What is luvox: Drug Database | Medication Decision Support

22.07.202306.07.2023 by alexxlab

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Luvox Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Warnings:

Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.

Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

Warnings:

Uses

Fluvoxamine is used to treat obsessive-compulsive disorder (OCD). It helps decrease thoughts that are unwanted or that don’t go away (obsessions), and it helps to reduce the urge to perform repeated tasks (compulsions such as hand-washing, counting, checking) that interfere with daily living. Fluvoxamine is known as a selective serotonin reuptake inhibitor (SSRI). This medication works by helping to restore the balance of a certain natural substance (serotonin) in the brain.

How to use Luvox Tablet

Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start taking fluvoxamine and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth with or without food as directed by your doctor, usually once daily at bedtime, or twice daily (once in the morning and once at bedtime). If you are taking this medication twice daily and the doses are not equal, then the larger of the 2 doses should be taken at bedtime.

The dosage is based on your medical condition, response to treatment, age, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). In children, the dosage may also be based on their age and gender. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor’s instructions carefully.

Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.

Keep taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as mood swings, headache, tiredness, sleep changes, and brief feelings similar to electric shock. To prevent these symptoms while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details. Report any new or worsening symptoms right away.

It may take up to several weeks before you get the full benefit of this drug.

Tell your doctor if your condition does not improve or if it worsens.

Side Effects

Precautions

Before taking fluvoxamine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: personal or family history of bipolar/manic-depressive disorder, personal or family history of suicide attempts, liver problems, seizures, low sodium in the blood, bleeding problems, personal or family history of glaucoma (angle-closure type).

This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Fluvoxamine may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.

The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using fluvoxamine, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).

Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics “water pills”) or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using fluvoxamine safely.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this drug, especially bleeding, or loss of coordination, QT prolongation. Older adults may also be more likely to develop a type of salt imbalance (hyponatremia), especially if they are taking “water pills” (diuretics). Loss of coordination can increase the risk of falling.

Children may be more sensitive to the side effects of this drug, especially loss of appetite and weight loss. Monitor weight and height in children who are taking this drug.

During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Also, babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying. If you notice any of these symptoms in your newborn, tell the doctor promptly.

Since untreated mental/mood problems (such as depression, obsessive compulsive disorder, post-traumatic stress disorder) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.

This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug are: other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen/naproxen, “blood thinners” such as dabigatran/warfarin).

Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

Many drugs besides fluvoxamine may affect the heart rhythm (QT prolongation), including pimozide, thioridazine, among others.

This medication can slow down the removal of other medications from your body, which may affect how they work. Examples of affected drugs include alosetron, clozapine, methadone, melatonin, ramelteon, tacrine, tizanidine, certain benzodiazepines such as alprazolam/diazepam/triazolam, certain beta-blockers such as metoprolol/propranolol, tricyclic antidepressants such as imipramine, among others.

Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and after treatment with this medication. Ask your doctor when to start or stop taking this medication.

The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/”ecstasy,” St. John’s wort, certain antidepressants (including other SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), tryptophan, among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.

This medication can increase the effects of caffeine. Avoid drinking large amounts of beverages containing caffeine (coffee, tea, colas) or eating large amounts of chocolate or taking nonprescription products that contain caffeine.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Cigarette smoking decreases blood levels of this medication. Tell your doctor if you smoke or if you have recently stopped smoking.

This medication may interfere with certain medical/laboratory tests (including brain scan for Parkinson’s disease), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Does Luvox Tablet interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: fast/slow/irregular heartbeat, trouble breathing, seizures.

Do not share this medication with others.

Keep all regular medical and psychiatric appointments.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Fluvoxamine (Luvox) | NAMI: National Alliance on Mental Illness

Generic name: fluvoxamine (floo VOKS a meen)

Brand names:

Luvox®
- Tablets (immediate release): 25 mg, 50 mg, 100 mg

Luvox CR®
- Capsules (extended release): 100 mg, 150 mg

All FDA black box warnings are at the end of this fact sheet. Please review before taking this medication.

What Is Fluvoxamine And What Does It Treat?

Fluvoxamine is an antidepressant medication that works in the brain. It is approved for the treatment of obsessive compulsive disorder (OCD) in adults and children ages 8 and older.

Obsessive Compulsive Disorder (OCD) occurs when a person experiences the following symptoms at the same time:

Obsessions (unwanted, recurrent, and disturbing thoughts)

Compulsions (repetitive, ritualized behaviors that the person feels driven to perform in order to lessen the anxiety produced by the obsessions)

Fluvoxamine may also be helpful when prescribed “off-label” for major depressive disorder (MDD), social phobia (also known as social anxiety disorder), posttraumatic stress disorder (PTSD), panic disorder, and eating disorders including bulimia nervosa and binge-eating disorder. “Off-label” means that it hasn’t been approved by the Food and Drug Administration for this condition. Your mental health provider should justify his or her thinking in recommending an “off-label” treatment. They should be clear about the limits of the research around that medication and if there are any other options.

Symptoms of depression include:

Depressed mood – feeling sad, empty, or tearful

Feeling worthless, guilty, hopeless, and helpless

Loss of interest or pleasure in your usual activities

Sleep and eat more or less than usual (for most people it is less)

Low energy, trouble concentrating, or thoughts of death (suicidal thinking)

Psychomotor agitation (‘nervous energy’)

Psychomotor retardation (feeling like you are moving and thinking in slow motion)

Suicidal thoughts or behaviors

Social phobia (also known as social anxiety disorder) is a fear of situations where one may feel as if they are being judged by others. Symptoms include:

Blushing

Difficulty talking

Nausea

Sweating

Shaking

What Is The Most Important Information I Should Know About Fluvoxamine?

Do not stop taking fluvoxamine, even when you feel better. With input from you, your health care provider will assess how long you will need to take the medicine.

Missing doses of fluvoxamine may increase your risk for relapse in your symptoms.

Stopping fluvoxamine abruptly may result in one or more of the following withdrawal symptoms: irritability, nausea, dizziness, vomiting, nightmares, headache, and/or paresthesias (prickling, tingling sensation on the skin).

Depression is also a part of bipolar illness. People with bipolar disorder who take antidepressants may be at risk for “switching” from depression into mania. Symptoms of mania include “high” or irritable mood, very high self-esteem, decreased need for sleep, pressure to keep talking, racing thoughts, being easily distracted, frequently involved in activities with a large risk for bad consequences (for example, excessive buying sprees).

Medical attention should be sought if serotonin syndrome is suspected. Please refer to serious side effects for signs/symptoms.

Are There Specific Concerns About Fluvoxamine And Pregnancy?

If you are planning on becoming pregnant, notify your health care provider to best manage your medications. People living with MDD who wish to become pregnant face important decisions. Untreated MDD has risks to the fetus, as well as the mother. It is important to discuss the risks and benefits of treatment with your doctor and caregivers. For women who take antidepressant medications during weeks 13 through the end of their pregnancy (second and third trimesters), there is a risk that the baby can be born before it is fully developed (before 37 weeks).

For mothers who have taken SSRIs during their pregnancy, there appears to be less than a 1% chance of infants developing persistent pulmonary hypertension. This is a potentially fatal condition that is associated with use of the antidepressant in the second half of pregnancy. However, women who discontinued antidepressant therapy were five times more likely to have a depression relapse than those who continued their antidepressant. If you are pregnant, please discuss the risks and benefits of antidepressant use with your health care provider.

Caution is advised with breastfeeding since fluvoxamine does pass into breast milk.

What Should I Discuss With My Health Care Provider Before Taking Fluvoxamine?

Symptoms of your condition that bother you the most

If you have thoughts of suicide or harming yourself

Medications you have taken in the past for your condition, whether they were effective or caused any adverse effects

If you experience side effects from your medications, discuss them with your provider. Some side effects may pass with time, but others may require changes in the medication.

Any other psychiatric or medical problems you have, including a history of bipolar disorder

All other medications you are currently taking (including over the counter products, herbal and nutritional supplements) and any medication allergies you have

Other non-medication treatment you are receiving, such as talk therapy or substance abuse treatment. Your provider can explain how these different treatments work with the medication.

If you are pregnant, plan to become pregnant, or are breastfeeding

If you drink alcohol or use drugs

How Should I Take Fluvoxamine?

Fluvoxamine is usually taken two times per day with or without food. The extended release formulation may be taken one time per day with or without food.

Typically patients begin at a low dose of medicine and the dose is increased slowly over several weeks.

The dose usually ranges from 50 mg to 300 mg. Only your health care provider can determine the correct dose for you.

Consider using a calendar, pillbox, alarm clock, or cell phone alert to help you remember to take your medication. You may also ask a family member or friend to remind you or check in with you to be sure you are taking your medication.

The extended-release forms should be swallowed whole. They should not be chewed, crushed, or broken.

What Happens If I Miss A Dose Of Fluvoxamine?

If you miss a dose of fluvoxamine, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your health care provider. Do not double your next dose or take more than what is prescribed.

What Should I Avoid While Taking Fluvoxamine?

Avoid drinking alcohol or using illegal drugs while you are taking antidepressant medications. They may decrease the benefits (e.g., worsen your condition) and increase adverse effects (e.g., sedation) of the medication.

What Happens If I Overdose With Fluvoxamine?

If an overdose occurs, call your doctor or 911. You may need urgent medical care. You may also contact the poison control center at 1-800-222-1222.

A specific treatment to reverse the effects of fluvoxamine does not exist.

What Are The Possible Side Effects Of Fluvoxamine?

Common side effects

Headache, nausea, diarrhea, dry mouth, dizziness, increased sweating, feeling nervous, restless, fatigued, or having trouble sleeping (insomnia). These will often improve over the first week or two as you continue to take the medication.

Sexual side effects, such as problems with orgasm or ejaculatory delay, often do not diminish over time.

Rare/serious side effects

Low sodium blood levels (symptoms of low sodium levels may include headache, weakness, difficulty concentrating and remembering), teeth grinding, angle closure glaucoma (symptoms of angle closure glaucoma may include eye pain, changes in vision, swelling or redness in or around eye), serotonin syndrome (symptoms may include shivering, diarrhea, confusion, severe muscle tightness, fever, seizures, and death), seizure

SSRI antidepressants including fluvoxamine may increase the risk of bleeding events. Combined use of aspirin, nonsteroidal anti-inflammatory drugs (e.g., ibuprofen, naproxen), warfarin, and other anti-coagulants may increase this risk. This may include symptoms such as gums that bleed more easily, nose bleed, or gastrointestinal bleeding. Some cases have been life threatening.

Are There Any Risks For Taking Fluvoxamine For Long Periods Of Time?

To date, there are no known problems associated with long term use of fluvoxamine. It is a safe and effective medication when used as directed.

What Other Medications May Interact With Fluvoxamine?

Fluvoxamine should not be taken with or within 6 weeks of taking monoamine oxidase inhibitors (MAOIs). These include phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®), rasagiline (Azilect®), and selegiline (Emsam®).

Although rare, there is an increased risk of serotonin syndrome when fluvoxamine is used with other medications that increase serotonin, such as other antidepressants, migraine medications called “triptans” (e.g., Imitrex®), some pain medications (e.g., tramadol (Ultram®), amphetamines, and the antibiotic linezolid (Zyvox®).

Fluvoxamine may increase the levels and effects of:

Warfarin (Coumadin®)

Theophylline (Theo-Dur®)

Certain anticonvulsants: carbamazepine (Tegretol®, Equetro®), phenytoin (Dilantin®)

Beta blockers, such as propranolol (Inderal®), metoprolol (Lopressor®, Toprol XL®)

Benzodizapines, such as alprazolam (Xanax®), diazepam (Valium®)

Certain antipsychotics, such as olanzapine (Zyprexa®), clozapine (Clozaril®), aripiprazole (Abilify®), quetiapine (Seroquel®)

Mexiletine (Mexitil®)

Omeprazole (Prilosec®)

Methadone (Dolophine®)

Tricyclic antidepressants, such as amitriptyline (Elavil®)

Fluvoxamine may decrease the effects of clopidogrel (Plavix®).

Fluvoxamine may increase the effects of other medications that can cause bleeding (e.g., ibuprofen (Advil®, Motrin®), warfarin (Coumadin®), and aspirin).

Combining fluvoxamine with ramelteon (Rozerem^TM), tizanidine (Zanaflex®), thioridazine (Mellaril®), pimozide, or alosetron (Lotronex®) is not recommended.

How Long Does It Take For Fluvoxamine To Work?

Sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working. Depressed mood and lack of interest in activities may need up to 6-8 weeks to fully improve.

Summary of FDA Black Box Warnings

Suicidal thoughts or actions in children and adults

Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients with major depressive disorder (MDD), both adult and pediatric, may experience worsening of their depression and/or the emergence of suicidal ideation and behavior (suicidality) or unusual changes in behavior, whether or not they are taking antidepressant medications. This risk may persist until significant remission occurs.

In short-term studies, antidepressants increased the risk of suicidality in children, adolescents, and young adults when compared to placebo. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24. Adults age 65 and older taking antidepressants have a decreased risk of suicidality. Patients, their families, and caregivers should be alert to the emergence of anxiety, restlessness, irritability, aggressiveness and insomnia. If these symptoms emerge, they should be reported to the patient’s prescriber or health care professional. All patients being treated with antidepressants for any indication should watch for and notify their health care provider for worsening symptoms, suicidality and unusual changes in behavior, especially during the first few months of treatment.

Provided by

(January 2023)

©2020 The American Association of Psychiatric Pharmacists (AAPP) and the National Alliance on Mental Illness (NAMI). AAPP and NAMI make this document available under the Creative Commons Attribution-No Derivatives 4.0 International License. Last Updated: January 2016.

This information is being provided as a community outreach effort of the American Association of Psychiatric Pharmacists. This information is for educational and informational purposes only and is not medical advice. This information contains a summary of important points and is not an exhaustive review of information about the medication. Always seek the advice of a physician or other qualified medical professional with any questions you may have regarding medications or medical conditions. Never delay seeking professional medical advice or disregard medical professional advice as a result of any information provided herein. The American Association of Psychiatric Pharmacists disclaims any and all liability alleged as a result of the information provided herein.

A cheap generic antidepressant called Luvox can reduce severe Covid-19 illness, studies show hospitalizations.

Marketed under the brand name Luvox, it is a selective serotonin reuptake inhibitor (SSRI) most commonly used to treat obsessive-compulsive disorder (OCD) and depression. But it can affect inflammation, said Dr. Angela Ryersen, an assistant professor of psychiatry at Washington University in St. Louis, who worked on the study, published in The Lancet Global Health.

“Fluvoxamine can reduce the production of inflammatory molecules called cytokines that can be caused by SARS-CoV-2 infection,” Ryersen said in a statement. The drug can also reduce the number of platelets in the blood, which can affect blood clotting in coronavirus infection.

Reyerson and colleagues gave 741 Covid-19 volunteers fluvoxamine 100 mg twice daily for 10 days, while 756 volunteers received a placebo.

Among patients treated with fluvoxamine, 79— or about 11% — needed treatment in the emergency room or hospital room, compared to almost 16% of those who received a placebo. Absolute risk decreased by 5% and relative risk by 32%.

More research is needed to see if the drug can be added to the treatment of coronavirus patients, but it’s cheap. “A 10-day course of fluvoxamine costs about $4 even in well-resourced settings,” the researchers wrote.

It’s not a cure, but if a cure helps keep patients out of hospital, it will be helpful.

“Given the safety, tolerability, ease of use, low cost, and wide availability of fluvoxamine, these results may influence national and international guidelines for the clinical management of COVID-19,” they concluded.

A related drug, Prozac or fluoxetine, is also cheap and even more available, and the researchers said the drug should be studied to see if it could help.

“Now it is critical to establish whether there is a class effect and whether these drugs can be used interchangeably for the treatment of COVID-19“, they wrote.

They noted that this is not a perfect study. This has been done in Brazil, and in other clinical trials, patients have had higher hospitalization rates than those with Covid-19.

“There is no standard of care that exists for early management of COVID-19, and various advocacy groups are promoting various interventions, including some of those evaluated in this and our previous studies. What’s more, few understand who is most at risk for the disease’s “progression of this disease, as some patients with multiple risk factors recover quickly, while some others with less established risk factors do not,” they write.

Prozac of Life – Indicator

Why mussel breeders need serotonin, how serotonin reuptake inhibitors work, and how Prozac conquered and then almost destroyed the United States, will tell the new issue of the Ig Nobel is Serious column.

Surely many of you have heard about serotonin, a neurotransmitter that is often called the “hormone of happiness,” which is absolutely wrong. Hormones are produced in some organs of our body, and perform their functions in others. Serotonin is produced and works in one place – the neurons of the brain. It conducts nerve impulses between neurons in parts of the brain, including those responsible for good mood. The physiological functions of serotonin are very diverse: it is involved in the regulation of vascular tone, plays an important role in the processes of blood coagulation, allergic and inflammatory reactions, enhances the peristalsis of the gastrointestinal tract and affects the reproductive system, namely, the processes of excitation and inhibition in the genital organs. This last property of serotonin has been used for a long time in the mussel and oyster industry: the owners of farms where mussels and oysters are grown add serotonin to the water – and the clams begin to multiply actively in response.

“Shellfish breeders—those who can afford it—use serotonin to stimulate spawning. When shellfish actively and simultaneously reproduce, farmers get a rich “harvest” that will be ready to be sold in a single batch,” says Peter Fong, winner of the 1998 Ig Nobel Prize in Biology. However, this pleasure is not cheap – about two decades ago, the cost of serotonin reached $ 22 per gram, which made this neurotransmitter too expensive for use in developing countries.

Peter Fong and his colleagues Peter Huminski and Lynette d’Urso found a cheaper alternative. They tested the effects of the selective serotonin reuptake inhibitors fluvoxamine, fluoxetine and paroxetine on the bivalve Sphaerium striatinum . What are they? Serotonin, like other neurotransmitters, must be transmitted from one nerve cell to the receptors of another, ensuring the transmission of a nerve impulse between them. But sometimes, when one neuron releases too much serotonin into the synaptic cleft, the excess “gathers” back into the same cell from which it was released – this is reuptake. Inhibitors (from the Latin word inhibere – “delay”, “slow down”) – substances that suppress or slow down the course of various processes – resist reuptake, and all serotonin can safely go to its destination.

All three substances studied by scientists had some effect on the reproduction of mollusks, but only fluoxetine accelerated the process ten times. A little later, Fong’s test subjects were the mollusks Dreissena polymorpha – fluoxetine acted on them in the same way.

Well, it’s time to show the cards. All three serotonin reuptake inhibitors are probably known to you as antidepressants by their trade names: fluvoxamine is Luvox, paroxetine is Paxil, and fluoxetine, which has shown itself to be the best of all, is Prozac. At the time of the events described (1998), Prozac cost about 190 times more than pure serotonin, but the benefits for farmers were obvious. Peter Fong told The New York Times: Shellfish breeders can use Prozac at concentrations a thousand times lower than serotonin concentrations, and the effect will be the same.

However, the 1998 Ig Nobel Prize in Biology was not just awarded for a study in which the reproduction of mollusks was sped up with the help of an antidepressant – it has a much deeper meaning. Prozac has become a real symbol of the era of the late XX – early XXI century, a drug that is taken by tens of millions of people around the world. The fact that its unusual use was included in the list of achievements “that make you laugh first, and then think” is very symptomatic.

Prozac’s active ingredient, fluoxetine, was discovered in 1972 by the pharmaceutical company Eli Lilly and Company among dozens of candidate molecules synthesized by its chemists, and in the mid-1980s, the US Food and Drug Administration (FDA) allowed bring the drug to market. In its first year, Prozac sold $350 million in the United States and became known as the “happiness pill.” In other countries, similar success awaited him, and by 19In 1994, the drug became the world leader among antidepressants. Prozac has been considered a panacea for major depressive disorder, obsessive-compulsive disorder, bulimia nervosa, panic disorder, and premenstrual dysphoric disorder. In 2001, the patent for the drug expired, and generics flooded the market.

However, in reality, not everything was so rosy. It was believed that the side effects of Prozac are significantly less than those of other antidepressants. However, they do include gastrointestinal disturbances, sleep problems, loss of appetite, manic episodes, seizures, and an increased risk of suicide, especially in people under 25 years of age. I would like to dwell on the last problem in more detail.

In the late 1990s – 2000s, Prozac in the United States began to be actively prescribed to pregnant women, children and adolescents, and then completely sold without a prescription. It was not for nothing that the Americans were called the “Prozac Nation” – more and more people “got hooked” on it. Meanwhile, the Food and Drug Administration was receiving more and more reports of patients taking Prozac who chose to voluntarily die, and dozens of lawsuits were filed against Eli Lilly and Company because of this. According to statistics, as the drug spread to a young audience in the country, the number of crimes committed by teenagers increased, and cases of shootings in schools became more frequent. In 2004, the FDA required manufacturers of antidepressants to display a warning on their packaging that the drug may increase the risk of suicide in people under 25 years of age.

As Vladislav Dorofeev writes in his book Great Medicines, later two independent panels of FDA experts conducted statistical studies based on the results of three hundred trials of 11 antidepressants. The work showed that the use of fluoxetine contributed to the manifestation of aggression and doubled the risk of suicide in children and adolescents, but in adults this risk decreased by about 30%. However, this information did not come as a surprise to the manufacturer: there are more than 500 studies of Prozac in the databases of scientific articles. At the same time, some reviews noted that manufacturers did not publish all the data obtained during the work. Eli Lilly and Company have been known to write off suicides during clinical trials of the drug as overdose or increased depression.

What do the other published studies of the drug say? Findings vary depending on the disorder the drug is being used against. For the fight against depression, a significant number of reviews call fluoxetine effective (sometimes only compared to placebo, and not other antidepressants), and the toxicity of the drug is lower compared to analogues. However, for example, in the case of obsessive-compulsive disorder, the situation is unclear, since there is not enough data for unambiguous conclusions. Prozac is recognized as a leader among other antidepressants for the fight against bulimia nervosa, but the authors are still not ready to recommend it as a standard treatment method, since not all clinical data are available for analysis. In addition, it is worth considering: Prozac is a serotonin reuptake inhibitor, and depression can be caused by a variety of reasons, such as serious diseases (cancer, diabetes, cirrhosis of the liver), lack of vitamins, psychological trauma.

So Prozac is not a “happiness pill” and not a panacea for mental problems, but just one of the many antidepressants, with its effectiveness and serious side effects, difficult to select dosage and intake, which should be carried out only under the supervision of a doctor.