Is Fluvoxamine better than Clomipramine? (+3 factors)

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.


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.


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