FLUVOXAMINE OPEN-LABEL TREATMENT OF ADOLESCENT INPATIENTS WITH OBSESSIVE-COMPULSIVE DISORDER OR DEPRESSION

Objective: Fluvoxamine, a monocyclic, specific serotonin uptake inhibi tor with demonstrated efficacy in obsessive-compulsive disorder (OCD) and depression in adults, is marketed in more than 30 countries worldw ide, including Israel. in the United States, where fluvoxamine is avai lable only on an investigational basis, marketing appears imminent. Th is study evaluates the safety and efficacy of fluvoxamine in adolescen ts. Method: In an 8-week, open-label trial of fluvoxamine, 20 adolesce nt inpatients, ages 13 to 18 years, were treated for OCD (n = 14) or m ajor depressive disorder (MDD)(n = 6) with daily doses ranging from 10 0 to 300 mg. Target symptoms were rated at regular intervals with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS); Suicide Potential Scal es (SPS); Beck Depression Inventory (BDI); the Overt Aggression Scale (OAS); and the Children's Global Adjustment Scale (CGAS). Results: Flu voxamine proved relatively safe and was especially effective in the pa tients with OCD; mean Y-BOCS scores decreased significantly (p < .0001 ) from 28.0 to 19.8 on medication. Although fluvoxamine also appeared effective in decreasing depression and bulimic symptoms, its impact on impulsive, suicidal, and anorectic symptoms was less clear. The commo nest side effects (n greater-than-or-equal-to 3) were dermatitis, inso mnia, hyperactivity, excitement, anxiety, tremor, and nausea. Fluvoxam ine was discontinued in four patients because of side effects; the mos t serious side effect occurred in two debilitated anorexic patients, o f whom one became delirious and the other developed hallucinations. Co nclusion: Preliminary evidence suggests that short-term treatment of a dolescents with fluvoxamine is relatively safe and may be effective fo r OCD and some affective spectrum symptoms.