Luvox, Floxyfral

US Brand Name: Luvox, Floxyfral
A link here will take you to the official website for the drug.
Other Brand Names: Dumirox (Korea; Spain)
Dumyrox (Greece; Portugal)Faverin (Australia; Bahrain; Cyprus; Egypt; England; Hong Kong; Iran; Iraq; Ireland; Jordan; Kuwait; Lebanon; Libya; Oman; Philippines; Qatar; Republic of Yemen; Saudi Arabia; Singapore; Syria; Thailand; United Arab Emirates)
Favoxil (Israel)
Fevarin (Bulgaria; Denmark; Finland; Germany; Hungary; Italy; Netherlands; Norway; Poland; Sweden; Turkey)
Fluvohexal (Germany)
Fluvoxin (India)
Voxamin (Colombia)
Generic Name: fluvoxamine maleate
Other Forms:
Class: Anti-Obsessive, but it’s really the first SSRI.
Read up on these sections if you haven’t done so already, because they cover a lot of information about multiple medications that I’m not going to repeat on many pages. I’m just autistic that way about not repeating myself.

FDA Approved Use: Obsessive-Compulsive Disorder

Off-Label Uses: Depression, Panic/Anxiety, Bipolar Depression, Premenstrual Dysphoric Disorder, Eating Disorders – two studies, one big and one small indicate that SSRIs just aren’t much good for eating disorders, Autistic Spectrum Disorders, PTSD
Luvox’s pros and cons:
Pros: Proven as the best med for OCD. Generally less agitating than other SSRIs. Tends to work faster than other SSRIs except Lexapro (escitalopram oxalate).
Cons: Who the hell prescribes Luvox? There’s just not much in the way of support from Solvay or anecdotal evidence about this drug. The lack of support is telling in Solvay’s withdrawing the brand name med from the US market. The short half-life can make discontinuation difficult.

Luvox’s side effects:

Typical Side Effects: The usual for SSRIs – headache, nausea, dry mouth, sweating, sleepiness or insomnia, and diarrhea or constipation, weight gain, loss of libido. Most everything but the weight gain and loss of libido usually goes away within a couple of weeks.

For tips on how to cope with these side effects, please see our side effects page.

Not So Common Side Effects: Worsening of symptoms, be it anxiety, depression or OCD. Even if you’re taking Luvox for one thing you might get the symptoms of something else.

These may or may not happen to you don’t, so don’t be surprised one way or the other.

Freaky Rare Side Effects: Agoraphobia, fecal incontinence, priapism. Time to stay inside and make the freakiest scat video ever!

You aren’t going to get these. I promise.

Interesting Stuff Your Doctor Probably Won’t Tell You: First of all, if you smoke you’ll increase the metabolism of Luvox by 25%. That’s out of the PI sheet, and a recent study confirms it. So you’ll get more out of it and it’ll make discontinuation easier. Somehow that’s apt for a med that is officially approved only for OCD, as nicotine is an effective treatment for OCD, so you’ll get a synergistic effect going if you’re willing to risk all the crap that comes with smoking. As always when tobacco is involved I recommend cigars – way more nicotine and far less added crap. Or pipes, as you can just get a small amount of tobacco as required, and still less crap. Once again, you can tell that I’m a freak.

Secondly mixing Luvox and benzodiazepines can be really tricky. With some, like Ativan (lorazepam), there’s no problem at all. But with others, like Xanax (alprazolam) and Valium (diazepam), you wind up making either or both meds work much, much better. Surprise! But you don’t know how much better, and it can vary from day to day, especially with Valium, so it’s not a good idea. This is spelled out in the PI sheet, but double check with your doctor and pharmacist.

Finally, and this is news to me, mixing caffeine and Luvox can be intensely unpleasant. The first study back in 1996 states, “The results indicate that intake of caffeine during fluvoxamine treatment may lead to caffeine intoxication.” Your one cup of joe will suddenly become like five cups, and the effects will last six times as long. These effects have been confirmed by subsequent studies, including one that shows these effects with just 10mg of fluvoxamine. Don’t mix coffee and fluvoxamine! Thanks to one this site’s readers for e-mailing the first study to me.

Luvox’s Dosage and How to Take Luvox: Initial dose is 50 mg at bedtime, increased by 50 mg a day every four to seven days as needed until the maximum dose of 300 mg a day is reached. Like any SSRI I recommend starting out with 25mg and then increasing to 50mg after a week. If you don’t feel anything go up to 100mg, but stay there until you’ve given it a try for a month, otherwise it’ll just be a pain in the ass to stop it. Even at 100mg you’ll know after a month if it’s going to do something for you.

Days to Reach a Steady State: The steady state for Luvox is non-linear. That means if you change the dosage, the steady state gets hosed. So Solvay doesn’t publish any steady state data. Figure at least a week, maybe two, after your last dosage adjustment.

When you’re fully saturated with the medication and less prone to peaks and valleys of effects. You still might have peaks of effect after taking many meds, but with a lot of the meds you’ll have fewer valleys after this point. In theory anyway.

How Long Luvox Takes to Work: Like all SSRIs anywhere from a couple days to over a month. If you don’t feel any positive benefit after six weeks, then you should talk to your doctor about either another SSRI or trying a med that hits another neurotransmitter. However in all the studies referenced above, Luvox tends to work faster than most SSRIs.

Luvox’s Half-Life & Average Time to Clear Out of Your System: 15.6 hours, the shortest of all true SSRIs.

How to Stop Taking Luvox: Your doctor should be recommending that you reduce your dosage 25-50mg every 4 days if you need to stop taking it. Because its half-life is so short and the steady state is non-linear, best to go for 25mg. Maybe even 12.5mg if the discontinuation seems harsh. I’ve found only one study online specific to fluvoxamine withdrawal, but there are several other references to it that aren’t online. My numbers are based on the 15.6 hour half-life. You may want to stretch that out to a week just to make things easier, and have a prescription for two week’s worth of 10mg of Prozac (fluoxetine) on hand just in case you do get discontinuation syndrome. For more information, please see the page on how to safely stop taking these crazy meds.
If you’ve worked your way up to a particular dosage, it’s usually best to spend this many days at the next lowest dosage before going down the next lowest dosage before that and so forth. This is the least sucky way to avoid problems when stopping any psychiatric medication. Presuming you have the option of slowly tapering off them.

How Luvox Works In Your Brain: Like all SSRIs Luvox doesn’t make you produce more serotonin, rather it makes your neurons soak for a longer period of time in the serotonin you already produce. Serotonin is one of the big three neurotransmitters responsible for depression, along with norepinephrine and dopamine. My wild-ass guess / rule of thumb is that imbalances of one or more of the three are responsible for 80% of the depression issues. It’s all just a matter of figuring out exactly the extent of the tweaking and what neurotransmitters you exactly need to tweak.

Comments: Be sure to read the sections on antidepressants and SSRIs if you haven’t done so already. Even though Luvox isn’t officially an antidepressant.
Approved by the FDA to treat OCD in 1994, fluvoxamine maleate has been kicking around Europe since the mid-1970s.

Note that Luvox is not really an antidepressant. It’s just one of two meds of which I’m aware that are officially approved only for OCD in the US. I don’t know if that was a marketing ploy by Solvay, or if something weird happened during one round of clinical trials. But, really, it’s just an SSRI like all the others, so you can take it like any other antidepressant, it just didn’t get much of a marketing push in the US for such. Its funky interaction with some benzodiazepines and a few of the older antipsychotics doesn’t help, either. However I must give Solvay the respect they are due for publishing extensive clinical efficacy data in the PI sheets. You won’t find that very often. Maybe it’s because for OCD Luvox has a better success rate than other meds for their approved uses. I don’t know. Solvay also provided the PI sheet in Word format. That not only allowed for easy conversion to HTML, but also included data that was struck from the PI sheet and replaced by updated information. That also goes a long way in helping you become a fully-informed consumer.

Brand name Luvox has currently been withdrawn from the US market. It may or may not return. The generic is still available in the US, and the multitude of brands are still available globally.

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