Fluvoxamine Bromazepam

Extracted bromazepam, clobazam, fluvoxamine, lorazepam, oxazepam... 

There is some evidence to suggest that the metabolism of some benzodiazepines (such as alprazolam, bromazepam, diazepam, and also possibly midazolam, nitrazepam and triazolam) may be reduced by some SSRIs (such as fluoxetine and fluvoxamine). On the whole, no clinically significant interaction appears to occur between other SSRIs and the benzodiazepines or related dri s such as cloral hydrate or zaleplon. There is some evidence to support the su estion that sedation is likely to be increased by the concurrent use of SSRIs and benzodiazepines. Rare cases of hallucinations have been seen with zolpidem and some SSRb. Symptoms of the serotonin syndrome have been reported in two patients taking paroxetine and a benzodiazepine. 

Fluvoxamine 50 mg twice daily increased the plasma levels of a single 12-mg dose of bromazepam in 12 healthy subjects hy 36% and increased the AUC almost 2.5-fold. Some increased impairment in cognitive function was seen. ... 

The evidence suggests that fluvoxamine inhibits the metabolism of those benzodiazepines that undergo oxidation (e.g. alprazolam, bromazepam, diazepam) thereby increasing and prolonging their effects, but not those that are metabolised by glucuronidation (e.g. lorazepam). Zaleplon is metabolised by aldehyde oxidase and therefore does not interact. 

Van Harten J, Holland RL, Wesnes K, Influence of multiple-dose administration of fluvoxamine on the pharmacokinetics of the benzodiazepines bromazepam and lorazepam a randomised, cross-over study, EurNeuropsychopharmacol (1992) 2,381. 

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