Fluvoxamine and clomipramine in the treatment of cataplexy.

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Abstract
Fluvoxamine 25-200 mg daily and clomipramine 25-200 mg daily were given for separate 3-wk periods to 18 subjects with narcolepsy and cataplexy. Both drugs improved cataplexy but not narcolepsy. Fluvoxamine was less active than clomipramine, but both drugs abolished cataplexy in individual subjects. Gastrointestinal side effects prevented treatment with fluvoxamine in 5 subjects. All patients completed the clomipramine phase of the trial, but 2 men complained of delayed ejaculation. Fluvoxamine is a more potent inhibitor of 5-hydroxytryptamine (5-HT) re-uptake in some systems, but not in others. Whether the greater anticataplectic effect of clomipramine is due to a greater inhibition of 5-HT re-uptake or to other mechanisms is uncertain.
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