The antidepressant, antiobsessive-compulsive, and antibulimic actions of Fluvoxamine are presumed to be linked to its inhibition of CNS neuronal uptake of serotonin. Fluvoxamine blocks the reuptake of serotonin at the serotonin reuptake pump of the neuronal membrane, enhancing the actions of serotonin on 5HT1A autoreceptors. SSRIs bind with significantly less affinity to histamine, acetylcholine, and norepinephrine receptors than tricyclic antidepressant drugs.

Fluvoxamine is one of the few SSRIs to have a monocyclic structure. Although all SSRIs inhibit the reuptake of serotonin, the pharmacological and adverse effect profiles of fluvoxamine are different from those of other drugs in its class.

Among the SSRIs, fluvoxamine has the highest affinity for sigma receptor subtype 1 (s1receptors), suggesting that it may have particular benefits in the treatment of depressed patients who show features of anxiety/stress and for whom memory impairment is particularly undesirable (such as in depressed elderly patients, and also in treating psychotic depression).

The effectiveness of fluvoxamine maleate tablets for long-term use, i.e., for more than 10 weeks, has not been systematically evaluated in placebo-controlled trials. Therefore, the physician who elects to use fluvoxamine maleate tablets for extended periods should periodically reevaluate the long-term usefulness of the drug for the individual patient.