From the FDA Drug Label
A dose range of 20 to 60 mg/day is recommended; however, doses of up to 80 mg/day have been well tolerated in open studies of OCD. In lower weight children, treatment should be initiated with a dose of 10 mg/day. Additional dose increases may be considered after several more weeks if insufficient clinical improvement is observed A dose range of 20 to 30 mg/day is recommended.
Increasing fluoxetine dose from 20 to 30mg:
- The FDA drug label recommends a dose range of 20 to 60 mg/day for adults with OCD, and a dose range of 20 to 30 mg/day for lower weight children.
- It is possible to increase the dose from 20 to 30mg, as 30mg is within the recommended dose range for some patients 1.
- However, the decision to increase the dose should be based on the patient's individual response to treatment and medical history.
- It is essential to monitor the patient's condition and adjust the dosage as needed to maintain the lowest effective dosage.
From the Research
Increasing fluoxetine from 20mg to 30mg can be considered under a doctor's supervision, as the most recent and highest quality study suggests that fluoxetine can be effective at various doses, including higher doses, for treating depression and anxiety 2. When considering this change, it's essential to discuss your symptoms and response to the current dose with your healthcare provider first. Typically, doctors may recommend a gradual increase if you haven't experienced adequate symptom improvement after 4-6 weeks on 20mg. To achieve a 30mg dose, your doctor might prescribe a combination of existing tablets or a new prescription strength. Some key points to consider include:
- Side effects may temporarily increase with the dose adjustment, including possible nausea, headache, insomnia, or increased anxiety, as seen in various studies 3, 4, 5, 6.
- These side effects usually subside within 1-2 weeks as your body adjusts.
- The increase to 30mg works by enhancing serotonin levels in the brain, potentially providing better symptom control for depression or anxiety.
- Allow 2-4 weeks after increasing to evaluate the full effect of the new dose before considering further adjustments. It's also important to note that fluoxetine has been compared to other antidepressants in terms of efficacy and tolerability, with some studies suggesting that it may be less effective than certain other medications, such as sertraline and venlafaxine, but more effective than others, such as ABT-200 and milnacipran 2. However, the clinical meaning of these differences is uncertain, and treatment decisions should be based on individual patient needs and considerations of drug toxicity, patient acceptability, and cost. Ultimately, any changes to your medication should be made under the guidance of a healthcare professional, taking into account your unique situation and medical history.