From the Guidelines
The recommended dosing of fluoxetine (Prozac) for females is 5-20 mg/day, as this range has been reported to be effective in delaying ejaculation and enhancing patient/partner satisfaction, with a clinically beneficial effect observed at daily doses as low as 5 mg 1.
Key Considerations
- The dosing regimen for fluoxetine can be either continuous daily dosing or situational dosing, with the choice often based on the frequency of sexual activity by the patient.
- Adverse effects of fluoxetine, such as nausea, dry mouth, drowsiness, and reduced libido, are generally similar to those reported in patients being treated for depression, but may be less frequent due to the lower doses used for premature ejaculation.
- Female patients should be aware of potential interactions with hormonal contraceptives and the risks associated with SSRI use during pregnancy.
Dosing Regimen
- The initial dose of 5-20 mg/day can be adjusted based on response, with some studies suggesting that higher doses may be more effective, but also potentially associated with increased side effects.
- The optimal interval for situational dosing before intercourse has not been established, but a dose of 5-20 mg/day has been shown to be effective in increasing ejaculatory latency.
Important Notes
- Fluoxetine should not be stopped abruptly, as this can cause withdrawal symptoms; dosage should be tapered gradually under medical supervision.
- Patients should be monitored for potential adverse effects, such as mania, withdrawal symptoms, and pharmacodynamic or pharmacokinetic interactions with other medications.
From the Research
Recommended Dosing of Fluoxetine for Females
- The recommended dosing of fluoxetine (Prozac) for females is not explicitly stated in the provided studies, but we can look at the general dosing recommendations for fluoxetine.
- According to the study 2, the efficacy and safety of fluoxetine in adults with moderate-to-severe major depression are well established, and the dose of 20 mg/day is considered effective.
- The study 3 suggests that the lower range of the licensed dose of fluoxetine, between 20 mg and 40 mg, achieves the optimal balance between efficacy, tolerability, and acceptability in the acute treatment of major depression.
- The study 4 found that starting fluoxetine at a low daily dose (5 mg) and increasing to the standard daily dose (20 mg) can be a useful strategy, particularly for patients with panic disorder who may be intolerant of the 20 mg/day dose.
- There is no specific mention of dosing recommendations for females in the provided studies, but the general recommendations for fluoxetine dosing can be applied to females as well.
Dosing Considerations
- The study 5 compared the efficacy and safety of venlafaxine and fluoxetine in outpatients with major depression, and found that fluoxetine 20 mg once daily was effective in achieving a clinical response.
- The study 6 discusses the optimal dose regimen for paroxetine, but not fluoxetine, and is therefore not directly relevant to the question of fluoxetine dosing.
- The study 3 provides a systematic review and dose-response meta-analysis of double-blind, randomized controlled trials of fluoxetine and other antidepressants, and suggests that the lower range of the licensed dose is optimal for efficacy, tolerability, and acceptability.