Does Fluvoxamine stunt growth? (3+tips)

In this article, we will discuss whether Fluvoxamine can stunt growth, the mechanism by which it affects the growth of children, and some tips for monitoring growth during Fluvoxamine treatment.

Does Fluvoxamine Stunt Growth?

Yes, Fluvoxamine can potentially affect growth in children (1). It’s recommended that a child’s height and weight be checked often if they are taking this medication. However, it’s important to note that the effects can vary and it’s always best to consult with a healthcare provider for personalized advice.

Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat conditions such as obsessive-compulsive disorder (OCD) and anxiety disorders (2). Fluvoxamine may affect the levels of dopamine in the brain as well.

Does Fluvoxamine affect bone development?

There is evidence to suggest that Fluvoxamine as a Selective Serotonin Reuptake inhibitor (SSRI), may have an impact on bone health.

A systematic review and meta-analysis of 11 studies found that the use of SSRIs was significantly associated with a reduction in bone mineral density (BMD) at the lumbar spine, particularly in older people1. Another review also suggested that depression, which is often treated with SSRIs, is associated with bone deterioration and an increased risk of fracture.

Furthermore, changes in serotonin signaling that normally regulate skeletal health may occur when SSRIs are used. With chronic use, SSRIs may reduce bone formation, leading to an imbalance between bone breakdown and bone build-up.

However, the exact nature of the serotonergic pathways influencing bone and the direct and/or indirect effects are still unclear. More research is needed to fully understand the relationship between SSRI use and bone metabolism.

What are the Potential Mechanisms of Fluvoxamine’s Effect on Growth?

Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) that has several mechanisms of action that could potentially affect growth (3):

Serotonin Transporter Inhibition:

Fluvoxamine inhibits the serotonin transporter in platelets, which could reduce platelet aggregation. This could potentially have an impact on growth, although the exact mechanism is not clear.

Sigma-1 Receptor Agonism:

Fluvoxamine has been shown to have strong activity at the sigma-1 receptor (S1R), which can potentiate nerve-growth factor (NGF)-induced neurite outgrowth. This could potentially stimulate growth in certain cells.

Anti-inflammatory Effects:

Fluvoxamine’s anti-inflammatory effects likely stem from its regulation of S1R, which modulates innate and adaptive immune responses. Inflammation can have an impact on growth and development, so this could potentially affect growth.

Regulation of Inositol-Requiring Enzyme 1α (IRE1)-Driven Inflammation:

Fluvoxamine is also an important regulator of IRE1-driven inflammation1. This could potentially have an impact on growth, although the exact mechanism is not clear.

It’s important to note that while these mechanisms could potentially affect growth, the exact effects can vary and more research is needed to fully understand these mechanisms.

What do Research Studies say about Fluvoxamine’s Impact on Growth?

While there are numerous studies on the effects of fluvoxamine, few specifically investigate its impact on growth. Most of the available research focuses on the drug’s impact on mental health conditions. Research on the impact of Selective Serotonin Reuptake Inhibitors (SSRIs) on children’s growth is still ongoing, and the results are not entirely conclusive.

A study investigated the impact of Selective Serotonin Reuptake Inhibitors (SSRIs) on growth and puberty in four children (aged 11.6 to 13.7 years) treated for psychiatric disorders.  The findings revealed growth attenuation in all four patients, with three experiencing growth retardation during an expected pubertal growth spurt.

In one case, a girl showed complete growth arrest during 6 months of fluvoxamine therapy, despite the onset of puberty and consistent weight gain. After discontinuation of the medication, her growth velocity returned to a normal rate of 6.6 cm/year.

In another case, a boy experienced a decrease in growth velocity to 1.4 cm/year, followed by complete growth arrest for 4 months during fluoxetine therapy. After the medication was stopped, his growth velocity improved to 5.1 cm/year. However, when the medication was resumed, his growth velocity decreased again to 3 cm/year. 

Additionally, three patients exhibited a reduced growth hormone response to stimulation, and one had decreased 24-hour growth hormone secretion that normalized after stopping therapy. The study suggested that SSRI therapy might lead to a decrease in growth rate, potentially linked to the suppression of growth hormone secretion (4).

Another study found that pregnant mothers treated with SSRIs had fewer depressive symptoms, and their fetuses had no delay in body growth but had delayed head growth and were at increased risk for preterm birth (5).

These cases suggest that SSRIs may have a significant impact on growth velocity in children and adolescents, although the exact mechanisms and long-term effects are still unclear.

What affects Fluvoxamine-induced growth impairment?

The exact factors that could affect fluvoxamine-induced growth impairment are not fully understood and may vary among individuals. However, several factors could potentially influence the risk of growth problems:

• Genetics: Genetic factors can play a significant role in how an individual responds to medication, including fluvoxamine. Variations in genes related to drug metabolism or the serotonin system could potentially influence the risk of growth problems.

• Diet: Nutritional status can influence growth and development. A diet lacking essential nutrients can impair growth, and this could potentially be exacerbated by medication side effects.

• Lifestyle: Physical activity levels, sleep patterns, and stress levels can all influence growth and development. These factors could potentially interact with medication effects to influence growth.

• Underlying health conditions: Certain health conditions, such as hormonal imbalances or chronic illnesses, can impair growth. If an individual with one of these conditions is also taking fluvoxamine, it could potentially influence their growth.

• Concurrent medications: If an individual is taking other medications in addition to fluvoxamine, these could potentially interact to influence growth.

It’s important to note that these are potential factors and the relationship between these factors and fluvoxamine-induced growth impairment is not fully understood. More research is needed to fully understand these relationships.

Tips for Monitoring Growth During Fluvoxamine Treatment

Monitoring growth during fluvoxamine treatment in pediatric patients is an essential aspect of comprehensive care. Guidelines for monitoring growth typically involve a combination of regular assessments and open communication between healthcare providers, parents, and caregivers. While specific guidelines may vary, here are general recommendations:

• Baseline Assessment:

Conduct a thorough baseline assessment of the child’s growth parameters before initiating fluvoxamine treatment. This includes measuring height, weight, and other relevant physical markers.

• Regular Height and Weight Measurements:

Schedule regular follow-up appointments to monitor height and weight throughout treatment. The frequency of these assessments may depend on the specific guidelines provided by healthcare professionals but is often done at least every 6 to 12 months.

• Plotting Growth Curves:

Plot the child’s growth measurements on standardized growth curves. This allows healthcare providers to track growth trends over time and compare them to population norms.

• Assessment of Pubertal Development:

In adolescents, assess pubertal development as part of the overall evaluation. Changes in pubertal development can impact growth patterns.

• Incorporating Parental Concerns:

Encourage parents and caregivers to communicate any concerns they may have about the child’s growth. Open dialogue is crucial for addressing potential issues promptly.

• Regular Healthcare Check-Ups:

Schedule regular healthcare check-ups to assess not only physical growth but also the child’s overall health and well-being. These check-ups provide an opportunity to discuss any emerging concerns or changes in the child’s health.

• Consideration of Other Factors:

Take into account other factors that may influence growth, such as nutrition, physical activity, and overall health. Addressing these factors comprehensively contributes to the overall well-being of the child.

• Shared Decision-Making:

Engage in shared decision-making with parents and caregivers when considering adjustments to the treatment plan. If concerns about growth arise, the decision to continue, adjust, or discontinue fluvoxamine should be made collaboratively.

• Individualized Approach:

Recognize that each child is unique, and growth patterns can vary. An individualized approach to monitoring growth, taking into account the child’s specific circumstances, is essential.

It’s important to note that guidelines may vary, and healthcare providers will tailor their approach based on the specific needs of the child. Regular communication between parents, caregivers, and healthcare professionals is key to ensuring that any concerns are addressed promptly and that the child’s overall health is closely monitored throughout fluvoxamine treatment.

Conclusion:

While the potential impact of fluvoxamine on growth is a valid concern, in my opinion, it is important to weigh this against the benefits of treatment. Fluvoxamine can be an effective treatment for conditions like OCD and anxiety disorders, and for many, the benefits of treatment outweigh the potential risks.

However, ongoing research is needed to fully understand the long-term effects of fluvoxamine on growth.

References