Luvox vs. Fluoxetine
See how Luvox and Fluoxetine compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Luvox and fluoxetine are both SSRIs used for OCD, but only fluoxetine is FDA-approved for depression, bulimia, and panic disorder as well.
Fluvoxamine strongly inhibits the liver enzyme CYP1A2, raising interaction risk, while fluoxetine's long half-life allows once-weekly dosing but a longer washout if switching drugs.
Both carry a boxed warning for suicidal thoughts in children, teens, and young adults, so either one requires close monitoring early in treatment.
Luvox vs. Fluoxetine Drug Summary
Luvox
Luvox (fluvoxamine) is an SSRI antidepressant FDA-approved for obsessive-compulsive disorder in adults and children ages 8 to 17. It's taken orally, usually once or twice a day, with higher doses split into two doses.
Fluoxetine
Fluoxetine is an SSRI approved for depression, OCD, bulimia, panic disorder, and certain bipolar depression combinations. It comes as a capsule, tablet, or liquid, and can be taken once daily or, at maintenance strength, once weekly using its long-acting formulation.
Luvox vs. Fluoxetine Side Effects
Luvox
Fluoxetine
Luvox vs. Fluoxetine Dosage
Luvox
Fluoxetine
| STAGE | DOSE | WHEN |
| Starting dose | 25 mg once daily | At the start |
| Maximum dose | 300 mg/day | If needed |
| Dose changes | 4 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | Week 1 |
| Maximum dose | 90 mg once weekly | If needed |
| Dose changes | 4 increases | Every week |
Luvox
| STAGE | DOSE | WHEN |
| Starting dose | 25 mg once daily | At the start |
| Maximum dose | 300 mg/day | If needed |
| Dose changes | 4 increases | As tolerated |
Fluoxetine
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | Week 1 |
| Maximum dose | 90 mg once weekly | If needed |
| Dose changes | 4 increases | Every week |
Luvox vs. Fluoxetine Indications
Luvox
Luvox is FDA-approved for obsessive-compulsive disorder in adults and children ages 8 to 17. It's also used off-label for depression, social anxiety disorder, and panic disorder, though these are not FDA-approved uses.
Obsessive-compulsive disorder in adults
Obsessive-compulsive disorder in children ages 8-17
Off-label: major depressive disorder
Off-label: social anxiety disorder
Off-label: panic disorder
Fluoxetine
Fluoxetine is FDA-approved for major depressive disorder, OCD, bulimia nervosa, panic disorder, and bipolar depression combined with olanzapine. It's also used off-label for PMDD, binge eating disorder, and selective mutism.
Major depressive disorder in adults and children 8-18
Obsessive-compulsive disorder in adults and children 7-17
Bulimia nervosa in adults
Panic disorder in adults
Off-label: premenstrual dysphoric disorder
Luvox vs. Fluoxetine Pros and Cons
Luvox
Luvox is FDA-approved only for OCD, though clinicians also use it off-label for depression and anxiety disorders. Its strong effect on the liver enzyme CYP1A2 makes drug interactions more likely than with many other SSRIs, so dosing is usually started low and increased slowly. Since brand-name Luvox has been discontinued, only generic fluvoxamine is available.
Pros
FDA-approved for OCD in children as young as 8
Available as immediate-release tablets or generic extended-release capsules
Being studied off-label for anti-inflammatory effects in COVID-19 treatment
Cons
Not FDA-approved for depression, unlike fluoxetine
Strong CYP1A2 inhibitor, raising interaction risk with caffeine, theophylline, and clozapine
Higher labeled rates of nausea, headache, and insomnia in trials
Fluoxetine
Fluoxetine has one of the broadest FDA approval lists among SSRIs, covering depression, OCD, bulimia, panic disorder, and treatment-resistant depression combined with olanzapine. Its long half-life means missed doses matter less day to day, but it also stays in the body for weeks after stopping. As one of the first SSRIs approved in the US, it has decades of generic use behind it.
Pros
FDA-approved for depression, OCD, bulimia, panic disorder, and bipolar depression combinations
Long-acting metabolite allows a once-weekly maintenance dosing option
Available in capsule, tablet, and liquid forms for flexible dosing
Cons
Long half-life can complicate switching to MAOIs or other serotonergic drugs, requiring a longer washout
Bipolar depression indication requires adding olanzapine, a second medication with its own side effects
Not studied for the anti-inflammatory or antiviral uses explored with fluvoxamine
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