Fluvoxamine in the Treatment of Obsessive-Compulsive Disorder and Related Conditions

The mainstay of the pharmacologic treatment of obsessive-compulsive disorder (OCD) is a 10- to12-week trial of a potent serotonin reuptake inhibitor (SRI) at an adequate dose. Double-blind, placebo-controlled trials have established the anti-obsessive-compulsive (OC) efficacy of five differentSRIs. One of the most thoroughly studied of these SRIs is fluvoxamine, the focus of this article.Fluvoxamine’s pharmacologic and pharmacokinetic properties, its efficacy, and guidelines for itsclinical use in OCD and related disorders are briefly reviewed. Potential drug-drug interactions arediscussed and placed in clinical perspective. The management of common SRI-induced side effects isalso addressed. Recent comparative studies suggest that fluvoxamine may be equivalent in efficacy toclomipramine, yet better tolerated. Fluvoxamine shows promise in the treatment of several so-calledOC-spectrum disorders, but additional controlled trials are needed.