Dear list,

I recently posted links to the two papers by the American College of Physicians in the Annals of Internal Medicine. The second one was:

Comparative Benefits and Harms of Second-Generation Antidepressants:
Background Paper for the American College of Physicians.
Ann Intern Med. 2008 Nov 18;149(10):734-750

There is much of interest in this, but one thing that stood out to me was the poor performance of fluvoxamine (Luvox). See the figures on pages 741 -743. I have marked the comparisons involving fluvoxamine in red.

Fluvoxamine was distinctly inferior to:

Citalopram
Escitalopram
Fluoxetine
Paroxetine
Sertraline
Duloxetine
Mirtazapine
Venlafaxine
Bupropion
Nefazodone
Trazodone

In addition, earlier comparisons have shown fluvoxamine to have a heavier burden of side effects than all the other SSRIs.

Number of reports of suspected adverse drug reactions received by the British Committee of Safety of Medicines during the first two years of marketing of each SSRI.

Edwards JG, Anderson I. 'Systematic review and guide to selection of selective serotonin reuptake inhibitors' Drugs 1999 Apr;57(4):507-33

With these pieces of evidence together, can anyone see a reason not to abandon fluvoxamine?

Cheers

David