What is the use of Fluoxetine (Selective Serotonin Reuptake Inhibitor, SSRI)?

From the Guidelines

Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) antidepressant that should be used to treat major depressive disorder, obsessive-compulsive disorder, panic disorder, and other conditions, with a typical starting dose of 20mg once daily, which may be increased to a maximum of 80mg daily based on response and tolerability, as supported by the most recent and highest quality study 1. The use of fluoxetine is supported by several studies, including a clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders, which recommends fluoxetine as a treatment option for anxiety disorders in children and adolescents 1. Additionally, a study on the pharmacokinetic pharmacogenetic prescribing guidelines for antidepressants found that fluoxetine is FDA approved for major depressive disorder, OCD, bulimia nervosa, premenstrual dysphoric disorder, panic disorder, and bipolar disorder (in combination with olanzapine) 1. Some key points to consider when using fluoxetine include:

• Treatment duration varies by condition, with therapy typically continuing for at least 6-12 months after symptom improvement for depression, and longer for anxiety disorders and obsessive-compulsive disorder 1.
• Fluoxetine works by increasing serotonin levels in the brain by blocking its reabsorption, which helps regulate mood, anxiety, and behavior 1.
• Common side effects include nausea, headache, insomnia, drowsiness, and sexual dysfunction, and patients should be aware that therapeutic effects may take 2-4 weeks to appear 1.
• Fluoxetine interacts with several medications, including MAOIs, triptans, and certain pain medications, so patients should inform their healthcare provider about all medications they're taking 1. It's also important to note that fluoxetine has a boxed warning for suicidal thinking and behavior in children and adolescents, and close monitoring is recommended, especially in the first months of treatment and following dosage adjustments 1. Overall, fluoxetine is a commonly prescribed and effective medication for the treatment of various conditions, but its use should be carefully considered and monitored by a healthcare provider.

From the FDA Drug Label

CLINICAL PHARMACOLOGYPharmacodynamicsThe antidepressant, antiobsessive compulsive, and antibulimic actions of fluoxetine are presumed to be linked to its inhibition of CNS neuronal uptake of serotonin.

The use of Fluoxetine, a Selective Serotonin Reuptake Inhibitor (SSRI), is for the treatment of:

• Major Depressive Disorder
• Obsessive-Compulsive Disorder (OCD)
• Bulimia Its mechanism of action is linked to its inhibition of CNS neuronal uptake of serotonin. 2

From the Research

Use of Fluoxetine

• Fluoxetine is a Selective Serotonin Reuptake Inhibitor (SSRI) used in the treatment of major depressive disorder 3, 4, 5, 6, 7.
• The efficacy of fluoxetine in treating major depressive disorder has been established in numerous clinical controlled trials, with meta-analyses confirming its effectiveness compared to tricyclic antidepressants and placebo 4, 5.
• Fluoxetine has been shown to be effective in treating bipolar II major depressive episodes, with a relatively low manic switch rate 6.
• The safety profile of fluoxetine is generally favorable, with common adverse events including insomnia, asthenia, and somnolence 3, 4, 7.
• Fluoxetine is available in various formulations, including a 90-mg enteric-coated weekly dose, which has been shown to be effective and tolerable for long-term treatment of depression 7.

Dosage and Administration

• Fluoxetine can be administered daily or weekly, depending on the formulation and patient needs 3, 7.
• The typical daily dose of fluoxetine is 20 mg, although higher doses may be used in some cases 3, 4.
• The 90-mg weekly dose of fluoxetine has been shown to be effective and safe for long-term treatment of depression 7.

Efficacy and Safety

• Fluoxetine has been shown to be effective in reducing symptoms of depression, with response rates similar to those of tricyclic antidepressants 4, 5.
• The safety profile of fluoxetine is generally favorable, although it can cause adverse events such as insomnia and asthenia 3, 4, 7.
• Fluoxetine may be a safe and effective treatment option for patients with bipolar II disorder, although further study is needed to confirm its efficacy and safety in this population 6.