Luvox/Fluvoxamine experiences anybody?

[newb1234]

I was prescribed Luvox - will taper down off escitalopram and taper up on the luvox over the next few weeks. I was surprised this was suggested, I expected a more commonly used SSRI like zoloft or something. My prescriber said this one should help me feel less tired and is a bit more activating than others, is good for OCD and PTSD. Just started the switch today with 15 mg escit (instead of my 20 mg normal amount) and 50 mg luvox. Will keep reducing the escit over time I guess.

Has anybody had a positive experience with this?

[panic_down_under]

I was prescribed Luvox - will taper down off escitalopram and taper up on the luvox over the next few weeks. I was surprised this was suggested, I expected a more commonly used SSRI like zoloft or something.

As a generalisation while no antidepressant (AD) is intrinsically better/more effective than the others for a particular disorder the SSRI fluvoxamine (Luvox) and the TCA clomipramine (Anafranil) seem to have an edge over other ADs for OCD so Luvox is definitely worth a shot.

[newb1234]

As a generalisation while no antidepressant (AD) is intrinsically better/more effective than the others for a particular disorder the SSRI fluvoxamine (Luvox) and the TCA clomipramine (Anafranil) seem to have an edge over other ADs for OCD so Luvox is definitely worth a shot.

Thank you, good to know. I hope it works well. So far definitely too early to tell, but I'm open-minded.

[panic_down_under]

I hope it works well.

If it doesn't then switching to clomipramine should be considered ahead of another SSRI, or SNRI, imo.

These days it and the other older TCAs are much underrated mostly because many doctors have had little experience with anything other than SSRIs and SNRIs. The newer meds aren't popular because they are more effective, but because they are perceived to be safer in overdose, which isn't actually true of all of them, and because they tend to have fewer ongoing side-effects, though this also isn't always the case in practice.

So far definitely too early to tell, but I'm open-minded.

As this isn't your first AD it may take a little longer to kick-in than escitalopram did.

[newb1234]

If it doesn't then switching to clomipramine should be considered ahead of another SSRI, or SNRI, imo.

These days it and the other older TCAs are much underrated mostly because many doctors have had little experience with anything other than SSRIs and SNRIs. The newer meds aren't popular because they are more effective, but because they are perceived to be safer in overdose, which isn't actually true of all of them, and because they tend to have fewer ongoing side-effects, though this also isn't always the case in practice.



As this isn't your first AD it may take a little longer to kick-in than escitalopram did.

That's interesting, nobody has ever suggested a TCA. You're right that SNRI and SSRIs are brought up for the most part. They suggested bupropion prior but I was concerned about my history of seizures when I was really young.

So far I just have a nagging headache right above my eyebrow today. I also was a little queasy this morning though that passed. It's been a long time since I went through start-up side effects.

[panic_down_under]

They suggested bupropion prior but I was concerned about my history of seizures when I was really young.

Childhood seizures don't usually preclude taking bupropion, but while it can be a very effective for depression it is often too stimulating for those with anxiety disorders.

Btw - small supplementary doses, <=75mg, can ease SSRI induced sexual dysfunction.

It's been a long time since I went through start-up side effects.

As you're switching between SSRIs the side-effects shouldn't be as severe as when you began taking the first AD. They will likely to much shorter lived too.

[newb1234]

Childhood seizures don't usually preclude taking bupropion, but while it can be a very effective for depression it is often too stimulating for those with anxiety disorders.

Btw - small supplementary doses, <=75mg, can ease SSRI induced sexual dysfunction.



As you're switching between SSRIs the side-effects shouldn't be as severe as when you began taking the first AD. They will likely to much shorter lived too.

Yes I hope you’re right. No headache today but some nausea on and off. Nothing unmanageable though.

[panic_down_under]

The enteric nervous system, the mini brain which controls the gut and seems to be the boss in the brain-gut axis, is by far the most serotonergic organ of the body so can be impacted more by SSRIs than the brain between our ears. Ginger and/or vitamin B6 supplements may help.

[newb1234]

Thank you! You got that right. It seems to be easing up a little. I am looking forward to hopefully getting my energy and motivation back but I know that could take time and a higher dose than 50 mg.

[panic_down_under]

a higher dose than 50 mg.

Most need to take 100-150mg. The recommended maximum is 300mg.

If you're taking immediate-release fluvoxamine then spitting doses above 100mg/day into half morning and night may produce a better result and/or ease any side-effects. If the dose can't be exactly halved then taking the larger part at night is preferable. But discuss this with your doctor first as there may be reasons for you not doing this. It is less of an issue with the slow-release formulations.