By Irfana
B.Sc (Psychiatry Ward)
18 April 2022 -
Medically reviewed by
Freny
D. Pharm
Fluvoxamine vs Citalopram
Table of Contents

What are Fluvoxamine and Citalopram?

Fluvoxamine belongs to the selective serotonin reuptake inhibitors (SSRIs) class of drugs. It is primarily used to treat people who suffer from obsessive-compulsive disorder (OCD). It can be used on adults and children at least eight years old. Order Fluvoxamine online from a certified online pharmacy and get great deals and discounts. (Benfield, P. and Ward, A., 1986)

Citalopram also belongs to the same class of drugs as Fluvoxamine does (the SSRIs). It is primarily used to treat depression and major depressive disorder (MDD). Citalopram can be used on adults and is usually not recommended for anyone under 18. Purchase Citalopram online from a trusted and a reputed online pharmacy. (Milne, R.J. and Goa, K.L., 1991)

Study

A double-blind study was conducted at the Psychiatric center Bloemendaal in The Netherlands. The objective was to study the efficacy and tolerability of Citalopram for gastrointestinal side-effects in comparison with Fluvoxamine in depressed outpatients. The study was conducted on 217 patients with a depressive disorder. 

The study showed that both, Fluvoxamine and Citalopram were equally effective. However, Citalopram was seen to be better tolerated than Fluvoxamine regarding adverse gastrointestinal events. 

Interactions

Combination of Fluvoxamine and Citalopram:

Nausea and tremor are frequent adverse effects of the citalopram–fluvoxamine combo, neither study found any significant side effects. However, this combination has the potential to cause serotonin syndrome, which is a significant side effect.

Fluvoxamine with other drugs:

Fluvoxamine can exacerbate this effect when used with other drowsiness-inducing medications. Also, before using an opioid, sleeping pill, muscle relaxant, or anxiety or seizure drug, consult your doctor.

Inform your doctor of all the medications you're taking. Fluvoxamine is influenced by a number of medicines, including:

  • Water pill or diuretic
  • Methadone, tramadol, theophylline
  • A blood thinner such as Jantoven or Warfarin
  • A migraine headache medicine such as Imitrex or Maxalt
  • Medicines used to treat anxiety or other mental illness (antidepressants, antipsychotics, or clozapine). (Jeppesen, U., Loft, S., Poulsen, H.E. and Brśen, K., 1996.)

Citalopram with other drugs:

Citalopram has the potential to cause major cardiac problems. If you use some other drugs for infections, asthma, heart problems, high blood pressure, depression, mental illness, cancer, malaria, or HIV, your risk may be increased.

Some drugs affecting Citalopram are:

  • Cimetidine
  • A blood thinner such as Warfarin or Coumadin
  • Lithium
  • Tramadol 
  • John’s wort.

Many other drugs can affect and interact with both Fluvoxamine and Citalopram, which are not mentioned in this article. That includes OTC, prescription, herbal, or vitamin medications. (Bezchlibnyk-Butler, K., Aleksic, I. and Kennedy, S.H., 2000.

Dosage

Fluvoxamine:

Typical Adult dose for OCD: Dosage for the immediate-release pill is 50 mg orally once a day before sleep. 

100 mg orally once a day at night for the first extended-release capsule dosage

100 to 300 mg orally each day as a maintenance dosage.

Maximum daily dose: 300 mg.

Typical pediatric dosage: 8–11 years old:

-Begin with a 25 mg dosage taken once a day at night.

-Maximum dose: 200 mg/day -Maintenance dose: 25 to 200 mg orally each day

11–17 years old:

-Begin with a 25 mg dosage taken once a day at night.

-Maximum dose: 300 mg/day -Maintenance dose: 25 to 300 mg orally each day

Fluvoxamine pills can be taken with or without food or on an empty stomach. If you forget to take a fluvoxamine dosage when it's due, skip the missed dose and take your next dose. To make up for a missing dosage, don't take two doses.

Citalopram:

Typical adult dose for depression: 20 mg orally once a day as a starting dosage

20 to 40 mg orally once a day as a maintenance dosage

Maximum daily dose: 40 mg orally

Patients over the age of 60:

20 mg orally once a day is the recommended dosage.

Citalopram is an antidepressant that may be taken with or without meals. Follow your doctor's instructions if they tell you to take it at a certain time.

When should you not take the medicines?

Fluvoxamine:

Fluvoxamine should not be used within 14 days of taking an MAO inhibitor or within 14 days of stopping it. A harmful medication interaction may occur. 

Suicide is a possibility for people who are depressed or have a mental illness. Some young individuals may have an increase in suicide thoughts after taking a depression medication for the first time. Any changes in your mood or symptoms should be closely monitored. Your family or caregivers should keep an eye on any abrupt changes in your behaviour.

Tell your doctor if you take stimulants, opioids, herbal items, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, severe infections, or nausea and vomiting prevention. An interaction with Fluvoxamine might result in serotonin syndrome, a dangerous illness.

Citalopram:

Citalopram has the potential to cause major cardiac problems. If you use some other drugs for infections, asthma, heart problems, high blood pressure, depression, mental illness, cancer, malaria, or HIV, your risk may be increased.

If you experience new or worsening depression or anxiety, panic attacks, difficulties sleeping, or feel impulsive, angry, agitated, hostile, aggressive, restless, more energetic, or talkative, or if you have thoughts about suicide or harming yourself, call your doctor straight once.

How Do They Work?

Fluvoxamine acts by preventing serotonin, a neurotransmitter, from being absorbed into the gaps between nerve cells after release. As a result, more serotonin is accessible in the gaps to bind to and stimulate other nerves.

Citalopram works by raising the brain's serotonin levels, a mood-enhancing neurotransmitter.

Side Effects

Fluvoxamine 

Some common side effects:

  • Anxiety
  • Blurred vision
  • Seizure
  • Changes in weight or appetite
  • Nausea
  • Upset stomach, gas
  • Sexual problems

Citalopram

Some common side effects:

  • Light-headed feeling
  • Blurred vision
  • Faster heartbeats
  • Sexual problems
  • Dizziness
  • Sleep problems
  • Nose bleeds or heavy menstrual bleeding

Both these medicines can cause other side effects not mentioned in this blog. It would be best if you took proper guidance under a medical professional before taking the medication and even during the treatment. You must consult a doctor if you have any symptoms of the side effects or for worsening conditions. 

Which one is better?

We can’t compare these two medicines in terms of which is better than the other. Fluvoxamine is used to treat OCD and is effective, while Citalopram is used to treat depression and is also very effective. Both serve different purposes even though they belong to the same drug class (SSRI). 

Additional Information

Keep the medicines away and out of sight from children. Do not share your medications with other people. We would also advise you to take the medication as prescribed. 

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