Controlled-release fluvoxamine in obsessive-compulsive disorder and social phobia

Specific serotonin reuptake inhibitors are currently recommended as first-line treatments for obsessive-compulsive disorder (OCD) and social phobia or social anxiety disorder (SAD). Fluvoxamine has demonstrated efficacy in both these conditions and has recently been marketed in a controlled-release (CR) formulation in the United States for treatement of OCD and SAD. Three 12-week double-blind, multicenter, randomized, placebo-controlled studies were conducted with this formulation - two in SAD and one in OCD. All three studies showed a robust effect on the key symptoms of OCD and SAD and had broadly comparable efficacy to studies conducted with immediate-release (IR) fluvoxamine. The beneficial effects of fluvoxamine CR were maintained in a 12-week double-blind, randomized extension to one SAD trial. The CR formulation, when compared to its IR counterpart, offers less daily fluctuation in fluvoxamine levels and a more rapid titration schedule; in addition, a more rapid onset of effect may result from these features. Overall, the benefits of the CR formulation, among them the convenience of oncedaily dosing, were achieved without an increased adverse event burden versus the IR form.