Key points
- The FDA labels for fluvoxamine tablets and extended-release capsules list one approved use: obsessive-compulsive disorder (OCD).
- Depression and social anxiety disorder are not on those labels, so they are off-label uses.
- Several medicines must not be combined with it, including tizanidine, thioridazine, alosetron, pimozide and MAOIs.
- The boxed warning covers suicidal thoughts and behaviors in children, teens and young adults.
- Stopping suddenly can cause withdrawal symptoms, so talk with your prescriber before any change.
What fluvoxamine is
Fluvoxamine is an antidepressant in the group called selective serotonin reuptake inhibitors, or SSRIs. MedlinePlus says it comes as a tablet and an extended-release capsule. Each form has its own FDA label.
This page is general information. It does not replace the Medication Guide that comes with a prescription.
What fluvoxamine is approved for, and off-label uses
Both labels list one approved use: obsessive-compulsive disorder (OCD). The tablet label describes OCD as recurrent unwanted thoughts or repeated behaviors that cause marked distress, take up time or interfere with work or social life.
Off-label means a use not on the FDA label. MedlinePlus says fluvoxamine is used for social anxiety disorder and sometimes for depression. Neither is on the FDA labels, so both are off-label. MedlinePlus asks people to talk with their doctor about the possible risks of using it for depression.
For under-18s, the tablet label is approved only for OCD, based on a trial in ages 8 to 17. The extended-release label says the capsules have not been evaluated in pediatric patients.
How fluvoxamine is thought to work
The label says its action in OCD is presumed to be linked to blocking the reuptake of serotonin, a natural chemical messenger, in brain cells. It also says fluvoxamine had no significant affinity for several other receptor types in lab studies.
The label describes fluvoxamine as a potent inhibitor of an enzyme called CYP1A2, which the body uses to process other medicines. This helps explain why its interaction list is so long, and it is the feature of this medicine worth knowing first.
Medicines that interact with fluvoxamine
Interactions are the most distinctive part of this label. Combining some of these can raise the level of the other medicine sharply, so a complete, current medicine list is the most useful thing to bring to a prescriber.
- Contraindicated on both labels: tizanidine, thioridazine, alosetron and pimozide.
- Ramelteon: contraindicated on the extended-release label. The tablet label says it should not be used in combination.
- MAOIs: contraindicated with fluvoxamine, or within 14 days of either one ending, because of serotonin syndrome. This includes linezolid and intravenous methylene blue.
- Use with caution or monitoring: some benzodiazepines such as alprazolam, and the label says diazepam is generally not advisable. Also clozapine, methadone, mexiletine, theophylline and warfarin.
- Other serotonin-affecting medicines, such as triptans, lithium, opioids, tryptophan and St. John's wort, raise the risk of serotonin syndrome.
What taking fluvoxamine can be like
MedlinePlus says it may take several weeks or longer to feel the full benefit, and that people should keep taking it even when they feel well. It also says the extended-release capsules should be swallowed whole. The label asks for close watching on mood and behavior, especially early on and at dose changes. It also notes that smoking changes how quickly the body processes fluvoxamine, so mention it if you smoke.
Do not stop fluvoxamine suddenly. MedlinePlus lists withdrawal symptoms such as irritability, agitation, dizziness, extreme worry, confusion, headache, tiredness, mood changes, trouble sleeping and electric-shock sensations. Talk with your prescriber first.
Side effects and warnings for fluvoxamine
Boxed warning: antidepressants increased the risk of suicidal thinking and behavior in children, teens and young adults in short-term studies. Studies did not show an increase in adults over 24, and showed a reduction at 65 and older. People of all ages should be watched closely for worsening, suicidal thoughts or unusual behavior changes, and families and caregivers are asked to help. If you are in crisis, call or text 988, or call 911. Locascio Wellness does not provide emergency services. Our crisis resources list more options.
The tablet label's most common side effects are nausea, sleepiness, trouble sleeping, weakness, nervousness, indigestion, ejaculation problems, sweating, decreased appetite, tremor and vomiting. The extended-release label also lists diarrhea and difficulty having an orgasm.
Other warnings on the labels include serotonin syndrome, a potentially life-threatening reaction, plus bleeding risk with NSAIDs, aspirin or warfarin. They also cover mania or hypomania, seizures, angle-closure glaucoma, low sodium and sexual problems. If you are pregnant, may become pregnant or are breastfeeding, tell your prescriber.
Can fluvoxamine be managed online in Pennsylvania and New York
The tablet label says fluvoxamine is not a controlled substance. A licensed psychiatrist on our team, a Doctor of Osteopathic Medicine, treats anxiety and depression by secure video for people physically located in Pennsylvania or New York during each visit. OCD is not named among those conditions, so ask us if OCD is your main concern. See online psychiatry in Pennsylvania or in New York.
Whether it is an option for you is a decision for you and your prescriber. Ask us whether our psychiatrist can help, using our contact form. Fees, insurance and the ages he sees are also things to ask us. Our therapists do not prescribe, and they see clients in Pennsylvania, West Virginia, Arizona, Colorado and Florida, not New York. In New York, psychiatry is available here but therapy is not.
Common questions
Is fluvoxamine approved for depression or anxiety?
No. The FDA labels list only obsessive-compulsive disorder. MedlinePlus says it is used for social anxiety disorder and sometimes for depression, which are off-label uses. Your prescriber can explain how the evidence and labeling apply to you, and what other options exist.
Why does fluvoxamine interact with so many medicines?
The label describes it as a potent inhibitor of CYP1A2, an enzyme the body uses to process other medicines, and it says it also inhibits other enzymes, including CYP3A4 and CYP2C19. That can raise levels of those medicines, sometimes sharply. Your prescriber and pharmacist need a full list of what you take, including over-the-counter products and supplements.
What should I tell my prescriber before taking fluvoxamine?
Share every medicine and supplement you take, especially tizanidine, thioridazine, alosetron, pimozide, ramelteon, MAOIs, benzodiazepines and blood thinners. Mention any personal or family history of bipolar disorder, plus seizures, glaucoma and whether you smoke. If you are pregnant, may become pregnant or are breastfeeding, tell your prescriber.
Sources
Published by Locascio Wellness. Published November 5, 2026. Clinically reviewed by Kenneth M. Levy, DO, Psychiatrist (Pennsylvania license OS007464L). This page is general information, not medical advice or a diagnosis.