OBJECTIVETo modify the synthetic method of fluvoxamine.

METHODSFluvoxamine was synthesized from 4-trifluoromethylbenzonitrile by the steps of Grignard reaction, hydrolysis and oximation.

RESULTThe chemical structure of the synthesized product was confirmed by (1)HNMR, and the total yield reached to 36.16%.

CONCLUSIONThe results indicate that the synthetic route is practical.

Rabbit Syndrome is an uncommon side effect of antipsychotic treatment. Although it is usually associated with typical antipsychotics, it can also be related to atypical antipsychotics. Anticholinergics are the most accepted treatment approach in treating Rabbit Syndrome. Fluvoxamine is a member of selective serotonin reuptake inhibitors and it is a potent agonist of sigma 1 receptors. In this article, we report a Rabbit Syndrome case who has benefited from fluvoxamine, in terms of both depressive disorder and Rabbit Syndrome; and present the data on the effects of sigma 1 agonist fluvoxamine on numerous movement disorders.
Antipsychotic Agents ; Cholinergic Antagonists ; Depressive Disorder ; Fluvoxamine ; Movement Disorders ; Receptors, sigma ; Serotonin Uptake Inhibitors

Hyposexuality after stroke has been frequently observed, but hypersexuality as a sequela of stroke has not been commonly documented. We report a patient who exhibited hypersexuality and obsessive-compulsive behaviors after stroke in the region of the left mesial frontal cortex and both basal ganglia. At 2 months after stroke, he visited psychiatric unit due to these symptoms. His motor function was almost full recovered. He was treated with fluvoxamine and perphenazine, With two-month medication, his hypersexuality and obsessive-compulsive behavior disappeared. This case may indicate that basal ganglia-thalamocortical circuit plays an important role in the mediation of sexual behavior and obsessive-compulsive behavior. Since changes in sexual activity may not be spontaneously reported, a systemic inquiry into patient's sexual functioning after infarction in frontal lobe or basal ganglia is warranted.
Basal Ganglia* ; Depression ; Fluvoxamine ; Frontal Lobe ; Humans ; Infarction ; Negotiating ; Perphenazine ; Sexual Behavior ; Stroke*

OBJECTIVE: Obsessive-compulsive disorder (OCD) is one of the more common serious mental illnesses. Effective psychological and drug treatments are available for the distressing, time-consuming, repetitive thoughts and rituals and the associated functional impairment. The decision of a treatment, however, is not easy because of the various clinical features and many treatment options. Therefore, practice guidelines and algorithms have been developed in some countries to provide the proper information to clinicians. We sought to develop the Korean Treatment Algorithm Project for OCD 2007 (KTAP-OCD 2007). METHODS: The survey questionnaire based on the Expert Consensus Guideline Series-Obsessive Compulsive disorder (1997) and was developed through modification and review by a study group for the KTAP-OCD 2007. Twenty-four (70.6%) of the 34 members of the review committee completed the survey. RESULTS: For the initial treatment of OCD, all of the selective serotonin reuptake inhibitor (SSRI)monotherapies, cognitive-behavioral therapy (CBT), and SSRI+CBT were included in the first treatment options. Fluoxetine, sertraline, paroxetine, citalopram, and fluvoxamine were included among the available SSRIs. The treatment for resistant OCD, maintenance treatment, treatment for comorbidities, and CBT for various clinical symptoms were also evaluated by the questionnaire. DISCUSSION: Most experts presented a consensus opinion as to the initial treatment of OCD, some nonconsensual opinions were expressed and gaps occurred between research data and clinical usage in some steps. And there are some differences were seen between Western countries and Korea. The KTAP-OCD 2007 is the first algorithm developed for OCD treatment in Korea, and our hope is that the KTAP-OCD will assist clinicians and researchers.
Advisory Committees ; Ceremonial Behavior ; Citalopram ; Comorbidity ; Consensus ; Fluoxetine ; Fluvoxamine ; Hope ; Korea ; Obsessive-Compulsive Disorder* ; Paroxetine ; Surveys and Questionnaires ; Serotonin ; Sertraline

Fluvoxamine is a selective serotonin reuptake inhibitor that is approved for psychiatric disorders such as major depressive episodes and obsessive-compulsive disorder. Beside inhibition of serotonin reuptake, fluvoxamine is also a potent agonist of endoplasmic reticulum (ER) protein sigma-1 receptors, which play a role in the pathophysiology of a number of psychiatric and neurodegenerative disorders. This report presents beneficial effects of sigma-1 agonist fluvoxamine on hyperkinetic movement disorders such as tardive dyskinesia and tardive akathisia. Fluvoxamine might be a novel treatmet approach in the treatment of hyperkinetic movement disorders.
Akathisia, Drug-Induced* ; Dyskinesias ; Endoplasmic Reticulum ; Fluvoxamine* ; Humans ; Hyperkinesis ; Movement Disorders* ; Neurodegenerative Diseases ; Obsessive-Compulsive Disorder ; Psychomotor Agitation ; Receptors, sigma ; Schizophrenia* ; Serotonin

Nowadays newer antidepressants are commonly used in clinical practice, since they are as effective as tricyclic antidepressant, but show less adverse effects. However there are many unexpected adverse effects of these drugs. It is one of the most common causes of treatment failure. I reviewed these adverse effects and pharmacological management focusing on common but under-recognized adverse effects of newer antidepressant. I reviewed newer antidepressant-induced sleep related movement disorder, sweating, tremor, abnormal bleeding. In this paper, newer antidepressants include selective serotonin reuptake inhibitor (fluoxetine, fluvoxamine, citalopram, escitalopram, sertraline, paroxetine), serotonin norepinephrine reuptake inhibitor (venlafaxine, duloxetine), norepinephrine and dopamine reuptake inhibitor (bupropion), noradrenergic and specific serotonergic antidepressant (mirtazapine), and reversible inhibitor of monoamine oxidase A (moclobemide). I suggest that psychiatrists should know not only well-recognized but also under-recognized common adverse effects and their pharmacological management of newer antidepressants, so that it will be helpful to treat patients with psychiatric illness using newer antidepressants and to make better outcome.
Antidepressive Agents* ; Citalopram ; Dopamine ; Fluvoxamine ; Hemorrhage ; Humans ; Monoamine Oxidase Inhibitors ; Movement Disorders ; Norepinephrine ; Psychiatry ; Serotonin ; Sertraline ; Sweat ; Sweating ; Treatment Failure ; Tremor

Newer antidepressants are commonly used in clinical practice to treat psychiatric disorder and psychosomatic disorder including chronic pain syndrome, fibromyalgia, headache. However there are many unexpected adverse effects of these drugs such as nausea and vomiting, weight gain, sexual dysfunction. These are 3 most well-recognized common adverse effects of newer antidepressant and are most common causes of treatment failure. I reviewed mechanisms, epidemiology, and pharmacological management of these adverse effects of newer antidepressants. In this paper, newer antidepressants include selective serotonin reuptake inhibitor(fluoxetine, fluvoxamine, citalopram, escitalopram, sertraline, paroxetine), serotonin norepinephrine reuptake inhibitor(venlafaxine, duloxetine), norepinephrine and dopamine reuptake inhibitor(bupropion), noradrenergic and specific serotonergic antidepressant(mirtazapine), and reversible inhibitor of MAO-A(moclobemide). I suggest that psychiatrists and clinicians in the psychosomatic field should know mechanisms, epidemiology, and management of these common and well-recognized adverse effects of newer antidepressants. Therefore it will be helpful to recognize easily and treat well for patients with psychiatric disorder and psychosomatic disorder using newer antidepressants.
Antidepressive Agents ; Chronic Pain ; Citalopram ; Dopamine ; Epidemiology* ; Fibromyalgia ; Fluvoxamine ; Headache ; Humans ; Nausea* ; Norepinephrine ; Psychiatry ; Psychophysiologic Disorders ; Serotonin ; Sertraline ; Treatment Failure ; Vomiting* ; Weight Gain*

Legalized gambling is a growing industry, and is probably a factor in the presently increasing prevalence of pathological gambling. We present a case of a 36-year-old pathological gambler who was treated with fluvoxamine, a selective serotonin reuptake inhibitor, and who was assessed by functional MRI before and after drug administration. During activation periods, the pathological gambler was shown cards as stimuli, and fMRI results in several brain regions showed differential effects before and after medication and a maintenance period. This case demonstrates that the treatment response to fluvoxamine in a pathological gambler was observed not only by subjective self-report, but also by objective fMRI results. Therefore, fMRI may be a useful tool in the diagnosis and prediction of treatment response in patients afflicted with pathological gambling.
Adult ; Behavior, Addictive/*drug therapy ; Fluvoxamine/*therapeutic use ; *Gambling ; Humans ; Magnetic Resonance Imaging ; Male ; Serotonin Uptake Inhibitors/*therapeutic use ; Treatment Outcome

To observe the clinical efficacy of dopamine modulator methylphenidate (MPH) of extended-release formulations (MPH-ER) augmentation of ongoing fluvoxamine treatment in refractory obsessive-compulsive disorder (OCD) and its effects on patient's anxiety and sleep quality.
 Methods: A pilot randomized, placebo-controlled, and double-blind trial was conducted at an outpatient, single-center academic setting. Participants included 44 adults with serotonin reuptake inhibitor treatment-refractory OCD and they received a stable fluvoxamine pharmacotherapy with Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores higher than 20. The 44 patients were randomly assigned into a study group and a control group, with 22 patiencs in each group. Fluvoxamine and MPH-ER were given to the study group, while fluvoxamine and placebo were given to the control group, with 8 weeks of the treatment course. Y-BOCS, Hamilton Anxiety Scale (HAMA) were used to assess the efficacy, Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality, and Treatment Emergent Symptom Scale (TESS) was used to evaluate the side effects. Data were analyzed in the intention-to-treat sample.
 Results: The improvement in the Y-BOCS total score, Y-BOCS obsession subscale score and HAMA score were more prominent in the study group than those in the control group (P<0.001). There was no significant difference in PSQI score and TESS score between the two groups. MPH-ER was well tolerated.
 Conclusion: Fluvoxamine combined with MPH-ER is effective in the treatment of refractory obsessive-compulsive disorder. It can improve anxiety and has no adverse effect on sleep quality.
Adult ; Double-Blind Method ; Drug Therapy, Combination ; Fluvoxamine ; therapeutic use ; Humans ; Methylphenidate ; therapeutic use ; Obsessive-Compulsive Disorder ; drug therapy ; Psychiatric Status Rating Scales ; Treatment Outcome

The clinical efficacy of serotonin reuptake inhibitors such as clomipramine in the treatment of obsessive compulsive disorder(OCD) has fueled interest in the neurobiological basis of the illness. OCD is responsive exclucively to potent serotonin reuptake clomipramine, fluoxetine, fluvoxamine, sertraline, and paroxetine and the point forms the important evidence supporting a cental role for serotonin in the pathogenesis of the disorder. Other serotonergic medications such as lithium, buspirone, trazodone, or fenfluramine may be useful as adjuvant treatments in treatment-refractory OCD and adjuvant antipsychotics are useful in tic disorder, personality disorders, and psychotic disorders. This paper reviews results of treatment studies, investigations of biological markers, and neuroendocrine challenges and implications for the role of serotonin in pathophysiology and treatment of OCD.
Antipsychotic Agents ; Biomarkers ; Buspirone ; Clomipramine ; Fenfluramine ; Fluoxetine ; Fluvoxamine ; Lithium ; Obsessive-Compulsive Disorder ; Paroxetine ; Personality Disorders ; Psychotic Disorders ; Serotonin Uptake Inhibitors ; Serotonin* ; Sertraline ; Tic Disorders ; Trazodone