Does Fluvoxamine cause gynecomastia? (3+ factors)
By
Ivan Kahwa
Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
In this article, we will answer the question “Does Fluvoxamine cause gynecomastia?”. We will also discuss research findings of antidepressant-induced gynecomastia and what other factors can contribute to this issue.
Does Fluvoxamine cause gynecomastia?
Fluvoxamine (also known as Luvox) does have the potential to cause gynecomastia in men. Fluvoxamine, an antidepressant belonging to the class of selective serotonin reuptake inhibitors (SSRIs), is approved by the FDA for the treatment of obsessive-compulsive disorder (OCD) (1). It has many ‘off-label uses’ in other depressive illnesses.
Gynecomastia is the enlargement of the breasts in men or boys. The breasts become large and sometimes may even grow unevenly. If there is an imbalance between estrogen and androgen hormones in men, gynecomastia may occur. Gynecomastia may be caused by various issues like hormonal changes, medicines, recreational drug use and tumours.
What is the link between Fluvoxamine and gynecomastia?
Antidepressants, particularly SSRIs are known to cause gynecomastia. This is often an overlooked side effect of antidepressant therapy. The increased levels of serotonin in the brain by Fluvoxamine and other SSRIs are the cause of gynecomastia.
Fluvoxamine and all other SSRIs work by increasing the level of serotonin in the brain. Serotonin increases the secretion of prolactin and weakens the inhibition of this hormone by dopamine. This causes even more increased levels of prolactin resulting in hyperprolactinemia. These elevated prolactin levels decrease androgen and increase estrogen and progesterone leading to gynecomastia (2,3).
What does research suggest?
Research findings show gynecomastia as a side effect of antidepressant therapy. Many studies have reported this adverse event to be caused in individuals receiving therapy for various depressive illnesses.
A case study assessing the effects of antidepressants on the occurrence of gynecomastia in an elderly male reported that altered dopamine and sexual hormone levels due to SSRIs are responsible for the occurrence of this side effect in the patient (3).
Another case study reported the occurrence of bilateral gynecomastia and galactorrhea in a 19-year-old male who was being treated for OCD with Fluvoxamine and risperidone. These side effects led to a change in prescription (4).
Another clinical study reported that Fluvoxamine can cause an increase in serum prolactin levels. The study reported that prolactin levels of individuals receiving therapy were checked before treatment with Fluvoxamine, and were found to be normal. So Fluvoxamine can indirectly affect prolactin-related mechanisms (5).
Fluvoxamine and other SSRIs like Lexapro are known to cause alterations in prolactin levels, which can lead to various hormonal issues in individuals taking therapy.
What other factors contribute to gynecomastia?
Gynecomastia can be caused by many other factors. Some of these are as follows (6):
Hormonal imbalance
A hormonal imbalance between estrogen and testosterone can be associated with the occurrence of gynecomastia. This imbalance can occur naturally like in newborns due to the effects of maternal estrogen.
Sometimes hormonal imbalance can also occur in puberty causing gynecomastia, which tends to go away after the changes in hormones go back to normal. Adults can also experience this effect due to a decrease in testosterone levels.
Medicines
Medicines such as antidepressants, steroids, opioids, estrogens and chemotherapeutic agents can contribute to this condition and can cause the occurrence of gynecomastia in patients receiving therapy with these agents.
Health conditions
Sometimes underlying medical conditions like breast cancer, tumours, obesity, adrenal disease, hypogonadism, thyroid disease, malnutrition and liver or kidney failure can also contribute to this condition.
Alcohol and drug abuse
Alcohol and recreational drugs like marijuana, amphetamines or heroin can also cause gynecomastia in men who are addicted to any of these substances.
How to manage Fluvoxamine-induced gynecomastia?
If you experience Fluvoxamine-induced gynecomastia, make sure to talk to your doctor about your condition. Your doctor will assess the benefits and risks of Fluvoxamine treatment and will suggest an appropriate plan. You may need a change in dosage or an alternative medication in place of Fluvoxamine.
If you experience symptoms like pain, tenderness, swelling or feel a hard mass within your breast you should talk to your healthcare provider immediately. Gynecomastia may be caused by some underlying medical condition that needs to be addressed.
There is not much you can do to manage Fluvoxamine-induced gynecomastia. You can by most avoid alcohol and substance abuse to decrease your risk of experiencing this side effect. Medications like tamoxifen, clomiphene and danazol do have a positive response in treating gynecomastia but also have an array of side effects so they are not well-tolerated.
Conclusion
To the best of my knowledge and according to research findings Fluvoxamine can cause gynecomastia in individuals receiving this medication. Although, this condition does not have many physical complexities but can affect the mental health of individuals because they are concerned about the way their breast looks. The only way to treat this condition is to get rid of the causative agent.
Was this helpful?
References
1.-
The Food and Drug Administration (FDA). HIGHLIGHTS OF PRESCRIBING INFORMATION. LUVOX® (fluvoxamine maleate) Tablets for oral administration. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/022235lbl.pdf
2.-
Bembo SA, Carlson HE. Gynecomastia: its features, and when and how to treat it. Cleveland Clinic Journal of Medicine. 2004 Jun 1;71(6):511-7. https://www.ccjm.org/content/ccjom/71/6/511.full.pdf
3.-
Kaufman KR, Podolsky D, Greenman D, Madraswala R. Antidepressant-selective gynecomastia. Annals of Pharmacotherapy. 2013 Jan;47(1):e6-. https://pubmed.ncbi.nlm.nih.gov/23324513/
4.-
Pratheesh PJ, Praharaj SK, Srivastava A. Euprolactinemic gynecomastia and galactorrhea with risperidone-fluvoxamine combination. Psychopharmacology Bulletin. 2011 Feb 2;44(1):70. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5044559/
5.-
Spigset O, Mjorndal T. The Effect of Fluvoxamine on Serum Prolactin and Serum Sodium Concentrations: Relation to Platelet 5-HT: 2A: Receptor Status. Journal of clinical psychopharmacology. 1997 Aug 1;17(4):292-7. https://journals.lww.com/psychopharmacology/abstract/1997/08000/the_effect_of_fluvoxamine_on_serum_prolactin_and.9.aspx
6.-
Vandeven HA, Pensler JM. Gynecomastia. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430812/
Find a supportive therapist who can help with Depression.
Discover the convenience of BetterHelp, an online therapy platform connecting you with licensed and accredited therapists specialized in addressing issues such as depression, anxiety, relationships, and more. Complete the assessment and find your ideal therapist within just 48 hours.
AskYourPharm is user-supported. We may earn a commission if you sign up for BetterHelp’s services after clicking through from this site
