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Depression & Anxiety

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Fluoxetine

Brand Names: Prozac, Sarafem
Drug Class: Selective serotonin reuptake inhibitor (SSRI) antidepressant
Available in: Capsules, oral solution
Available OTC? No
As Generic? Yes

Side Effects

Serious: Agitation, shaking, difficulty breathing, rash, hives, itching, joint or muscle pain, chills or fever. If such symptoms occur, call your doctor immediately.

Common: Nervousness, drowsiness, anxiety, insomnia, headache, diarrhea, excessive sweating, nausea, decreased appetite, decreased initiative.

Less Common: Nasal congestion, unusual or vivid dreams, cough, increased appetite, chest pain, constipation, vision disturbances, abdominal pain, stomach gas, constipation, vomiting, frequent urination, difficulty concentrating, sexual dysfunction, heartbeat irregularities, trembling, fatigue, dizziness, change in taste, flushing of the skin on the face and neck, dry mouth, menstrual pain.

Principal Uses

To treat major depression, obsessive-compulsive disorder, panic disorder, chronic pain, and premenstrual dysphoric disorder (PMDD).

How the Drug Works

Fluoxetine affects levels of serotonin, a brain chemical that is thought to be linked to mood, emotions, and mental state.

Dosage

To start, 20 mg a day, taken in the morning. Your doctor may increase the dose gradually to a maximum of 80 mg a day. Older adults: To start, 10 to 20 mg a day. It may be increased gradually by your doctor to a maximum of 40 to 60 mg a day.

Onset of Effect

1 to 4 weeks.

Duration of Action

Unknown.

Dietary Advice

Taking the drug with liquid or food can lessen stomach irritation. Capsules may be opened and mixed with food or juice if the patient has difficulty swallowing them.

Storage

Store in a tightly sealed container away from heat, moisture, and direct light. Keep the liquid form refrigerated, but do not allow it to freeze.

If You Miss a Dose

Take it as soon as you remember. If it is near the time for the next dose, skip the missed dose and resume your regular dosage schedule. Do not double the next dose.

Stopping the Drug

Take it as prescribed for the full treatment period, even if you begin to feel better before the scheduled end of therapy. Discontinuing the drug abruptly may produce unpleasant withdrawal symptoms. Dosage should be reduced gradually according to your doctor's instructions.

Prolonged Use

The usual course of therapy lasts 6 months to 1 year; some patients benefit from additional therapy. The usual course of therapy for obsessive-compulsive disorder lasts 1 year or more.

Precautions

Over 60: Adverse reactions may be more likely and more severe in older patients, since their metabolism is slower. A lower dose may be warranted.

Driving and Hazardous Work: Use caution when driving or engaging in hazardous work until you determine how the medicine affects you.

Alcohol: Avoid alcohol.

Pregnancy: Fluoxetine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Before you take this medicine, tell your doctor if you are pregnant or plan to become pregnant.

Breast Feeding: Fluoxetine may pass into breast milk; caution is advised. Consult your doctor for specific advice.

Infants and Children: Not recommended for use by children under age 12.

Special Concerns: Take it at least 6 hours before bedtime to prevent insomnia, unless the drug causes drowsiness.

Overdose

Symptoms: Agitation, excitement, severe nausea and vomiting, seizures.

What to Do: Call your doctor, emergency medical services (EMS), or the nearest poison control center immediately.

Drug Interactions

Fluoxetine should not be used within 5 weeks of taking MAO inhibitors or thioridazine. The following drugs may interact with fluoxetine. Consult your doctor for specific advice if you are taking nortriptyline, caffeine, oral anticoagulants, central nervous system depressants, digitalis preparations, lithium, loratadine, dextromethorphan, ketorolac, buspirone, phenytoin, trazodone, tryptophan, sumatriptan, naratriptan, or zolmitriptan.

Food Interactions

No known food interactions.

Disease Interactions

Use of fluoxetine may cause complications in patients with liver or kidney disease, since these organs work together to remove the medication from the body. Use of the drug may make diabetes or seizures worse.


From The Johns Hopkins Consumer Guide to Drugs. You can order this book now on our secure server.


 


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2005
WHITE PAPERS
Depression & Anxiety

The arthritis White Paper from The Johns Hopkins White Papers series is an annual, in-depth report written by Hopkins physicians.


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Johns Hopkins Consumer Guide to Drugs

Find out everything you need to know about medications for arthritis and other conditions in The Johns Hopkins Consumer Guide to Drugs.

 

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