Would luvox (fluvoxamine) normally be considered the last choice for ocd-after others have failed--the caffeine interaction is a real turnoff?

Doctor choice: I don't know what the statistics are on the use of Luvox in obsessive compulsive disorder. I can tell you that in my practice is not the medication that i pick first-line. Mean reason for that is that the more effective of the two is Luvox cr which is not yet generic. I tend to pick the generic medications first if they have a good proven efficacy. I suspect in the us that either Prozac or zoloft (sertraline) would be the more frequently used medicationsin obsessive-compulsive disorder. I'm curious to hear what my colleagues have to say about this.

Depends: The key to successful medications for ocd is a high dose of medication affecting serotonin. Commonly this is done with an ssri like sertraline, fluoxetine, paroxetine, or fluvoxamine. Other hooves include tricyclics like clomipramine or even amitriptylene. Finding one that works for a specific person is a complex clinical issue best decided between patient and clinician.