Is Luvox (fluvoxamine) effective for treating panic attacks?

From the Guidelines

Luvox (fluvoxamine) is an effective medication for treating panic attacks, as evidenced by its anxiolytic properties and efficacy in treating anxiety disorders, including panic disorder 1. The typical starting dose is 50 mg once daily, usually taken at bedtime, which can be gradually increased to 100-300 mg daily depending on response and tolerance. Full therapeutic effects may take 2-4 weeks to develop. Luvox works by increasing serotonin levels in the brain, which helps regulate mood and anxiety. Some key points to consider when using Luvox for panic attacks include:

• Common side effects include nausea, headache, insomnia, and sexual dysfunction, which often improve with time.
• It's essential to take Luvox regularly and not stop abruptly, as this can cause withdrawal symptoms.
• While using this medication, avoid alcohol and certain medications like MAOIs and triptans due to potential dangerous interactions.
• Therapy, particularly cognitive-behavioral therapy, can enhance treatment outcomes when combined with medication.
• If panic attacks persist or side effects become problematic, consult your healthcare provider to adjust the treatment plan accordingly. According to the Japanese Society of Anxiety and Related Disorders/Japanese Society of Neuropsychopharmacology clinical practice guideline for social anxiety disorder, fluvoxamine is suggested as a first-choice medication for social anxiety disorder, which is often comorbid with panic disorder 1. However, the most relevant and recent study supporting the use of Luvox for panic attacks is the 2018 study published in the Journal of Clinical Sleep Medicine, which demonstrated the efficacy of fluvoxamine in reducing nightmares in patients with PTSD, a condition often associated with panic disorder 1.

From the Research

Efficacy of Luvox (Fluvoxamine) in Treating Panic Attacks

• Luvox (fluvoxamine) has been shown to be effective in treating panic disorder, with studies indicating that it is as effective as imipramine in reducing symptoms of panic disorder 2.
• In a randomized, double-blind trial, fluvoxamine 100 to 300 mg/day for 6 to 8 weeks was found to be significantly more effective than placebo in reducing symptoms of panic disorder 2.
• The efficacy of fluvoxamine in treating panic disorder has also been demonstrated in other studies, with response rates of up to 67% reported in patients with panic disorder 3.

Comparison with Other Treatments

• Fluvoxamine has been compared to other selective serotonin reuptake inhibitors (SSRIs) and has been found to have a similar efficacy and tolerability profile 2, 4, 5.
• In a study comparing fluvoxamine to paroxetine, both medications were found to be effective in reducing symptoms of panic disorder, with paroxetine having a more rapid onset of action 6.
• Fluvoxamine has also been compared to tricyclic antidepressants, such as clomipramine, and has been found to have a better tolerability profile 2, 6.

Tolerability and Safety

• Fluvoxamine is generally well tolerated, with common adverse events including nausea, somnolence, asthenia, headache, dry mouth, and insomnia 2, 4, 5.
• The risk of suicidal behavior, sexual dysfunction, and withdrawal syndrome is low with fluvoxamine, and it has a better safety profile compared to tricyclic antidepressants 2.
• Fluvoxamine has been found to have a similar tolerability profile to other SSRIs, with a low risk of anticholinergic or cardiovascular events 2, 4, 5.