Thirty-one studies with a total of 2,343 participants. Eight trials with 979 participants compared fluvoxamine with imipramine and placebo; five trials with 304 participants compared fluvoxamine with imipramine only (no placebo arm); five studies with 211 participants compared fluvoxamine with clomipramine; six studies with 344 participants compared fluvoxamine with tricyclics and placebo; two trials with 113 participants compared fluvoxamine with mianserin; five studies with 392 participants compared fluvoxamine with antidepressants and placebo
Fluvoxamine compared with imipramine and placebo:
Five of the eight trials found fluvoxamine and imipramine both equally efficacious and better than placebo. Over a four-week period, improvement in depression scores as a result of fluvoxamine ranged from 37.4% to 51.9%, improvement with imipramine was 41%-53.6% and improvement with placebo was 18.7% to 41.7%.
Fluvoxamine compared with imipramine:
HAM-D scores decreased 36.4% to 67% in the fluvoxamine group compared with 30.5% to 62.5% in the imipramine group.
Fluvoxamine compared with clomipramine:
HAM-D scores decreased from 54.1% to 72.9% in the fluvoxamine group compared with 59.1% to 66.3% in the clomipramine group.
Fluvoxamine compared with miscellaneous tricyclics:
HAM-D scores decreased from 39.2% to 60.9% in the fluvoxamine group compared with 28.9% to 59.9% in the tricyclic groups. A placebo group in one study had a decrease in depression scores of 29%.
Fluvoxamine compared with mianserin:
In one study, depression symptoms decreased by 65.5% in the fluvoxamine group compared with 60.8% in the mianserin group.
Fluvoxamine compared with miscellaneous antidepressants:
Overall, fluvoxamine was equivalent to moclobemide, maprotiline and sertraline and superior to placebo. Fluvoxamine was significantly less effective then flupenthixol.
Adverse effects:
Overall, fluvoxamine was associated with inducing a variety of gastrointestinal adverse effects.