Is Fluvoxamine Better Than Clomipramine? (+3 Factors)

By Dr Drielli Vital-Fujii (PhD)

Page last updated: 06/02/2024 | Next review date: 06/02/2026

Author bio

Dr Drielli Vital-Fujii, PhD, is a Pharmacist with expertise in Drug Design and Development, Enzymes, Molecular Modelling, and Photodynamic Therapy. She writes and reviews content on these topics.

Dr Drielli Vital-Fujii’s Highlights:

Postdoctoral fellow at the Department of Biochemistry at the University of São Paulo, emphasizing therapy of neglected diseases using light.

PhD in Pharmaceutical Sciences focusing on drug design and development at the Faculty of Pharmaceutical Sciences of the University of São Paulo.

Six months as an international researcher at the Center for Discovery and Innovation in Parasitic Diseases (University of California San Diego)

Master’s degree in Pharmaceutical Sciences focusing on drug design and development at the Faculty of Pharmaceutical Sciences of the University of São Paulo.

Bachelor of Pharmacy at the University of Mogi das Cruzes – São Paulo / Brazil

Professional Experience:

2012 – 2018 Project manager at University of São Paulo – Pharmacy Department

Dr Drielli Vital-Fujii has worked with computational studies, synthesis, biological evaluation, design, and development of new inhibitor candidates for Chagas Disease and Leishmaniasis.

2017 – 2017 International research fellow at University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences – Center for Discovery and Innovation in Parasitic Diseases.

She used Virtual Screening (VS) and High-Throughput Screening (HTS) Integration in the Discovery of new drugs against neglected tropical diseases (NTDs).

2018 – 2019 Faculdades Oswaldo Cruz

Dr Drielli Vital-Fujii was a professor in the Faculty of Pharmacy, teaching the subjects of Pharmaceutical Chemistry and Drug Development.

2019 – 2021 Researcher in Biochemistry University of São Paulo – Biochemistry Department

She applied Photodynamic Therapy in Leishmaniasis Treatment, mentored undergraduate students in scientific activities, and wrote, executed, translated, and reported scientific projects with funding agencies.

2023-2023 UniPiaget – University Center.

Dr Drielli Vital-Fujii was a Biology, Nutrition, Physiotherapy, and Pharmacy professor.

Education:

2018 -2021 Postdoctoral at the Department of Biochemistry at the University of São Paulo

2013 -2018 PhD of Science: Drugs and Medicines at Department of Pharmacy at University of São Paulo

2012 -2013 M.Sc. of Sciences: Drugs and Medicines at the Department of Pharmacy at the University of São Paulo

2005-2008 Bachelor of Pharmacy at the University of Mogi das Cruzes

The leading publications of Dr Drielli Vital-Fujii are:

Vital-Fujii, D.G, Baptista, M.S. (2021). Progress in the photodynamic therapy treatment of Leishmaniasis. Brazilian Journal of Medical and Biological Research, 54, 1-11.

Gatti, F. M., Gomes, R.A., da Fonseca, A.L., Lima, E.J.C., Vital-Fujii, D.G., Taranto, A.G., Varotti, F.P., Trossini, G.H.G. (2020). Antiplasmodial activity of sulfonylhydrazones: in vitro and in silico approaches. Future medicinal chemistry, 13, 233-250.

Silva, E.J., Bezerra-Souza, A., Passero, L.F., Laurenti, M.D., Ferreira, G.M., Fujii, D.G.V., et al. (2018). Synthesis, leishmanicidal activity, structural descriptors and structure-activity relationship of quinoline derivatives. Future medicinal chemistry, 10, 2069-2085.

Leite, F.H.A., Froes, T.Q., da Silva, S.G., de Souza, E.I.M., Vital-Fuji,i D.G., Trossini, G.H.G., et al. (2017). An integrated approach towards the discovery of novel non-nucleoside Leishmania major pteridine reductase 1 inhibitors. European Journal of Medicinal Chemistry, 132, 322-332.

Vital, D.G., Damasceno, F.S., Rapado, L.N., Silber, A.M., Vilella, F.S., Ferreira, R.S., et al. (2017). Application of bioisosterism in design of the semicarbazone derivatives as cruzain inhibitors: a theoretical and experimental study. Journal of Biomolecular Structure and Dynamics, 35, 1244–1259.

Mello, J. F.R., Gomes, R.A., Vital-Fujii, D.G., Ferreira, G.M., Trossini, G.H.G. (2017). Fragment-based drug discovery as alternative strategy to the drug development for neglected diseases. Chemical Biology & Drug Design, 90, 1067-1078.

Pantaleao, S.Q., Fujii, D.G.V., Maltarollo, V.G., da C. Silva, D., Trossini, G.H.G., Weber, K.C., et al. (2017). The Role of QSAR and Virtual Screening Studies in Type 2 Diabetes Drug Discovery. Medicinal Chemistry, 13, 706-720.

Vital, D., Arribas, M., Trossini, G. (2014). Molecular Modeling and Docking Application to Evaluate Cruzain Inhibitory Activity by Chalcones and Hydrazides. Letters in Drug Design and Discovery, 11, 249-255.

Blau, L., Menegon, R.F., Trossini, G.H.G., Molino, J.V.D., Vital, D.G., Cicarelli, R.M.B., et al. (2013). Design, synthesis and biological evaluation of new aryl thiosemicarbazone as antichagasic candidates. European Journal of Medicinal Chemistry, 67, 142-151.

You can view some of Dr Drielli’s work below and links to her professional profile.

Orcid: https://orcid.org/0000-0001-9270-0466

Research Gate: https://www.researchgate.net/profile/Drielli-Gomes-Vital-Fujii

Scopus: https://www.scopus.com/authid/detail.uri?authorId=55829534000

Google Scholar: https://scholar.google.com/citations?user=F9U50AEAAAAJ&hl=pt-BR

Linkedin: linkedin.com/in/driellivital

Escavador: https://www.escavador.com/sobre/6101380/drielli-gomes-vital

CDIPD: https://cdipd.org/index.php/about-us/visiting-scientists

Dr Drielli Vital-Fujii (PhD)

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In this article, we will discuss whether Fluvoxamine is better than Clomipramine. We will also discuss some key differences between the two medications and how to choose between Fluvoxamine and Clomipramine.

Is Fluvoxamine better than Clomipramine?

The superiority between Fluvoxamine and Clomipramine depends on individual responses and side effect tolerability, with both showing effectiveness in treating obsessive-compulsive disorder.

Both Fluvoxamine and Clomipramine are prescription medications and should not be taken without your doctor’s approval. This is because medications are not only prescribed on the basis of their therapeutic strength but also if your body can tolerate them enough.

This is why it is important to talk to your healthcare provider if you are experiencing anxiety or depression. They will assess your condition properly and prescribe the best possible medication according to your symptoms.

What does research suggest?

Several research studies compared the effectiveness of Fluvoxamine and Clomipramine in patients with obsessive-compulsive disorder (OCD).

One study indicated that in a population of 227 people, Fluvoxamine and Clomipramine were given randomly for 10 weeks (1).

Results indicated that both medications were equally effective in treating OCD, but Clomipramine caused more side effects like dry mouth and gastrointestinal disturbances, resulting in more than 40% of people taking Clomipramine stopping treatment compared to Fluvoxamine (1).

The study suggests that both medications worked well for OCD but Fluvoxamine might be easier to tolerate.

Another study indicated a case in which 79 OCD patients were tested for a few weeks with Fluvoxamine and Clomipramine randomly. Results indicated that 56% of patients with Fluvoxamine and 54% of patients with Clomipramine treatment responded well in both groups (2).

However, in both groups side effects differed; Fluvoxamine caused insomnia and nervousness while Clomipramine caused dry mouth and constipation, but were equally safe (2).

What is the basic difference between Fluvoxamine and Clomipramine?

Fluvoxamine and Clomipramine are both antidepressants used to treat symptoms of anxiety and depression but they have some basic differences. These include:

Mechanism of action

Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI). It primarily works by inhibiting the reuptake of serotonin by the brain cells, thereby increasing the serotonin concentration in the brain (3).

Serotonin plays an important role in reducing anxiety and mood disorders.

Clomipramine, on the other hand, is a tricyclic antidepressant (TCA). It affects both serotonin and norepinephrine (neurotransmitters) levels in the brain, thereby treating anxiety and depression (4).

Therapeutic uses

Fluvoxamine, an SSRI, is approved by the FDA for the treatment of obsessive-compulsive disorder (OCD). Like other SSRIs, such as Escitalopram, etc, its off-label uses include social anxiety disorder (SAD) and generalized anxiety disorder (GAD) (5).

Clomipramine, on the other hand, is FDA-approved for obsessive-compulsive disorder (OCD). Its off-label uses include panic disorder and other anxiety disorders (6).

So, which of these two antidepressants is best for you?

That totally depends on how you feel. Determining the best antidepressant is a trial-and-error process, and it may take multiple attempts to find the one that suits you best.

If your body settles on Fluvoxamine and you feel better, it is best to stick to it for as long as it works. If you feel better on Clomipramine, then you should keep taking it.

It totally depends on how your body responds when you take these medications and which one of them compliments your physiological composition.

Always consult your healthcare provider if you want to switch to another antidepressant or if the current medication is not making you feel better.

Which one works faster?

When comparing the onset of action between Fluvoxamine and Clomipramine, it is seen that Fluvoxamine, an SSRI, has an early onset of action and starts showing its effects within a few weeks of starting the treatment.

Clomipramine may take a longer time i.e. several weeks to months to show its full effects.

However, the duration of treatment for both medications might continue from months to years depending on the patient’s response and doctor’s guidance.

Dosage form and prices

Fluvoxamine is usually available in the form of tablets (25mg, 50mg, 100mg) and also in the form of extended-release capsules (100mg and 150mg). Fluvoxamine’s price can range from 20-50$ but may vary depending on dosage strength and brand.

Clomipramine is mostly available in the form of capsules (25mg, 50mg, 75mg). Its price ranges from 15-50$ but may vary depending on dosage strength and brand.

What are the side effects of Fluvoxamine and Clomipramine?

Fluvoxamine is usually associated with the following side effects (7):

Nausea
Vomiting
Diarrhoea
Dizziness
Drowsiness
Tiredness

Clomipramine, on the other hand, is associated with the following side effects (8):

Sedation
Dizziness
Dry mouth
Constipation
Gastrointestinal disturbances
Blurred vision
Excessive sweating
Tiredness

How to choose between FLuvoxamine and Clomipramine?

The choice between Fluvoxamine and Clomipramine often depends on several factors including:

Side effects: Fluvoxamine has a favourable side effect profile as compared to Clomipramine. Due to its tricyclic nature, Clomipramine is associated with pronounced side effects such as dry mouth, constipation and sedation.

Individual responses: Individual responses to medications vary. So, some individuals may respond better to one medication due to different genetic profiles and sensitivity to particular drugs.

Safety and tolerance: Fluvoxamine has fewer drug interactions compared to Clomipramine.

Medical history: The patient’s medical history and preexisting conditions or previous experience with medications can influence the choice.

So, the decision between Fluvoxamine and Clomipramine should be made in consultation with a healthcare professional. They can assess your specific situation and provide treatment tailored to your specific needs.

What is the importance of seeking professional advice?

Seeking professional advice is crucial when it comes to anxiety treatment and choosing the right medication. A healthcare provider can offer personalized guidance based on your specific condition, medical history and treatment goals.

Your doctor can accurately diagnose your specific condition and recommend the most effective medication for your situation.

A healthcare professional can also help you understand the proper use of medication, including dosage, frequency and duration of treatment. They will also provide information about the potential side effects and how to manage them if they occur. This way you can achieve your treatment goals safely and effectively.

Conclusion

In my view, the superiority between Fluvoxamine and Clomipramine varies depending on individual response, tolerability, and side effects profiles.

I suggest consulting your healthcare provider for personalized guidance and treatment plans.