From the Guidelines
Fluoxetine is primarily used to treat major depressive disorder, obsessive-compulsive disorder (OCD), bulimia nervosa, and panic disorder, and it belongs to a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs) 1. The uses of fluoxetine include:
- Major depressive disorder
- Obsessive-compulsive disorder (OCD)
- Bulimia nervosa
- Panic disorder
- Premenstrual dysphoric disorder (PMDD)
- Social anxiety disorder or post-traumatic stress disorder (PTSD) (off-label use)
Fluoxetine works by increasing the levels of serotonin in the brain, which can help improve mood, reduce anxiety, and decrease compulsive behaviors 1. It's typically taken once daily and is available only by prescription, and may take several weeks to reach its full therapeutic effect 1. While generally well-tolerated, it can cause side effects such as nausea, dry mouth, drowsiness, and reduced libido, and should be taken under the guidance of a healthcare provider 1. The most recent evidence suggests that fluoxetine is effective in treating anxiety disorders in children and adolescents, but it should be used with caution due to the risk of suicidal thinking and behavior, behavioral activation/agitation, and other potential side effects 1.
Some key points to consider when prescribing fluoxetine include:
- Slow up-titration to avoid unintentionally exceeding the optimal medication dose
- Close monitoring for suicidality, especially in the first months of treatment and following dosage adjustments
- Educating parents/guardians and patients about the potential side effects, including behavioral activation/agitation and sexual dysfunction
- Avoiding combination with other serotonergic medications to minimize the risk of serotonin syndrome.
From the FDA Drug Label
Prozac is indicated for the treatment of major depressive disorder. Prozac is indicated for the treatment of obsessions and compulsions in patients with obsessive compulsive disorder (OCD), Prozac is indicated for the treatment of binge–eating and vomiting behaviors in patients with moderate to severe bulimia nervosa Prozac is indicated for the treatment of panic disorder, with or without agoraphobia, as defined in DSM–IV
The uses of Fluoxetine (Prozac) are:
- Major Depressive Disorder: treatment of major depressive disorder
- Obsessive Compulsive Disorder (OCD): treatment of obsessions and compulsions in patients with OCD
- Bulimia Nervosa: treatment of binge–eating and vomiting behaviors in patients with moderate to severe bulimia nervosa
- Panic Disorder: treatment of panic disorder, with or without agoraphobia 2
From the Research
Uses of Fluoxetine (Prozac)
- Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) with demonstrated efficacy in the treatment of major depressive episodes 3, 4, 5.
- It is effective in the treatment of obsessive-compulsive disorder (OCD) with an effective dose range of 40 to 60 mg daily 3.
- Fluoxetine has been found to alleviate collateral depressive symptoms by significantly reducing suicidal ideation and impulsiveness in OCD patients 3.
- It may be especially effective in patients with pronounced obsessive-compulsive symptoms, weight gain with depression or from antidepressants, and in patients who have not responded to tricyclic therapy 4.
- Fluoxetine has been used to treat other conditions such as:
- Anorexia nervosa 6
- Bulimia nervosa 6
- Tourette's syndrome 6
- Trichotillomania 6
- Pain relief in certain diabetics 6
- Premenstrual syndrome 6
- Migraine headache 6
- Panic disorders 6
- Paraphilias and related conditions 6
- Substance abuse, alcoholism, and cocaine abuse 6
- Abusing injurious behavior 6
- Dysthymic disorder 6
- Fibrositis 6
- Postanoxic action myoclonus 6
- Pathologic jealousy 6
- Personality disorder 6
- Pseudobulbar affect 6
- Social phobia 6
Dosage and Administration
- The recommended dose of fluoxetine is 20 mg per day, given in the morning or early in the day 4.
- For OCD, the effective dose range is 40 to 60 mg daily 3.
- The optimal fluoxetine dose is 40 to 60 mg daily with a minimum treatment duration of 1 to 2 years 3.
- Efficacy should not be evaluated before 8 weeks to allow for onset of the therapeutic effects 3.