Active Ingredients

Fluvoxamine – Effect, Application & Risks

Fluvoxamine

Fluvoxamine is an antidepressant that belongs to the group of selective serotonin reuptake inhibitors. In Germany, the active ingredient was approved for the treatment of depression and obsessive -compulsive disorders , but is also often used to treat anxiety and panic disorders as well as post-traumatic stress disorders . When using the drug, interactions with other drugs such as monoamine oxidase inhibitors (MAOIs) must be taken into account, and significant side effects can occur.

What is fluvoxamine?

Fluvoxamine is a drug with the chemical molecular formula C15H21F3N2O2. It contains a monocyclic aromatic ring and has been approved as an antidepressant in Germany since the mid-1980s. The medicine belongs to the group of selective serotonin reuptake inhibitors (SSRIs). The abbreviation SSRI is derived from the English term “selective serotonin reuptake inhibitor”.

The monocyclic structure and its special binding ability and affinity to the σ – receptors (sigma receptors) distinguish fluvoxamine from most other antidepressants, which have a special binding affinity to opioid receptors.

Among other things, the active ingredient shows a strong interaction with reversible and irreversible MAO inhibitors (monoamine oxidase inhibitors), which non-selectively inhibit the breakdown of neurotransmitters such as serotonin , noradrenaline and dopamine and are also used as antidepressants. Fluvoxamine must therefore not be taken together with MAO inhibitors. Fixed waiting times must be observed before changing therapy from MAO inhibitors to fluvoxamine or vice versa.

Pharmacological action

As a selective serotonin reuptake inhibitor, fluvoxamine only influences the reuptake or the return transport of serotonin into the vesicles of certain cells or the degradation of this neurotransmitter, so that its concentration in the synaptic cleft increases.

Due to the selective mode of action of the drug, the breakdown or return transport of the other neurotransmitters from the group of monoamines such as adrenaline , dopamine , melatonin and others are not affected. Fluvoxamine therefore leads to a unilateral increase in the concentration of serotonin in the synaptic cleft due to its longer residence time there.

Psychological effects are ascribed to the monoamine serotonin as a neurotransmitter in the central nervous system (CNS). Among other things, serotonin is considered to be mood-enhancing, motivating and anxiolytic. In the case of depressive moods and depressions, a lack of serotonin can often be detected. Assuming that eliminating the reduced serotonin concentration also resolves the depressive mood, an attempt is made to remedy the relative deficiency by supplying additional serotonin or by preventing the messenger substance from being deactivated quickly.

Taking fluvoxamine leads to an increased concentration of serotonin by inhibiting the rapid inactivation of serotonin. If the serotonin concentration exceeds a certain level, the effect of the messenger substance can be almost reversed. A serotonin syndrome sets in , which is typically characterized by symptoms such as anxiety , inner restlessness , muscle tension, tremors and muscle twitching .

A serotonin syndrome can occur, for example, if the interaction of fluvoxamine with MAO inhibitors is ignored and an uncontrolled high serotonin level occurs.

Medical Application & Use

In its capacity as a selective serotonin reuptake inhibitor, taking fluvoxamine leads to an increase in the serotonin level in the blood and can therefore be considered for the treatment of all mental illnesses that are associated with a reduced serotonin level. This applies primarily to pathological depression.

It is not yet sufficiently known whether manifest depression is the cause or consequence of serotonin deficiency. Fluvoxamine is therefore primarily prescribed to treat depression.

Originally approved in the mid-1980s, the drug is also specifically intended to improve obsessive-compulsive disorder. In the course of other applications that go well beyond the range of diseases originally researched, the drug is also often used for the treatment of anxiety disorders, panic attacks, post-traumatic stress disorders and social phobia , as well as for irritable bowel syndrome . Treatment with the SSRI fluvoxamine is also quite common in the case of a diagnosed borderline syndrome , which can be classified in the border region between neurosis and manifest psychosis .

Empirical knowledge has gained acceptance that anxiety disorders, which can develop into social phobia, for example, are also accompanied by a reduced serotonin level. In order to treat the social phobia itself and thus prevent the development of a number of negative side effects, many doctors are considering and sometimes even preferring the use of fluvoxamine.

In addition to its effectiveness, the drug is often valued for its relatively short physiological half-life of around 15 hours. The short half-life allows a quick switch to an alternative psychotropic drug within a few days if intolerance to the drug is determined.

Risks & side effects

Like other inhibitors of selective serotonin inhibitors, fluvoxamine intervenes relatively insensitively, one-sidedly and systemically in the metabolism of monoamines. There is a unilateral increase in the concentration of serotonin in the nervous system without the associated systemic effects on many relevant metabolic processes being fully understood.

Despite the undoubted success of treatment in improving a number of psychopathological diseases, the use of fluvoxamine is often accompanied by undesirable side effects. Anxiety, drowsiness , tremors and trouble sleeping can occur after taking fluvoxamine . Likewise, there is often an increase in heart rate , sweating and hypersensitivity reactions of the skin .

Serotonin syndrome, a toxic oversupply of serotonin, can develop, especially in combination with medications that lead to an increase in serotonin levels in other ways. Serotonin syndrome is typically accompanied by decreased consciousness , muscle rigidity , tremors, and fever , and requires immediate medical attention.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.