title: Fluvoxamine may prevent onset of psychosis: a case report of a patient at ultra-high risk of psychotic disorder.
abstract: BACKGROUND
  There is emerging evidence that antidepressants may be effective in preventing patients with non-specific and psychotic-like prodromal symptoms, defined as patients at ultra-high risk (UHR) of psychotic disorder, from transitioning to psychosis. However, the mechanism of such an effect is still unknown.
  
  
  METHODS
  We report the case of a 19-year-old Japanese man determined to be at UHR of psychotic disorder in whom fluvoxamine (one of the antidepressants with sigma-1 receptor agonism) showed preventive effects on psychotic-like prodromal symptoms.
  
  
  RESULTS
  Our patient's depressive symptoms were reduced and maintained below remission as a result of treatment with 100 mg/day of fluvoxamine. In addition, it is likely that an additional dose of fluvoxamine (50 mg/day) improved his psychotic-like prodromal symptoms directly, independent of its antidepressive effects.
  
  
  CONCLUSIONS
  Fluvoxamine, a sigma-1 receptor agonist, may be effective in preventing patients at UHR of psychotic disorder from onset of psychosis via its neuroprotective/neurotropic actions, independent of its antidepressive effects.
authors.affiliation: Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan. tadokoroshigenori@gmail.com.
authors.forename: Shigenori
authors.initials: S
authors.lastname: Tadokoro
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Kanahara
authors.forename: Shuichi
authors.initials: S
authors.lastname: Kikuchi
authors.forename: Kenji
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Iyo
authors.initials: I
authors.lastname: Masaomi