FLUVOXAMINE MALEATE (Luvox) Side Effects Guide

Table of Contents

Luvox (Fluvoxamine) Side Effects: Real Patient Data, FDA Trials, and Alternatives

Side Effects Overview Table

How Other Drugs Compare

Week-by-Week Timeline

Why Doctors Still Prescribe Luvox

The Worst Side Effects

The Most Common Side Effects

Deep Dive: Feeling Very Tired or Drowsy

Deep Dive: Headaches

Discontinuation & Withdrawal

Dosage by Condition

Alternatives

Clinical Trials

Decision Map

Monitoring & What to Track

Pregnancy & Breastfeeding

Emergency Warning Signs

Summary & Next Steps

Appendix A: FDA Label Data Summary

Appendix B: Reddit User-Reported Side Effects

Appendix C: Clinical Trials with Different Mechanisms

Appendix D: Methodology

Sources

Luvox (Fluvoxamine) Side Effects: Real Patient Data, FDA Trials, and Alternatives

Side Effects Overview Table

How Other Drugs Compare

Week-by-Week Timeline

Why Doctors Still Prescribe Luvox

The Worst Side Effects

The Most Common Side Effects

Deep Dive: Feeling Very Tired or Drowsy

Deep Dive: Headaches

Discontinuation & Withdrawal

Dosage by Condition

Alternatives

Clinical Trials

Decision Map

Monitoring & What to Track

Pregnancy & Breastfeeding

Emergency Warning Signs

Summary & Next Steps

Appendix A: FDA Label Data Summary

Appendix B: Reddit User-Reported Side Effects

Appendix C: Clinical Trials with Different Mechanisms

Appendix D: Methodology

Sources

In-depth guide to Luvox (fluvoxamine) side effects, drawing on FDA trial data and real patient reports. Covers top issues, coping strategies, and new alternatives.

Medication: Luvox (FLUVOXAMINE MALEATE) Drug Class: Antidepressant Author: Michael Baskerville Gill, B. Sc.

Reviewed by the Power Medical Content Team

Luvox (Fluvoxamine) Side Effects: Real Patient Data, FDA Trials, and Alternatives

Day 1: That unmistakable nausea. Day 3: Drowsiness so thick you could nap through your own alarm. Week 2: Jitters, maybe a tremor. Sometimes you can't sleep, sometimes you can't keep your eyes open. Sound familiar? Welcome to Luvox.

Luvox (fluvoxamine maleate) is a classic antidepressant—specifically, a selective serotonin reuptake inhibitor (SSRI, which raises serotonin (a mood-regulating brain chemical) levels by preventing its reabsorption). It's been a mainstay for OCD and depression for decades. About 34% of clinical trial patients reported nausea; 35% couldn't sleep; 27% were too sleepy—and that's just for starters FDA label.

Yet, for many, it's the first SSRI that finally cracks obsessive-compulsive cycles. For others, the side effects are a dealbreaker. And in real life? Reddit is full of users saying, "I would fall asleep in class," or "HORRIBLE sweating, decreased appetite, weakness..." source.

There are plenty of antidepressants. Why stick with a drug whose side effect profile reads like a medical dictionary? Because for some, nothing else works—or at least not as well. But for those struggling, new clinical trials might finally offer another way forward.

Interested in clinical trials? Many trials for depression now target different mechanisms than Antidepressant—potentially offering different side effect profiles. Browse clinical trials →

Side Effects Overview Table

Side Effect	FDA Rate	Reddit Reports	Severity	Duration	Example
Feeling very tired or drowsy	27%	🔴 very_frequent (10 posts)	🟡 Moderate	Ongoing or weeks	source
Sexual side effects	11%	🟡 occasional (3 posts)	🟢 Mild	While on med	source
Headaches	32%	🟡 occasional (3 posts)	🟡 Moderate	Weeks, sometimes ongoing	source
Nausea and upset stomach	34%	🟡 occasional (3 posts)	🟡 Moderate	Days to weeks	source
Difficulty falling or staying asleep	35%	🟡 occasional (3 posts)	🟢 Mild	Days to weeks	source
Tremors or shakiness	6%	🟡 occasional (3 posts)	🟡 Moderate	1-2 weeks, sometimes ongoing	source
Excessive sweating	7%	🟢 rare (2 posts)	🟠 Severe	Ongoing	source
Decreased appetite	13%	🟢 rare (2 posts)	🟢 Mild	Days to weeks	source
Dizziness or lightheadedness	12%	🟢 rare (2 posts)	🟡 Moderate	Days, withdrawal	source
Diarrhea	18%	🟢 rare (2 posts)	🟢 Mild	Days	source
Feeling weak or lacking strength	26%	🟢 rare (2 posts)	🟢 Mild	Days to weeks	source
Withdrawal symptoms	N/A	🟢 rare (2 posts)	🟡 Moderate	Few days - week	source
Nightmares or vivid dreams	3%	🟢 rare (1 post)	🟢 Mild	Ongoing	source
Easy bruising	4%	🟢 rare (1 post)	🟢 Mild	Ongoing	source
Jaw clenching	N/A	🟢 rare (1 post)	🟢 Mild	Days to weeks	source

→ View all 97 side effects from FDA trials → View all 15 user-reported side effects

How Other Drugs Compare

If you're weighing options, here's how Luvox (fluvoxamine) stacks up against alternatives:

Metric	Luvox (Antidepressant)	Bupropion (NDRI)	CYB003 (Psilocybin analogue)	Osavampator (AMPA-PAM)
MECHANISM
Drug class	SSRI	NDRI (Norepinephrine/Dopamine Reuptake Inhibitor)	Deuterated psilocybin analogue (Psychedelic-derived)	AMPA receptor positive allosteric modulator
How it works	Blocks serotonin reuptake transporter (prevents reabsorption of serotonin)	Inhibits reuptake of norepinephrine/dopamine	Agonist at 5-HT2A receptor (psychedelic effect, resets mood circuits)	Enhances AMPA receptor response (glutamate-mediated mood boost)
EFFICACY
Response rate	~45-60% (SSRI class, MDD trials) source	~60% source	53.3% (3 weeks) source	Not reported yet source
Remission rate	~30% (SSRI class, MDD)	~35%	75% at 4 months source	Not reported yet
Time to effect	4-6 weeks typical	2-4 weeks	1-3 weeks	Possibly faster
KEY SIDE EFFECTS
Feeling tired/drowsy	27%	3%	N/A	N/A
Sexual dysfunction	11%	<5%	0% reported in trials	0% reported
Nausea	34%	9%	8-15% (transient)	0-2%
Sweating	7%	2%	0%	0%

→ Find clinical trials matched to your situation

Week-by-Week Timeline

Week	Common Experiences	What's Normal	When to Call Your Doctor
Week 1	Nausea, headache, jitters, sleepiness	Startup effects	Severe anxiety, suicidal thoughts
Week 2-3	Sleep changes, appetite loss, tremors	Still adjusting	Worsening depression
Week 4-6	May start feeling benefits	Gradual improvement	No improvement at all
Week 6-8	Full effect usually reached	Stable	Intolerable side effects

Most side effects peak in Week 1-2 and improve by Week 4.

If you're still struggling at Week 8, it may be time to consider alternatives.

→ Explore clinical trials with faster onset

Why Doctors Still Prescribe Luvox

Let’s be blunt: fluvoxamine isn’t beloved for its side effects. It’s here because of what it does—not just what it ruins. Mechanistically, Luvox acts as a selective serotonin reuptake inhibitor (prevents the brain from reabsorbing the serotonin neurotransmitter at synapses—those gaps between nerve cells—so serotonin lingers longer, smoothing mood and (sometimes) cutting obsessive thoughts).

So why so many side effects? Because serotonin is everywhere: in your gut (nausea), your sweat glands (sweating), and your brain’s sleep-wake systems (insomnia, drowsiness). You want only your OCD dialed down; you get drowsy, dry-mouthed, asexual and sometimes strangely obsessed with naps. It’s the classic bargain: symptom relief at the cost of mild-to-moderate system-wide interference.

And why does this drug stick around? We know its risks. But it’s been around for decades, so its dangers are less likely to surprise—no new scary signals, no hidden fatal flaws. For some, that’s worth a lot.

The Worst Side Effects

"The worst part for me was the drowsiness. I would fall asleep in class." source Reported as moderate to severe by 6 out of 10 users; this is the single most disabling side effect according to real patients. For many, it fades after the first few weeks, but others change dose timing or switch meds.

Management tip: Try taking Luvox at night if you’re overwhelmingly sleepy, or split your dose (with doctor approval).

Excessive Sweating

"HORRIBLE sweating, decreased appetite, weakness, dizziness, diarrhea, ..." source Severity: reported as severe (1/2 posts mentioning sweating); some patients say it never goes away until they stop Luvox.

Management tip: Dress in layers, use antiperspirants, and avoid spicy foods or hot drinks. Sometimes switching to another SSRI or lowering the dose helps.

Headache and Nausea

"I am extremely nauseous and have a horrible headache." source Often appear together, especially in the first week. Reported as moderate by 2/3 users mentioning each. Usually improve over the first two weeks.

Management tip: Take with food, stay hydrated, consider a ginger supplement (but check drug interactions).

How Clinical Trials Compare

Drowsiness/somnolence: 27% (Luvox) vs 0-3% (bupropion, newer trials)
Sweating: 7% (Luvox) vs 0-2% (most new antidepressant trials)
Headache and nausea: 32%/34% (Luvox) vs 8-15% (psilocybin and related agents)

In CYB003 trials: No sexual dysfunction, sedation, or persistent nausea reported CYB003 phase 2.

→ Find trials with lower rates of these side effects

The Most Common Side Effects

Here’s where the statistics and the actual stories match up. The most common Luvox side effects aren’t subtle—and some, like drowsiness, are so cliché that users start making memes.

Feeling very tired or drowsy
- FDA: 27% report somnolence (drowsiness) FDA label
- Reddit: 🔴 very_frequent (10/15 posts, moderate severity)
- What helps: Switch to night dosing, avoid alcohol, and see if it fades after 2-4 weeks
- Timeline: Improves for some, persists for others
- Sample quote: “The worst part for me was the drowsiness. I would fall asleep in class.” source
Insomnia / Difficulty sleeping
- FDA: 35%
- Reddit: 🟡 occasional (3/15 posts, mild severity)
- What helps: Take dose in the morning if insomnia is a problem, avoid caffeine after noon
- Timeline: Often improves after a couple weeks
- Sample quote: “I have noticed some lack of sleep but I don't think that is caused by the medication.” source
Nausea / upset stomach
- FDA: 34%
- Reddit: 🟡 occasional (3/15 posts, moderate severity)
- What helps: Take with food, hydrate, try ginger
- Timeline: First week or two, usually fades
- Sample quote: “I am extremely nauseous and have a horrible headache.” source
Headaches
- FDA: 32%
- Reddit: 🟡 occasional (3/15 posts, moderate severity)
- What helps: Hydrate, over-the-counter painkillers (as approved)
- Timeline: Often only in startup phase
- Sample quote: “I was on fluvoxamine for several weeks and it made me very tired and giving me headaches, so I had to change to a different antidepressant.” source
Tremors or shakiness
- FDA: 6%
- Reddit: 🟡 occasional (3/15 posts, moderate severity)
- What helps: Split dosing, magnesium supplements (consult doctor)
- Timeline: Peaks in week 1, often fades
- Sample quote: “I was super shaky at first, about a week or two. It was really bad though, I literally could not sit still.” source
Sexual dysfunction
- FDA: 11% (all types)
- Reddit: 🟡 occasional (3/15 posts, mild severity)
- What helps: Switching to bupropion, trying drug holidays (only with doctor supervision)
- Timeline: Persists as long as on med
- Sample quote: “I do have some sexual dysfunction with it but it's manageable.” source
Sweating
- FDA: 7%
- Reddit: 🟢 rare (2/15 posts, severe in one case)
- What helps: Cooling clothing, dose reduction
- Timeline: Can persist
- Sample quote: “HORRIBLE sweating, decreased appetite, weakness, dizziness, diarrhea...” source

Deep Dive: Feeling Very Tired or Drowsy

The sheer prevalence of drowsiness with Luvox is impossible to ignore—it's not just a medical label line, it's something real patients complain about the most. Reddit users describe “falling asleep in class” source, or being “a little more sleepy but not too much so yes it was manageable” source.

FDA trials reported somnolence (medical term for abnormal drowsiness) in 27% of patients, but among online user reports it’s both more nuanced and more disruptive: severity ranges from barely noticeable to a reason for missing school or work, with 6/10 users rating it moderate or worse. Some manage by switching to night dosing; others find the sleepiness fades after a few weeks. For a subset, however, "the drowsiness never goes away" source.

What helps:

Take Luvox at night (if approved by your doctor)
Split dosing for steadier blood levels
Watch for additive sedative effects if combined with other drowsiness-inducing medications
Consider alternatives if drowsiness remains intolerable after a month

In summary: Luvox drowsiness is common, sometimes debilitating, and for many, manageable—if you're lucky enough to be in the right subgroup. Always worth a trial of night dosing before giving up.

Deep Dive: Headaches

"I am extremely nauseous and have a horrible headache." source That quote sums up Luvox headaches perfectly: sudden, intense, and likely to show up in your very first week. FDA data puts headache at 32% and nausea at 34%—but only 3/15 users in Reddit reports described headaches as more than mild, most reporting moderate severity (and always paired with other early startup effects).

A different user noted, "giving me headaches, so I had to change to a different antidepressant" source. For others, it's all over by week two, no Advil needed.

What helps:

Take Luvox with food and water
Hydration and small, frequent meals (to avoid sharp swings in blood sugar, which can make headaches worse)
NSAIDs (like ibuprofen) as approved by your doctor
If headaches don’t resolve by week 3, discuss with your clinician

Bottom line: For most, it’s a transient startup nuisance. For the unlucky, it’s a fast track to switching drugs.

Discontinuation & Withdrawal

Roughly 20-25% of SSRI users experience withdrawal symptoms if they stop suddenly, and Luvox is no exception FDA label. Symptoms include dizziness, nausea, lethargy, sleep disturbances, mood swings, “brain zaps” (those weird electrical sensations), and sometimes even hypomania.

“I will note to be careful not to run out or stop taking it suddenly, because there are withdrawal symptoms (dizziness, lightheadedness, nausea...).” source

Luvox’s half-life (how long the drug stays active in your body) is relatively short—about 15-22 hours—so symptoms can hit quickly, usually within a day or two. Why does this matter? Shorter half-life means higher withdrawal risk unless you taper. Gradually reducing your dose over several weeks, never abruptly, is best practice—especially since some patients report protracted symptoms.

Management tips:

Always taper, under supervision
Decrease by 25mg every 1-2 weeks (for higher doses, go even slower at the end)
Watch for withdrawal effects (keep a log)

Timeline: Most symptoms resolve in 1-2 weeks post-taper; some report ongoing dizziness or fatigue if withdrawal is rushed.

Dosage by Condition

Condition	Starting Dose	Typical Dose	Maximum Dose
OCD (adults)	50mg at bedtime	100-300mg daily (divided or single dose)	300mg daily
OCD (children 8-17 yrs)	25mg at bedtime	50-200mg daily (divided or single dose)	200mg daily (8-11 yrs), 300mg (12-17 yrs)
Depression (adults)	50mg at bedtime	100-300mg daily	300mg daily

Doses above 100mg should be split due to absorption quirks and tolerability. Higher doses increase the odds of side effects—especially drowsiness, nausea, and insomnia. Always titrate (increase dose gradually) with doctor guidance.

Find Top Clinical Trials

Choose from over 30,000 active clinical trials.

Alternatives

FDA-approved options for depression and OCD:

Bupropion (NDRI): Generally activating; avoids sexual side effects but can raise anxiety. Not used for OCD.
SNRIs (e.g., venlafaxine, duloxetine): Affect both serotonin and norepinephrine (brain chemicals for mood and alertness). More likely to cause blood pressure issues but can be a good fit if SSRIs aren't enough.
MAOIs: Older, require dietary restrictions, useful in treatment-resistant cases.
TMS (Transcranial Magnetic Stimulation): Device-based, minimal systemic side effects.
Spravato (esketamine nasal spray): For treatment-resistant depression; rapid effect, requires in-clinic dosing.

Which might avoid what?

Bupropion for no sexual side effects, less sedation
TMS or newer clinical trials for zero medication systemic side effects

→ Compare your options on WithPower

Clinical Trials

Promising clinical trials if Luvox isn’t working, or the side effects are intolerable:

CYB003 (deuterated psilocybin analogue):
- Rapid onset (response 1-3 weeks), 75% remission at 4 months
- Side effect profile: Headache and nausea common, but no persistent sexual dysfunction, sedation, or withdrawal source
Osavampator (AMPA-PAM):
- Phase 3, low risk of sedation, sexual side effects, or weight gain
- Glutamate pathway = may work faster, different side effect risks
D-cycloserine (NMDA partial agonist):
- As adjunct, can boost standard meds for treatment-resistant patients with fewer side effects source
Psilocybin (classic psychedelic):
- Multiple phase 2/3 trials, FDA Breakthrough Designation for depression; faster onset, fewer lingering side effects source

What to expect in a trial:

Free (or subsidized) treatment, extensive monitoring, sometimes placebo arms
Often more hands-on attention than routine care
Uncertainty is real: phase 2 means proof-of-concept, not a guarantee

Find the right match—especially if drowsiness, sexual dysfunction, or nausea have made Luvox a no-go.

Interested in clinical trials? Many trials for depression now target different mechanisms than Antidepressant—potentially offering different side effect profiles. Browse clinical trials →

Decision Map

Here’s your map if certain Luvox side effects are dealbreakers:

If drowsiness/fatigue is the dealbreaker → try bupropion (if depression, not OCD) OR CYB003 trials
If sexual dysfunction is intolerable → bupropion (again, for depression), or psilocybin trials (early data: no persistent sexual dysfunction)
If nausea/headaches won’t relent → osavampator (in trials), or slow titration/food tricks with your current dose
If insomnia is the issue → sertraline or citalopram (sometimes less activating), or trials like D-cycloserine as adjunct
If you’ve had bad withdrawal symptoms before, trials with one-time treatments (e.g., psilocybin) might be a fit

Clinical trials link: find current options and locations

Luvox (fluvoxamine) - antidepressant medication Image: Plushcare.com

Monitoring & What to Track

What your doctor should monitor:

PHQ-9 or HAM-D (depression scales)
For OCD: Y-BOCS (Yale-Brown Obsessive Compulsive Scale)
Sexual side effect screening (ask about libido and function)
Weight changes
Suicidal thoughts, especially if under 25 or with sudden mood shifts
Drug interactions (CYP enzyme warnings)

What you should track:

Daily mood (1-10 scale)
Any side effects: log the onset, severity, timing
Sleep hours and quality
Libido, energy

If your doctor isn’t tracking these, ask—especially as some (like sexual dysfunction or fatigue) often go unmentioned but are life-changing.

Pregnancy & Breastfeeding

Pregnancy and breastfeeding risk:

FDA category: Not assigned; fluvoxamine crosses the placenta and appears in breast milk. Risks are uncertain but SSRIs as a class have been linked to rare birth defects (persistent pulmonary hypertension, neonatal adaptation syndrome—temporary jitteriness and breathing issues).
Breastfeeding: Small amounts in breast milk, theoretical risk of irritability, feeding problems, or sedation in baby. Most guidelines say to avoid unless no safer alternative exists.
Benefits: Uncontrolled depression or OCD during pregnancy can be just as dangerous—risk of relapse, poor self-care, suicide risk.
Bottom line: This is a risk-benefit discussion with your doctor, not a yes/no answer. Do NOT stop suddenly—always taper under medical supervision if pregnancy occurs.

For more: FDA label details

Emergency Warning Signs

⚠️ Call 911 or go to the ER immediately if you experience:

Suicidal thoughts or actions (especially new or worsening)
Signs of serotonin syndrome: agitation, hallucinations, rapid heart rate, fluctuating blood pressure, muscle rigidity, fever, excessive sweating
Severe allergic reaction: rash, swelling of face/tongue/throat, difficulty breathing
Seizures (new onset)
Sudden chest pain, irregular heartbeat, loss of consciousness
Signs of severe bleeding or unusual bruising

📞 Call your doctor urgently if:

Persistent vomiting or diarrhea
Severe anxiety or agitation
Worsening depression, mood swings, or new confusion
Noticeable yellowing of eyes/skin (jaundice)
Severe tremor, muscle twitching
New or worsening seizures

Poison Control: 1-800-222-1222 National Suicide Prevention Lifeline: 988

Summary & Next Steps

Key takeaways:

Luvox causes feeling very tired/drowsy (reported by 10/15 users) and sexual side effects (3/15), with FDA trials showing headache (32%) and nausea (34%) among the most common issues.
For most, side effects peak in the first two weeks; about a third quit early due to intolerance. 75% remission rate seen in recent CYB003 trials suggests alternatives are finally arriving.

If Luvox is working for you:

Keep taking as directed, track any new or changing side effects, and check in with your doctor every 2-3 months.
Consider a slow taper (under supervision) if planning to stop.

If side effects are intolerable:

Discuss dose adjustment (split dosing, night dosing, etc.)
Consider alternatives like bupropion (less sedation/sexual dysfunction)
Explore clinical trials (e.g., CYB003, osavampator) with new mechanisms

Your next steps:

Track your symptoms for 2 weeks using a mood diary
Discuss this guide with your doctor at your next appointment
If considering alternatives, → explore clinical trials

→ Find clinical trials matched to your situation

Appendix A: FDA Label Data Summary

Adverse Reactions by Prevalence (Clinical Trial Data)

Side Effect	Drug Rate	Placebo Rate	Category	System
insomnia	35%	20%	very common	Nervous System
nausea	34%	13%	very common	Gastrointestinal
headache	32%	31%	very common	Nervous System
somnolence	27%	11%	very common	Nervous System
asthenia	26%	8%	very common	General
diarrhea	18%	8%	very common	Gastrointestinal
anorexia	13%	5%	common	Metabolic
dizziness	12%	10%	common	Nervous System
sexual dysfunction (all types)	11%	2%	common	Reproductive/Sexual
abnormal ejaculation	10%	0%	common	Reproductive/Sexual
dry mouth	10%	9%	common	Gastrointestinal
dyspepsia	8%	5%	common	Gastrointestinal
sweating	7%	0.1%	very common	Dermatologic
tremor	6%	0%	very common	Nervous System
decreased libido	6%	2%	common	Reproductive/Sexual
anxiety	6%	2%	common	Psychiatric
pharyngitis	6%	0.1%	common	Respiratory
vomiting	6%	2%	common	Gastrointestinal
anorgasmia	5%	0%	common	Reproductive/Sexual
myalgia	5%	2%	common	Musculoskeletal
accidental injury	5%	3%	common	General
constipation	4%	0.1%	common	Gastrointestinal
ecchymosis	4%	2%	common	Hematologic
abnormal thinking	3%	0.1%	common	Nervous System
apathy	3%	0%	common	Psychiatric
menorrhagia	3%	0%	common	Reproductive/Sexual
abnormal dreams	3%	2%	common	Nervous System
agitation	2%	0.1%	common	Psychiatric
yawning	2%	0%	common	Respiratory
taste perversion	2%	0.1%	common	Special Senses

Boxed Warnings (Most Serious)

Increased risk of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults taking antidepressants for major depressive disorder and other psychiatric disorders.

Drug Interactions

Drugs inhibiting or metabolized by cytochrome P450 isoenzymes (CYP1A2, CYP2C9, CYP3A4, CYP2C19): may increase levels of drugs metabolized by these enzymes (e.g., warfarin, theophylline, propranolol, tizanidine, alprazolam, omeprazole, phenytoin, certain benzodiazepines)
Carbamazepine: elevated carbamazepine levels and toxicity
Sumatriptan: rare reports of weakness, hyperreflexia, incoordination; risk of serotonin syndrome
Tacrine: increased tacrine levels and cholinergic side effects (nausea, vomiting, sweating, diarrhea)
Tricyclic antidepressants (TCAs): increased plasma TCA levels; monitor and reduce TCA dose if needed
Tryptophan: severe vomiting
Diltiazem: bradycardia
Propranolol or metoprolol: increased beta-blocker levels; reduce dose and titrate cautiously
Lithium: increased serotonergic effects; risk of seizures
Methadone: increased risk of serotonergic effects

Appendix B: Reddit User-Reported Side Effects

Data extracted from Reddit discussions. Counts show how many posts/comments mentioned each side effect.

Side Effect	Mentions	Severity	Duration	Persists?
Feeling very tired or drowsy	10 posts	🟡 Moderate (6/10)	Ongoing for some, improves after a few weeks for others	Resolves
Sexual side effects or sexual dysfunction	3 posts	🟢 Mild (2/3)	Ongoing while on medication	Resolves
Headaches, sometimes severe	3 posts	🟡 Moderate (2/3)	First week(s), sometimes ongoing	Resolves
Nausea and upset stomach	3 posts	🟡 Moderate (2/3)	First days to weeks, sometimes ongoing	Resolves
Difficulty falling or staying asleep	3 posts	🟢 Mild (2/3)	First days to weeks, sometimes ongoing	Resolves
Tremors or shakiness	3 posts	🟡 Moderate (2/3)	First week or two, sometimes ongoing	Resolves
Excessive sweating	2 posts	🟠 Severe (1/2)	Ongoing while on medication	Resolves
Decreased appetite	2 posts	🟢 Mild (1/2)	First days to weeks	Resolves
Dizziness or feeling lightheaded	2 posts	🟡 Moderate (1/2)	First days, especially with withdrawal	⚠️ Yes
Diarrhea	2 posts	🟢 Mild (1/2)	First days	Resolves
Feeling weak or lacking strength	2 posts	🟢 Mild (1/2)	At night, especially when starting	Resolves
Withdrawal symptoms when stopping suddenly	2 posts	🟡 Moderate (1/2)	A few days after stopping, resolves in days to a week	⚠️ Yes
Nightmares or vivid dreams	1 posts	🟢 Mild (1/1)	Ongoing while on medication	Resolves
Easy bruising	1 posts	🟢 Mild (1/1)	Ongoing while on medication	Resolves
Jaw clenching	1 posts	🟢 Mild (1/1)	First days to weeks	Resolves

User Quotes by Side Effect

Feeling very tired or drowsy (Starts within first days, can persist for weeks or longer, sometimes improves with time)

"The worst part for me was the drowsiness. I would fall asleep in class." source

"Only side effect was being a little more sleepy but not too much so yes it was manageable." source

"Aside from the drowsiness of the Luvox, the side effects are way better with luvox than lamictal in my experience." source

Sexual side effects or sexual dysfunction (Begins after starting, persists as long as on medication)

"My experience: I took it for two years and it was very helpful for OCD but did have sexual side effects." source

"I do have some sexual dysfunction with it but it's manageable." source

Headaches, sometimes severe (Starts in first days, may persist for several weeks or until medication is changed)

"I am extremely nauseous and have a horrible headache." source

"I was on fluvoxamine for several weeks and it made me very tired and giving me headaches, so I had to change to a different antidepressant." source

Nausea and upset stomach (Starts first day or two, often improves after first week or two)

"I am extremely nauseous and have a horrible headache." source

"I experienced stomach pain and diarrhea the first night." source

Difficulty falling or staying asleep (Starts within first days, may persist or resolve after a few weeks)

"I have noticed some lack of sleep but I don't think that is caused by the medication." source

"I'm also experiencing twithcing, insomnia, bruising and extreme irritability." source

Tremors or shakiness (Starts in first days, peaks in first week, may resolve after a couple weeks)

"The most alarming symptoms have been the random body twitches and random bouts of shaking/tremors. They don't last a long time but whenever they start up, I get worried." source

"I was super shaky at first, about a week or two. It was really bad though, I literally could not sit still, my knee was always bouncing, even my hands." source

Excessive sweating (Starts after beginning medication, persists)

"HORRIBLE sweating, decreased appetite, weakness, dizziness, diarrhea, ..." source

Decreased appetite (Starts after beginning medication, may resolve after a few weeks)

"HORRIBLE sweating, decreased appetite, weakness, dizziness, diarrhea, ..." source

Dizziness or feeling lightheaded (Starts with withdrawal or missed doses, resolves after resuming or after a few days)

"I will note to be careful not to run out or stop taking it suddenly, because there are withdrawal symptoms (dizziness, lightheadedness, nausea, ...)." source

Diarrhea (Starts first day or two, usually resolves quickly)

"I experienced stomach pain and diarrhea the first night." source

Feeling weak or lacking strength (Starts after beginning medication, may resolve after a few weeks)

"I am also extremely tired and weak at night. (Which is why I'm taking it at night)." source

Withdrawal symptoms when stopping suddenly (Begins within a day or two of stopping, resolves after resuming or after a few days)

"I will note to be careful not to run out or stop taking it suddenly, because there are withdrawal symptoms (dizziness, lightheadedness, nausea, ...)." source

Nightmares or vivid dreams (Starts after beginning medication, persists)

"Ive been on fluvoxamine (luvox / faverin) for about 6 months now for depression and anxiety. 2 pills of 50mg a night." source

Easy bruising (Starts after beginning medication, persists)

"I'm also experiencing twithcing, insomnia, bruising and extreme irritability." source

Jaw clenching (Starts after beginning medication, may resolve after a few weeks)

"headache, jaw clenching, fatigue, nausea, insomnia, HORRIBLE sweating, decreased appetite, weakness, dizziness, diarrhea, ..." source

Appendix C: Clinical Trials with Different Mechanisms

These trials target mechanisms different from Antidepressant. Phase 2 results do not guarantee Phase 3 success.

CYB003 (deuterated psilocybin analog)

Sponsor: Cybin Inc.
Phase: Phase 2 (Breakthrough Therapy Designation)
NCT: NCT05385783
Mechanism: Deuterated psilocybin analog (psychedelic-derived, 5-HT2A receptor agonist)
Side Effect Comparison: Transient mild-to-moderate headache and nausea most common; no sexual dysfunction, weight gain, or sedation reported (unlike SSRIs/SNRIs). No evidence of dependence or withdrawal. No persistent cognitive impairment.
Efficacy Data:
- Response rate: 53.3% (CYB003 16mg) vs 20% (placebo) at 3 weeks
- Remission rate: 75% at 4 months (Phase 2, CYB003)
- MADRS change: -14.08 points (CYB003 16mg) vs -8.24 points (placebo) at 3 weeks
- Time to response: 1-3 weeks
- Source
Why it might interest you: Rapid onset (1-3 weeks), high remission rates, and a side effect profile that avoids common SSRI/SNRI issues like sexual dysfunction, weight gain, and sedation. Novel mechanism may help those not responding to or intolerant of standard antidepressants.
Results: Significant and rapid reduction in depressive symptoms; 75% remission at 4 months; well-tolerated in trial population.
Sources: 1, 2, 3

Osavampator (NBI-1065845, TAK-653)

Sponsor: Neurocrine Biosciences
Phase: Phase 3 (recruiting)
Mechanism: AMPA receptor positive allosteric modulator (AMPA-PAM)
Side Effect Comparison: Phase 2 data: No significant increase in weight, sexual dysfunction, or sedation compared to placebo. Side effect profile appears favorable vs SSRIs/SNRIs, with low rates of common antidepressant side effects.
Efficacy Data:
- Response rate: Not yet reported
- Remission rate: Not yet reported
- MADRS change: Not yet reported (Phase 3 ongoing)
- Time to response: Expected to be faster than SSRIs/SNRIs (based on AMPA modulation)
- Source
Why it might interest you: AMPA modulation is a novel, non-monoaminergic mechanism with potential for faster onset and fewer side effects (notably less sexual dysfunction, weight gain, and sedation) than standard antidepressants.
Results: Phase 2 data suggest rapid antidepressant effects and good tolerability; Phase 3 underway to confirm efficacy and safety.
Sources: 1, 2, 3

D-cycloserine (adjunctive)

Sponsor: Not specified (academic/NIH)
Phase: Phase 2 (completed)
NCT: NCT00408031
Mechanism: NMDA receptor partial agonist (glycine-site, D-cycloserine)
Side Effect Comparison: Generally well-tolerated; no increase in sexual dysfunction, weight gain, or sedation compared to standard antidepressants. No cognitive impairment or withdrawal reported.
Efficacy Data:
- Response rate: Not specified
- Remission rate: Not specified
- MADRS change: Not specified; significant improvement in depressive symptoms in TRD (Phase 2)
- Time to response: Within 2 weeks (reported in some studies)
- Source
Why it might interest you: Acts via glutamatergic system (NMDA modulation), offering a different approach for those who do not respond to or cannot tolerate standard antidepressants. Fewer side effects, especially regarding sexual function and weight.
Results: Adjunctive D-cycloserine improved depressive symptoms in treatment-resistant depression and bipolar depression.
Sources: 1

Psilocybin (various studies, including NCT06141876)

Sponsor: Multiple (Compass Pathways, Usona, academic)
Phase: Phase 2/3 (multiple ongoing)
NCT: NCT06141876
Mechanism: Classic psychedelic (5-HT2A receptor agonist)
Side Effect Comparison: Transient anxiety, headache, and nausea most common; no persistent sexual dysfunction, weight gain, or sedation. No evidence of dependence or withdrawal. Side effect profile generally more favorable than SSRIs/SNRIs.
Efficacy Data:
- Response rate: Varies by study; up to 70% at 1-4 weeks
- Remission rate: Varies by study; up to 60% at 4 weeks in some trials
- MADRS change: Not specified (psilocybin received FDA Breakthrough Therapy for TRD based on significant efficacy in multiple studies)
- Time to response: 1-2 weeks
- Source
Why it might interest you: Rapid onset, high response/remission rates, and a side effect profile that avoids the most common and bothersome issues of standard antidepressants. Particularly promising for those with inadequate response or intolerable side effects from current medications.
Results: Rapid and robust antidepressant effects in TRD and MDD; FDA Breakthrough Therapy Designation for TRD.
Sources: 1, 2

Appendix D: Methodology

To develop this guide, we analyzed over 30,000 clinical trial records from ClinicalTrials.gov, reviewed more than 300 journal articles via PubMed, and examined 52 patient forum threads. Additionally, 97 Luvox-related adverse effects were extracted from the OpenFDA Drug Label, and 15 distinct user-reported side effects were categorized and assessed for frequency and severity. Quotations and clinical data were integrated to provide a nuanced, patient-focused resource.