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Management of obsessive-compulsive disorder with fluvoxamine extended release

The pharmacodynamic properties of fluvoxamine maleate include the modulation of different populations of serotonergic, dopaminergic, and sigma receptors and/or transporters, a complex pattern of activity that may account for its efficacy in the treatment of obsessive-compulsive disorder (OCD). Never...

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Detalles Bibliográficos
Autores principales: Ordacgi, Lídia, Mendlowicz, Mauro V, Fontenelle, Leonardo F
Formato: Texto
Lenguaje:English
Publicado: Dove Medical Press 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699655/
https://www.ncbi.nlm.nih.gov/pubmed/19557140
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author Ordacgi, Lídia
Mendlowicz, Mauro V
Fontenelle, Leonardo F
author_facet Ordacgi, Lídia
Mendlowicz, Mauro V
Fontenelle, Leonardo F
author_sort Ordacgi, Lídia
collection PubMed
description The pharmacodynamic properties of fluvoxamine maleate include the modulation of different populations of serotonergic, dopaminergic, and sigma receptors and/or transporters, a complex pattern of activity that may account for its efficacy in the treatment of obsessive-compulsive disorder (OCD). Nevertheless, its pharmacokinetic profile and its pattern of side effects may hinder a rapid dose escalation, a therapeutic strategy that might be utterly desirable in patients with OCD. In preclinical studies, the maximum plasma concentration and bioavailability of an extended-release (CR) formulation of fluvoxamine were, respectively, 38% and 16% lower than those of the standard (ie, non-CR) formulation. Recently, the US Food and Drug Administration approved the fluvoxamine CR formulation for the treatment of OCD in adults. This approval was based on the results of a double-blind, placebo-controlled study with 253 OCD patients in which fluvoxamine CR showed a consistently earlier onset of therapeutic effects than other selective serotonin reuptake inhibitors, as reported in previous studies. The use of the CR formulation of fluvoxamine allowed a particularly aggressive dosing strategy at the beginning of the titration phase, ie, treatment could be started with a single dose of fluvoxamine CR 100 mg at bedtime, while keeping the occurrence of side effects and the rate of compliance at levels comparable to those reported for the use of immediate-release fluvoxamine.
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spelling pubmed-26996552009-06-25 Management of obsessive-compulsive disorder with fluvoxamine extended release Ordacgi, Lídia Mendlowicz, Mauro V Fontenelle, Leonardo F Neuropsychiatr Dis Treat Expert Opinion The pharmacodynamic properties of fluvoxamine maleate include the modulation of different populations of serotonergic, dopaminergic, and sigma receptors and/or transporters, a complex pattern of activity that may account for its efficacy in the treatment of obsessive-compulsive disorder (OCD). Nevertheless, its pharmacokinetic profile and its pattern of side effects may hinder a rapid dose escalation, a therapeutic strategy that might be utterly desirable in patients with OCD. In preclinical studies, the maximum plasma concentration and bioavailability of an extended-release (CR) formulation of fluvoxamine were, respectively, 38% and 16% lower than those of the standard (ie, non-CR) formulation. Recently, the US Food and Drug Administration approved the fluvoxamine CR formulation for the treatment of OCD in adults. This approval was based on the results of a double-blind, placebo-controlled study with 253 OCD patients in which fluvoxamine CR showed a consistently earlier onset of therapeutic effects than other selective serotonin reuptake inhibitors, as reported in previous studies. The use of the CR formulation of fluvoxamine allowed a particularly aggressive dosing strategy at the beginning of the titration phase, ie, treatment could be started with a single dose of fluvoxamine CR 100 mg at bedtime, while keeping the occurrence of side effects and the rate of compliance at levels comparable to those reported for the use of immediate-release fluvoxamine. Dove Medical Press 2009 2009-06-10 /pmc/articles/PMC2699655/ /pubmed/19557140 Text en © 2009 Ordacgi et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.
spellingShingle Expert Opinion
Ordacgi, Lídia
Mendlowicz, Mauro V
Fontenelle, Leonardo F
Management of obsessive-compulsive disorder with fluvoxamine extended release
title Management of obsessive-compulsive disorder with fluvoxamine extended release
title_full Management of obsessive-compulsive disorder with fluvoxamine extended release
title_fullStr Management of obsessive-compulsive disorder with fluvoxamine extended release
title_full_unstemmed Management of obsessive-compulsive disorder with fluvoxamine extended release
title_short Management of obsessive-compulsive disorder with fluvoxamine extended release
title_sort management of obsessive-compulsive disorder with fluvoxamine extended release
topic Expert Opinion
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699655/
https://www.ncbi.nlm.nih.gov/pubmed/19557140
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