Millions of individuals take prescription medications for depression in the United States. Fluoxetine is a widely used drug prescribed for depression treatment. What should you know about Fluoxetine usage?
What Is Fluoxetine and What Is It Used For?
Fluoxetine is an antidepressant medication in the class of selective serotonin reuptake inhibitors (SSRIs). It is used to treat major depressive disorder, an eating disorder (bulimia nervosa), obsessive-compulsive disorder (OCD), panic disorder, and other mental health conditions.
Brand names for fluoxetine include Prozac, Prozac Weekly, Rapiflux, Sarafem, and Selfemra. There is also generic fluoxetine.
Understanding Fluoxetine
Anyone prescribed fluoxetine should knowhow it works. Briefly, the drug balances the body’s neurotransmitters by increasing the brain’s serotonin levels. This, in turn, helps improve mental health for those experiencing depression and other mental health conditions.
However, despite significant uses and benefits, fluoxetine’s side effects must be considered.
Uses and Benefits
The FDA approved fluoxetine for the treatment of depression, including major depressive disorder, affecting an estimated 21 million adults in the U.S. Other uses include treatment for panic disorder, bulimia, OCD, depression caused by bipolar I disorder, pre-menstrual dysphoric disorder, and treatment-resistant depression. Off-label, fluoxetine may be prescribed to treat generalized anxiety disorder and social anxiety disorder.
Fluoxetine benefits include improved energy, less anxiety and more relaxation, improved appetite and sleep, and improved mental focus. It helps you reduce impairments that interfere with daily living.
Risks and Side Effects
As with any prescription medication, caution is essential. No one should indiscriminately take a depression drug without knowing its risks and side effects.
What are the Common Side Effects of Taking Fluoxetine?
All medications have side effects. Not all are serious or require medical attention. Furthermore, many side effects accompanying fluoxetine usage may disappear during treatment. That’s because the body adjusts to the drug, mitigating or eliminating the side effects.
Common fluoxetine side effects include:
- Agitation
- Anxiety
- Attention difficulties
- Decreased appetite
- Dizziness
- Dream abnormality
- Drowsiness
- Exaggerated, quick, successive mood changes
- Extreme or excessive muscle activity
- Forgetfulness
- Headache
- Hostility
- Insomnia
- Nervousness
- Numbness, tingling, burning, prickling, or itching in hands, fingers, feet, and toes
- Persistent restlessness
- Sense of taste distortion
- Tension
- Tremor
Serious Side Effects
Many medications have potentially serious side effects. This is also true with fluoxetine usage. Some individuals taking this drug may experience fluoxetine side effects that can be severe and require immediate medical attention. Serious side effects, which aren’t common, include:
- Allergic reaction
- Anxiety
- Appearance of red or purple skin spots
- Behavior or mood changes
- Breathing difficulties
- Chills
- Cold sweats
- Concentration difficulties
- Confusion
- Diarrhea
- Drowsiness
- Dry mouth
- Excitability that’s uncontrolled (acting, talking, and feeling)
- Extreme hunger
- Fast, irregular, or racing heartbeat
- Fever
- Headache
- Incomplete or unusual facial or body movements
- Listlessness, lack of energy
- Pain in joints or muscles
- Pale, cool skin
- Restlessness
- Seizures
- Shaking and shivering
- Skin rash, itching, and hives
- Unable to sit still
- Unsteady gait, shaking when walking
- Unusual bleeding
- Unusual fatigue, weakness, or tiredness
Fluoxetine carries a boxed warning about potential suicidal behaviors and thoughts.
Precautions and Considerations
With fluoxetine, there are some precautions and considerations.
- Pregnant women should not take fluoxetine due to the increased risk of heart defects. Furthermore, exposure to the drug in late pregnancy may contribute to preeclampsia and gestational hypertension. Breast milk may contain trace amounts of the drug.
- Fluoxetine may trigger hypomanic or manic episodes in those with bipolar disorder. Careful monitoring for the appearance of mood changes during treatment with fluoxetine is essential.
- Some individuals may have increased sleep disturbance and anxiety while taking the drug.
- Anyone taking fluoxetine who develops an allergic reaction or rash should stop taking it.
- Sexual dysfunction can occur in those taking fluoxetine or other SSRIs.
- While taking fluoxetine, cognitive ability and motor skills may be impaired. Exercise caution during tasks requiring mental alertness, such as operating machines. Some individuals with dementia, however, may experience enhanced cognitive functioning.
- Never combine fluoxetine with alcohol or other drugs, as this can lead to other health risks.
- Older individuals or those with a seizure history should only use fluoxetine with caution.
- Drug interactions may occur with benzodiazepines, ADHD drugs, fentanyl and other opioids, buspirone, tricyclic antidepressants, lithium, seizure medications certain heart medications, diuretics, drug thinners, antipsychotics, mental health and schizophrenia drugs, Tourette syndrome drugs, HIV medications, and MAOIs.
Is Fluoxetine Addictive?
Since the DEA does not classify fluoxetine as a controlled substance, and it has no properties of physical addiction or abuse, it is not an addictive drug. However, it may cause those who take it to feel a psychological dependence and go through symptoms of withdrawal when they cease use.
Dosage and Administration
General information in an antidepressant medication guide on fluoxetine usage indicates that the drug is available in several oral forms: capsule, delayed-release capsule, solution, tablet, and compounding powder. Fluoxetine has multiple strengths: 10 mg, 15 mg, 20 mg, 40 mg, 20 mg/5mL, and 60 mg.
The exact dosage is determined according to several factors: age, other health conditions, and other medications you take. This information is not to be used for self-prescribing.
For depression:
The usual dosage of immediate-release fluoxetine for adults experiencing depression is initially 20 mg daily, taken in the morning. The doctor may increase the dosage if desired clinical results are not apparent after several weeks. Maintenance doses are 20 to 60 mg orally, with a maximum daily dosage of 80 mg. Increased doses may be divided and taken in the morning and noontime.
Those prescribed delayed-release fluoxetine for depression usually receive a prescription for 90 mg of oral capsule taken once weekly after the last daily 20 mg dose of immediate-release fluoxetine.
For OCD:
The usual adult dosage of fluoxetine for OCD is 20 mg orally daily, taken in the morning. The prescribing doctor may increase the dose if desired clinical results are absent after several weeks. The maintenance dose is 20 to 60 mg orally daily, with a maximum daily oral dose of 80 mg.
How Long Does It Take to Work?
Treating depression, OCD, and other mental health issues with fluoxetine requires time to work. Symptom improvement may take one to two weeks, while it may be 30 days to six weeks to experience the drug’s full benefits. The drug levels must build in the body, and the body must adapt to fluoxetine.
Treatment Duration and Withdrawal
Compared with other SSRI medications, fluoxetine usage is generally not linked with abrupt withdrawal symptoms onset once individuals stop taking the drug. Fluoxetine’s prolonged half-life lessens the likelihood of withdrawal symptoms common with other antidepressant cessation, such as fever, nausea, disturbed sleep, uneasiness, and dissatisfaction.
As for how long fluoxetine treatment will last, experts say that it may be three to six months for symptoms to improve to the point you’re no longer depressed. However, individuals may need to take the medication for approximately a year to realize its full benefits.
Discontinuing Fluoxetine
When your doctor says you can discontinue fluoxetine, the process will include tapering the dosage over a month or longer. Withdrawal symptoms may occur, so it’s vital to be aware of them and have sufficient coping methods. Also, it’s essential to rest and stay hydrated during the withdrawal period.
What Should I Discuss with My Doctor Before Taking Fluoxetine?
When your doctor recommends that you begin fluoxetine treatment, you will receive an antidepressant medication guide (either from your doctor or pharmacist). It is essential that you carefully read the information about fluoxetine usage and raise any questions or concerns you have about the drug.
Also, speak with your doctor about common fluoxetine side effects and how you may be able to reduce or prevent some of them from occurring with fluoxetine usage.
Another vital concern to discuss with your doctor is the potential benefits and risks of taking fluoxetine. What are the risks and benefits if your condition isn’t treated? Keep in mind that depression and mental illness put you at increased risk for suicidal thoughts and ideation. The risk increases if other family members have experienced mania, bipolar disorder, or have contemplated suicide.
Making the Decision
The decision to take fluoxetine as part of your doctor’s recommended treatment plan for your condition is between you and your doctor. The overall treatment approach likely includes counseling, behavioral and other therapies, participation in support groups, and prescription medication. Other medications may be prescribed in addition to or instead of fluoxetine to reduce symptom frequency, duration, intensity, or severity.
Remember, you want the most effective treatment for your condition. If you have questions about fluoxetine or about other potential treatment options, our experts at Restore-Mental Health are here to help. Contact us anytime for a free and confidential consultation.
