Does fluvoxamine affect dopamine? (3+ side effects)

In this article, we will discover the possibility of fluvoxamine’s ability to affect dopamine levels. We will also focus on the effects of fluvoxamine by affecting dopamine and what research suggests about the potential link between the two.

Does fluvoxamine affect dopamine?

Yes, fluvoxamine may affect dopamine levels in the brain. Fluvoxamine may affect the levels of dopamine in the brain but this is not its primary mechanism of action.

Fluvoxamine (Luvox) is an antidepressant belonging to the class of selective serotonin reuptake inhibitor (SSRI). It works primarily by blocking the reuptake of serotonin neurotransmitter thus increasing the levels of serotonin in the brain. It is mainly indicated for depression and obsessive-compulsive disorder. (2)

Dopamine is a neurotransmitter found in the brain. It plays an important role in reward as well as movement regulation in the brain. Dopamine dysregulation can be due to various factors which in turn can lead to neurodegenerative diseases e.g. there is a decrease in dopamine in Parkinson’s disease. (1)

Serotonin and dopamine are both neurotransmitters whose balance is essential for maintaining different aspects of physical and mental health. Serotonin is mainly responsible for mood regulation. Therefore, an imbalance of serotonin can lead to mood disorders such as depression and anxiety. Dopamine is mainly known as a ‘feel-good’ neurotransmitter and it is involved in the motivation to seek reward and reinforcement.

In some cases, dopamine and serotonin have an inverse relationship. The increase in serotonin levels can lead to a decrease in dopamine levels. (7)

What does research suggest?

The effect of fluvoxamine on dopamine is under investigation and has been studied in animal models. One study suggested that apart from affecting the levels of serotonin in the brain, fluvoxamine is also responsible for increasing the levels of dopamine in the striatum, prefrontal cortex and hippocampus. (4)

A study was performed with OCD (Obsessive-compulsive disorder) patients who were treated (never had been given SSRIs before). The study showcased that fluvoxamine increases D2 receptor availability in the ventral and dorsal striatum of OCD patients who either completely or partially responded to SSRI treatment. The normalization of D2 receptor availability was not observed in the dorsal striatum of participants who were nonrespondent to SSRI. (3)

Research showcased that fluvoxamine increases dopamine neurotransmission in the prefrontal cortex of the adrenalectomized/castrated mice through a dual mechanism which involved the inhibition of serotonin reuptake and activation of sigma 1 receptors. (5)

How does fluvoxamine affect dopamine levels?

Fluvoxamine is primarily responsible for decreasing the levels of serotonin in the brain. It has been discovered that it also affects the level of dopamine in the brain in some individuals. 

Fluvoxamine increases the release of dopamine in the brain. Dopamine is the neurotransmitter which is reduced in Parkinson’s disease. Fluvoxamine can be considered beneficial for Prakinson’s patients under such circumstances. (4)

Dopamine dysregulation can lead to a variety of neurodegenerative diseases such as Parkinson’s, schizophrenia, attention deficit hypersensitivity disorder etc. Therefore, normalizing the levels of dopamine can lead to the enhancement of cognitive and limbic function. (6) 

How to know if your dopamine levels were affected?

The detection of an imbalance in dopamine levels is a difficult task and might require the involvement of healthcare professionals as the signs and symptoms vary depending on various factors.

Symptoms in case of decreased dopamine levels are listed below:

• Mood changes: Lack of motivation, dissatisfaction and apathy.
• Sleep disturbances: Difficulty staying asleep or insomnia.
• Lack of energy levels: Fatigue.
• Concentration: Difficulty concentrating and forgetfulness.
• Changes in motor function: Tremors, difficulty controlling/initiating movements or stiffness.

Symptoms in case of increased dopamine levels are listed below:

• Mood changes: Restlessness, anxiety or irritability.
• Sleep disturbances: Difficulty in falling asleep.
• Lack of energy levels: Alertness (persistent increase in dopamine levels will lead to fatigue)
• Concentration: Difficulty concentrating due to overstimulation.
• Changes in motor function: Excessive movements or tics.
• Craving and addiction

The signs and symptoms that can be caused by fluvoxamine influencing dopamine levels have not been researched and are not present in scientific literature.

What are the side effects of fluvoxamine?

Some of the common side effects are listed below:

• Nausea (accompanied by vomiting)
• Constipation
• Diarrhoea
• Dyspepsia
• Anorexia
• Somnolence
• Dizziness
• Nervousness
• Insomnia
• Dry mouth
• Asthenia
• Agitation
• Abnormal/delayed ejaculation
• Sweating

During clinical trials, it was reported that 15% of the 25000 participants, discontinued fluvoxamine (Luvox) treatment due to one of the adverse effects. The most common causes of discontinuation of fluvoxamine were insomnia, somnolence and asthenia in obsessive-compulsive disorder patients. 

Who is at risk?

It is very important to consider the medical history, individual health factors and drug interactions when prescribing a new medication. Different populations can be at risk of experiencing different adverse effects.

Paediatric population: In the case of fluvoxamine, they are more prone to suicidal tendencies.

Geriatric population: They may encounter adverse effects due to their age and other comorbidities.

Individuals with other brain disorders: Fluvoxamine may cause hypomanic or manic episodes in patients with bipolar disorder. It also tends to trigger seizures by lowering the seizure threshold.

Pregnant and breastfeeding women: Safe use of fluvoxamine has not been established during pregnancy and breastfeeding.

Individuals taking MAOi (monoamine oxidase inhibitors) class drugs: Fluvoxamine interacts with MAOi drugs and can lead to serotonin syndrome.

What to do if fluvoxamine is affecting dopamine levels?

In case you notice symptoms of dopamine dysregulation or suspect the levels of dopamine are being disturbed, consult with your healthcare provider or psychiatrist. It is very important to discuss the signs and symptoms you are experiencing because of medication with healthcare professionals.

 It is important to keep track of the signs and symptoms experienced to report to your healthcare professional. They can try to alleviate the symptoms by adjusting the dose of the medication or providing alternative options, whichever is in the best interest of the individual.

It is very important to follow the treatment plans for antidepressants and stick to them. In case of any changes made, be vigilant of the adjustments and follow them appropriately to get the best results.

Conclusion

In this article, we discussed that fluvoxamine affects dopamine neurotransmitters in addition to serotonin. In my opinion, this field needs more investigation for it to be potentially used for patients with dopamine imbalance. 

References