Fluoxetine

Fluoxetine is a type of antidepressant belonging to the selective serotonin reuptake inhibitor (SSRI) group of medicines. It is widely prescribed to treat depression and other mental health conditions like panic disorder and obsessive-compulsive disorder.

Fluoxetine helps many people to recover from depression by improving their mood and relieving anxiety and tension. It is also used to treat bulimia nervosa (an eating disorder), where it reduces binge-eating and purging (vomiting).

• Depression: Used for treatment of depressive illness.
• Bulimia Nervosa: Used to reduce binge-eating and purging.
• Obsessive-Compulsive Disorder: Used for treatment of OCD.
• Panic Disorder: Used for treatment of panic disorder.

Phenothiazine related drugs

Selective Serotonin Reuptake Inhibitor (SSRI)

Fluoxetine has been shown to selectively inhibit the reuptake of serotonin at the presynaptic neuronal membrane which causes increased synaptic concentration of serotonin in the CNS. This results in numerous functional changes associated with enhanced serotonergic neurotransmission. Fluoxetine appears to have no effect on the reuptake of norepinephrine and dopamine and does not exhibit anticholinergic, antihistaminic or α1 adrenergic blocking activity at usual therapeutic doses.

Fluoxetine selectively inhibits serotonin reuptake, increasing serotonin levels in the brain, which improves mood and relieves symptoms of depression, panic and obsessive disorders.

Adult Dose (Oral):

• Depression: Initial: 20 mg once daily; may increase up to 80 mg daily in 2 divided doses.
• Bulimia Nervosa: 60 mg daily as a single or in divided doses.
• OCD: Initial: 20 mg once daily; may increase up to 60 mg daily; Max: 80 mg daily.
• Panic Disorder: Initial: 10 mg once daily; increase to 20 mg daily after 1 week; may increase up to 60 mg daily.
• PMDD: 20 mg daily continuously or started 14 days before menstruation.
• Elderly: Max: 60 mg daily.

Child Dose (>7 years, OCD): Initial: 10 mg daily; may increase to 20 mg daily after 2 weeks; up to 60 mg daily if required.

Take this medicine in the dose and duration as advised by your doctor; do not chew, crush or break it. Fluoxetine may be taken with or without food, but it is better to take it at a fixed time.

If you miss a dose of Fluoxetine, take it as soon as possible; however, if it is almost time for your next dose, skip the missed dose.

Common Side Effects:

• Erectile dysfunction
• Indigestion
• Influenza like syndrome
• Loss of appetite
• Low sexual desire
• Nausea
• Sore throat
• Sweating
• Tremor
• Weakness
• Yawning
• Abnormal dreams
• Delayed ejaculation
• Dry mouth
• Insomnia
• Nervousness
• Sleepiness
• Sinus infection

Precautions:

• Fluoxetine may affect your ability to drive.
• Take in the morning (can keep you awake if taken late at night).
• May cause anxiety and agitation when first starting.
• May cause weight loss and decreased appetite.
• Talk to doctor if sudden mood changes or suicidal thoughts occur.
• Inform doctor if difficulty having orgasm or decreased sex drive.
• Addiction/dependence potential is very less.
• Do not stop taking suddenly without doctor consultation.

Contraindications:

• Severe renal or hepatic failure
• Hypersensitivity
• Lactation
• Concomitant MAOIs or within 2 weeks of MAOI withdrawal

Drug Interactions:

• Warfarin, Digoxin: Transient shift in plasma concentration may occur.
• Diazepam: T1/2 is prolonged.
• Clopidogrel: Avoid concurrent use.
• Potentially Fatal: Serious reactions with MAOIs; 5 weeks should elapse after fluoxetine treatment before starting MAOI.
• Other antidepressants: Two-fold increase in plasma levels.
• Lithium: Monitor levels.

Food Interactions: It is unsafe to consume alcohol with Fluoxetine.

Use in Pregnancy: May be unsafe; animal studies have shown harmful effects; doctor will weigh benefits and potential risks.

Use in Lactation: Probably unsafe; limited data suggests drug may pass into breastmilk and harm the baby.

Pediatric Use: Dose for OCD in children >7 years provided above; dose for depression in children >8 years provided.

Geriatric Use: Max: 60 mg daily.

Renal Impairment: Probably safe; dose adjustment may not be needed; caution in severe renal impairment.

Hepatic Impairment: Use with caution; dose adjustment may be needed.

Overdose: Overdose may cause nausea, vomiting, drowsiness, dizziness, seizures, serotonin syndrome; symptomatic treatment.

Storage: Keep below 30 degree C, away from light and moisture. Keep out of reach of children.

Fluoxetine