How should I taper off Luvox (fluvoxamine)?

Half-life of 15–22 hours requires a slower taper cadence than longer-acting SSRIs. CR formulation available; tablets can be split or dissolved in water for fine titration. Strong CYP1A2 inhibition warrants review of co-medications during dose changes. Shorter half-life than most SSRIs justifies a slower taper pace; reductions of ~10% every 2–4 weeks. Aqueous suspension (dissolving tablets in water) allows precise sub-tablet dosing where compounding is unavailable.

Luvox Tapering Guide

Q: What are the withdrawal symptoms of Luvox (fluvoxamine)?

Common withdrawal symptoms of Luvox (fluvoxamine) include: brain zaps, dizziness, nausea, insomnia, irritability. Symptom severity varies by individual, dose, and duration of use.

fluvoxamine

SSRIFDA 1994

Try TaperMeds

Boxed Warning

Suicidality risk in children, adolescents, and young adults under 25 during initial treatment.

Overview

Fluvoxamine is an SSRI primarily approved for obsessive-compulsive disorder (OCD). It is a potent inhibitor of CYP1A2 and CYP2C19 and also has sigma-1 receptor agonist activity, which may contribute to its anxiolytic properties.

Common Doses

25mg, 50mg, 100mg, 200mg

Formulations

Tablets: 25mg, 50mg, 100mg; Extended-release capsules (CR): 100mg, 150mg

Pregnancy

Category C (risk cannot be ruled out)

Mechanism of Action

Selective serotonin reuptake inhibitor (SSRI) that potently inhibits the serotonin transporter (SERT). Also acts as a sigma-1 receptor agonist, which may provide additional anti-anxiety and neuroprotective effects.

Taper Notes

Half-life of 15–22 hours requires a slower taper cadence than longer-acting SSRIs. CR formulation available; tablets can be split or dissolved in water for fine titration. Strong CYP1A2 inhibition warrants review of co-medications during dose changes.

Maudsley Deprescribing Guidance

Shorter half-life than most SSRIs justifies a slower taper pace; reductions of ~10% every 2–4 weeks. Aqueous suspension (dissolving tablets in water) allows precise sub-tablet dosing where compounding is unavailable.

Common Withdrawal Symptoms

brain zapsdizzinessnauseainsomniairritability

Interactions & Safety

Drug Interactions

MAOIs — contraindicated (serotonin syndrome risk)
Thioridazine — contraindicated
Alosetron — contraindicated (CYP1A2 inhibition)

Food Interactions

No significant food effect on absorption
Caffeine levels may increase significantly due to CYP1A2 inhibition
Avoid alcohol during treatment

Contraindications

MAOIs within 14 days
Thioridazine
Alosetron

Toxicity

Serotonin syndrome with serotonergic combinations. Significant drug interactions due to CYP1A2 inhibition (e.g., with theophylline, clozapine, tizanidine).

Pharmacokinetics

ADME Profile

Absorption

Completely absorbed after oral administration. Bioavailability ~53% due to first-pass metabolism. Tmax 3–8 hours. Food does not significantly affect absorption.

Distribution

~25 L/kg

Metabolism

Extensively metabolized hepatically via CYP2D6 and CYP1A2. Potent inhibitor of CYP1A2 and CYP2C19, moderate inhibitor of CYP2C9 and CYP3A4. No active metabolites.

Elimination

Renal (~94% as metabolites, ~2% unchanged).

Protein Binding

~77–80%

Clearance

~1400 mL/min (apparent oral clearance)

Build Luvox taper plans in minutes

TaperMeds turns these protocols into prescriber-ready taper schedules with hyperbolic dose curves, symptom tracking, and patient handouts — for the clinicians supervising the taper.