From the Research
There is no conclusive evidence connecting fluoxetine with the occurrence of ovarian cysts, and the patient's symptoms are more likely related to other factors. The provided evidence does not establish a direct link between fluoxetine and ovarian cysts. Studies such as 1 suggest that ovarian cysts are generally diagnosed incidentally and can be managed expectantly. Some key points to consider include:
- Ovarian cysts are common in premenopausal women and are often benign 2
- The risk of malignancy increases with age, and symptoms such as weight loss, abdominal distension, and pelvic pain may indicate a malignant ovarian cyst 2
- Functional cysts usually resolve spontaneously without the need for intervention, especially if they are less than 5 cm in diameter 2, 3
- Other factors such as normal menstrual cycling, polycystic ovary syndrome, endometriosis, and pelvic inflammatory disease are more commonly associated with ovarian cysts 2, 4, 1 Given the lack of evidence linking fluoxetine to ovarian cysts, it is recommended to refer the patient for gynecological evaluation to determine the type and cause of the cysts, rather than changing their medication regimen. If the patient is concerned about the potential effects of fluoxetine, alternative antidepressant options from different classes, such as bupropion or mirtazapine, could be discussed 5.