fluvoxamine and Vomiting

Of nine nonsuppressors on the dexamethasone suppression test (DST), five (56%) developed intolerable side effects during treatment with fluvoxamine, a new serotonin uptake inhibiting antidepressant, compared with three of 24 suppressors (13%).

Topics: Adult; Antidepressive Agents; Clinical Trials as Topic; Depressive Disorder; Dexamethasone; Double-Blind Method; Female; Fluvoxamine; Humans; Hydrocortisone; Male; Nausea; Oximes; Serotonin Antagonists; Vomiting

Outpatients with major affective disorder, unipolar depressed type (N=101), were treated in a 4-week placebo-controlled double-blind study to compare the efficacy and safety of fluvoxamine, a new serotonin reuptake inhibitor antidepressant, with imipramine and placebo. Therapy was initiated at 50 mg/day; thereafter, dosage ranged between 100 and 300 mg/day for both drugs. Results indicate statistically significant efficacy, measured by both patient and physician rating scales, for both active drugs over placebo. Fluvoxamine showed some evidence of earlier onset of action. Anticholinergic side effects were more common in the imipramine-treated patients, while fluvoxamine produced more gastrointestinal distress and insomnia.

Topics: Adult; Aged; Ambulatory Care; Antidepressive Agents; Clinical Trials as Topic; Depressive Disorder; Double-Blind Method; Female; Fluvoxamine; Humans; Imipramine; Male; Middle Aged; Nausea; Oximes; Patient Dropouts; Placebos; Psychiatric Status Rating Scales; Sleep Initiation and Maintenance Disorders; Vomiting; Xerostomia

Depression and anxiety disorders are frequently seen in the postpartum period. Primary pharmacological agents for these disorders are antidepressants, especially selective serotonin reuptake inhibitors. Despite no adverse reports, data on safety for the maternal use of fluvoxamine on breastfed infants are limited. This case report presents diarrhea and vomiting in the breastfed baby of a woman using fluvoxamine at 50 mg/d.

Topics: Adult; Breast Feeding; Depression, Postpartum; Diarrhea; Female; Fluvoxamine; Humans; Infant; Selective Serotonin Reuptake Inhibitors; Vomiting

Selective serotonin reuptake inhibitors fluvoxamine and fluoxetine, as well as serotonin (5-HT), induced vomiting in Suncus murinus (a house musk shrew). Fluvoxamine- and fluoxetine-induced vomiting gradually decreased with their repeated administration. Vomiting induced by serotonin also decreased with repeated treatment with serotonin. In these shrews, fluvoxamine-induced vomiting was partially inhibited. Fluvoxamine might induce vomiting, at least partially, by indirectly activating peripheral 5-HT(3) receptors, since serotonin has been reported to induce vomiting by activating peripheral 5-HT(3) receptors and granisetron, a 5-HT(3) antagonist, partially suppressed fluvoxamine-induced vomiting in our previous finding. In addition, fluvoxamine-induced vomiting was impaired more effectively using a step-wise dose-up schedule of fluvoxamine than a fixed high-dose schedule. Therefore, a careful dosing strategy starting with a low dose might be effective for avoiding emesis associated with the clinical use of fluvoxamine.

Topics: Animals; Dose-Response Relationship, Drug; Female; Fluoxetine; Fluvoxamine; Male; Selective Serotonin Reuptake Inhibitors; Shrews; Vomiting

Topics: Adult; Antiemetics; Child; Chronic Disease; Disabled Persons; Feeding and Eating Disorders of Childhood; Fluvoxamine; Humans; Male; Mental Disorders; Selective Serotonin Reuptake Inhibitors; Vomiting

The presence of nausea and vomiting is problematic for all selective serotonin re-uptake inhibitors (SSRIs), and their usefulness as anti-depressants is limited in this respect. In an attempt to examine the background of SSRI-induced emesis, the present study aims to describe the role of 5-hydroxytryptamine (serotonin:5-HT) from the viewpoint of 5-HT release in the mouse-isolated ileum. In this study, it was demonstrated that 5-HT release from the mouse-isolated ileum was significantly increased by fluvoxamine at a concentration of 10(-6) M. Also, it was demonstrated that granisetron, a 5-HT3 receptor antagonist, inhibited significantly the increase in fluvoxamine (10(-6) M) -induced 5-HT release. The effect of granisetron on fluvoxamine-induced 5-HT release was occurred in a concentration-dependent manner. The present study demonstrated for the first time that the SSRI-induced increase in 5-HT release from the isolated ileum was significantly inhibited by 5-HT3 receptor antagonist. These results suggest that 5-HT3 receptors might be involved in SSRI-induced 5-HT release from the mouse isolated ileal tissue. Fluvoxamine (10(-6) M)-induced 5-HT release was inhibited concentration -dependently by the concomitant perfusion of diltiazem. The results suggest that L-type calcium channel might be also involved in SSRI-induced 5-HT release from the isolated ileum. Furthermore, tetrodotoxin (10(-6) M) completely inhibited the increase in 5-HT release induced by fluvoxamine. This finding suggests that the increase of 5-HT induced by fluvoxamine involves enterochromaffin (EC) cell stimulation via an inter-neuron pathway in the gastrointestinal tract (GI). SSRI initiates an increase in the concentration of 5-HT in the GI tract. 5-HT released from the EC cells of the intestinal mucosa may stimulate the 5-HT3 receptors on vagal afferent nerve fibers. This depolarization of vagal afferents may result in a 5-HT increase in the brainstem and, thus, lead to emesis.

Topics: Animals; Antiemetics; Calcium Channel Blockers; Diltiazem; Drug Interactions; Fluvoxamine; Granisetron; Ileum; Male; Mice; Mice, Inbred ICR; Selective Serotonin Reuptake Inhibitors; Serotonin; Vomiting

The results of a small pilot study using Fluvoxamine (Faverin) in the treatment of non-vomiting bingeing female patients and women with bulimia nervosa is presented. Ten non-vomiting subjects and six with bulimia nervosa were treated on an open basis with Fluvoxamine 100-200 mg daily. Assessment was made using established questionnaires for severity of eating disorder and abnormality of mood. Five non-vomiting patients and three with bulimia nervosa completed the study. Non-vomiters showed a significant weight loss; a significant reduction in number of binges; a significant reduction in the scores on the BITE and the EAT; and a significant reduction in anxiety. Those with bulimia nervosa had a significant reduction in hunger and a reduction in depression which tended towards significance. Firm conclusions cannot be drawn from this study as it is an open pilot study of a small number of women. However, the results indicate that Fluvoxamine may have a role in the treatment of eating disorders where bingeing is a prominent symptom and that further research would be valuable. Comments are also made on the usefulness of various questionnaires designed to assess eating disorders.

Topics: Adolescent; Adult; Bulimia; Depression; Feeding and Eating Disorders; Female; Fluvoxamine; Humans; Obesity; Surveys and Questionnaires; Vomiting; Weight Loss

In 3 patients the addition of fluvoxamine to a constant dosage of carbamazepine (CZP) caused a substantial rise of plasma CZP accompanied by symptoms of intoxication. As this drug combination may occur increasingly in the future, this probably pharmacokinetic interaction is of practical relevance.

Topics: Adult; Borderline Personality Disorder; Carbamazepine; Dose-Response Relationship, Drug; Epilepsy, Generalized; Female; Fluvoxamine; Humans; Male; Metabolic Clearance Rate; Nausea; Vomiting