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How Effective Is Fluvoxamine In Treating OCD Symptoms?
Question: I have some OCD symptoms due to some effects of Solian in 5HT7 and 5HT2b receptors and some dopaminergic activity. During one month and a half, my psychiatrist tried Lexapro 40 mg and there was an important improvement (say 80%), but not a full recovery. So now my psychiatrist decided to try Luvox (Fluvoxamine) to try a recovery at 100 %, and i'll take Luvox 100 mg the first week and 200 mg after one week. I would like to know how long fluvoxamine takes to work since i am on lexapro 40 mg for a month and before different other dosages of Lexapro too. I am on Solian (amisulpride) 100 mg, Keppra 1500 mg as mood stabilizer and Klonopin 2 mg. I am a poor metabolizer for cyp2c19 and probably mild for cyp2d6.
Thanks beforehand
Thanks beforehand
Brief Answer:
It will start work within 15 days
Detailed Answer:
Hi, thanks for writing through HCM.
Lexapro is not much effective as antiobsessive but it is good antidepressant drug.
Fluvoxamine is primarily used and indicated for Obsessive compulsive disorder. It is very effective drug. It is a SSRI drug and used for different indication, so similar to other SSRI drugs it will take 15 t 20 days to show it's effects.
CYP2D6, which is crucially involved in the metabolism of paroxetine and fluoxetine, appears to play a clinically insignificant role in the metabolism of fluvoxamine. The drug is excreted in the urine, predominantly as metabolites.
Fluvoxamine shows a biphasic pattern of elimination with a mean terminal elimination half-life of 12 to 15 hours after a single oral dose; this is prolonged by 30 to 50% at steady-state. Its elimination is prolonged in patients with hepatic cirrhosis. Fluvoxamine inhibits oxidative drug metabolising enzymes (particularly CYP1A2, and less potently and much less potently CYP3A4 and CYP2D6, respectively) and has the potential for clinically significant drug interactions. Drugs whose metabolic elimination is impaired by fluvoxamine include tricyclic antidepressants (tertiary, but not secondary, amines), alprazolam, bromazepam, diazepam, theophylline, propranolol, warfarin and, possibly, carbamazepine.
Lexapro is metabolized by CYP2C19, CYP2D6 and CYP3A4. So there is a possibility that fluvoxamine can inhibit the metabolism of Lexapro and increase its plasma concentration. Which can have beneficial effects in terms of improvement in OCD or harmful effects in terms of side effects. You can ask detail about this to your prescribing doctor.
If you are poorer metabolizer for cyp2c19 and cyp2d6, then you might have extremely high level of drugs which can be dangerous. The opinion is strictly based on scientific research.
Hope I have answered your query. If you have further query then I will be happy to help. Wish you good health.
It will start work within 15 days
Detailed Answer:
Hi, thanks for writing through HCM.
Lexapro is not much effective as antiobsessive but it is good antidepressant drug.
Fluvoxamine is primarily used and indicated for Obsessive compulsive disorder. It is very effective drug. It is a SSRI drug and used for different indication, so similar to other SSRI drugs it will take 15 t 20 days to show it's effects.
CYP2D6, which is crucially involved in the metabolism of paroxetine and fluoxetine, appears to play a clinically insignificant role in the metabolism of fluvoxamine. The drug is excreted in the urine, predominantly as metabolites.
Fluvoxamine shows a biphasic pattern of elimination with a mean terminal elimination half-life of 12 to 15 hours after a single oral dose; this is prolonged by 30 to 50% at steady-state. Its elimination is prolonged in patients with hepatic cirrhosis. Fluvoxamine inhibits oxidative drug metabolising enzymes (particularly CYP1A2, and less potently and much less potently CYP3A4 and CYP2D6, respectively) and has the potential for clinically significant drug interactions. Drugs whose metabolic elimination is impaired by fluvoxamine include tricyclic antidepressants (tertiary, but not secondary, amines), alprazolam, bromazepam, diazepam, theophylline, propranolol, warfarin and, possibly, carbamazepine.
Lexapro is metabolized by CYP2C19, CYP2D6 and CYP3A4. So there is a possibility that fluvoxamine can inhibit the metabolism of Lexapro and increase its plasma concentration. Which can have beneficial effects in terms of improvement in OCD or harmful effects in terms of side effects. You can ask detail about this to your prescribing doctor.
If you are poorer metabolizer for cyp2c19 and cyp2d6, then you might have extremely high level of drugs which can be dangerous. The opinion is strictly based on scientific research.
Hope I have answered your query. If you have further query then I will be happy to help. Wish you good health.
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Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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