Overview
Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) antidepressant used to treat major depressive disorder, obsessive-compulsive disorder, bulimia nervosa, panic disorder, and premenstrual dysphoric disorder. It works by increasing serotonin levels in the brain.
Mechanism of Action
Fluoxetine selectively inhibits serotonin reuptake at the presynaptic neuronal membrane, increasing serotonin concentration in the synaptic cleft and enhancing serotonergic neurotransmission.
Indications
- Major Depressive Disorder (MDD)
- Obsessive-Compulsive Disorder (OCD)
- Bulimia Nervosa
- Panic Disorder
- Premenstrual Dysphoric Disorder (PMDD)
Dosage
Initial dose: 20 mg once daily in the morning. May increase after several weeks if needed. Maximum dose: 80 mg/day. Dosage varies by indication and patient response.
Contraindications
- Hypersensitivity to fluoxetine
- Concurrent use with MAOIs or within 14 days of discontinuing MAOI therapy
- Concurrent use with pimozide or thioridazine
Side Effects
- Nausea
- Headache
- Insomnia
- Anxiety
- Drowsiness
- Dry mouth
- Sweating
- Decreased libido
- Sexual dysfunction
- Weight changes
Interactions
- MAO inhibitors (serotonin syndrome risk)
- Other serotonergic drugs
- Drugs metabolized by CYP2D6
- Warfarin (increased bleeding risk)
- NSAIDs (increased bleeding risk)
- Tricyclic antidepressants
- Antipsychotics