Fluvoxamine nervous system

Lapierre YD, Browne M, Horn E, et al Treatment of major affective disorder with fluvoxamine. J Clin Psychiatry 48 65-68, 1987 Lapierre YD, Ravindran AV, Bakish D Dysthymia and serotonin. Int Clin Psychopharmacol 8 (suppl 2) 87-90, 1993 Lapin 1, Oxenkrug G Intensification of the central serotonergic process as a possible determinant of thymoleptic effect. Lancet 1 132-136, 1969 Larkin JG, McKee PJ, Blacklaw J, et al Nimodipine in refractory epilepsy a placebo-controlled, add-on study. Epilepsy Res 9 71-77, 1991 Larsson LI, Rehfeld JF Localization and molecular heterogeneity of cholecystokinin in the central and peripheral nervous system. Brain Res 165 201-218, 1979 Laruelle M, Abi-Dargham A, Casanova M, et al Selective abnormality of prefrontal serotonergic receptors in schizophrenia a post mortem study. Arch Gen Psychiatry 50 810-818, 1993... 

FLUOXETINE, FLUVOXAMINE, PAROXETINE BZDs - ALPRAZOLAM, DIAZEPAM, MIDAZOLAM t in plasma concentrations of these BZDs. Likely t sedation and interference with psychomotor activity Alprazolam, diazepam and midazolam are subject to metabolism by CYP3A4. Fluvoxamine, fluoxetine and possibly paroxetine are inhibitors of CYP3A4 sertraline is a weak inhibitor. SSRIs are relatively weak compared with ketoconazole, which is possibly 100 times more potent as an inhibitor Warn patients about risks associated with activities that require alertness. Consider use of alternatives such as oxazepam, lorazepam and temazepam, which are metabolized by glucuronidation >- For signs and symptoms of CNS depression, see Clinical Features of Some Adverse Drug Interactions, Central nervous system depression... 

Selective serotonin reuptake inhibitors (SSRIs) inhibit the neuronal reuptake of serotonin in the central nervous system and have shown mixed efficacy in the treatment of autistic symptoms (Moore et al., 2004). A number of studies have shown reductions in repetitive behaviors, lethargy, inappropriate speech, and improvements in the ability to relate to others, cognition, language improvement with fluoxetine (DeLong et al., 1998 Fatemi et al., 1998 Peral et al., 1999), fluvoxamine (McDougle et al., 1996b), and sertraline (Steingard et al., 1997). However, other studies have shown a lack of response with fluvoxamine (Martin et al., 2003) and citalopram (Couturier and Nicolson, 2002). 

Linnoila M, Stapleton JM, George DT, Lane E, Eckardt MX Effects of fluvoxamine, alone and in combination with ethanol, on psychomotor and cognitive performance and on autonomic nervous system reactivity in healthy volunteers. J Clin Psychopharmacol (1993) 13, 175-80. 

---