- Dose and Dosage: The typical starting dose for adults is 20 mg per day, usually taken in the morning. Depending on the individual’s response, the dosage may be adjusted by the healthcare provider. For children and adolescents, the starting dose is usually lower, around 10 mg per day.
- Frequency: Fluoxetine is typically taken once daily.
- Route of Administration (ROA): It is taken orally, usually as a tablet or capsule.
- Mechanism of Action (MOA): Fluoxetine is a selective serotonin reuptake inhibitor (SSRI), which works by increasing the levels of serotonin, a neurotransmitter, in the brain. This helps improve mood and relieve symptoms of depression, obsessive-compulsive disorder (OCD), panic disorder, and other conditions.
- Pharmacokinetics (PK): Fluoxetine is well-absorbed after oral administration, with peak plasma concentrations reached within 6 to 8 hours. It has a long half-life, allowing for once-daily dosing.
- Pharmacodynamics (PD): Fluoxetine’s therapeutic effects are primarily mediated by its inhibition of serotonin reuptake, leading to increased serotonin levels in the synaptic cleft.
- Pathophysiology: Fluoxetine’s effects on serotonin modulation contribute to its efficacy in treating various mood and anxiety disorders.
- Indications: Fluoxetine is indicated for the treatment of major depressive disorder (MDD), obsessive-compulsive disorder (OCD), bulimia nervosa, panic disorder, and premenstrual dysphoric disorder (PMDD).
- Contraindications: Fluoxetine should not be used in individuals who are allergic to the drug or its components. It is contraindicated in combination with monoamine oxidase inhibitors (MAOIs) and thioridazine due to the risk of serotonin syndrome.
- Drug Interactions: Fluoxetine may interact with other medications, including MAOIs, thioridazine, pimozide, and certain drugs metabolized by the CYP2D6 enzyme. It’s essential to inform your healthcare provider about all medications you’re taking to avoid potential interactions.
- Precautions: Patients should be monitored closely, especially during the initial weeks of treatment, for signs of worsening depression or suicidal thoughts. Fluoxetine may increase the risk of suicidal thinking and behavior in children, adolescents, and young adults.
- Monitoring and Laboratory Tests: Periodic monitoring of liver function tests and electrolyte levels may be recommended during long-term fluoxetine therapy, especially at higher doses. Additionally, monitoring for signs of serotonin syndrome or discontinuation syndrome may be necessary.
Medication Information and Guidelines
- Purpose: Fluoxetine is primarily used to treat depression, obsessive-compulsive disorder (OCD), bulimia nervosa, panic disorder, and premenstrual dysphoric disorder (PMDD). It helps improve mood, appetite, sleep, and energy levels by restoring the balance of serotonin in the brain.
- Usage: Take fluoxetine exactly as prescribed by your healthcare provider. It is usually taken once daily, in the morning, with or without food. Follow the instructions on your prescription label carefully.
- Other Uses: Fluoxetine may also be used off-label to treat other conditions such as anxiety disorders, post-traumatic stress disorder (PTSD), and certain eating disorders.
- Precautions: It’s important to avoid abruptly stopping fluoxetine without consulting your doctor, as it may cause withdrawal symptoms. Tell your doctor about any other medications you are taking, including over-the-counter drugs and supplements, to avoid potential interactions.
- Dietary Changes: While taking fluoxetine, there are no specific dietary restrictions. However, it’s essential to maintain a balanced diet and avoid excessive alcohol consumption.
- Missed Dose: If you miss a dose of fluoxetine, take it as soon as you remember. However, if it’s almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take double doses to make up for a missed one.
- Side Effects: Common side effects of fluoxetine may include nausea, headache, insomnia, drowsiness, dizziness, dry mouth, and sexual dysfunction. Notify your doctor if these side effects persist or worsen.
- Storage and Disposal: Store fluoxetine at room temperature away from moisture and heat. Keep it out of reach of children and pets. Dispose of any unused medication properly, following local regulations or guidelines.
- Overdose or Emergency: In case of an overdose, seek emergency medical attention or call your local poison control center immediately. Symptoms of overdose may include rapid heartbeat, fainting, seizures, confusion, and difficulty breathing.