Luvox vs. Remeron

See how Luvox and Remeron compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Luvox is FDA-approved only for obsessive-compulsive disorder, while Remeron is approved for major depressive disorder, though both are used off-label for other conditions.

  • Both drugs carry a boxed warning for increased suicidal thinking in children and young adults, but Remeron also carries a warning for rare, severe neutropenia.

  • Luvox is more likely to cause nausea and insomnia, while Remeron is more likely to cause sedation, increased appetite, and weight gain.

Luvox vs. Remeron Drug Summary

Luvox

Luvox (fluvoxamine) is a selective serotonin reuptake inhibitor (SSRI) approved for obsessive-compulsive disorder in adults and children ages 8 and older. It is taken as an oral tablet, usually starting at 50 mg once daily and increasing as needed, with higher doses split into two daily doses.

Remeron

Remeron (mirtazapine) is a tetracyclic antidepressant approved for major depressive disorder in adults. It is taken as a single tablet at bedtime, starting at 15 mg and increasing every one to two weeks up to a maximum of 45 mg based on response.

Luvox vs. Remeron Side Effects

Luvox

Most common
Nausea (up to 40%)
Headache (up to 35%)
Insomnia (up to 35%)
Somnolence (up to 27%)

Remeron

Most common
Somnolence (up to 54%)
Dry mouth (up to 25%)
Increased appetite (up to 17%)
Constipation (up to 13%)

Luvox vs. Remeron Dosage

Luvox

Dosage
Dosage Table
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

Remeron

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 15 mg once daily At the start
Maximum dose 45 mg once daily If needed
Dose changes 2 increases As tolerated

Luvox vs. Remeron Indications

Luvox

Luvox is FDA-approved to treat obsessive-compulsive disorder in adults and in children and adolescents ages 8 to 17. It is also prescribed off-label for depression, social anxiety, and panic disorder, though it is not FDA-approved for those 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

Remeron

Remeron is FDA-approved to treat major depressive disorder in adults. It is also used off-label for insomnia, anxiety, appetite stimulation, and nausea in pregnancy, though these are not FDA-approved uses.

  • Major depressive disorder in adults

  • Off-label: insomnia

  • Off-label: anxiety disorders

  • Off-label: appetite/weight stimulation

  • Off-label: nausea in pregnancy (hyperemesis)

Luvox vs. Remeron Pros and Cons

Luvox

Luvox is the only one of the two approved for OCD, including in children as young as 8. It tends to cause less weight gain and sedation than Remeron, but it comes with more drug interaction concerns due to its effect on liver enzymes.

Pros

  • Approved specifically for OCD, including in children as young as 8

  • Less likely to cause weight gain than Remeron

  • No boxed warning for severe neutropenia or QT prolongation

  • Generally less sedating at typical doses

Cons

  • Not FDA-approved for depression, only for OCD

  • Strong CYP1A2 inhibitor with many drug interactions (caffeine, clozapine, theophylline)

  • Higher rates of nausea and insomnia than Remeron

  • Often requires twice-daily dosing at higher doses

Remeron

Remeron is approved for a broader condition, major depressive disorder, and its sedating effect can help patients whose depression includes insomnia. It has fewer drug interaction concerns than Luvox but carries its own risks around weight gain and rare blood cell effects.

Pros

  • Approved for major depressive disorder, a broader use than Luvox's OCD approval

  • Sedating effect can help with insomnia related to depression

  • Simple once-daily bedtime dosing with only three dose levels

  • Fewer significant drug-drug interactions than Luvox

Cons

  • Not approved for use in pediatric patients at any age

  • Higher risk of weight gain and increased appetite

  • Boxed risk of rare but serious neutropenia/agranulocytosis

  • Sedation can be more pronounced at lower doses, affecting daytime function

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