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Depression | Obsessive-Compulsive Disorder in Adults | Obsessive-Compulsive Disorder in Children and Adolescents | Panic Disorder | Social Anxiety Disorder | Posttraumatic Stress Disorder | Obsessive-Compulsive Spectrum Disorders | Eating Disorders
Excerpt
The first trial to assess the role of fluvoxamine in the treatment
of depression dates back to 1976. We identified 38 randomized, single-
or double-blind studies conducted since then to test the antidepressant
efficacy of fluvoxamine against placebo, SSRIs (sertraline, fluoxetine,
citalopram, and paroxetine), serotonin-norepinephrine reuptake inhibitors
(SNRIs; venlafaxine and milnacipran), tricyclic antidepressants
(clomipramine, imipramine, desipramine, amitriptyline, and nortriptyline),
tetracyclic antidepressants (mianserin and maprotiline), and a reversible
inhibitor of monoamine oxidase (moclobemide). These trials varied
widely in design, including the diagnostic and inclusion criteria
utilized, the requirement for a washout period before initiation
of study drug, and the way treatment response was defined. However,
taken together, these studies support the efficacy and safety of
fluvoxamine in the treatment of mild, moderate, and severe depression—including
psychotic depression—across all age groups and in both
inpatient and outpatient settings (Fukuchi and Kanemoto 2002; Haffmans et al. 1996; Kiev and Feiger 1997; Otsubo et al. 2005; Rapaport et al. 1996; Rossini et al. 2005; Ware 1997; Zanardi et al. 2000; Zohar et al. 2003). Among all studies,
none showed fluvoxamine to be inferior in efficacy to another active
comparator when a priori response criteria were applied. Study durations ranged
from 4 to 7 weeks, and dosages ranged from 50 to 300 mg/day.
Furthermore, the benefits from fluvoxamine seem to be sustained
over the long term. In a double-blind, placebo-controlled study
assessing the efficacy of fluvoxamine continuation treatment, fluvoxamine
at 100 mg/day was significantly superior to placebo in
preventing symptom recurrence over the 1-year maintenance period
(Terra and Montgomery 1998).