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What are the side effects of Fluvoxin and Clonil?

Thursday, 07 January 2010
Answered by: Dr Chandra M Gulhati
Editor, MIMS, New Delhi
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Q. I am a 34 years old man suffering with obsessive-compulsive disorder (OCD) and taking Fluvoxin and Clonil for the same. Is it true that after taking these medicines for a couple of years I will become dull and suffer memory loss? If yes, then what can I do avoid its side effects?

A.  Fluvoxin is the brand name; the name of the medicine is fluvoxamine (also sold under other brand names such as Sorest and Uvox). Similarly Clonil contains clomipramine. Unfortunately you have not given the dosage of the two drugs. Fluvoxin (fluvoxamime) increases the blood level of Clonil (clomipramine) from 15% to as much as 500% (and even 1000% in some patients) and hence the dose must be adjusted downwards to avoid toxicity. It is better to give desipramine instead of clomipramine since the blood level of desipramine is only slightly and marginally affected. An attempt should always be made to gradually reduce the dose of anti-psychotics (or at least change the drug) to avoid adverse effects due to prolonged use.

The list of side effects that may be seen in some patients given Fluvoxin include worsening of depression, suicidal tendency, headache, malaise, palpitations, asthenia, dizziness, sweating, anxiety, nervousness, tremor, convulsions, urinary frequency, abnormal ejaculation in males, decreased libido, rhinitis, taste perversion; severe agitation-type events including agitation, disinhibition, emotional lability, hostility, aggression & depersonalisation; teeth grinding, abnormal bleeding; serotonin syndrome, neuroleptic malignant syndrome (NMS)-like reactions, which can be quite serious.

A.  Fluvoxin is the brand name; the name of the medicine is fluvoxamine (also sold under other brand names such as Sorest and Uvox). Similarly Clonil contains clomipramine. Unfortunately you have not given the dosage of the two drugs. Fluvoxin (fluvoxamime) increases the blood level of Clonil (clomipramine) from 15% to as much as 500% (and even 1000% in some patients) and hence the dose must be adjusted downwards to avoid toxicity. It is better to give desipramine instead of clomipramine since the blood level of desipramine is only slightly and marginally affected. An attempt should always be made to gradually reduce the dose of anti-psychotics (or at least change the drug) to avoid adverse effects due to prolonged use.

The list of side effects that may be seen in some patients given Fluvoxin include worsening of depression, suicidal tendency, headache, malaise, palpitations, asthenia, dizziness, sweating, anxiety, nervousness, tremor, convulsions, urinary frequency, abnormal ejaculation in males, decreased libido, rhinitis, taste perversion; severe agitation-type events including agitation, disinhibition, emotional lability, hostility, aggression & depersonalisation; teeth grinding, abnormal bleeding; serotonin syndrome, neuroleptic malignant syndrome (NMS)-like reactions, which can be quite serious.

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