Fluvoxamine ( Fluvoxamine ) - a modern (registered by the US FDA December 5, 1994) antidepressant from the SSRI group (a selective serotonin reuptake inhibitor ). By pharmacological properties, it is close to fluoxetine , with the difference that its effect occurs somewhat faster [1] . It also has anxiolytic (anti-anxiety) effect [2] .
Fluvoxamine | |
---|---|
Fluvoxamine | |
Chemical compound | |
IUPAC | ( E ) -5-methoxy-1- [4- (trifluoromethyl) phenyl] pentan-1-one O -2-aminoethyl oxime |
Gross formula | C 15 H 21 F 3 N 2 O 2 |
Molar mass | 318,335 |
Cas | |
PubChem | |
Drugbank | |
Classification | |
ATX | |
Pharmacokinetics | |
Bioavailable | 50-80% |
Metabolism | Liver |
The half-life. | 15 hours |
Excretion | The kidneys |
Dosage Forms | |
50 and 100 mg tablets | |
Route of administration | |
inward | |
Other names | |
Fevarin, Faverin, Avoxin, Luvox, Favoxil | |
Content
Pharmacological action ( pharmacodynamics ) and indications
Strongly and specifically slows down the reuptake of serotonin by neurons , thereby increasing its concentration in the synapse and enhancing its effect; with little effect on the reuptake of dopamine and norepinephrine . According to the antidepressant effect, indications for use, it is similar to imipramine , amitriptyline , but it is better tolerated, since it has significantly less anticholinergic activity [2] .
It is used for depression [2] of various etiologies and for OCD [3] [4] .
Side Effects
Nausea, vomiting, constipation, anorexia , dry mouth, drowsiness, anxiety and restlessness, visual impairment, tremor [5] , headache, allergies [6] , sexual dysfunctions [7] (including decreased potency [6] ) , convulsions [8] , hypomanic and manic states, dyspepsia , tachycardia , arthralgia , allergic reactions [2] , serotonin syndrome (in high doses), hepatotoxic effect [6] .
Contraindications
Manic states ; hypersensitivity to the drug; concomitant treatment with MAO inhibitors [9] ; childhood; severe violations of the liver [5] and kidneys; diabetes mellitus ; history of epilepsy ; pregnancy and lactation [2] , poisoning with alcohol, psychotropic drugs and other drugs [10] .
Precautions and interactions
With caution, prescribe the drug to pregnant women and people whose work requires a quick mental reaction [5] . Patients taking fluvoxamine should never drink alcohol. When fluvoxamine is combined with antithrombotic agents or with vitamin K antagonists, it is necessary to control prothrombin time and, if necessary, adjust the dose of antithrombotic agents or vitamin K antagonists [11] .
Fluvoxamine should not be taken simultaneously with MAO inhibitors , treatment with drugs of this group should be discontinued 2 weeks before starting fluvoxamine [5] to avoid the risk of serotonin syndrome . An interval of 2 weeks should also be maintained between the withdrawal of SSRIs and the appointment of MAO inhibitors [12] . The administration of SSRIs should also be avoided in conjunction with other serotonergic drugs [13] . In addition, serotonin syndrome can occur with a combination of SSRI antidepressants with buspirone, levodopa [14] , herbal antidepressant drugs containing St. John's wort [15] , 5-hydroxytryptophan , S-adenosylmethionine (SAM, heptral) [16] and tryptophan [17] ] , dextromethorphan , tramadol [13] and other opioid analgesics [18] , carbamazepine , lithium preparations [13] , metoclopramide [19] and some other drugs.
The drug slows down the metabolism of haloperidol and other antipsychotics of the butyrophenone derivative group , increasing their concentration in the blood by 2 times (at the same time, the concentration of fluvoxamine increases by 2-10 times) [20] , as a result of which it can reach a toxic level [12] . When fluvoxamine is combined with the atypical antipsychotics olanzapine [21] or clozapine , the metabolism of this antipsychotic and its concentration in the blood also slows down [20] (when combined with clozapine - several times [21] ).
Fluvoxamine also slows the metabolism of certain tricyclic antidepressants with a possible increase in their concentration and the development of intoxication; the combined effects of fluvoxamine with beta-blockers , theophylline , caffeine , alprazolam , carbamazepine [20] , propranolol , and warfarin [5] lead to similar effects. It is not recommended to combine with amitriptyline , clomipramine , imipramine , desipramine , carbamazepine [5] . The drug potentiates the effect of alcohol [5] , barbiturates [6] . Enhances side effects of cardiac glycosides , tryptophan [11] . In combination with benzodiazepines, fluvoxamine may increase the severity of psychomotor disorders. The drug is not combined with theophylline (toxic effects). It is dangerous to combine fluvoxamine with lithium preparations, since this enhances the effect of neurotoxicity [21] , and the side effects of lithium preparations increase [11] .
Notes
- β Lopukhov I.G. Comparative clinical evaluation of fluoxetine and fluvoxamine // Zh. nevrol. and a psychiatrist. them. S. S. Korsakova. - M. , 1996. - No. 4 . - S. 53-57 .
- β 1 2 3 4 5 Mashkovsky M.D. Medicines. - 15th ed. - M .: New Wave, 2005 .-- 1200 p. - ISBN 5-7864-0203-7 .
- β "FDA Advisory Committee Recommends Luvox (Fluvoxamine) Tablets for Obsessive Compulsive Disorder" , PRNewswire, 10/18/93
- β I. Yu. Dorozhenok, M.A. Terentyev. Fevarin in a dermatological clinic (treatment of depression and obsessive-compulsive disorders) // Psychiatry and Psychopharmacology. - 2006. - T. 8 , No. 1 . Archived January 19, 2013.
- β 1 2 3 4 5 6 7 Gubsky Yu. I., Shapovalova V.A., Kutko I.I., Shapovalov V.V. Medicines in psychopharmacology. - Kiev - Kharkov: Health - Torsing, 1997. - 288 p. - 20,000 copies. - ISBN 5-311-00922-5 , 966-7300-04-8.
- β 1 2 3 4 Podkorytov V.S., Chaika Yu. Yu. Depression. Modern therapy. - Kharkov: Tornado, 2003 .-- 352 p. - ISBN 966-635-495-0 .
- β Montejo AL , Llorca G. , Izquierdo JA , Rico-Villademoros F. Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients. Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. (Eng.) // The Journal of clinical psychiatry. - 2001. - Vol. 62 Suppl 3. - P. 10-21. - PMID 11229449 .
- β Gelder M., Get D., Mayo R. Oxford Guide to Psychiatry: Per. from English - Kiev: Sphere, 1999. - T. 2. - 436 p. - 1000 copies. - ISBN 966-7267-76-8 .
- β Reference guide for psychopharmacological and antiepileptic drugs approved for use in Russia / Ed. S. N. Mosolova. - 2nd, rev. - M .: "BINOM Publishing House", 2004. - 304 p. - 7000 copies. - ISBN 5-9518-0093-5 .
- β Puzhinsky S. Pharmacotherapy of depressive conditions // Depression and comorbid disorders / Ed. Smulevich A.B .. - M. , 1997.
- β 1 2 3 Drug Interactions and Pharmacotherapy Effectiveness / L. V. Derimedved, I. M. Pertsev, E. V. Shuvanova, I. A. Zupanets, V. N. Khomenko; under the editorship of prof. I. M. Pertseva. - Kharkov: Publishing house "Megapolis", 2001. - 784 p. - 5,000 copies. - ISBN 996-96421-0-X.
- β 1 2 Pharmacotherapy in neurology and psychiatry: [Per. from English.] / Ed. S. D. Enna and J. T. Coyle. - Moscow: LLC: βMedical News Agencyβ, 2007. - 800 pp., Ill. with. - 4000 copies. - ISBN 5-89481-501-0 .
- β 1 2 3 Mosolov C. N., Kostyukova E. G., Serditov O. V. Serotonin syndrome in the treatment of depression // International Journal of Medical Practice. - MediaSfera, 2000. - No. 8 . Archived October 4, 2013.
- β Schlienger RG, Shear NH. Serotonin Syndrome ( British ) // British Journal of Psychiatry . - Royal College of Psychiatrists 1996. - Vol. 169 (suppl.31) . - P. 15-20 . Translation: Serotonin Syndrome // Review of Modern Psychiatry. - 1998. - Vol. 1 .
- β Antidepressant Therapy and Other Treatments for Depressive Disorders: CINP Working Group Report Based on a Survey of Evidence / Editors T. Bagai, H. Grunze, N. Sartorius. A translation into Russian was prepared at the Moscow Scientific Research Institute of Psychiatry of the Russian Health Ministry, edited by V.N. Krasnova. - Moscow, 2008 .-- 216 p. Archived March 4, 2016. Archived March 4, 2016 on Wayback Machine
- β Drug Interactions: SSRIs . iHerb.Com. Archived March 15, 2012.
- β Arana J., Rosenbaum J. Pharmacotherapy of mental disorders. Per. from English - M .: Publishing house BINOM, 2004 .-- 416 p. - ISBN 5-9518-0098-6 .
- β Bykov Yu.V., Becker R.A., Reznikov M.K. Resistant depression. A practical guide. - Kiev: Medkniga, 2013 .-- 400 p. - ISBN 978-966-1597-14-2 .
- β Fisher AA, Davis MW Serotonin Syndrome Caused by Selective Serotonin Reuptake-Inhibitors-Metoclopramide Interaction. (English) // The Annals of Pharmacotherapy : journal. - January 2002. - Vol. 36 , no. 1 . - P. 67-71 . - PMID 11816261 .
- β 1 2 3 Malin D.I. Drug interactions of psychotropic drugs (Part II) // Psychiatry and psychopharmacotherapy. - 2000.
- β 1 2 3 Minutko V.L. Depression. - Moscow: GEOTAR-Media, 2006 .-- 320 p. - 2000 copies. - ISBN 5-9704-0205-2 .