Luvox Drug Classification
Luvox (fluvoxamine) is a selective serotonin reuptake inhibitor (SSRI). 1, 2
Mechanism of Action
- Fluvoxamine facilitates serotonergic neurotransmission through potent and selective inhibition of serotonin (5-HT) reuptake into presynaptic neurons. 3
- The drug is chemically unrelated to other SSRIs and clomipramine, belonging to the 2-aminoethyl oxime ethers of aralkylketones chemical series. 2
- Fluvoxamine has little or no effect on other monoamine reuptake mechanisms, distinguishing it from non-selective agents. 4
FDA-Approved Indications
- Fluvoxamine is FDA-approved for the treatment of obsessive-compulsive disorder (OCD). 1
- The drug was the first SSRI registered for treatment of OCD in children and adolescents. 5
Pharmacological Profile
Cytochrome P450 Interactions
- Fluvoxamine has substantial pharmacological interactions due to its effects on multiple cytochrome P450 enzymes. 6
- It is a weak inhibitor of CYP2D6, a moderate inhibitor of CYP2C19 and CYP3A4, and a potent inhibitor of CYP1A2. 4, 6
- This interaction profile differs from other SSRIs, with fluvoxamine having less effect on CYP2D6 compared to agents like fluoxetine or paroxetine. 4
Receptor Affinity
- Fluvoxamine demonstrates poor affinity for adrenergic, muscarinic, cholinergic, or histaminergic receptors, contributing to its favorable tolerability profile. 7
- Among SSRIs, fluvoxamine has the highest affinity for Sigma-1 receptors, which modulate cytokine levels and may have anti-inflammatory properties. 1
Common Pitfalls
- Do not confuse fluvoxamine's SSRI classification with its unique pharmacokinetic profile—its potent CYP1A2 inhibition creates different drug-drug interactions compared to other SSRIs like sertraline or citalopram. 6, 4
- Fluvoxamine's substantial pharmacological interactions require careful consideration when prescribing with other medications, particularly those metabolized by CYP1A2. 6
- The drug's high affinity for Sigma-1 receptors distinguishes it mechanistically from other SSRIs, though this does not change its primary classification. 1