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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Is The Treatment For Extreme Depression?

What is the maximum allowed dosage of fluvoxamine for healthy 30 year old man? Is it safe to have 200 mg fluvoxamine per day ?

Hi, at the age of 23 I was having Fluoxamine per day 175mg to 200mg ( morning 1.5 (75mg), afternoon - 0 and night 2 ( 100mg) ) for Depression, OCD, ADD and social anxiety. In this dosage i was feeling very well and happy. Along with that i was also having Alzolam 0.25 mg per day. I was continuing this for 5 years. In between i sometimes stop medication completely and whenever i feel discomfort i restart the medication.

Later on i switched to Venlafaxine and then to Sertraline thinking that it could give me much better benefits however it didnt' work that well with me. I don't know whether it is because of lower dosage of what i am having. Currently i am having sertraline 25mg per day however it gives me side effects like on interest in sex, feeling sleepy, etc.

Around 9 months back i was having Crestor 10mg per day for cholesterol but now i have stopped it.

Now i want to switch again to Fluvoxamine as i think this was working well with me than any other medicine but in a higher dosage. Is it safe to have 200 mg or 175 mg per day ? I am a 30 yr old health male.
Tue, 12 Aug 2014
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Psychiatrist 's  Response
Hi, thanks for the query. First & foremost I would strongly urge you to NOT to change/switch any medication on your own & what ever are your issues with current set of medications should be discussed & dealt with only under supervision of a qualified medical doctor preferably a Psychiatrist. I am using strong words since all these aforementioned medications come under category of SSRI/SNRI & taking 2 SSRI together can cause a potentially dangerous condition named serotonin syndrome; while abruptly stopping any or all of these medications cause a flu like discontinuation syndrome; not to mention flaring up the symptoms of original illness (OCD; Depression in your case). Coming to your query; Fluvoxamine is a very good choice for controlling symptoms of both OCD & Depression & maximum permissible dose of Fluvoxamine is 300mg/day in a healthy person; so depending upon your symptom response; 175-200mg/day is perfectly fine. I would like to know your symptom profile of both OCD & depression so that I can advice whether we can plan for additional therapy in addition to medications for quicker response. Good Luck
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What Is The Treatment For Extreme Depression?

Hi, thanks for the query. First & foremost I would strongly urge you to NOT to change/switch any medication on your own & what ever are your issues with current set of medications should be discussed & dealt with only under supervision of a qualified medical doctor preferably a Psychiatrist. I am using strong words since all these aforementioned medications come under category of SSRI/SNRI & taking 2 SSRI together can cause a potentially dangerous condition named serotonin syndrome; while abruptly stopping any or all of these medications cause a flu like discontinuation syndrome; not to mention flaring up the symptoms of original illness (OCD; Depression in your case). Coming to your query; Fluvoxamine is a very good choice for controlling symptoms of both OCD & Depression & maximum permissible dose of Fluvoxamine is 300mg/day in a healthy person; so depending upon your symptom response; 175-200mg/day is perfectly fine. I would like to know your symptom profile of both OCD & depression so that I can advice whether we can plan for additional therapy in addition to medications for quicker response. Good Luck