Is fluvoxamine an MAOI? (+3 differences)

In this article, we will discuss whether fluvoxamine is an MAOI. We will also discuss the key differences between fluvoxamine and MAOIs including the mechanism of action, therapeutic uses, and side effects. 

Is fluvoxamine an MAOI?

No, fluvoxamine is not a monoamine oxidase inhibitor (MAOI). Fluvoxamine belongs to the class of selective serotonin reuptake inhibitors (SSRIs). Both MAOIs and SSRIs are different classes of antidepressant medications. They have their unique mechanism of action and therapeutic uses.

Fluvoxamine is known for having a more tolerable safety profile with mild to moderate side effects, whereas monoamine oxidase inhibitors have more side effects and drug interactions. This is because monoamine oxidase inhibitors affect various neurotransmitters including serotonin, dopamine, and norepinephrine (1). 

How is fluvoxamine different from MAOIs?

Fluvoxamine is different from monoamine oxidase inhibitors for many reasons including their mechanism of action, therapeutic uses, duration of treatment, and side effects.

Mechanism of action

Fluvoxamine is an SSRI antideressant medication. It works by inhibiting the reuptake of serotonin which in turn increases the levels of serotonin in the brain. High levels of serotonin help in the elevation of mood and reduction of various symptoms associated with various mental disorders including major depressive disorder, anxiety disorder, and obsessive-compulsive disorder (2). Other commonly prescribed SSRI medications include citalopram, sertraline, escitalopram, and fluoxetine.

MAOIs on the other hand, are a class of antidepressant medications that work by inhibiting the enzyme monoamine oxidase, which is responsible for the metabolism of various neurotransmitters including serotonin, dopamine, and norepinephrine. The inhibition of monoamine oxidase increases the levels of these neurotransmitters in the brain which in turn are responsible for the therapeutic action of MAOIs (3).

The most common antidepressant medications belonging to the class of MAOIs include selegiline, isocarboxazid, phenelzine, moclobemide, and tranylcypromine. 

Therapeutic uses

Fluvoxamine and MAOIs are prescribed for various mental health disorders, as both SSRIs and MAOIs are classes of antidepressant medication so they share some common indications. However, the choice between them depends on several factors, including the specific diagnosis, individual patient characteristics, and potential side effects.

Here are some therapeutic uses of fluvoxamine and MAOIs (4,5):

Fluvoxamine is most frequently indicated for the following conditions:

• geriatric depression 
• major depressive disorder
• social anxiety disorder
• panic disorders 
• obsessive-compulsive disorders (OCD) in children
• social phobia
• post-traumatic stress disorders

Whereas, MAOIs are primarily prescribed to manage and treat the following conditions:

• resistant depression
• atypical depression
• anxiety disorders
• bipolar depression
• bulimia nervosa
• Parkinson’s disease (MAO-B inhibitors)
• panic disorders

Side effects

Both MAOIs and fluvoxamine can cause side effects, but the nature and severity of these side effects can vary between the two classes of antidepressants. 

The side effects caused by fluvoxamine generally range from mild to moderate and are well tolerated. The most common side effects include (5):

• nausea
• vomiting
• dizziness
• drowsiness
• insomnia
• weight changes
• headache
• dry mouth
• agitation

The side effects caused by MAOIs include (3):

• Hypertensive crisis
• muscle cramps
• insomnia
• muscle rigidity
• aggression
• sexual side effects
• weight gain
• sedation
• palpitations
• headaches

Individual responses to medications may vary from one person to another, and not everyone who takes these medications experiences these side effects. You should always discuss any concerns about side effects with your healthcare provider, and any adjustments to medication should only be made under professional guidance.

What is the efficacy rate of fluvoxamine and MAOIs? 

Fluvoxamine is effectively used in the management of various mental disorders such as obsessive-compulsive disorder, anxiety disorders, and depression.

Fluvoxamine

According to research findings, fluvoxamine demonstrated a significant reduction in symptoms of OCD, exceeding response rates of 50% compared to a placebo in a period of over a 10-weeks (7). Another study demonstrated that fluvoxamine showed effectiveness in patients with mild depression, within 28 days of treatment, achieving a response rate of up to 57% (8).

Additionally, treatment of anxiety and depression with fluvoxamine resulted in complete improvement in 54% and partial improvement in 16% of patients within 6 weeks (9). 

MAOIs 

According to research, MAOIs demonstrated significant effectiveness, with a success rate of 71%, particularly in the treatment of atypical depression (10). 

Another research indicated the effectiveness of MAOIs in the management of social phobia. The results showed a significant improvement in symptoms within 64% of individuals undergoing treatment with an MOAI medication (4).

What is the treatment duration of fluvoxamine and MAOIs?

The treatment duration for fluvoxamine and MAOIs can vary based on the individual’s condition, response to the medication, and the specific mental health disorder being treated.

Research suggests that fluvoxamine may take several weeks to show its therapeutic benefits. However, the exact duration of treatment or time for improvement of symptoms may depend on the underlying conditions and individual factors (7). Fluvoxamine may take up to 6 weeks for the management of OCD whereas the symptoms of mild depression may subside after 4 weeks of treatment (8). 

Improvement in symptoms with MAOIs may take a few weeks, but they generally take a longer time to treat mental disorders. However, the exact treatment duration with MAOIs can vary depending on the specific drug and the underlying mental condition for which they are prescribed.

According to research, the onset of effectiveness for MAOIs typically occurs within 2 to 3 weeks of starting the medication. However, for optimal therapeutic benefits and to minimize the risk of symptomatic relapse, patients are advised to continue taking the antidepressant for at least six months (6).

Can you take fluvoxamine and MAOIs together?

Combining fluvoxamine and MAOIs can result in elevated serotonin levels, increasing the risk of serotonin syndrome. Symptoms of serotonin syndrome may include dizziness, aggression, palpitations, dilated pupils, muscle rigidity, tremors, elevated body temperature, convulsions, and, in some cases, coma.

It is highly risky to use these medications concurrently, which highlights the importance of avoiding their simultaneous administration. It is crucial to maintain clear communication with your healthcare provider, particularly when adjusting the dosage regimens or switching between antidepressants like SSRIs and MAOIs.

It is important to always follow the advice of your healthcare provider and never make any changes to your medication regimen without consulting them first. If you have any concerns or questions regarding your medications, it’s best to discuss them with your healthcare provider to receive personalized guidance based on your specific health situation.

Conclusion

In conclusion, based on my knowledge and experience fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) antidepressant medication. It does not belong to a class of monoamine oxidase inhibitors. Both of these classes are different in their mechanism of action, therapeutic benefits, and side effects.

References