Obsessive compulsion (OCD) can begin with obsessive, irrational thoughts and fears. These irrational thoughts are followed by ritualistic actions, such as repetitive hand washing, door closing, or gestures. These rituals are the means to cope with the intrusive, irrational thoughts, but instead a vicious cycle is set into motion. Severe OCD can completely disrupt an individual’s life and also affect family and friends, as they watch their loved one become more and more consumed by compulsive behaviors.
The exact cause of OCD is unknown and may be different for each individual, but a deficit of the neurotransmitter serotonin has been identified as a likely culprit. Treatment for OCD involves both intensive cognitive behavioral therapy and high doses of antidepressant medications. Specifically, drugs belonging to the selective serotonin reuptake inhibitor (SSRI) class have shown success in achieving remission for individuals with OCD.
Luvox (fluvoxamine) is an SSRI but is structurally quite different from other drugs in the class such as Paxil (paroxetine) or Prozac (fluoxetine). Currently, it is the preferred treatment option for people with OCD. Interestingly, studies have shown that the action of Luvox and other antidepressants in treating OCD is completely independent of depression. In other words, a person with OCD need not be depressed to benefit from Luvox treatment.
Other studies have suggested that Luvox improves the response to behavioral therapy. This shouldn’t be surprising, as nearly all psychiatric conditions benefit from a multipronged treatment approach. Luvox is also safe and well-tolerated. Another antidepressant, Norpramin (desipramine), may actually be slightly more effective than Luvox, but it carries a greater risk of side effects.
With OCD, dosages near the high end of the safety guidelines are necessary to achieve improvement and eventual remission. Recently, a new, extended-release formulation of Luvox has been developed that may be well suited to the treatment of OCD. The dosage of the immediate-release formulation must be gradually increased, thereby delaying the positive effects. The extended-release version, on the other hand, offers a much faster onset of symptom improvement.
Concentrations of medication in blood plasma are a reliable indication of drug concentrations in the brain. Blood plasma measurements have confirmed that the Luvox extended-release formula achieves an effectiveness threshold much faster than the standard, immediate-release formulation. With its combination of fast action and safety, Luvox extended-release may soon be the first-line treatment for adults with moderate or severe OCD.
References:
- PubMed Health. (n.d.). National Center for Biotechnology Information. Fluvoxamine. Retrieved April 4, 2012, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000955/
- Ordacgi, L., Mendlowicz, M. V., Fontenelle, L. F. (2009). Management of obsessive-compulsive disorder with fluvoxamine extended release. Neuropsychiatric Disease and Treatment, 5, 301-308.
Several research studies have investigated the possibility that the antidepressant medication Luvox (fluvoxamine) could be an effective therapy for alcoholism. Most of the studies involved rats, but researchers consider the results applicable to humans as well. Despite the enormous public health burden of alcoholism, treatments for the disease are still well behind the curve. The rate of successful remission and abstinence is low, regardless of treatment plan. Comorbid disorders such as severe depression or anxiety further complicate matters and increase the likelihood of eventual relapse. Adequate treatment usually requires a combination of approaches—cognitive therapy for treatment of mood disorders, pharmaceuticals for managing alcohol withdrawal and cravings, and ongoing counseling to reduce the chances of a return to drinking.
A study with lab rats revealed that Luvox potentially reduces the response to food, or alcohol, or both, depending upon the experimental conditions. The goal of the study was to determine if Luvox might reduce the craving for alcohol, but the results were not conclusive in that regard. Significant changes in stimulus response were recorded even at very low doses of the medication. When food and alcohol were presented together, rats treated with Luvox responded less to food but maintained the same consumption of alcohol. However, presenting one stimulus and then another in sequence had differential effects. Responses to the second stimulus, regardless of whether it was food or alcohol, were decreased in the presence of Luvox. The temptation has always been to link all reward-seeking behaviors into a single category. Studies like the above, however, demonstrate that food-seeking and drug- or alcohol-seeking are biologically distinct events. The intricate and complex workings of such behaviors are still largely mysterious.
Due to uncertainties in its effectiveness for the purpose, Luvox is unlikely to play a role in the reduction of alcohol cravings. The rat studies returned mixed or confusing results, and no human trials have demonstrated a predictable, reliable mechanism of action. At this time, there isn’t enough evidence to conclude that the medication can successfully manage alcohol cravings. However, Luvox is effective in treating the depression and anxiety that accompany the recovery process after alcoholism. As a safe and effective mood stabilizer, Luvox reduces the chances of relapse. When Luvox is combined with cognitive therapy, a person recovering from alcohol addiction has a high likelihood of achieving a healthy outcome.
References
- PubMed Health [Internet]. (n.d.). Bethesda (MD): National Library of Medicine. Fluvoxamine. Retrieved April 4, 2012, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000955/
- Ginsburg, B. C., Lamb, R. J. (2006). Fluvoxamine effects on concurrent ethanol- and food-maintained behaviors. Experimental and Clinical Psychopharmacology, 14(4), 483-492.
Depression and anxiety are among the most common mood problems, regardless of age or demographics. Children and adolescents experience anxiety and depression at a significant rate, although treatment for this population brings some complicating factors. The most frequently prescribed antidepressant medications incur a small but real risk of suicide or suicidal thoughts in young people. Known as selective serotonin reuptake inhibitors (SSRIs), this class of antidepressants is otherwise well regarded for both safety and effectiveness. When parents and physicians are cautious and attentive, SSRIs can be prescribed to children with a fair degree of safety. However, other side effects appear in younger patients that do not seem to affect adults. Hyperactivity, for example, is one such side effect of SSRIs that is confined to children and adolescent patients.
A review of previous studies revealed that so-called “activation events†might be extremely common in children taking certain antidepressants. Activation events are defined by abnormal energy, hyperactivity, and disinhibition. None of these effects reaches the level of mania, however, and sometimes it’s difficult to distinguish between “normal†activity levels and hyperactivity in young children. In a clinical trial of Luvox (fluvoxamine) prescribed to children, nearly 50% of participants experienced an activation event. Age appeared to be a significant factor—younger children were more likely to experience these side effects. Blood tests also showed that children who experienced activation events had higher concentrations of Luvox in their blood, despite lowering the dosage to mitigate side effects. This suggests that the medication is metabolized differently depending on the individual.
In the case of Luvox, hyperactivity as a side effect is not typically serious enough to require a change of medication. If the side effect is accompanied by self-injurious behavior, however, then a medication change is likely the best solution. Insomnia and aggressiveness are also signs of mania beyond simple hyperactivity. In a review of published work, researchers determined that demographic or family characteristics were not predictive of activation side effects. In addition, these side effects typically diminished and did not recur once the dosage was lowered.
In summary, because of differences in metabolism and physiology, children and adolescents react differently to medications. With Luvox and other antidepressants, there is a strong possibility of hyperactive or disinhibited behavior but not to the point of mania. Physicians and parents should always monitor children taking antidepressants for signs of worsening symptoms or suicidal tendencies. The side effect of hyperactivity by itself is generally not considered to be a cause for concern.
References
- PubMed Health [Internet]. (n.d.). Bethesda (MD): National Library of Medicine. Fluvoxamine. National Center for Biotechnology Information. Retrieved April 4, 2012, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000955/
- Reinblatt, S.P., dos Reis, S., Walkup, J.T., Riddle, M.A. (2009). Activation adverse events induced by the selective serotonin reuptake inhibitor fluvoxamine in children and adolescents. Journal of Child and Adolescent Psychopharmacology, 19(2), 119-126.