When Do I Use Fluvoxamine/Luvox

Рет қаралды 5,692

2 жыл бұрын

This is the next video in the series how to select an SSRI. In this video I cover fluvoxamine or Luvox and explain why I would or would not use this medication in clinical practice.
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Пікірлер: 79

@emerson23946 Жыл бұрын

Fluvoxamine really changed the game with my OCD. I don’t manically clean anymore and can really work with my compulsions. I can avoid in engaging in my behaviors. It totally changed my life.

@ShrinksInSneakers Жыл бұрын

Great, for some people this medication can be a life changing experience. When I talk about fluvoxamine not necessarily being a better option in OCD we are talking about large patient populations and large randomized controlled trials. On a case by cases basis a medication that would not necessarily be better in general can work wonders. Thanks for sharing and if you haven't subscribed to the channel please do and spread the word about what we are doing here

@NehaSingh-wm1pv 11 ай бұрын

@@ShrinksInSneakerssir how much weight gain can we gain on fluvoxamine??

@ShrinksInSneakers 10 ай бұрын

@@NehaSingh-wm1pv It's hard to say as no one has truly studied this in a randomized controlled setting. All antidepressants carry some risk of weight gain and some are better than others for example bupropion would be a lower risk

@NehaSingh-wm1pv 10 ай бұрын

@@ShrinksInSneakers ok sir Thankyou for so kuch fo your reply one more question.What if we have to take this medicine for the rest of our life?? Do we gain keep gaining weight for the whole life??

@celticwarrior5646 2 жыл бұрын

That was quick! Thought you'd done the video especially for me, privileged 😁. I'm in the UK where it is approved for depression and social anxiety. I've taken all the SSRI'S over the last 30 years for anxiety with depression. Panic,GAD and Social. Found them all effective for depression,panic and GAD,but not effective enough on Social anxiety,hence I'm trying Fluvoxamine for the first time. Good videos.

@colsonrizzuto7973 2 жыл бұрын

Any update on social anxiety?

@celticwarrior5646 2 жыл бұрын

@@colsonrizzuto7973 Hi,as they all increase serotonin in similar ways, Fluvoxamine has also had a similar effect on my social anxiety,no worse,no better. I couldn't say that I would recommend any particular SSRI over another for social anxiety and that includes 5-htp which I've also taken which makes sense. I've read that curing anxiety disorders involves more then just raising serotonin levels,and I would completely agree with that also. Anxiety is much more complicated than raising a chemical in your brain. Every SSRI I've taken I would say, has an effeciency rating of 70-75% on anxiety and that bears out with the average ratings on review sites. That said,there are differences in other ways like side effect profiles, withdrawal etc

@colsonrizzuto7973 2 жыл бұрын

@@celticwarrior5646 I understand it is incredibly complex, there are so many factors contributing to social anxiety and lack of confidence for most people. What is the efficiency rating of this drug and how does it compare to sertraline which is approved for SAD?

@celticwarrior5646 2 жыл бұрын

@@colsonrizzuto7973 I much prefer Fluvoxamine to Sertraline. Sertraline for me is far too activating on anxiety compared to Fluvoxamine which is more sedating like Citalopram and Paroxetine. Unlike the latter two,I have lost weight rather than put on weight which is very strange but fantastic. Been on Fluvoxamine for 10 months now,so don't expect to alter. Everyone has different experiences on these medications,what happens to one person might not happen to another,but there is a lot of lethargy and tiredness experienced by most people.

@colsonrizzuto7973 2 жыл бұрын

@@celticwarrior5646 that’s great. I’m going to have my first dose tonight. I also have OCD and MDD, so I may need quite a bit lol, how many mg are you taking if you don’t mind sharing? And Is it the extended release version?

@DanielSRosehill 9 ай бұрын

Thanks my friend! I've just been prescribed this (it will be my fourth SSRI after sertraline, escitalopram, and sertraline). Weirdly I don't have OCD, although pure OCD is a self diagnosis. I think my psych liked it because he said it was somewhat sedating (fluoxetine made me very agitated) and had relatively low incidence of sexual sides. Half life sounds a bit worrisome but I'm guessing that can be alleviated during withdrawal by careful tapering? Also interesting about the interactions - I see caffeine is even an issue due to inhibited metabolism. Thanks for the info anyway. I'm glad that you took the time to demystify this!

@KomradeKlonopin 2 ай бұрын

If you look into studies on the brain itself fluvoxamine has a longer brain elimination half life. So while the plasma half life is even shorter than paxil, the brain half life is like 32-76 hours and more in line with Zoloft in terms of withdrawal timeline.

@PirateWW Жыл бұрын

I was on this drug for a few months in the mid 90s and I hated it. I felt extremely tired the entire time and was so glad to get off it!!

@austinolson9191 Жыл бұрын

My provide just prescribed Luvox for me. She states that I have an unhealthy obsession with how my treatment goes. This prevents her from doing her job as a provider when I have an obsession with what medication we should be doing. My provider said this can cause severe relationship problems with friends, work, and family. My question is what are alternatives to Clomipramine and Luvox for OCD? I tried Clomipramine with no success and now we are trying Luvox. Is there any other options for me?

@EphesianRose 2 жыл бұрын

would you be able to do a video on Clomipramine (Anafranil) at some point. And zoning in on OCD-specific medications in general.Thanks!

@ShrinksInSneakers 2 жыл бұрын

I have a video on TCAs in general, check that out it covers all the mechanism and side effects. The big take away for OCD treatment is the doses must be much higher than what we use for depression or anxiety. For example 120 mg of fluoxetine or 350 mg of sertraline, the other piece to that is the medication must be continued longer, I do not consider it a failed trial until the person has been on high doses for 12 weeks. The next step is to add either risperidone or ariripirazole if the say 120 of fluoxetine does not work. Also exposure and response prevention therapy is very helpful. Hope this helps if you have not subscribed to the channel please do, and spread the word about what we are doing here.

@meganleanza1054 2 жыл бұрын

Hi, thanks for your video! I have a few questions for you... I've been researching Prozac and Luvox because I'm looking for an SSRI that manages my anxiety well without being too sedating. Zoloft and Lexapro made me too drowsy. All 3 SNRI's were less effective for anxiety. Which medication do you think would be the better option? Which of the two do you think has fewer sexual side effects? Which medication would be a better pairing with Wellbutrin if I decided to add that for depression? I've read that Wellbutrin isn't a good combo with Prozac due to increased risk of seizures. Thank you for reading and taking the time to help!

@ShrinksInSneakers Жыл бұрын

This is not medical advice and it's for educational purposes only. one easy way to fix the sedation problem is to take the medication at night. If sexual side effects and sedation are the most concerning side effects Wellbutrin is a good option although it's not FDA approved for anxiety disorders. As long as the dose of wellbutrin remains at 300 mg or less there is not significant increased risk of seizure, see my other video where I explain exactly what that risk is. When I use wellbutrin in combination I prefer escitalopram. Hope this helps, if you haven't subscribed to the channel please do and spread the word about what we are doing here

@pvn271 2 жыл бұрын

Sir, I'm in psych residency right now in India and here we have an extended release preparation of Fluvoxamine? Isn't that available in the US? Wouldn't that make the short half life and withdrawal problems practically non existent? Please share your thoughts Thank you, and subscribed.

@yourstrulylindsay Жыл бұрын

Dr Rossi- Been on 50mg of Luvox for 8 years. Barely feel it. But continue to take it. I unfortunately fell into depression this year- and just started Mirtazapine 7.5mg. What are your feelings on this combo? I think Mirtazapine with an SSRI could definitely be beneficial.

@yuriydovgan3107 7 ай бұрын

Good day! Is there any information regarding drug interactions between fluvoxamine and bupropion? Thank you!

@jd737 Жыл бұрын

Luvox is the only medication that has ever came me any relief from my intrusive thinking

@1houndgal Жыл бұрын

I am on Luvox and have been for years. This drug worked where so many drugs have failed. My life is better because of it, I have much less ocd and social anxiety symptoms. 🙃

@ShrinksInSneakers Жыл бұрын

That's great, when we discuss research it's "in general" and every person will respond to medication differently so what works for one person might not work for another. I know I'm a little hard on fluvoxamine but some people have had success on it. I'm glad you found a treatment that works for you. If you haven't subscribed to the channel please do and spread the word about what we are doing.

@vegetossgss1114 Жыл бұрын

Hello! Is fluvoxamine activating or sedating? Are you able to wake up early in the morning to go the university / to your job? How much do you sleep each night? I have been on Paxil for 5 years. Amazing drug, but too sedating. I tried sertraline but it made me even more drowsy than paroxetine, even with a very low dose (perhaps because I am a poor CYP2C19 metabolizer). I would love to have your review on fluvoxamine's side effects.

@juztnlast953 5 ай бұрын

I tried some common SSRI's like zoloft or paxil with significant side effects and also antipsychotics like abilify and geodon with terrible effects. My doctor wants to try me on Luvox and I had such a rough experience with the geodon I am terrified to try something new. My symptoms of anxiety and "the sky is falling" negative seem to get work on treatment. My doctor seems to think lots of my anxiety is obsessive driven so we are going with the Luvox. I feel so discouraged based on the lack of success I have had on previous medications.

@Psychiatube 2 жыл бұрын

Timely for the COVID excitement regarding the drug!

@ShrinksInSneakers 2 жыл бұрын

This is true, I had a consult doctor recently use it for a COVID patient I'll keep you posted on the outcome

@alessandrojaker7160 2 жыл бұрын

In my experience, Luvox causes extreme weight gain. On Luvox, I gained 80 pounds twice. The first time was when I was put on it at age 16 (for depression and OCD). Then after a few years I went off of Luvox and lost all the weight. Then when I was 25 I was put on it again when I was in the hospital for a depressive episode. I asked for a different medication, but they said, "this medication helped you in the past" so they put me on it again and I gained 80 pounds again. Since then I have lost much of the weight, I now take different medications.

@ShrinksInSneakers 2 жыл бұрын

I appreciate you sharing your experience, I always learn a lot when I go through these comments

@ShrinksInSneakers 2 жыл бұрын

@@tunneling-nanotubes There is a lot of animal studies looking at sigma-1 antagonism for substance use disorder and binge eating disorders. We can't always translate that data to humans but it is interesting. This is a paradox because sigma-1 agonism has also shown in animal studies a reduction in depression, anxiety, and psychotic symptoms. You just can't win

@celticwarrior5646 2 жыл бұрын

Keeps my weight down with less of an appetite.

@libotoole8489 Жыл бұрын

@@ShrinksInSneakers I have never been someone with maladaptive behaviour of binge eating (although I have done binge drinking back when I drank alcohol). I'm 2 weeks into taking this luvox and started bing eating and am gaining weight. Unfortunately my mood is low too. I'm on the starting dose still

@ShrinksInSneakers Жыл бұрын

@@libotoole8489 I did an entire video on binge eating if you are interested and went over the pharmacotherapy for the disorder. In general with OCD you need much higher doses of SSRIs and you need a full 12 weeks on the high dose to assess response. Most people stop treatment too early or have doctors who are uncomfortable going above FDA approved maximums. Hope this helps, if you haven't subscribed please do and spread the word about what we are doing here.

@vegetossgss1114 Жыл бұрын

@Pedro-kq5tl Жыл бұрын

Sedating

@phoebejanemiller1671 2 жыл бұрын

In my experience, Luvox is the only antidepressant that’s actually helped my symptoms. It doesn’t really cause side effects- just some fatigue. Having been through withdrawal from benzodiazepines, cymbolta, and Effexor, I’m not too worried about that either. However, my doctors only tried me on it after trying a myriad of other drugs. So far I’ve been on it for over a year along with a low dose of Seroquel and 1200mg gabapentin.

@ShrinksInSneakers 2 жыл бұрын

These videos are general concepts not everyone will respond poorly or have side effects and for some patients this could be the medication that changes their life. Glad to hear you found a combination that works well for you, check out my latest video on fluvoxamine as a COVID-19 treatment, Appreciate the comment

@vegetossgss1114 Жыл бұрын

@phoebejanemiller1671 Жыл бұрын

@@vegetossgss1114 Hi! In my experience Luvox is very sedating. I’d say (for me) it’s a bit more sedating that sertraline. However, I’m on a pretty high dose (250mg). It is very effective at helping with anxiety and obsessive thoughts. On it, I can sleep 8+ hours a night. However, I am also on Seroquel- and that’s a very sedating drug as well. When I don’t take the Seroquel I can’t wake up early without an issue. But even on both, I’ve survived two years of uni and a couple of jobs that I had 9:00am shifts for. I think it varies person to person! Please let me know if you have any more questions. All the best wishes ❤️.

@vegetossgss1114 Жыл бұрын

@@phoebejanemiller1671 Thanks very much for your answer!

@ashleyzeleznik5388 2 жыл бұрын

I don’t know, the sigma 1 agonism is intriguing to me. I dose twice a day which isn’t a problem and don’t take any other meds so I’m okay with this med. Also, I’ve had less start up sides compared to even lexapro.

@ShrinksInSneakers 2 жыл бұрын

Good to hear that you are having a positive response to the medication. I did another video on fluvoxamine as treatment for COVID-19 where I talk more about sigma 1 agonism and the inflammatory response. We now have good evidence to support high states of inflammation as a possible mediator of depression. This may be why it's effective. If you haven’t subscribed to the channel, please do, and spread the word about what we are doing here. We also have daily content posted on Instagram @Shrinsk_In_Sneakers

@vegetossgss1114 Жыл бұрын

@celticwarrior5646 2 жыл бұрын

Sorry, it's not approved for social anxiety in UK, depression and OCD only.

@The_Avant_Garde_Album 11 ай бұрын

Spoken well for someone without OCD.

@ShrinksInSneakers 11 ай бұрын

There are many ways to address OCD and I still like psychotherapy as primary intervention. Medications can be helpful so can some of the newer TMS treatments. You never know I might have OCD

@The_Avant_Garde_Album 11 ай бұрын

@@ShrinksInSneakers Sorry, was feeling a bit saucy that night. I know better than to comment. Respect your profession and your expertise. I can take my comment down, or it can be a marker for me to stop writing after rum. lol Thanks for your content. Keep up the great work.

@ShrinksInSneakers 11 ай бұрын

@@The_Avant_Garde_Album no worries I'm always open to a conversation and try to honest with everyone on here. I get how frustrating things can be, and I feel for you. As always i'm here to help in any way I can

@bjornolson21 5 күн бұрын

Prozac saved my life from ocd

@musavirabbas2340 Жыл бұрын

Sir plz help me i eat fluvoxamine 25 I am 6 weeks pregnant it is safe forpregnancy

@rheannak3934 2 жыл бұрын

I’m trying to liquid taper off of Luvox so I can switch to another anti depressant but my Dr says I have to come all the way off and have a two week washout because you can’t add anything else to this med. I’m really suffering. I’ve even asked pharmacists and ARNP’s if this is true and they all say yes you cant add anything or even cross taper up on something else. I don’t see how that is possible because I’m only on 17 mg and how could such a low dose possible cause an excessive concentration when combined with a low dose of another anti d. Do you have any thoughts on this ?

@ShrinksInSneakers 2 жыл бұрын

This is only true if you were switching to something like an MAOI. There is risk of developing serotonin syndrome and there is a warning indicating caution must be used if adding another antidepressant within 2 weeks after stopping. This is warning on all SSRI medications. I have seen cases where withdrawal symptoms are bad in which case fluoxetine is used and started once the other medication is low enough. In short it can be done it will depend on the level of comfort your doctor has with the plan. If you haven’t subscribed already, please do, and spread the word about what we are doing here. Here are some examples for educational purposes Venlafaxine 75 mg/day plus fluoxetine 20 mg/day - Sertraline 25 mg/day plus fluoxetine 5 mg/day - Paroxetine 10 mg/day plus fluoxetine 2.5 mg/day - Clomipramine 75 mg/day plus fluoxetine 20 mg/day - Paroxetine 20 mg/day plus fluoxetine 20 mg/day

@vegetossgss1114 Жыл бұрын

@@ShrinksInSneakers what are the exemples you gave here meant for? cross tappering?

@hallamacchadunga7702 2 ай бұрын

its very effectivve in controlling anxietty more than other ssri i feel but withdrawal are terrible 😐😐😶‍🌫

@samohic Жыл бұрын

I have been on fluvoxamine for almost two months now for Pure O / intrusive thoughts. The intensity and frequency of intrusive thoughts/ obsessions have come down partially. Started on 50 mg titrated to 150 mg. Higher doses for me have correlated with lower intensity of obsessions. My doc wants me to be on 200 mg as the target dosage. I hope this further helps. I was on Prozac and lexapro before but could not tolerate even small doses of it. Fluvoxamine also has its fair bit of side effects especially nausea and increase anxiety. For this i was prescribed clonazepam 0.5 mg daily till fluvoxamine had its effects. For me this has been a good drug till now compared to prozac and lexapro

@ShrinksInSneakers Жыл бұрын

In general for OCD doses of all SSRIs must be very high. 120 mg of prozac for example and the person must remain on the medication for 13 weeks not the usual 4-6 weeks to call it an adequate trial of medication. Most doctors are too uncomfortable with these doses. Also psychotherapy is very important in these cases and should be done along with medication management. Hope this helps if you haven't subscribed to the channel please do and spread the word about what we are doing here

@samohic Жыл бұрын

@@ShrinksInSneakers I love watching your videos it indeed helps knowing about mental health and pharmacotherapy. Will share it with my colleagues who are interested in mental health

@samohic Жыл бұрын

@@ShrinksInSneakers Off late when I touched 200 mg per day I got severe panic attacks developed agoraphobia because of it and then was again put down to 150 for 25 days and then to 75 mg with 1mg of clonazepam. And I am having worst withdrawal symptoms because of its short half life. My doc wants me to put me back on lexapro (i guess the best tolerated). I hardly have any of those obsessions or intrusive thoughts now but severe anxiety as withdrawal symptoms.

@ShrinksInSneakers Жыл бұрын

I have a video where I talk about optimal dosing of all antidepressants. Take a look in my playlist for it, I think it will help you understand things.

@vegetossgss1114 Жыл бұрын

@chanheosican6636 Жыл бұрын

You forgot about caffiene reactions.

@plockacherrys5765 2 жыл бұрын

I use this luvox for ppl who have hyperhidrosis induced by antidepressants. Also withdrawal symptoms is not a high risk for luvox I disagree with u. Effexor and paroxetine is another story tho.

@ShrinksInSneakers 2 жыл бұрын

I agree with the hyperhidosis there is some evidence to support it. I stand by the research regarding short half life and risk for withdrawal syndrome. The half life is shorter than Paxil. It’s also dosed multiple times per day and may not be a good option for people who forget to take medication. Appreciate the comment and reminder about excessive sweating

@rachelann8275 2 жыл бұрын

What would you reccomend instead?

@ShrinksInSneakers 2 жыл бұрын

This is not medical advice and it's for educational purposes only. Pease talk with your doctor before making any changes. Based on the data I prefer a few medications. I usually start with escitalopram, sertraline, or bupropion. Each one has a place and there are reasons behind those choices. For example sertraline is the safest of the medications and can be used while breast feeding and in cardiac patients. Escitalopram is good for anxiety and has slightly better efficacy. Bupropion offers the bennfit of no sexual side effects for younger patients this is a real problem and should be addressed. Hope this helps, If you haven't subscribed to the channel please do, I appreciate the question.

@vegetossgss1114 Жыл бұрын

@@ShrinksInSneakers I took Escitalopram during a year and although it helped a bit for my depression, it did nothing at all for my anxiety, neither for my OCD! I then switched to Paxil these 5 last years.

@jatinsharma5024 Жыл бұрын

Doc is there any SSRI which does not decrease libido.

@ShrinksInSneakers Жыл бұрын

A lot of the sexual side effects I’ve found to be dependent on the individual. All the SSRIs and SNRIs have risk for sexual side effects. Of the SNRIs duloxetine has a lower risk. Vortioxetine and bupropion are other options. How this helps

@jatinsharma5024 Жыл бұрын

@@ShrinksInSneakers thanks