Re: Fluvoxamine help
Originally Posted by
JMB
Hi I have just been prescibed this for my anxiety & to help with my 10mg diazepam withdrawal, I am also on pregabalin 300mg at bedtime however I have just noticed on every site that fluvoxamine has Major interaction with diazepam and not so sure about the pregabalin.. All of these r meant to be taken before bed, so my question is considering every site saying major interaction would it be safe to take them all?
There are several problems with this if you have been/will be prescribed a therapeutic fluvoxamine dose, i.e. 100mg plus/day. It can slow the rate that diazepam is metabolised by about half, so diazepam plasma levels will rise likely increasing side-effects such as sedation. Cutting the diazepam dose might nullify much of this, but the medical consensus is that the combo is best avoided. The problem with pregabalin is fluvoxamine also affects the rate it is metabolised and in turn pregabalin affects fluvoxamine breakdown and elimination too.
Is this med regime safe? Well it probably won't directly harm, but there may be an increased risk of accidents because of sedation. You will need to be extra cautious until you work out how you're affected. I wouldn't drive, or operate potentially dangerous machinery, etc, for a while and it would be wise to delete skydiving from your bucket list too. And definitely do not drink alcohol (you shouldn't while on diazepam or pregabalin anyway).
Did your GP say why fluvoxamine was chosen? Do you have an OCD spectrum disorder? Also, what if anything did the chemist say?
It seems of all the antidepressants fluvoxamine seem to interact the worst with diazepam.
It isn't only with diazepam. Fluvoxamine interacts with many medications, both prescribed and over-the-counter which is why I think it should only be prescribed for OCD spectrum disorders for which it has a better track record than the other SSRIs, and even then only if the TCA clomipramine (Anafranil) isn't suitable for some reason.
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The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.