Fluvoxamine
Generic name: fluvoxamine maleate · Brand name: Luvox® / Luvox CR®
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How It Works
Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) most commonly used for OCD and social anxiety. It works by blocking serotonin reabsorption in the brain. Fluvoxamine is unique among SSRIs in that it also acts on sigma-1 receptors, which may contribute to its anti-anxiety effects. It has more drug interactions than other SSRIs and is typically dosed twice daily due to its shorter half-life.
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What It Treats
Obsessive-Compulsive Disorder (OCD)FDA-approved; reduces obsessions and compulsions in adults and children
Social Anxiety DisorderFDA-approved (Luvox CR); reduces fear and avoidance in social situations
Major Depressive DisorderUsed off-label when other SSRIs have not been effective
PTSD & Panic DisorderUsed off-label with supporting evidence
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Dosing Overview
| Population | Start | Typical Range | Max |
|---|---|---|---|
| Adults OCD | 50 mg | 100–200 mg | 300 mg |
| Adults Social Anxiety (CR) | 100 mg | 100–300 mg | 300 mg |
| Children (8+) OCD | 25 mg | 50–200 mg | 200 mg |
Regular tablets taken twice daily (morning and evening). Luvox CR taken once daily at bedtime. Take with food to reduce nausea. Has more drug interactions than other SSRIs — always share your full medication list.
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What to Expect — Timeline
1–2
Weeks 1–2
Body adjusting. May notice sleep changes, mild nausea, or fatigue before mood lifts
3–4
Weeks 3–4
Many notice improved sleep, energy, or motivation. Anxiety may still feel elevated
6–8
Weeks 6–8
Mood and anxiety typically improve significantly at a therapeutic dose
3–6m
3–6 Months
Full therapeutic benefit. Duration discussed based on your history and goals
⏳ Be patient. Most people need at least 4–8 weeks at a therapeutic dose before evaluating effectiveness. Do not stop without talking to your provider.
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Side Effects
Common (often temporary)
- Nausea (most common)
- Drowsiness or fatigue
- Dry mouth
- Constipation
- Insomnia
- Decreased appetite
- Headache
- Sexual side effects
Call us if you notice
- Worsening depression or anxiety
- New or increased suicidal thoughts
- Agitation or restlessness
- Unusual bleeding
- Hypomania or mania-like symptoms
- Serotonin syndrome signs (fever, confusion, tremor)
Nausea is the most common complaint with fluvoxamine — taking it with food and starting low helps significantly. Fluvoxamine has more drug interactions than other SSRIs, including with caffeine, which it can make feel stronger.
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Tips for Success
Same Time DailyTake at the same time each day for consistent levels in your system.
With FoodTaking with food can reduce nausea, especially in the first weeks.
Don't Stop AbruptlyStopping suddenly can cause dizziness and mood changes. Always taper with guidance.
Limit AlcoholAlcohol worsens depression and anxiety and may increase side effects.
Tell All ProvidersLet other prescribers know you take this medication — interactions matter.
Track Your MoodJournaling or a mood app helps you and your provider see what is changing.
Watch CaffeineFluvoxamine slows caffeine metabolism — you may feel its effects more strongly. Consider reducing caffeine intake.
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Important Safety Information
Black Box Warning (under 25): Antidepressants may increase risk of suicidal thinking in children, adolescents, and young adults, especially in the first few weeks. Monitor closely and contact us right away if new or worsening thoughts of self-harm appear.
Serotonin Syndrome: A rare but serious reaction when combined with MAOIs, triptans, tramadol, or St. John's Wort. Signs include fever, agitation, rapid heart rate, muscle twitching, or confusion — seek emergency care immediately.
Drug Interactions: Do not take with MAOIs (must wait 14 days between). Use caution with blood thinners and NSAIDs. Always share your full medication list with your provider.
Pregnancy & Breastfeeding: Discuss risks and benefits with your provider. Do not stop without consultation.
Many Drug Interactions: Fluvoxamine inhibits several liver enzymes and has more interactions than other SSRIs. It can increase levels of caffeine, theophylline, warfarin, benzodiazepines, and many other medications. Always provide your complete medication list.
Questions? I'm here.
Reach me between appointments if you have concerns about side effects, notice mood changes, or have questions about your medication. You don't have to wait until your next visit.
360-389-3712
info@rootedmindspsychiatry.com