Fluoxetine is prescribed for the treatment of depression--that is, a continuing depression that interferes with daily functioning. The symptoms of major depression often include changes in appetite, sleep habits, and mind/body coordination; decreased sex drive; increased fatigue; feelings of guilt or worthlessness; difficulty concentrating; slowed thinking; and suicidal thoughts.
Fluoxetine is also prescribed to treat obsessive-compulsive disorder. An obsession is a thought that won't go away; a compulsion is an action done over and over to relieve anxiety. The drug is also used in the treatment of bulimia. It has also been used to treat other eating disorders and obesity.
In addition, Fluoxetine is used to treat panic disorder, including panic associated with agoraphobia. People with panic disorder usually suffer from panic attacks--feelings of intense fear that develop suddenly, often for no reason. Various symptoms occur during the attacks, including a rapid or pounding heartbeat, chest pain, sweating, trembling, and shortness of breath.
In children and adolescents, Fluoxetine is used to treat major depression and obsessive-compulsive disorder.
Fluoxetine Weekly is approved for treating major depression.
Under the brand name Sarafem, the active ingredient in Fluoxetine is also prescribed for the treatment of premenstrual dysphoric disorder, formerly known as premenstrual syndrome. Symptoms of PMDD include mood problems such as anxiety, depression, irritability or persistent anger, mood swings, and tension. Physical problems that accompany PMDD include bloating, breast tenderness, headache, and joint and muscle pain. Symptoms typically begin 1 to 2 weeks before a woman's menstrual period and are severe enough to interfere with day-to-day activities and relationships.
Fluoxetine belongs to the class of drugs called selective serotonin re-uptake inhibitors. Serotonin is one of the chemical messengers believed to govern moods. Ordinarily, it is quickly reabsorbed after its release at the junctures between nerves. Re-uptake inhibitors such as Fluoxetine slow this process, thereby boosting the levels of serotonin available in the brain.
Fluoxetine capsules and liquid contain the active ingredient fluoxetine, which is a type of antidepressant known as a selective serotonin reuptake inhibitor. Fluoxetine is also available without a brand name, ie as the generic drug.
Antidepressant drugs act on nerve cells in the brain. In the brain there are numerous different chemical compounds called neurotransmitters. These act as chemical messengers between the nerve cells. Serotonin is one such neurotransmitter and has various functions that we know of.
When serotonin is released from nerve cells in the brain it acts to lighten mood. When it is reabsorbed into the nerve cells, it no longer has an effect on mood. It is thought that when depression occurs, there may be a decreased amount of serotonin released from nerve cells in the brain.
SSRIs work by preventing serotonin from being reabsorbed back into the nerve cells in the brain. This helps prolong the mood lightening effect of any released serotonin. In this way, fluoxetine helps relieve depression.
Fluoxetine may also be used in the treatment of bulimia nervosa and obsessive compulsive disorder in adults. It is not fully understood how fluoxetine works in these illnesses.
It may take between two to four weeks for the benefits of this drug to appear, so it is very important that you keep taking it, even if it doesn't seem to make much difference at first. If you feel your depression has got worse, or if you have any distressing thoughts or feelings in these first few weeks, then you should talk to your doctor.
Why is this drug prescribed?
In adults fluoxetine is used to treat:
- a psychiatric disorder in which tasks are excessively repeated;
- bulimia nervosa.;
- depressive illness;
In children and adolescents aged eight years and over fluoxetine is used to treat:
- moderate to severe major depressive episodes, if the depression is unresponsive to psychological therapy after four to six sessions.
- yawning;
- weakness;
- vomiting;
- upset stomach;
- tremors;
- sweating;
- sore throat;
- sleepiness;
- sinusitis;
- sex-drive changes;
- rash;
- nervousness;
- nausea;
- loss of appetite;
- itching;
- insomnia;
- impotence;
- headache;
- gas;
- flushing;
- flu-like symptoms;
- dry mouth;
- dizziness;
- diminished sex drive;
- diarrhea;
- anxiety;
- abnormal vision;
- abnormal ejaculation;
- visual disturbances.;
- sweating.;
- small purplish blood spots in the skin.;
- sexual problems.;
- seizures.;
- pain in the muscles and joints.;
- headache.;
- hair loss.;
- fatigue.;
- dry mouth.;
- dizziness.;
- disturbances of the gut such as diarrhoea constipation nausea vomiting or abdominal pain.;
- difficulty in sleeping.;
- decreased appetite and weight loss.;
- anxiety and agitation.;
- allergic reactions such as itchy blistering skin rash or swelling of the lips tongue and throat.;
- abnormal dreams;
DEPRESSION
It may take 4 weeks before the full antidepressant effect of Fluoxetine is seen.
Adults
The recommended starting dose is 20 mg a day, usually taken in the morning. If needed, the doctor may gradually increase the dose up to a maximum of 80 mg a day. The usual daily dose ranges from 20 to 60 mg. Daily doses above 20 mg should be taken in the morning or in two smaller doses taken in the morning and at noon.
Children 8 years and older
The usual starting dose is 10 or 20 mg a day. Children starting at 10 mg will have their dose increased to 20 mg a day after 1 week. Underweight children may need to remain at the 10-mg dose.
Fluoxetine Weekly
You need to wait at least 7 days after stopping your daily dose of Fluoxetine before switching to the once-weekly formulation. One Fluoxetine Weekly capsule contains 90 mg of medication.
OBSESSIVE-COMPULSIVE DISORDER
It may take 5 weeks before the full effects of Fluoxetine are seen.
Adults
The recommended starting dose is 20 mg a day, usually taken in the morning. If needed, the doctor may gradually increase the dose up to a maximum of 80 mg a day. The usual daily dose ranges from 20 to 60 mg. Daily doses above 20 mg should be taken in the morning or in two smaller doses taken in the morning and at noon.
Children 7 years and older
The recommended starting dose is 10 mg a day. After 2 weeks, the doctor will increase the dose to 20 mg. If needed, the doctor may further increase the dose up to a maximum of 60 mg a day. The recommended dosage range for underweight children is 10 to 30 mg a day
BULIMIA
Adults
The recommended dose is 60 mg a day taken in the morning. The doctor may start you at a lower dose and gradually increase it over a period of several days.
PANIC DISORDER
Adults
The recommended starting dose is 10 mg a day. After 1 week, the doctor will increase the dose to 20 mg. If no improvement is seen after several weeks, the doctor may increase the dose to a maximum of 60 mg a day.
PREMENSTRUAL DYSPHORIC DISORDER
Adults
The usual dose of Sarafem is 20 mg a day. The doctor will instruct you to take the dose either every day of the month or only during the 2 weeks before menstruation begins. If there's no improvement after several weeks, the dose can be increased, usually to 60 mg a day. The maximum dose is 80 mg daily.
DOSAGE ADJUSTMENT
For all indications, the doctor may need to prescribe a lower dose if you are elderly, have liver disease, or are taking other medications.
