Intro
Brand name: Luvox
Class: SSRI
MOA: Selective Serotonin Reuptake Inhibitor
Indications
FDA Indications: OCD
Off-label uses: Depression, Panic Disorder, GAD, PTSD
Dosing
Forms:
->Instant Release: Tablet: 25, 50 (scored), 100 (scored)
->Extended Release: Capsule: 100, 150
Starting: 50mg qDay, increase to 50mg BID in 4-7 days. Can increase by 50mg every 4-7 days.
Maintenance: 100-300mg qDay (dosed BID)
Max: 300mg (though some go to 450mg for OCD)
Pharmacokinetics
Half-life: 9-28 hours
Inhibits: CYP3A4, CYP1A2, CYP2PC9, CYP2C19
Side Effects
Serious: Serotonin Syndrome, SIADH, increased risk of SI in children
Notable: Sexual dysfunction (delayed ejaculation, ED, anorgasmia), GI (n/v/d, dec appetite), Sedation, Bruising
Gems
-Inhibits CYP1A2. Meds metabolized by 1A2 (e.g. clozapine) thus won’t be metabolized as well, leading to increased levels
-Ideally dosed BID due to short half-life
-Good choice for patients with anxious depression or MDD with comorbid anxiety
-The SSRI least likely to cause sexual dysfunction
-May be useful for OCD symptoms in patients with schizophrenia taking antipsychotics
-Though not FDA approved for depression, still used off-label
-Extended-release formulation less likely to cause sedation/GI effects