fluvoxamine / Generic mfg. - LARVOL DELTA

Clinical outcomes in patients with multiple myeloma and antidepressant use: A retrospective cohort study (ASH 2025) - "Adult patients with multiple myeloma since 2010 and prescribed antidepressants (sertraline, escitalopram, citalopram, paroxetine, fluoxetine, fluvoxamine, venlafaxine, duloxetine, trazodone, mirtazapine, or bupropion) were identified using ICD-10 diagnostic and RxNorm codes. While some associations were modest in magnitude, the consistent pattern of increased risk suggests that pre-existing depression and its treatment may identify a more vulnerable subgroup of multiple myeloma patients. Further prospective studies are needed to clarify underlying mechanisms and to evaluate the potential impact of early psychiatric intervention."

Clinical data • Retrospective data • Chronic Kidney Disease • CNS Disorders • Depression • Hematological Malignancies • Infectious Disease • Major Depressive Disorder • Multiple Myeloma • Musculoskeletal Diseases • Nephrology • Renal Disease

The impact of antidepressant use on antibiotic treatment outcomes in urinary tract infections and pneumonia: A population-based cohort study. (PubMed, Psychiatry Clin Neurosci) - "Antidepressants are associated with a modest rise in UTI treatment failure risk, possibly due to antibiotic resistance or other mechanisms. Despite this, their essential role in mental health management outweighs the small risk, emphasizing the need for judicious use, particularly in females and older adults. Further research is warranted to clarify underlying mechanisms."

Journal • Infectious Disease • Nephrology • Pneumonia • Respiratory Diseases

Middle meningeal artery lidocaine infusion for refractory migraine: First case report in Portugal (EHF-EHC 2025) - "Various pharmacologic classes were tried without benefit: antihypertensives and calcium channel blockers (propranolol, candesartan, flunarizine), antiepileptics (valproic acid, topiramate, oxcarbazepine), antidepressants (amitriptyline, nortriptyline, venlafaxine, fluvoxamine, sertraline, clomipramine), other preventives (prednisolone, oxitriptan, melatonin), cycles of botulinum toxin (PREEMPT protocol), monoclonal antibodies (galcanezumab, fremanezumab, erenumab), and atogepant. At the time of the procedure, the patient was on eptinezumab 100 mg and botulinum toxin every three months but continued to have daily headaches, with severe intensity and reliance on eletriptan for acute relief...It constitutes an invasive therapeutic approach that should be considered only as a rescue option for carefully selected patients with severely refractory migraine. Further studies and long-term follow-up are needed to assess efficacy and safety."

Case report • Clinical • Anorexia • CNS Disorders • Migraine • Pain

Comparative gastrointestinal effects of antidepressants for the acute treatment of adults with major depressive disorder: a network and dose‒response meta-analysis. (PubMed, Transl Psychiatry) - "Commonly used antidepressants have different gastrointestinal effects. Duloxetine, levomilnacipran, and vilazodone carry a higher risk of inducing nausea and vomiting, whereas trazodone, amitriptyline, agomelatine, and mirtazapine tend to be better tolerated. Amitriptyline, clomipramine, and reboxetine are more prone to induce constipation. Diarrhoea is more commonly associated with vilazodone, fluvoxamine, and sertraline. Amitriptyline, reboxetine, and duloxetine are more likely to cause anorexia. Amitriptyline, reboxetine, and trazodone are related to causing dry mouth. Compared with the placebo, amitriptyline, fluoxetine, and paroxetine were associated with a greater incidence of dyspepsia."

Journal • Retrospective data • Review • Anorexia • CNS Disorders • Constipation • Depression • Dyspepsia • Gastroenterology • Gastrointestinal Disorder • Major Depressive Disorder • Mood Disorders • Psychiatry • Xerostomia

Vormatrigine Exhibits a Favorable Drug-Drug Interaction Profile Supporting Broad Combination Use with Antiseizure Medications (AES 2025) - "Key enzymes assessed included CYP1A2, 2C19, 3A4, and UGT isoforms, along with major efflux and uptake transporters.Clinically, the Phase 1 PRAX-628-102 study enrolled healthy adults and examined the pharmacokinetics (PK) of single 10 mg doses of vormatrigine alone and in combination with fluvoxamine (CYP1A2/2C19 inhibitor), itraconazole (CYP3A4 inhibitor) and probenecid (non-selective UGT inhibitor). Vormatrigine exhibits a highly favorable DDI profile, supported by both preclinical mechanistic studies and human PK data. With no clinically meaningful interactions observed with inhibitors or inducers of major CYP and UGT pathways—except a moderate effect via CYP1A2—vormatrigine is well-suited for use in multi-drug epilepsy regimens, including a broad array of ASMs without the need for dose adjustments. These findings reinforce vormatrigine's potential as a best-in-class sodium channel modulator and support its continued clinical development in the ENERGY program for..."

CNS Disorders • Epilepsy • ABCB1 • CYP1A2

Fluvoxamine Attenuates Blood-Brain Barrier Disruption in Drug-Resistance Epilepsy and inhibits Ferroptosis via the Sigma-1 Receptor-TAMM41 signaling in bEnd.3 cells. (PubMed, Mol Neurobiol) - "Using the lamotrigine-pentylenetetrazol kindling drug-resistant epilepsy model, we found that fluvoxamine effectively converted drug-resistant epilepsy in mice to drug responsiveness, including against gabapentin, phenytoin sodium, and carbamazepine...In contrast, fluoxetine, despite sharing similar pharmacokinetic features and receptor spectrum with fluvoxamine, didn't elevate TAMM41 levels or exhibit anti-drug-resistant epileptic activity. Collectively, our findings demonstrate that fluvoxamine restores the responsiveness of DRE mice to antiepileptic drugs, alleviates BBB impairment, and inhibits BMVECs ferroptosis by activating the S1R-TAMM41 axis in BMVECs. Given the critical role of BBB disruption in drug-resistant epilepsy pathogenesis, this study may offer novel therapeutic strategies for treating drug-resistant epilepsy."

Journal • CNS Disorders • Epilepsy

Real-world pharmacovigilance and clinical risks of fluvoxamine: A disproportionality analysis based on FAERS data. (PubMed, J Affect Disord) - "Clinicians should remain vigilant for psychiatric, neurological, ocular, and cardiac AEs, as well as potential drug interactions. This study offers valuable evidence to inform clinical monitoring, risk management, and future research aimed at optimizing the safe use of fluvoxamine in diverse patient populations."

Adverse events • Journal • Real-world evidence • Cardiovascular • CNS Disorders • Cushing’s Disease • Depression • Endocrine Disorders • Genetic Disorders • Mental Retardation • Mood Disorders • Movement Disorders • Ophthalmology • Otorhinolaryngology • Psychiatry

The Impact of Fluvoxamine on Clozapine and Norclozapine Serum Concentrations. (PubMed, Eur J Drug Metab Pharmacokinet) - "Fluvoxamine significantly increases clozapine and norclozapine concentrations, and their ratio. Doses > 25 mg lead to greater fold increases and more variability. Initiation at 25 mg with a 50% clozapine dose reduction is recommended."

Journal • Psychiatry • CYP1A2

Novel Sigma-1 receptor agonist alleviates renal ischemic injury by targeting apoptotic and inflammatory pathways. (PubMed, Sci Rep) - "We previously showed that the Sigma-1 receptor (S1R) agonist fluvoxamine protects against IRI and IRI-induced graft injury during transplantation...Taken together, S1R activation by VCC904125 decreases renal IRI via ameliorating apoptotic and inflammatory pathways. These results highlight the therapeutic promise of S1R activation in mitigating cold and warm ischemia and improving transplant outcomes."

Journal • Acute Kidney Injury • Cardiovascular • Inflammation • Nephrology • Reperfusion Injury • Transplantation • KIM1

Drug-Drug Interactions and Individualized Clozapine Therapy in Patients with Depression: Insights from Real-World Data. (PubMed, Drug Des Devel Ther) - "This study provides the first real-world evidence to guide safe and individualized clozapine dosing in patients with depression, particularly in the context of fluvoxamine co-administration. When patients with depression patient are treated with fluvoxamine maleate, the dosage of clozapine needs to be reduced."

Journal • Real-world evidence • CNS Disorders • Depression • Mood Disorders • Psychiatry

Pharmacogenetic Guidelines and Resources to Support Antidepressant and Antipsychotic Use in Child and Adolescent Psychiatry (AACAP 2025) - "The FDA categorizes drug-gene pairs by implications on therapeutic management, safety, or pharmacokinetics. If a patient has genotype results available, the CPIC and/or FDA currently provide assessments supporting the utility of PGx to inform the use of many antidepressants including es/citalopram (CYP2C19), fluvoxamine (CYP2D6), paroxetine (CYP2D6), sertraline (CYP2C19 and CYP2B6), TCAs (CYPC19 and/or CYP2D6), venlafaxine (CYP2D6), and vortioxetine (CYP2D6)...FDA labeling provides specific dosing based on CYP2D6 poor metabolizer genotypes for aripiprazole, brexpiprazole, iloperidone, pimozide, and thioridazine... CPIC and FDA resources are useful for identifying evidence-based PGx information for commonly used antidepressants and antipsychotics. PharmGKB and Sequence2Script support access to foundational literature and the clinical implementation of PGx results.PPC, ADP, APS"

Biomarker • Clinical • CNS Disorders • Psychiatry • CYP19A1 • CYP2C19 • HTR2A • SLC6A4

The effects of antidepressants on cardiometabolic and other physiological parameters: a systematic review and network meta-analysis. (PubMed, Lancet) - "We found strong evidence that antidepressants differ markedly in their physiological effects, particularly for cardiometabolic parameters. Treatment guidelines should be updated to reflect differences in physiological risk, but choice of antidepressant should be made on an individual basis, considering clinical presentation and preferences of patients, carers, and clinicians."

Journal • Retrospective data • CNS Disorders • Mental Retardation • Metabolic Disorders • Psychiatry

SEVERE BRADYCARDIA AND HEMODYNAMIC INSTABILITY DUE TO FLUVOXAMINE-TIZANIDINE INTERACTION: A CASE OF RECURRENT SYNCOPE (CHEST 2025) - "CASE PRESENTATION: We present the case of a a 32-year-old female with chronic psychiatric disorders on Fluvoxamine, Lamictal, and Alprazolam who was transferred to our hospital due to syncopal episodes, fatigue, dizziness, and vision changes that had been occurring periodically over the last month...She was eventually discharged in her normal state of health with levothyroxine and discontinuation of Tizanidine and Fluvoxamine... The patient's chronic psychiatric medications, particularly Fluvoxamine, in combination with tizanidine likely resulted in her recurrent syncope and hemodynamic instability. The identification of subclinical hypothyroidism as a possible contributor complicates the picture, but its role in profound bradycardia is less certain. This case underscores the importance of careful medication reconciliation with particular care given to drug interactions that may have serious cardiovascular effects."

Clinical • Cardiovascular • CNS Disorders • Endocrine Disorders • Fatigue • Heart Failure • Infectious Disease • Mental Retardation • Movement Disorders • Psychiatry • Xerostomia • CYP1A2

Real-World Clinical and Economic Impact of Pharmacogenetic-Supported Prescribing in Kids: Results from a Large Canadian Mirror Image Trial (WCPG 2025) - "The study enrolled over 1,900 participants, referred by more than 300 psychiatrists, family physicians, and pediatricians across Alberta, Saskatchewan, British Columbia, and Manitoba. PGx testing revealed that 82% of participants had at least one actionable genotype. The most frequently prescribed PGx-guided psychotropic medications were sertraline (18%), fluvoxamine (9%), risperidone (8%), aripiprazole (7%), and atomoxetine (6%)."

Biomarker • Clinical • HEOR • Real-world • Real-world evidence • Pediatrics • Psychiatry

Dystonia associated with fluoxetine in a patient, CYP2D6*4/*4 (poor) metabolizer: role of drug-drug interactions (MDS Congress 2025) - "Olanzapine and aripiprazole are substantially, but not extensively metabolized by CYP2D6 A 19-years-old female Caucasian patient was addmited to Neurology Clinic beacause of cervical dystonia...A year eralier, after a few days of haloperidol 5 mg twice daily and fluvoxamine 100 mg daily, she exhibited myoclonic head yerks, which stopped after the therapy was discontinued... Genetics variations in CYP2D6 enzymes determine enzymatic activity, which can have a large effect on drug levels and toxicity. In the presence of strong CYP2D6 inhibitor, individuals with a poor metabolizer genotype have a greater risk of manifesting poor metabolizer phenotype and adverse reaction. Genotyping may reflect the CYP2D6 poor metabolizer phenotype when using multiple drugs that are substrates and/or inhibitors of CYP2D6."

Clinical • CNS Disorders • Dystonia • Movement Disorders • Psychiatry

Side effect profile and comparative tolerability of newer generation antidepressants in the acute treatment of major depressive disorder in children and adolescents: protocol for a systematic review and network meta-analysis. (PubMed, BMJ Open) - "The following antidepressants will be considered: agomelatine, alaproclate, bupropion, citalopram, desvenlafaxine, duloxetine, edivoxetine, escitalopram, fluoxetine, fluvoxamine, levomilnacipran, milnacipran, mirtazapine, paroxetine, reboxetine, sertraline, venlafaxine, vilazodone and vortioxetine. The findings will be published in a peer-reviewed journal and may be presented at international conferences. CRD420251011399."

Adverse events • Journal • Retrospective data • CNS Disorders • Depression • Major Depressive Disorder • Mental Retardation • Mood Disorders • Psychiatry • Suicidal Ideation

Fluvoxamine Augmentation of Clozapine and Dose-dependent Interaction Patterns: A Case Report. (PubMed, J Clin Psychopharmacol) - No abstract available

Journal

SARS-CoV-2 vaccination and plasma levels of psychotropic agents: a prospective cohort study. (PubMed, Expert Opin Drug Metab Toxicol) - "In clozapine-treated patients, plasma levels remained by mean almost constant after both inoculations, although changes were larger in patients without vs. with co-medication with fluvoxamine (p < 0.001 at all timepoints except for timepoint T2; p = 0.9), with minor changes in interleukin 6 (IL-6) and C-reactive protein (CRP). For aripiprazole, quetiapine, olanzapine, lithium, sertraline, escitalopram, duloxetine, and paroxetine, no distinct plasma level patterns at post-vaccination emerged...Observed CRP increases did not reach concentrations that may be associated with elevated drug levels. Nevertheless, monitoring of CRP and drug levels is recommended to capture post-vaccineplasma level changes, particularly in patients receiving clozapine."

Journal • Infectious Disease • Novel Coronavirus Disease • Psychiatry • Respiratory Diseases • CRP • IL6

A comparison of five different drug-drug interaction checkers for selective serotonin reuptake inhibitors. (PubMed, Front Pharmacol) - "A total of 1,190 potentially interacting drugs with fluoxetine (FXT) were reported, 1,129 for fluvoxamine (FVM), 1,131 for citalopram (CIT), 1,084 for paroxetine (PAR), 1,206 for sertraline (SER) and 1,146 for escitalopram (ESC). The findings reveal substantial discrepancies in the identification and severity categorization of SSRIs-related DDIs among ICs, underscoring the challenges faced by healthcare providers in ensuring safe prescribing practices. The study advocates for the standardization of IC databases and severity criteria to enhance consistency and reliability."

Journal • CNS Disorders • Depression • Mood Disorders • Psychiatry

Report of a case: importance of multidisciplinary work in a day hospital (ECNP 2025) - "Over the years, he has received various treatments without reaching a premorbid level or maintaining an improvement of obsessive symptoms: pharmacological (fluvoxamine, fluoxetine, risperidone, clomipramine, bromazepam, sertraline), psychotherapeutic (poor adherence and ineffectiveness of psychotherapeutic intervention) and surgical (rejected by the surgeon because he believed there were still less invasive therapeutic options)...The treatment was adjusted by adding Abilify and Venlafaxine and lowering the Sertraline dose...CONCLUSIONS A psychiatric day hospital offers an alternative to traditional hospitalization and it is an effective option for the treatment of Obsessive Compulsive Disorder, as it offers a structured environment and intensive support that allows patients to develop skills to manage their symptoms over the long term, while maintaining daily life. Day hospital benefits patients by improving their quality of life, reducing social isolation, increasing..."

Clinical • CNS Disorders • Cognitive Disorders • Mood Disorders • Obsessive-Compulsive Disorder • Psychiatry

Hoarding disorder: a case report (ECNP 2025) - "In the first stage of treatment, fluvoxamine, an agent commonly used in OCD, was preferred since there was no previous psychiatric medication use... This case study demonstrates the effects of hoarding disorder on the individual and family quality of life and family dynamics. It may be indicated that biological factors such as the patient's childhood illness and hearing loss may play a role in the development of hoarding disorder. It may also indicate that the patient's occupational history and social environment may have an effect on the development of the disorder."

Case report • Clinical • CNS Disorders • Cognitive Disorders • Psychiatry

Sigma-1 receptor agonists show neuroprotective and antidepressant effects: a translational review of clinical and preclinical evidence (ECNP 2025) - "Fluvoxamine—an SSRI with sigma-1 receptor agonism—demonstrated greater efficacy than paroxetine in randomized controlled trials for treatment-resistant depression, reducing MADRS scores by 12.8 vs. 8.3 points (p < 0.05, Cohen's d = 0.71). Sigma-1 receptor agonists represent a unique and promising therapeutic class that acts at the interface of neurodegeneration and neuropsychiatry. Their pleiotropic mechanisms—ranging from modulation of ER-mitochondrial signaling to neurotrophin upregulation—position them as ideal candidates for treating diseases with overlapping molecular substrates such as AD and MDD. As research advances, sigma-1-targeting drugs like Anavex 2-73 may pave the way toward disease-modifying treatments, offering both symptomatic relief and neuroprotection."

Preclinical • Review • Alzheimer's Disease • CNS Disorders • Depression • Major Depressive Disorder • Mental Retardation • Mood Disorders • Psychiatry • Aβ42

Brainstorms and blues: the delicate balance of antidepressants in epilepsy (ECNP 2025) - "Serotonin-norepinephrine reuptake inhibitors (SNRIs) can also be considered, although venlafaxine may have a dose-dependent effect on seizure threshold, requiring careful dose titration...Similarly, bupropion, a norepinephrine-dopamine reuptake inhibitor, is generally avoided in patients with epilepsy due to its significant potential to lower the seizure threshold, especially at higher doses. Mirtazapine, an atypical antidepressant that enhances serotonergic and noradrenergic neurotransmission, is often a favorable choice for patients with epilepsy, as it has a low risk of seizure provocation and can also aid with sleep disturbances, which are common in this population. Agomelatine, a melatonin receptor agonist with antidepressant properties, is another option with a favorable safety profile in epilepsy, although its use remains less common compared to SSRIs and SNRIs...Certain enzyme-inducing antiepileptic drugs, such as carbamazepine and phenytoin, can accelerate the..."

CNS Disorders • Depression • Epilepsy • Mood Disorders • Neuralgia • Psychiatry • Sleep Disorder

Beyond guidelines: the challenge of routine clinical practice in OCD, report of a clinical case (ECNP 2025) - "During follow-up, sertraline was prescribed up to 100 mg per day without notable clinical improvement...A therapeutic alliance was established, and fluvoxamine 100 mg per day was prescribed, with no significant clinical response. An augmentation with aripiprazole was then proposed; the patient preferred monotherapy and agreed to switch treatment (up to 15 mg per day), resulting in partial symptom improvement but also the development of limiting akathisia...While SSRIs and cognitive-behavioral therapy remain the mainstays of treatment, pharmacological augmentation with atypical antipsychotics can be a valuable strategy in resistant cases. This case underscores the potential efficacy of atypical antipsychotics, such as cariprazine, as monotherapy in OCD, highlighting the importance of personalized treatment plans to optimize long-term outcomes."

Clinical • CNS Disorders • Mood Disorders • Obsessive-Compulsive Disorder • Psychiatry

Beyond mood: a systematic review and network meta-analysis of the physiological and cardiometabolic effects of antidepressants (ECNP 2025) - "Clinically meaningful differences included approximately 4 kg variation in weight change, with significant weight loss observed for agomelatine and marked weight gain for maprotiline. Cardiovascular effects varied notably; nortriptyline increased heart rate by over 21 bpm relative to fluvoxamine, which decreased it...While paroxetine, duloxetine, desvenlafaxine, and venlafaxine decreased body weight, they significantly raised total cholesterol levels, with duloxetine additionally elevating glucose. Liver enzyme elevations were consistently observed with duloxetine, desvenlafaxine, and levomilnacipran, though these were not deemed clinically significant...Healthcare organisations recommend that consideration and discussion of potential side effects should form an integral part of the antidepressant prescribing process (3). Incorporating these differential physiological risks into clinical guidelines can support tailored prescribing decisions, balancing psychiatric..."

Retrospective data • Review • Bipolar Disorder • CNS Disorders • Depression • General Anxiety Disorder • Major Depressive Disorder • Mental Retardation • Mood Disorders • Musculoskeletal Pain • Obsessive-Compulsive Disorder • Post-traumatic Stress Disorder • Psychiatry • Schizophrenia