From the Research
Fluoxetine should be tapered gradually over a period of several weeks to minimize the risk of discontinuation symptoms, with a recommended reduction of 10mg every 2-4 weeks, as supported by the most recent and highest quality study 1.
Tapering Schedule
When tapering fluoxetine, the following schedule can be considered:
- For patients taking 40mg daily, reduce to 30mg for 2-4 weeks, then 20mg for 2-4 weeks, then 10mg for 2-4 weeks before stopping completely.
- For patients on 20mg, consider using 20mg every other day for 2-4 weeks before stopping.
Considerations
- Fluoxetine's long half-life (2-3 days for the parent compound and 7-9 days for its active metabolite norfluoxetine) provides a natural buffer against withdrawal symptoms, making it generally easier to discontinue than shorter-acting SSRIs 2.
- However, some patients still experience discontinuation symptoms including dizziness, headaches, nausea, sensory disturbances, and irritability, and if these occur, slowing the taper is recommended 2.
- Individual factors like treatment duration, dose, and medical history affect the optimal tapering schedule, and patients should always consult with their prescribing healthcare provider before changing medication dosages 1.
Key Points
- Gradual tapering of fluoxetine is necessary to minimize discontinuation symptoms.
- The recommended tapering schedule is a reduction of 10mg every 2-4 weeks.
- Fluoxetine's long half-life provides a natural buffer against withdrawal symptoms.
- Individual factors affect the optimal tapering schedule, and patients should consult with their healthcare provider before changing medication dosages.