Fluvoxamine Alcohol

Amit Z, Brown Z, Sutherland A, et al Reduction in alcohol intake in humans as a function of treatment with zimelidine implications for rrearment, in Research Advances in New Psychopharmacological Treatments for Alcoholism. Edired by Naranjo CA, Sellers EM. Amsrerdam, Elsevier, 1985 Angelone SM, Bellini L, Di Bella D, er al Effects of fluvoxamine and citalopram in maintaining abstinence in a sample of Italian detoxified alcoholics. Alcohol Alcohol 33 151-156, 1998... 

Angelone SM, Bellini L, DiBella D, et al Effects of fluvoxamine and citalopram in maintaining abstinence in a sample of Italian detoxified alcoholics. Alcohol Alcoholism 33 151-156, 1998... 

Theophylline is a narrow therapeutic index drug with significant difference in bioavailability following oral administration. The half-life of the drug is increased by heart failure, cirrhosis and viral infections, in elderly patients, and by certain drugs, such as cimetidine, ciprofloxacin, oral contraceptives and fluvoxamine. The half-life is decreased in smokers, chronic alcoholism, and by certain drugs, such as phenytoin, rifampicin and carbamazepine. 

Drugs that may affect duloxetine include inhibitors of CYP1A2 (eg, fluvoxamine, guinolone antibiotics), inhibitors of CYP2D6 (eg, fluoxetine, guinidine, paroxetine), and alcohol. 

Ramelteon is affected by alcohol, azole antifungals, fluvoxamine, and rifampin. Drug/Food interactions Ramelteon should not be taken with or immediately after a high-fat meal. 

Smoking cessation, with or without nicotine substitutes, may alter response to concomitant medication in ex-smokers. Smoking may affect alcohol, benzodiazepines, beta-adrenergic blockers, caffeine, clozapine, fluvoxamine, olanzapine, tacrine, theophylline, clorazepate, lidocaine (oral), estradiol, flecanide, imipramine, heparin, insulin, mexiletine, opioids, propranolol, catecholamines, and cortisol. 

In contrast to anticonvulsants and alcohol, drugs such as bupropion, fluoxetine, fluvoxamine, nefazodone, quinidine, paroxetine, and some antipsychotics can inhibit specific CYP enzymes (7, 11, 36, 37, 41, 42, 43 and 44). Thus, TCAs, certain BZDs, bupropion, some steroids, and antipsychotics can all have their metabolism inhibited by drugs such as fluoxetine. For example, fluoxetine at 20 mg/day produces on average a 500% increase in the levels of coprescribed drugs which are principally dependent on CYP 2D6 for their clearance. That can lead to serious or even life-threatening toxicity if the drug has a narrow therapeutic index and the dose is not adjusted for the change in clearance caused by the coadministration of fluoxetine. 

In comparison with TCAs, SSRIs cause fewer pharmacodynamic drug-drug interactions but some (i.e., fluvoxamine, fluoxetine, paroxetine) cause more CYP enzyme mediated pharmacokinetic drug-drug interactions. Unlike TCAs, SSRIs do not potentiate alcohol and perhaps even slightly antagonize its acute CNS effects. Nevertheless, there are some important adverse interactions. 

The earliest and unfortunately still one of the commonest treatments of social phobia is self-medication with alcohol. The behaviorally disinhibiting actions of alcohol allow many social phobics to engage in social contacts that would otherwise be impossible. Legitimate therapeutic drugs for social phobia are now being discovered at a fast pace (Fig. 9—7). In fact, one of the SSRIs (paroxetine) already has been formally approved for use in the treatment of social phobia, and several other SSRIs and antidepressants are rapidly accumulating evidence of their efficacies in this condition as well. Specifically, studies of all five SSRIs (paroxetine, fluvoxamine, fluoxetine, sertraline, and citalopram) have indicated their efficacy in social phobia. Currently, SSRIs are considered first-line treatments for social phobia. 

Other medications that can slow down the metabolism of the liver, thereby causing a person to get a higher dose of methadone than they normally would, include Cimetidine, commonly used for upset stomachs, diazepam, a commonly used anti-anxiety medication, and fluvoxamine, a recently introduced antidepressant medication. Interestingly, alcohol, when used only occasionally, increases methadone levels as compared to decreasing methadone levels when it is used and abused on a chronic basis. 

Clinically important, potentially hazardous interactions with alcohol, aprepitant, clarithromycin, CNS depressants, delavirdine, digoxin, efavirenz, fluconazole, fluoxetine, fluvoxamine, grapefruit juice, indinavir, itraconazole, ivermectin, kava, ketoconazole, propoxyphene, ritonavir, saquinavir, St John s wort... 

Clinically important, potentially hazardous interactions with alcohol, fluconazole, fluvoxamine, ketoconazole, rifampin... 

The primary uses for the SSRIs include MMD and bipolar depression (fluoxetine, paroxetine, sertraline, and citalopram), atypical depression (i.e., depressed patients with unusual symptoms, e.g., hypersomnia, weight gain, and interpersonal rejection sensitivity fluoxetine, paroxetine, sertraline, and citalopram), anxiety disorders, panic disorder (sertraline and paroxetine), dysthymia, premenstrual syndrome, postpartum depression, dysphoria, bulimia nervosa (fluoxetine), obesity, borderline personality disorder, obsessive-compulsive disorder (fluvoxamine, fluoxetine, paroxetine, and sertraline), alcoholism, rheumatic pain, and migraine headache. Among the SSRIs, there are more similarities than differences however, the differences between the SSRIs could be clinically significant. 

One study found that fluvoxamine 150 mg daily with alcohol impaired alertness and attention more than alcohol alone, whereas another study in subjects given 40 g of alcohol (blood-alcohol levels up to 70 mg%) found no evidence to suggest that the addition of fluvoxamine 50 mg twice daily worsened the performance of the psychomotor tests, and it even appeared to reverse some of the effects. The pharmacokinetics of alcohol were hardly affected by fluvoxamine, but the steady state maximum plasma levels of the fluvoxamine were increased by 20%, although the fluvoxamine AUC was unchanged. It was suggested that administration of alcohol may have promoted dissolution of fluvoxamine and increased the absorption rate without affecting bioavailability. Another study also found that fluvoxamine does not appear to enhance the detrimental effects of alcohol on the performance of psychomotor tests. ... 

The results of the few studies reported above suggest that no pharmacokinetic or pharmacodynamic interactions occur with most SSRIs and alcohol, although modest effects were seen with fluvoxamine and possibly paroxetine. However, most manufacturers of SSRIs suggest that concurrent use with alcohol is not advisable. This is presumably because both drugs act on the CNS and also because of the risk of alcohol abuse in depressed patients. ... 

Duphar Laboratories, Study of the effects of the antidepressant fluvoxamine on driving skills and its interaction with alcohol. Data on file, 1981. 

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