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Efficacy, tolerability and side-effect profile of fluvoxamine for major depression: meta-analysis

¹ Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
² Department of Neuropsychiatry, School of Medicine, Keio University, Tokyo, Japan
³ Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
⁴ Health Service and Population Research Department, Section of Evidence-Based Mental Health, Institute of Psychiatry, King's College London, London, UK

^* To whom correspondence should be addressed.

	Abstract

Abstract

Fluvoxamine, one of the oldest selective serotonin reuptaking inhibitors, is commonly prescribed to patients with major depression. Several studies have reviewed the efficacy and tolerability of fluvoxamine for the treatment of major depression. However, these reviews are outdated, have not been systematic and/or suffered from several methodological weaknesses. We conducted a systematic review to synthesize the best available evidence on the efficacy of fluvoxamine for adult patients suffering from major depression in comparison with other active antidepressive agents. Relevant randomized controlled trials were identified through a comprehensive search. The primary outcome was a relative risk of response, and the secondary outcome was a relative risk of remission. Tolerability and side-effect profile were also examined. Fifty-three trials were included. There were no large differences between fluvoxamine and any other antidepressants in terms of efficacy and tolerability. There is evidence of differing side effect profiles, especially when comparing gastrointestinal side effects between fluvoxamine and tricyclics. Clinicians should focus on practically or clinically relevant differences including those in side-effect profiles.

Key Words: fluvoxamine, antidepressive agents, major depressive disorder, meta-analysis

First published on June 18, 2008, doi:10.1177/0269881108089876

Journal of Psychopharmacology 2009;23:539.

A more recent version of this article appeared on July 1, 2009
This version was published on September 18, 2008


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