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Fluvoxamine as an adjunctive agent in schizophrenia
1Sha'ar Menashe Mental Health Center, Rappaport Faculty of Medicine, Technion, Haifa, Israel. mdsilver@tx.technion.ac.il
CNS Drug Reviews
|October 19, 2001
Summary
Adding selective serotonin reuptake inhibitor (SSRI) fluvoxamine to antipsychotics may improve negative symptoms in schizophrenia. This combination is generally safe, but requires careful monitoring, especially with clozapine.
Area of Science:
- Psychiatry
- Pharmacology
- Clinical Neuroscience
Background:
- Schizophrenia is a disabling mental disorder with inadequate treatment response, particularly for negative symptoms.
- Negative symptoms impede patient rehabilitation and are challenging to manage with antipsychotics alone.
Purpose of the Study:
- To review the efficacy, tolerability, and safety of combining the SSRI fluvoxamine with antipsychotics for schizophrenia negative symptoms.
- To discuss methodological challenges, such as distinguishing primary from secondary negative symptoms.
Main Methods:
- Systematic review of existing evidence on fluvoxamine augmentation in schizophrenia treatment.
- Analysis of studies differentiating primary and secondary negative symptoms.
Main Results:
- Fluvoxamine augmentation appears to improve primary negative symptoms in chronic schizophrenia patients on typical antipsychotics.
- Evidence suggests potential benefits for some patients on clozapine, though caution is advised due to drug interaction risks.
- Effective augmentation doses of fluvoxamine are lower than those used for depression.
Conclusions:
- Combining fluvoxamine with antipsychotics is a promising strategy for improving negative symptoms in schizophrenia.
- Careful dose titration and drug level monitoring are essential, particularly when using clozapine.
- Further research is needed to identify specific patient groups who benefit most from this combined treatment.
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