Fluvoxamine Maleate is indicated in:

• Obsessive-Compulsive Disorder
• Depressive illness

It is also indicated in:

• Panic Disorder
• Eating Disorder
• Chronic Tension Headache

The mechanism of action of fluvoxamine maleate 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. In in vitro studies, fluvoxamine maleate had no significant affinity for histaminergic, alpha or beta adrenergic, muscarinic, or dopaminergic receptors. Antagonism of some of these receptors is thought to be associated with various sedative, cardiovascular, anticholinergic, and extrapyramidal effects of some psychotropic drugs.

Fluvoxamine blocks the reuptake of serotonin at the serotonin reuptake pump of the neuronal membrane, enhancing the actions of serotonin on 5HT1A autoreceptors. Studies have also demonstrated that fluvoxamine has virtually no affinity for α1- or α2-adrenergic, β-adrenergic, muscarinic, dopamine D2, histamine H1, GABA-benzodiazepine, opiate, 5-HT1, or 5-HT2 receptors, despite having an affinity for binding to σ1 receptors.

Obsessive-Compulsive Disorder:

• Adult: Initially 50 mg in the evening for 3-4 days, increasing if necessary to 300 mg daily (over 150 mg in divided doses).
• Child: Over 8 years, initially 25 mg daily, increased if necessary in steps of 25 mg every 3-4 days to a maximum of 200 mg daily in divided doses.

Depression:

• Adult: Initially 50-100 mg daily in the evening, increased if necessary to 300 mg daily (over 150 mg in divided doses). Usual maintenance dose is 100 mg daily.
• Child: Not recommended.

Fluvoxamine maleate should not be used concurrently with monoamine oxidase inhibitors, warfarin, benzodiazepines, theophylline, aminophylline, tricyclic antidepressants, and alcohol.

Fluvoxamine maleate should not be used if the patient enters a manic phase.

Gastrointestinal side effects, anorexia with weight loss (increased appetite and weight gain also reported), hypersensitivity reactions including rash, urticaria, angioedema, arthralgia, myalgia, and photosensitivity. Other side effects include dry mouth, nervousness, anxiety, headache, insomnia and sexual dysfunction, palpitation, tachycardia (may also cause bradycardia), rarely postural hypotension, confusion, ataxia, and abnormal liver function tests.

Fluvoxamine maleate should be avoided in pregnancy and lactation.

Fluvoxamine maleate should be used with caution in patients with a history of mania, seizures, suicidal tendency, concomitant ECT, cardiac disease, diabetes mellitus, angle-closure glaucoma, history of bleeding disorders (especially gastrointestinal bleeding), and hepatic or renal impairment. Fluvoxamine maleate may also impair the performance of skilled tasks (e.g., driving).

Symptoms: In case of overdosage, the symptoms include gastrointestinal complaints (nausea, vomiting and diarrhoea), somnolence, and dizziness have been seen. Cardiac events (tachycardia, bradycardia, hypotension), liver function disturbances, convulsions, and coma have also been reported.

Treatment: There is no specific antidote to fluvoxamine. In case of overdose, the stomach should be emptied as soon as possible after tablet ingestion and symptomatic treatment should be given. The repeated use of medicinal charcoal, if necessary, accompanied by an osmotic laxative, is also recommended.

SSRIs & related anti-depressant drugs

Store below 25°C in a cool and dry place. Keep away from light. Keep out of the reach of children.