Fluvoxamine monotherapy for psychotic depression: the potential role of sigma-1 receptors

Psychotic depression is a clinical subtype of major depressive disorder. A number of clinical studies have demonstrated the efficacy of the combination of an antidepressant (for example, a tricyclic antidepressant or selective serotonin reuptake inhibitor (SSRI)) and an atypical antipsychotic or electroconvulsive therapy in treating psychotic depression.

In some cases, the clinician or patient may prefer to avoid antipsychotic drugs altogether because of the risk of extrapyramidal side effects (EPS) in patients with psychotic depression treated with these drugs.

Methods: We report five cases where fluvoxamine monotherapy was effective in the patients with psychotic depression.

Results: The scores on the Hamilton Depression (HAM-D) scale and the Brief Psychiatric Rating Scale (BPRS) in the five patients with psychotic depression were reduced after fluvoxamine monotherapy.

Conclusion: Doctors should consider fluvoxamine monotherapy as an alternative approach in treating psychotic depression because it avoids the risk of EPS from antipsychotic drugs.

Author: Tsutomu FuruseKenji Hashimoto
Credits/Source: Annals of General Psychiatry 2009, 8:26

Published on: 2009-12-21

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Comments Page 1 of 1

Ann Blake-Tracy, PhD

Posted 884 days ago

Well fluvoxamine did a GREAT job of CREATING psychotic depression in Eric Harris the lead shooter at Columbine High School! Sure makes any suggestion of using this or any SSRI for that treatment suspect, doesn't it? Malcomb Bowers of Yale reports the similarity of SSRIs to LSD and we wonder where the psychosis might come from? Study the work of Dr. Felix Sulman and find that ELEVATED serotonin levels are common in both mania and psychosis and you will understand why so many patients are going manic and psychotic on SSRIs.

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