Tapering Fluoxetine (Prozac) from 80mg
For fluoxetine specifically, gradual tapering is generally unnecessary due to its exceptionally long half-life, making it unique among antidepressants—most patients can reduce directly from 80mg to a lower dose or discontinue without the elaborate tapering protocols required for other SSRIs. 1
Why Fluoxetine Is Different
- Fluoxetine has an extended half-life that distinguishes it from all other serotonin reuptake inhibitors, eliminating the need for gradual tapering that is necessary for agents with shorter half-lives like paroxetine, venlafaxine, and fluvoxamine 1
- The long half-life of fluoxetine and its active metabolite (norfluoxetine) provides a "self-tapering" effect as the drug naturally clears slowly from the body over weeks 1
Practical Tapering Approach for Fluoxetine 80mg
If you choose to taper (for patient reassurance or to minimize any potential symptoms), reduce the dose over 10-14 days using available dosage forms:
- Week 1: Reduce from 80mg to 60mg daily for 5-7 days 2
- Week 2: Reduce to 40mg daily for 5-7 days before discontinuation 2
- Alternatively, you can reduce from 80mg to 40mg for one week, then discontinue 2
Managing Discontinuation Symptoms
While fluoxetine rarely causes withdrawal symptoms, if they occur they are typically mild and self-limiting: 1
- Somatic symptoms may include dizziness, light-headedness, nausea, fatigue, myalgia, or sensory disturbances 1
- Psychological symptoms may include anxiety, agitation, crying spells, or irritability 1
- Mild symptoms can be managed with reassurance that they are transient 1
- For more severe symptoms (rare with fluoxetine), reinstitute the previous dose and slow the taper rate 1
Critical Distinction from Other Antidepressants
Do not apply the hyperbolic tapering protocols designed for short half-life SSRIs to fluoxetine. The hyperbolic tapering approach (reducing doses to very small amounts over months) is recommended for medications like paroxetine and sertraline to minimize withdrawal, but fluoxetine's pharmacokinetics make this unnecessary 3. The evidence supporting months-long tapers and hyperbolic dose reductions applies to SSRIs that lack fluoxetine's self-tapering properties 3.