What is the treatment for extreme depression?
Patient: What is the maximum allowed dosage of fluvoxamine for healthy 30 year old man? Is it safe to have 200 mg fluvoxamine per day ?Hi, at the age of 23 I was having Fluoxamine per day 175mg  to 200mg ( morning 1.5 (75mg), afternoon - 0 and night 2 ( 100mg) ) for Depression, OCD, ADD and social anxiety. In this dosage i was feeling very well and happy. Along with that i was also having Alzolam 0.25 mg per day. I was continuing this for 5 years. In between i sometimes stop medication completely and whenever i feel discomfort i restart the medication.  Later on i switched to Venlafaxine and then to Sertraline thinking that it could give me much better benefits however it didnt' work that well with me. I don't know whether it is because of lower dosage of what i am having.  Currently i am having sertraline 25mg per day however it gives me side effects like on interest in sex, feeling sleepy, etc. Around 9 months back i was having Crestor 10mg per day for cholesterol but now i have stopped it.Now i want to switch again to Fluvoxamine as i think this was working well with me than any other medicine but in a higher dosage.  Is it safe to have 200 mg or 175 mg per day ? I am a 30 yr old health male. Doctor: Hi, thanks for the query. First & foremost I would strongly urge you to NOT to change/switch any medication on your own & what ever are your issues with current set of medications should be discussed & dealt with only under supervision of a qualified medical doctor preferably a Psychiatrist. I am using strong words since all these aforementioned medications come under category of SSRI/SNRI & taking 2 SSRI together can cause a potentially dangerous condition named serotonin syndrome; while abruptly stopping any or all of these medications cause a flu like discontinuation syndrome; not to mention flaring up the symptoms of original illness (OCD; Depression in your case). Coming to your query; Fluvoxamine is a very good choice for controlling symptoms of both OCD & Depression & maximum permissible dose of Fluvoxamine is 300mg/day in a healthy person; so depending upon your symptom response; 175-200mg/day is perfectly fine. I would like to know your symptom profile of both OCD & depression so that I can advice whether we can plan for additional therapy in addition to medications for quicker response. Good Luck