# Structural Biochemistry/Luvox
## Overview

The drug Luvox is a selective serotonin reuptake inhibitor (SSRI) with the generic name Fluvoxamine Maleate and the chemical name : 5-methoxy-4’-(trifluoromethyl)valerophenone-(E)-O-(2-aminoethyl)oxime maleate (1:1). It can be used in the treatment of chronic depression, obsessive compulsive disorder (OCD) and social anxiety disorders. The drug works to increase the amount of serotonin in the brain in order to ward off feelings of depression, anxiety, and fear. Serotonin is a naturally produced neurotransmitter in the body that maintains mental balance and feelings of calm or happiness.
The drugs comes in a tablet form and has approximately 80% of fluvoxamine bound to plasma protein, consisting of mostly albumin, over a concentration range of 20 to 2000 ng/mL. The absolute bioavailability of fluvoxamine maleate is 53%. The tablet should be taken orally by mouth without crushing or chewing them. Dosages are usually prescribed by doctors starting with low doses and gradually increasing the amount over time. The full effect of the drug may take up to several weeks to start working.

## Biochemical Interactions

Fluvoxamine maleate is extensively metabolized by the liver. The main human metabolite is fluvoxamine acid and the drug has a half-life of 15.6 hours in the body. The drug targets chemical imbalances in the brain to help treat chronic depression.
Between the synapse and a nerve cell, there is an exchange of neurotransmitters. Serotonin is one of these neurotransmitters that can send messages between nerve cells. The nerve cells contain reuptake channels that can reabsorb neurotransmitters when their job has been performed and they are no longer needed. When the message exchange is faster, serotonin spends less time in the synapse as it is taken back up faster, which is believed to cause depression. If the levels of serotonin in the body become unbalanced, OCD or other anxiety disorders can occur. SSRI drugs, like Luvox, can selectively bind to the reuptake channels of serotonin, therefore blocking the reuptake channels from reabsorbing serotonin. This causes the serotonin to remain in the synapse, thus helping to fight off feelings of depression. Studies have proved that Luvox is an effective drug to treat OCD in both adults and children.

## Side Effects

Some serious side effects include seizures, fever, and increased thoughts of suicide. Some of the more serious side effects include chest pain, coordination issues, dizziness, hallucinations, pain, loss of consciousness, difficulty breathing, and vomiting or excreting blood.
Other signs of an allergic reaction listed below may be encountered when taking this medication:
* skin rash or hives
* difficulty breathing
* swelling of face, lips, tongue, or throat
Individuals should immediately call the doctors if any new or worsening symptoms such as mood or behavior changes, anxiety, trouble sleeping, panic attacks, or if feeling impulsive. If you stop taking fluvoxamine suddenly, you may feel some withdrawal symptoms, which include irritability, dizziness, headaches, changes in mood, pain, difficulty in sleeping, or tingling in the extremities. Doctors should assist in decreasing doses gradually before you stop taking the drug.

## Precautions

Before taking fluvoxamine, it is important to inform the doctor or pharmacist if any kind of allergic affect can happen because this kind of medication contains inactive ingredients that can cause allergic reactions or other serious problems. Be wise when taking this kind of medicine. Remember to always tell the doctor of pharmacist of one's medical history especially that of family history disorder, personal history disorder, etc.
When taking this medication, remember that driving may be dangerous because dizziness may occur. Therefore, do not use machinery and do not drive. Also do not do any kind of activity that requires a good sense of alertness until one is sure that it is safe to perform that certain activity. Remember to never drink alcoholic beverages when taking fluvoxamine.
People of different ages may have different side effects of this drug. For example, older adults may be more sensitive to the side effects, especially that of bleeding. Taking water pills, older adults many develop a type of mineral imbalance in their body. Just like older adults, young people such as children may be more sensitive to the side effects of this drug. Children may encounter a lost of appetite and weight loss. Hence, it is important for parents to monitor their children weight and height while taking this medication.
Pregnant women who are taking fluvoxamine may harm their unborn baby in the stomach. Therefore, it is always better to ask the doctor before actually taking it. If a mother notice their three month baby having any of this symptoms listed below, they should immediately contact their baby doctor:
* feeding/breathing difficulties
* seizures
* muscle stiffness
* constant crying
Breast feeding mother should contact doctor.

## References

* ↑ http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000955/
* ↑ http://anxiety.emedtv.com/luvox/luvox-p2.html
* ↑ http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000955/
http://www.medicinenet.com/fluvoxamine/article.htm
https://online.epocrates.com
http://www.rxlist.com
http://online.factsandcomparisons.com