Luvox (fluvoxamine maleate) is a selective serotonin reuptake inhibitor (SSRI) approved for the treatment of obsessive-compulsive disorder (OCD) in both pediatric and adult populations. It functions by precisely modulating serotonin levels in the central nervous system, restoring neurotransmitter balance to reduce the frequency and intensity of intrusive thoughts and compulsive behaviors. Its established efficacy and well-documented safety profile make it a cornerstone in psychopharmacological management for indicated conditions. This agent is also utilized off-label for several anxiety spectrum disorders, social anxiety disorder, and depressive episodes, under specialist supervision.

Features

• Active Ingredient: Fluvoxamine maleate
• Drug Class: Selective Serotonin Reuptake Inhibitor (SSRI)
• Available Forms: Immediate-release tablets (25 mg, 50 mg, 100 mg); extended-release capsules (100 mg, 150 mg)
• FDA-Approved Indications: Obsessive-compulsive disorder (adults and children aged 8–17)
• Mechanism of Action: Potent inhibition of serotonin reuptake pumps, increasing synaptic serotonin availability
• Half-Life: Approximately 15–22 hours
• Metabolism: Hepatic, primarily via CYP450 isoenzymes (CYP1A2, CYP2D6, CYP3A4)

Benefits

• Reduces frequency and severity of obsessive thoughts and compulsive rituals in patients with OCD
• Alleviates symptoms of anxiety disorders, improving daily functioning and social engagement
• Provides a non-tricyclic option with a generally favorable side effect profile compared to older antidepressants
• Supports long-term maintenance therapy with a demonstrated relapse prevention benefit
• May improve sleep architecture and reduce somatic symptoms associated with anxiety
• Available in pediatric and adult formulations, allowing for age-appropriate dosing

Common use

Luvox is primarily prescribed for the management of obsessive-compulsive disorder in individuals aged 8 years and older. It is also used off-label for the treatment of social anxiety disorder (SAD), panic disorder, post-traumatic stress disorder (PTSD), and major depressive disorder (MDD). In clinical practice, it is sometimes selected for patients who have not responded adequately to other SSRIs due to its distinct receptor binding profile. Its use in body dysmorphic disorder and eating disorders has also been documented in psychiatric literature.

Dosage and direction

Dosage must be individualized based on diagnosis, age, hepatic function, and treatment response.

• Adults (OCD): Initial dose 50 mg once daily at bedtime. May be increased in 50 mg increments every 4–7 days, as tolerated. Target therapeutic range: 100–300 mg/day. Maximum dose: 300 mg/day.
• Children (8–17 years, OCD): Start with 25 mg daily at bedtime. Increase by 25 mg every 4–7 days. Maximum dose: 200 mg/day; daily doses above 50 mg should be divided (BID).
• Extended-Release Capsules: Swallow whole; do not crush or chew. Take once daily at bedtime.
• Administration: Should be taken with food to minimize gastrointestinal upset.
• Titration: Slow titration is recommended to mitigate initial side effects. Regular monitoring during dose adjustments is advised.

Precautions

• Monitor for emergence of anxiety, agitation, panic attacks, insomnia, irritability, hostility, impulsivity, or suicidality—especially during early treatment or dose changes.
• Use with caution in patients with a history of seizures, hepatic impairment, or bleeding disorders.
• May cause drowsiness or dizziness; advise patients to avoid driving or operating machinery until response is known.
• Discontinuation should be gradual; abrupt cessation may lead to withdrawal symptoms (dizziness, nausea, paresthesia).
• Screen for bipolar disorder prior to initiation; may precipitate manic episodes in susceptible individuals.
• Regular clinical evaluation for serotonin syndrome or hyponatremia (especially in elderly patients) is recommended.

Contraindications

• Hypersensitivity to fluvoxamine or any component of the formulation
• Use of monoamine oxidase inhibitors (MAOIs) concurrently or within 14 days of discontinuing Luvox
• Use of thioridazine, pimozide, or other drugs that prolong QT interval
• Use of alosetron, tizanidine, or ramelteon due to potent CYP1A2 inhibition
• Uncontrolled narrow-angle glaucoma

Possible side effect

Common side effects (≥5%) include:

• Nausea, vomiting, diarrhea, dyspepsia
• Somnolence, insomnia, dizziness, asthenia
• Dry mouth, sweating
• Anorexia, weight changes

Less common but serious side effects:

• Serotonin syndrome (agitation, hallucinations, tachycardia, hyperthermia)
• Abnormal bleeding or bruising
• Hyponatremia
• Mania or hypomania
• Seizures
• Angle-closure glaucoma
• Sexual dysfunction (decreased libido, anorgasmia, erectile dysfunction)

Drug interaction

Luvox is a potent inhibitor of CYP1A2, CYP2C19, and CYP3A4, and a moderate inhibitor of CYP2D6. Significant interactions include:

• MAOIs: Risk of serotonin syndrome; contraindicated.
• Anticoagulants (e.g., warfarin): Increased bleeding risk.
• Benzodiazepines (e.g., alprazolam, diazepam): Increased sedation and prolonged half-life.
• Tricyclic antidepressants (e.g., clomipramine): Elevated TCA levels.
• Theophylline, clozapine, olanzapine: Markedly increased plasma concentrations.
• Triptans, tramadol, linezolid: Increased serotonergic effects.

Missed dose

If a dose is missed, take it as soon as remembered unless it is close to the time of the next dose. Do not double the dose to make up for a missed one. Patients should maintain a consistent dosing schedule to ensure stable plasma levels.

Overdose

Symptoms may include nausea, vomiting, drowsiness, dizziness, and tachycardia. Severe overdose may lead to coma, seizures, ECG changes, or serotonin syndrome. Management is supportive and symptomatic; there is no specific antidote. Activated charcoal may be considered if presented early. ECG monitoring is advised. Contact a poison control center immediately.

Storage

Store at room temperature (20–25°C/68–77°F). Keep in a tightly closed container, away from light, moisture, and heat. Do not store in the bathroom. Keep out of reach of children and pets.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Do not disregard professional medical advice or delay in seeking it because of something you have read here.

Reviews

Clinical studies and patient reports generally reflect a positive response profile for Luvox, particularly in treatment-resistant OCD. Many users note a significant reduction in obsessive thoughts and compulsive behaviors after 4–6 weeks of consistent use. Some report initial side effects such as nausea or drowsiness, which often subside with continued treatment. A number of patients appreciate its non-sedating nature compared to some alternatives. As with all SSRIs, individual response varies, and a period of dose adjustment is often necessary.