubMedCrossRefGoogle Scholar
  125. 125.
    van Megen HJGM, Westenberg HGM, den Boer JA, et al. Effect of the selective serotonin reuptake inhibitor fluvoxamine on CCK-4 induced panic attacks. Psychopharmacology 1997 Feb; 129: 357–64PubMedCrossRefGoogle Scholar
  126. 126.
    Den Boer JA, Westenberg HGM. Serotonin function in panic disorder: a double blind placebo controlled study with fluvoxamine and ritanserin. Psychopharmacology 1990; 102: 85–94CrossRefGoogle Scholar
  127. 127.
    Bakish D, Hooper CL, Filteau M-J, et al. A double-blind placebo-controlled trial comparing fluvoxamine and imipramine in the treatment of panic disorder with or without agoraphobia. Psychopharmacol Bull 1996; 32(1): 135–41PubMedGoogle Scholar
  128. 128.
    de Beurs E, van Balkom AJLM, Lange A, et al. Treatment of panic disorder with agoraphobia: comparison of fluvoxamine, placebo, and psychological panic management combined with exposure and of exposure in vivo alone. Am J Psychiatry 1995; 152(5): 683–91PubMedGoogle Scholar
  129. 129.
    de Beurs E, van Balkom AJLM, Van Dyck R, et al. Long-term outcome of pharmacological and psychological treatment for panic disorder with agoraphobia: a 2-year naturalistic follow-up. Acta Psychiatr Scand 1999; 99: 59–67PubMedCrossRefGoogle Scholar
  130. 130.
    De Vane CL, Ware MR, Emmanuel NP, et al. Evaluation of the efficacy, safety and physiological effects of fluvoxamine in social phobia. Int Clin Psychopharmacol 1999 Nov; 14: 345–51CrossRefGoogle Scholar
  131. 131.
    Stein MB, Fyer AJ, Davidson JRT, et al. Fluvoxamine treatment of social phobia (social anxiety disorder): a double-blind, placebo-controlled study. Am J Psychiatry 1999 May; 156: 756–60PubMedGoogle Scholar
  132. 132.
    van Vliet IM, den Boer JA, Westenberg HGM. Psychopharmacological treatment of social phobia; a double blind placebo controlled study with fluvoxamine. Psychopharmacology 1994; 115: 128–34PubMedCrossRefGoogle Scholar
  133. 133.
    Marmar CR, Schoenfeld F, Weiss DS, et al. Open trial of fluvoxamine treatment for combat-related posttraumatic stress disorder. J Clin Psychiatry 1996; 57 Suppl. 8: 66–72PubMedGoogle Scholar
  134. 134.
    De Boer M, Op den Velde W, Falger PJR, et al. Fluvoxamine treatment for chronic PTSD: a pilot study. Psychother Psychosom 1992; 57: 158–63PubMedCrossRefGoogle Scholar
  135. 135.
    Davidson JRT, Weisler RH, Malik M, et al. Fluvoxamine in civilians with posttraumatic stress disorder. J Clin Psychopharmacol 1998 Feb; 18(1): 93–5PubMedCrossRefGoogle Scholar
  136. 136.
    Hollander E. Obsessive-compulsive disorder-related disorders: the role of selective serotonergic reuptake inhibitors. Int Clin Psychopharmacol 1996 Dec; 11 Suppl. 5: 75–87PubMedCrossRefGoogle Scholar
  137. 137.
    Hollander E, Benzaquen SD. The obsessive-compulsive spectrum disorders. Int Rev Psychiatry 1997; 9: 99–109CrossRefGoogle Scholar
  138. 138.
    Fichter MM, Krüger R, Rief W, et al. Fluvoxamine in prevention of relapse in bulimia nervosa: effects on eating-specific psychopathology. J Clin Psychopharmacol 1996 Feb; 16: 9–18PubMedCrossRefGoogle Scholar
  139. 139.
    Fichter MM, Leibl C, Krüger R, et al. Effects of fluvoxamine on depression, anxiety, and other areas of general psychopathology in bulimia nervosa. Pharmacopsychiatry 1997 May; 30: 85–92PubMedCrossRefGoogle Scholar
  140. 140.
    Ayuso-Gutierrez JL, Palazón M, Ayuso-Mateos JL. Open trial of fluvoxamine in the treatment of bulimia nervosa. Int J Eat Disord 1994 Apr; 15:245–9PubMedCrossRefGoogle Scholar
  141. 141.
    Hudson JI, McElroy SL, Raymond NC, et al. Fluvoxamine in the treatment of binge-eating disorder: a multicenter placebocontrolled, double-blind trial. Am J Psychiatry 1998 Dec; 155: 1756–62PubMedGoogle Scholar
  142. 142.
    Hollander E, DeCaria CM, Mari E, et al. Short-term single-blind fluvoxamine treatment of pathological gambling. Am J Psychiatry 1998 Dec; 155: 1781–3PubMedGoogle Scholar
  143. 143.
    Hollander E, DeCaria CM, Finkell JN, et al. A randomized double-blind fluvoxamine/placebo crossover trial in pathologic gambling. Biol Psychiatry 2000; 47(9): 813–7PubMedCrossRefGoogle Scholar
  144. 144.
    Hollander E, Cohen L, Simeon D, et al. Fluvoxamine treatment of body dysmorphic disorder. J Clin Psychopharmacol 1994 Feb; 14: 75–7PubMedGoogle Scholar
  145. 145.
    Phillips KA, Dwight MM, McElroy SL. Efficacy and safety of fluvoxamine in body dysmorphic disorder. J Clin Psychiatry 1998 Apr; 59: 165–71PubMedCrossRefGoogle Scholar
  146. 146.
    Perugi G, Giannotti D, Di Vaio S, et al. Fluvoxamine in the treatment of body dysmorphic disorder (dysmorphophobia). Int Clin Psychopharmacol 1996 Dec; 11: 247–54PubMedCrossRefGoogle Scholar
  147. 147.
    Arnold LM, Mutasim DF, Dwight MM, et al. An open clinical trial of fluvoxamine treatment of psychogenic excoriation. J Clin Psychopharmacol 1999 Feb; 19: 15–8PubMedCrossRefGoogle Scholar
  148. 148.
    O’Sullivan RL, Phillips KA, Keuthen NJ, et al. Near-fatal skin picking from delusional body dysmorphic disorder responsive to fluvoxamine. Psychosomatics 1999 Jan–Feb; 40: 79–81PubMedCrossRefGoogle Scholar
  149. 149.
    McDougle CJ, Naylor ST, Cohen DJ, et al. A double-blind, placebo-controlled study of fluvoxamine in adults with autistic disorder. Arch Gen Psychiatry 1996 Nov; 53: 1001–8PubMedCrossRefGoogle Scholar
  150. 150.
    Stanley MA, Breckenridge JK, Swann AC. Fluvoxamine treatment of trichotillomania. J Clin Psychopharmacol 1997 Aug; 17: 278–83PubMedCrossRefGoogle Scholar
  151. 151.
    Black DW, Monahan P, Gabel J. Fluvoxamine in the treatment of compulsive buying. J Clin Psychiatry 1997 Apr; 58: 159–63PubMedCrossRefGoogle Scholar
  152. 152.
    Chong SA, Low BL. Treatment of kleptomania with fluvoxamine. Acta Psychiatr Scand 1996 Apr; 93: 314–5PubMedCrossRefGoogle Scholar
  153. 153.
    Durst R, Katz G, Knobler HY. Buspirone augmentation of fluvoxamine in the treatment of kleptomania. J Nerv Ment Dis 1997 Sep; 185: 586–8PubMedCrossRefGoogle Scholar
  154. 154.
    McElroy SL, Keck Jr PE, Pope Jr HG, et al. Compulsive buying: a report of 20 cases. J Clin Psychiatry 1994; 55(6): 242–8PubMedGoogle Scholar
  155. 155.
    Black DW. Compulsive buying: a review. J Clin Psychiatry 1996; 57 Suppl. 8: 50–5PubMedGoogle Scholar
  156. 156.
    Monahan P, Black DW, Gabel J. Reliability and validity of a scale to measure change in persons with compulsive buying. Psychiatry Res 1996 Aug 30; 64: 59–67PubMedCrossRefGoogle Scholar
  157. 157.
    Wagner W, Zaborny BA, Gray TE. Fluvoxamine. A review of its safety profile in world-wide studies. Int Clin Psychopharmacol 1994; 9(4): 223–7PubMedCrossRefGoogle Scholar
  158. 158.
    Edwards JG, Inman WHW, Wilton L, et al. Prescription-event monitoring of 10401 patients treated with fluvoxamine. Br J Psychiatry 1994 Mar; 164: 387–95PubMedCrossRefGoogle Scholar
  159. 159.
    Pollack MH. Psychopharmacology update. In: Panic disorder: a treatment update. J Clin Psychiatry 1997 Jan; 58(1): 38–40Google Scholar
  160. 160.
    Ebert D, Albert R, May A, et al. The serotonin syndrome and psychosis-like side-effects of fluvoxamine in clinical use — an estimation of incidence. Eur Neuropsychopharmacol 1997 Feb; 7: 71–4PubMedCrossRefGoogle Scholar
  161. 161.
    Lenzi A, Raffaelli S, Marazziti D. Serotonin syndrome-like symptoms in a patient with obsessive-compulsive disorder, following inappropriate increase in fluvoxamine dosage. Pharmacopsychiatry 1993 May; 26: 100–1PubMedCrossRefGoogle Scholar
  162. 162.
    Bastani JB, Troester MM, Bastani AJ. Serotonin syndrome and fluvoxamine: a case study. Nebr Med J 1996 Apr; 81: 107–9PubMedGoogle Scholar
  163. 163.
    Hindmarch I. The behavioural toxicity of antidepressants: effects on cognition and sexual function. Int Clin Psychopharmacol 1998; 13 Suppl. 6: S5–8PubMedCrossRefGoogle Scholar
  164. 164.
    Waldinger MD, Hengeveld MW, Zwinderman AH, et al. Effect of SSRI antidepressants on ejaculation: a double-blind, randomized, placebo-controlled study with fluoxetine, fluvoxamine, paroxetine, and sertraline. J Clin Psychopharmacol 1998 Aug; 18: 274–81PubMedCrossRefGoogle Scholar
  165. 165.
    Montejo-Gonzalez AL, Llorca G, Izquierdo JA, et al. SSRI-induced sexual dysfunction: fluoxetine, paroxetine, sertraline, and fluvoxamine in a prospective, multicenter, and descriptive clinical study of 344 patients. J Sex Marital Ther 1997 Fall; 23: 176–94PubMedCrossRefGoogle Scholar
  166. 166.
    Haddad P. The SSRI discontinuation syndrome. J Psychopharmacol 1998 Sep; 12: 305–13PubMedCrossRefGoogle Scholar
  167. 167.
    Benazzi F. SSRI discontinuation syndrome related to fluvoxamine [letter]. J Psychiatry Neurosci 1998 Mar; 23: 94PubMedGoogle Scholar
  168. 168.
    Mallya G, White K, Gunderson C. Is there a serotonergic withdrawal syndrome? Biol Psychiatry 1993 Jun 1–15; 33: 851–2PubMedCrossRefGoogle Scholar
  169. 169.
    Coupland NJ, Bell CJ, Potokar JP. Serotonin reuptake inhibitor withdrawal. J Clin Psychopharmacol 1996 Oct; 16: 356–62PubMedCrossRefGoogle Scholar
  170. 170.
    Price JS, Waller PC, Wood SM, et al. A comparison of the post-marketing safety of four selective serotonin re-uptake inhibitors including the investigation of symptoms occurring on withdrawal. Br J Clin Pharmacol 1996 Dec; 42: 757–63PubMedCrossRefGoogle Scholar
  171. 171.
    Therrien F, Markowitz JS. Selective serotonin reuptake inhibitors and withdrawal symptoms: a review of the literature. Hum Psychopharm 1997 Jul–Aug; 12: 309–23CrossRefGoogle Scholar
  172. 172.
    The European Agency for the Evaluation of Medicinal Products. CPMP position paper on selective serotonin uptake inhibitors (SSRIs) and dependency/withdrawal reactions. Available from: URL http://www.eudra.org/humandocs/PDFs/PP/277599en.pdf; accessed 2000 Aug 23 [4 pages]
  173. 173.
    Barbey JT, Roose SP. SSRI safety in overdose. J Clin Psychiatry 1998; 59 Suppl. 15: 42–8PubMedGoogle Scholar
  174. 174.
    Garnier R, Azoyan P, Chataigner D, et al. Acute fluvoxamine poisoning. J Int Med Res 1993; 21: 197–208PubMedGoogle Scholar
  175. 175.
    Doogan DP. Toleration and safety of sertraline: experience worldwide. Int Clin Psychopharmacol 1991; 6 Suppl. 2: 47–56PubMedCrossRefGoogle Scholar
  176. 176.
    Wernicke JF. The side effect profile and safety of fluoxetine. J Clin Psychiatry 1985 March; 46 (3 (Sec. 2)): 59–67PubMedGoogle Scholar
  177. 177.
    Mackay FJ, Dunn NR, Wilton LV, et al. A comparison of fluvoxamine, fluoxetine, sertraline and paroxetine examined by observational cohort studies. Pharmacoepidemiol Drug Saf 1997 Jul–Aug; 6: 235–46PubMedCrossRefGoogle Scholar
  178. 178.
    Ottevander EA. SSRI treatment-emergent nausea [abstract no. P-58-42]. Neuropsychopharmacology 1994; 10 Suppl. 3: 104SGoogle Scholar
  179. 179.
    Meryn S, de Zwaan M, Schönbeck G, et al. Effect of overweight and weight reduction with dietary therapy and/or fluvoxamine on liver function in obesity [abstract]. Gastroenterology 1990 May; 98(5): A607Google Scholar
  180. 180.
    Harris B, Ashford J. Maintenance antidepressants and weight gain: a comparison of fluvoxamine and amitriptyline. Br J Clin Res 1991; 2: 81–8Google Scholar
  181. 181.
    Harris B, Szulecka TK, Anstee JA. Fluvoxamine versus amitriptyline in depressed hospital out-patients: a multicentre double-blind comparative trial. Br J Clin Res 1991; 2: 89–99Google Scholar
  182. 182.
    Bennett JA, Moioffer M, Stanton SP, et al. Arisk-benefit assessment of pharmacological treatments for panic disorder. Drug Saf 1998; 18(6): 419–30PubMedCrossRefGoogle Scholar
  183. 183.
    Steffens DC, Krishnan KRR, Helms MJ. Are SSRIs better than TCAs? Comparison of SSRIs and TCAs: ameta-analysis. Depression Anxiety 1997; 6: 10–8CrossRefGoogle Scholar
  184. 184.
    Roos JC. Cardiac effects of antidepressant drugs: a comparison of the tricyclic antidepressants and fluvoxamine. Br J Clin Pharmacol 1983; 15 Suppl. 3: 439S–45SPubMedCrossRefGoogle Scholar
  185. 185.
    Wagner W, Houser V, Wong LF. The safety profile of fluvoxamine in elderly patients. Hum Psychopharm 1996 Jul–Aug; 11: 267–72CrossRefGoogle Scholar
  186. 186.
    Prager G, Cimander K, Wagner W, et al. The cardiotropic effect of antidepressants: a comparison with fluvoxamine. Adv Pharmacother 1986; 2: 133–50Google Scholar
  187. 187.
    Strik JJ, Honig A, Lousberg R, et al. Cardiac side-effects of two selective serotonin reuptake inhibitors in middle-aged and elderly depressed patients. Int Clin Psychopharmacol 1998 Nov; 13(6): 263–7PubMedCrossRefGoogle Scholar
  188. 188.
    Harmant J, van Rijckevorsel-Harmant K, de Barsy T, et al. Fluvoxamine: an antidepressant with low (or no) epileptogenic effect [letter]. Lancet 1990; 2: 386CrossRefGoogle Scholar
  189. 189.
    Trabert W, Hohagen F, Winkelmann G, et al. A seizure, and electroencephalographic signs of a lowered seizure threshold, associated with fluvoxamine treatment of obsessive-compulsive disorder. Pharmacopsychiatry 1995 May; 28: 95–7PubMedCrossRefGoogle Scholar
  190. 190.
    Regina W, Vandel S. Fluvoxamine and convulsive syncope: case report (letter) [in French]. Therapie 1998 Sep–Oct; 53: 504–5PubMedGoogle Scholar
  191. 191.
    Solvay Pharmaceuticals. Fluvoxamine. European summary of product characteristics [on line]. Available from: http://www.solvay.com/depression/summeryofproduct.htm [6 pages; revised 1998 Jul 7]. Accessed 2000 Jul 4
  192. 192.
    Janssen Pharmaceutica. Limited-access program announced in United States to ensure appropriate use of Propulsid (cisapride): product no longer to be promoted in United States [on line]. Available from: URL: http://www.us.janssen.com/news/current/propulslimacc.html [2 pages]. Accessed 2000 May 30
  193. 193.
    Gottlieb S. Antihistamine drug withdrawn by manufacturer. BMJ 1999; 319: 7PubMedCrossRefGoogle Scholar
  194. 194.
    Friedman MA, Woodcock J, Lumpkin MM, et al. The safety of newly approved medicines: do recent market removals mean there is a problem? JAMA 1999; 281(18): 1728–34PubMedCrossRefGoogle Scholar
  195. 195.
    National Mental Health Association. Anxiety disorders education campaign [on line]. Available from: URL: http://www.nmha.org/pbedu/anxiety/index.cfm [1 page]. Accessed 2000 Jul 5
  196. 196.
    Kobak KA, Greist JH, Jefferson JW, et al. Behavioral versus pharmacological treatments of obsessive compulsive disorder: a meta-analysis. Psychopharmacology 1998 Apr; 136: 205–16PubMedCrossRefGoogle Scholar
  197. 197.
    Ravizza L, Maina G, Bogetto F, et al. Long term treatment of obsessive-compulsive disorder. CNS Drugs 1998 Oct; 10(4): 247–55CrossRefGoogle Scholar
  198. 198.
    Cartwright C, Hollander E. SSRIs in the treatment of obsessive-compulsive disorder. Depression Anxiety 1998; 8 Suppl. 1: 105–13CrossRefGoogle Scholar
  199. 199.
    Panic disorder: a treatment update. J Clin Psychiatry 1997; 58 (1): 36–42Google Scholar
  200. 200.
    Sheehan DV. Current concepts in the treatment of panic disorder. J Clin Psychiatry 1999; 60 Suppl. 18: 16–21PubMedGoogle Scholar
  201. 201.
    Ninan PT. Issues in the assessment of treatment response in panic disorder with special reference to fluvoxamine. J Clin Psychiatry 1997; 58 Suppl. 5: 24–31PubMedGoogle Scholar
  202. 202.
    Lecrubier Y. Comorbidity in social anxiety disorder: impact on disease burden and management. J Clin Psychiatry 1998; 59 Suppl. 17: 33–7PubMedGoogle Scholar
  203. 203.
    Van Ameringen M, Mancini C, Oakman JM, et al. Selective serotonin reuptake inhibitors in the treatment of social phobia: the emerging gold standard. CNS Drugs 1999 Apr; 11(4): 307–15CrossRefGoogle Scholar
  204. 204.
    Prakash A, Foster RH. Paroxetine: a review of its use in social anxiety disorder. CNS Drugs 1999 Aug; 12: 151–69CrossRefGoogle Scholar
  205. 205.
    Fichtner CG, Poddig BE, deVito RA. Post-traumatic stress disorder: pathophysiological aspects and pharmacological approaches to treatment. CNS Drugs 1997 Oct; 8(4): 293–322CrossRefGoogle Scholar
  206. 206.
    Baldwin D, Rudge S. The role of serotonin in depression and anxiety. Int Clin Psychopharmacol 1995; 9 Suppl. 4: 41–5PubMedCrossRefGoogle Scholar
  207. 207.
    Lane R, Baldwin D, Preskorn S. The SSRIs: advantages, disadvantages and differences. J Psychopharmacol 1995; 9(2) Suppl: 163–78PubMedGoogle Scholar
  208. 208.
    Stahl SM. Not so selective serotonin reuptake inhibitors. J Clin Psychiatry 1998 Jul; 59(7): 343–4PubMedCrossRefGoogle Scholar
  209. 209.
    Van Den Berg SJ. Comparing SSRIs: from chemistry to clinical choice. Hum Psychopharm 1995 Oct; 10 Suppl. 3: S199–209CrossRefGoogle Scholar
  210. 210.
    Leonard BE. SSRI differentiation: pharmacology and pharmacokinetics. Hum Psychopharm 1995 Oct; 10 Suppl. 3: 149–58CrossRefGoogle Scholar
  211. 211.
    Hood SD, Argyropoulos SV, Nutt DJ. Agents in development for anxiety disorders: current status and future potential. CNS Drugs 2000 Jun; 13(6): 421–31CrossRefGoogle Scholar

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© Adis International Limited 2000

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  1. 1.Adis International LimitedMairangi Bay, Auckland 10New Zealand

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