Generic Name: Fluoxetine
Brand Name: Prozac, Rapiflux, Sarafem, Selfemra
Fluoxetine (Prozac) is in the class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). Prozac is indicated for depression, obsessive-compulsive disorders, premenstrual dysphoria, panic disorder and bulimia nervosa. Occasionally fluoxetine is used to treat alcoholism, attention-deficit disorders, borderline personality disorders, schizophrenia, Tourette's syndrome, anxiety, and phobias.
Fluoxetine is good for depression accompanied by hypersomnia, fatigue, increased appetite or hunger. Occasionally it contributes to undesirable activation and agitation. Therefore fluoxetine may be not well tolerated by patients with panic, anxiety, or insomnia.
Adults: initially 20 mg once daily in the morning. Increase after several weeks if insufficient clinical improvement noted (max, 80 mg/day). Weekly dosing (90 mg delayed-release capsule) may be started 7 days after last 20 mg/day dose. If response is not satisfactory, consider reestablishing daily dosage regimen. Studies comparing fluoxetine 20, 40, and 60 mg/day to placebo indicate that 20 mg/day is sufficient to obtain a satisfactory response in major depressive disorder in most cases.
Children and adolescents 8–18 years of age: 10 mg/day; increase after 1 week if insufficient clinical improvement noted (max, 20 mg/day).
Although symptomatic improvement may be apparent within the first 1–3 weeks of fluoxetine, optimal results usually require at least 4 weeks or more.
Premenstrual Dysphoric Disorder:
Fluoxetine (Sarafem) significantly calms irritability, dysphoria and improves social functioning in women with premenstrual syndrome (PMS) or premenstrual dysphoric disorder. Fluoxetine works within hours for premenstrual dysphoria, as opposed to 3-4 weeks for depression.
The dose is 20 mg/day continuously (every day of menstrual cycle) or intermittently (starting 14 days prior to anticipated onset of menstruation through first full day of menses and repeating with each new cycle). It may be increased if no clinical improvement noted (max, 80 mg/day).
Obsessive Compulsive Disorder:
Adults: initially 20 mg once daily in the morning; increase after several weeks if insufficient clinical improvement noted (max, 80 mg/day).
Children 7 years of age and older: Initial: 10 mg/day; increase after 2 wk if insufficient clinical improvement noted (max, 60 mg/day).
Fluoxetine cuts down the frequency of binge eating, purging, and vomiting in bulimia nervosa.
Adults: initially 10 mg/day; increase to 20 mg/day after 1 wk. Further increases may be considered after several weeks if no clinical improvement noted (max, 60 mg/day).
Nervous system: headache (20%), weakness or fatigue (20%), nervousness (15%), anxiety (10%), insomnia (14%), drowsiness (12%), dizziness (9%), tremor (8%).
Gastrointestinal: nausea (21%), diarrhea (12%), anorexia (8%), xerostomia (10%), dyspepsia (6%), constipation (5%).
Cardiovascular: vasodilation (5%).
Urogenital: abnormal ejaculation (7%), impotence (7%), decreased libido (10%).
Miscellaneous: abnormal vision (3%), excessive sweating (8%), rash (4%).
Fluoxetine is an inhibitor of CYP2D6 enzymes.
Pregnancy & Lactation
Pregnancy Category C.
Store at room temperature of 15°C to 30°C (50°F to 86°F). Oral liquid form should be dispensed in a light-resistant container.