Fluoxetine

Fluoxetine is a prescription medication that treats depression and several other mental health conditions. It belongs to a class of drugs called selective serotonin reuptake inhibitors, or SSRIs. These medications work by changing the balance of certain chemicals in your brain.

Doctors have prescribed fluoxetine for more than 30 years. It was one of the first SSRI medications approved in the United States. Many people know it by its brand name Prozac. Fluoxetine comes in capsules, tablets, and liquid form.

This medication requires a prescription from a licensed healthcare provider. Your doctor will determine if fluoxetine is right for your specific situation. They will also decide the correct dose and monitor your progress over time.

• Major depressive disorder in adults and children 8 years and older
• Obsessive-compulsive disorder in adults and children 7 years and older
• Panic disorder in adults
• Bulimia nervosa in adults
• Bipolar depression when used with olanzapine
• Treatment-resistant depression when used with olanzapine
• Premenstrual dysphoric disorder

Fluoxetine increases the amount of serotonin available in your brain. Serotonin is a chemical messenger that helps regulate mood, sleep, and emotions. People with depression often have lower levels of serotonin activity. By blocking the reabsorption of serotonin, fluoxetine allows more of it to stay active between brain cells.

This process does not happen immediately. Most people need to take fluoxetine for 4 to 6 weeks before noticing improvement. Some people may need 8 to 12 weeks to feel the full benefits. Your brain needs time to adjust to the new chemical balance.

For depression in adults, the typical starting dose is 20 mg once daily. Your doctor may increase this to 40 mg or 60 mg per day based on your response. The maximum dose is usually 80 mg per day. For children, doctors typically start with lower doses of 10 mg daily. Take fluoxetine at the same time each day, usually in the morning. Your healthcare provider will determine the exact dose and schedule that works best for you.

• Nausea or upset stomach
• Headache
• Trouble sleeping or drowsiness
• Nervousness or anxiety
• Dry mouth
• Sweating more than usual
• Decreased appetite or weight changes
• Sexual side effects like reduced desire or difficulty with orgasm
• Dizziness or feeling shaky

Serious side effects need immediate medical attention. These include unusual bleeding or bruising, severe headache, confusion, weakness, seizures, or thoughts of self-harm. Some people experience serotonin syndrome, which causes agitation, fever, fast heartbeat, and muscle stiffness. Contact your doctor right away if you notice any of these symptoms.

• Monoamine oxidase inhibitors, or MAOIs, can cause dangerous reactions and must be stopped at least 14 days before starting fluoxetine
• Other antidepressants that increase serotonin may cause serotonin syndrome
• Blood thinners like warfarin may increase bleeding risk
• Nonsteroidal anti-inflammatory drugs, or NSAIDs, may increase bleeding risk
• Certain heart medications like pimozide or thioridazine can cause dangerous heart rhythm problems
• Medications that affect liver enzymes may change how fluoxetine works in your body
• St. John's Wort and other supplements that affect serotonin
• Alcohol may increase drowsiness and should be limited

Your doctor may recommend blood tests to monitor your health while taking fluoxetine. Sodium levels should be checked because fluoxetine can sometimes cause low sodium, especially in older adults. This condition is called hyponatremia and can cause confusion, weakness, and headaches. Liver enzyme tests may also be ordered because your liver processes this medication. People with existing liver problems may need more frequent monitoring. Your healthcare provider will determine how often you need testing based on your individual health factors and response to treatment.