Psilocybin

2026-05-20T06:44:14Z

Noob: Added effect: Hallucinations

{{MedTemplate
| generic = Psilocybin
| brand =
| structure =
| classes = Classic Psychedelic, Tryptamine
| mechanism = Prodrug of psilocin; 5-HT2A agonist
| uses =
| starting_dose =
| preparations =
| fda_max =
| routes =
| onset =
| duration =
| halflife =
| bioavailability =
| pregnancy =
| legal =
| intro =
| pharmacokinetics =
| pharmacodynamics =
| indications =
| dosing =
| effects =
<effect ref="hallucinations" author="Noob"/>
| interactions = <pharmaInteractions/>
| pregnancy_details =
| monitoring =
| counseling =
| anecdotes =
| seealso =
| references =
}}

{{PendellsCorner
| quote = Entheogenic, manifesting god within. And yet that doesn't say it. Psychedelic, revealing the soul. And yet that doesn't say it. Hallucinogenic, generating visions. And yet that doesn't say it, either.
| volume = Gnosis
| page = 28
}}

[[Category:Psychedelics]]
[[Category:Classical Psychedelics (Serotonergic)]]
[[Category:Classic_Psychedelics]]
[[Category:Tryptamines]]

Fluoxetine

2026-05-20T06:40:34Z

Noob: Added Problem: Embarrassment

{{MedTemplate
| generic = Fluoxetine
| brand = Prozac
| structure = Fluoxwhite.svg
| classes = SSRI, Anxiolytic, Antidepressant
| uses = <vote slug="anxiety-use">Anxiety</vote>, <vote slug="premature-ejaculation-use">Premature ejaculation</vote>, <vote slug="low-mood-use">Low mood</vote>
| starting_dose = 10 mg
| preparations = 10 mg, 20 mg, 40 mg caps
| fda_max = 40 mg/d
| pill_id =
* '''10 mg:''' green/cream capsule, "PLIVA 647"
* '''20 mg:''' green/cream capsule, "PROZAC 20"
* '''40 mg:''' olive/cream capsule, "DISTA 3107"
* '''Oral solution:''' 20 mg / 5 mL, clear
| routes = Oral
| onset =
| duration = Very long
| halflife = 1–4 days (7–15 days for norfluoxetine)
| bioavailability = 70–90% (oral)
| pregnancy = Category C<ref name="lactmed">S0</ref>
| legal = Rx-only in US
| mechanism = TrkB/BDNF<ref name="trkb">S1</ref> <vote slug="ssri-claim">Fluoxetine is a selective serotonin reuptake inhibitor.</vote>
| intro = Fluoxetine was the first of a long line of SSRIs. It is notable for its extremely long half-life and relative lack of withdrawal syndrome. It can also be useful in helping taper and discontinue other SxRI meds.
| indications = <problem ref="depression" author="MDElliottMD"/>
<problem ref="anxiety-disorders" author="MDElliottMD">
Including generalized anxiety, panic, and social anxiety.
</problem>
<problem ref="panic" author="MDElliottMD"/>
<problem ref="social-anxiety" author="MDElliottMD"/>
<problem ref="ocd" author="MDElliottMD"/>
<problem ref="ptsd" author="MDElliottMD">
Potentially.
</problem>

<problem ref="premature-ejaculation"/>

<problem ref="embarrassment" author="Noob">
I was very embarrassed when I told somebody I was using it.
</problem>
| dosing = <titration slug="standard" author="MDElliottMD" title="Standard adult or child">
Start no higher than 10 mg for the first dose. May increase by 10 mg every 2–12 weeks, or remain at 10 mg if the response is adequate, up to a typical starting maximum of 40 mg. Absolute max: 80 mg.
</titration>

<titration slug="ocd" author="MDElliottMD" title="OCD">
Start at 10 mg daily; increase by 10–20 mg every 2–6 weeks, up to 80 mg. OCD typically requires elevated doses (60–80 mg).
</titration>
| effects =
* <effect ref="anxiolysis" author="MDElliottMD">Classically starting at 3–4 weeks and improving for another 8–12.</effect>
* <effect ref="delayed-ejaculation" author="MDElliottMD"/>
* <effect ref="mood-enhancement" author="MDElliottMD"/>
* <effect ref="nausea" author="MDElliottMD">Common, often improves over 1–2 weeks.</effect>
* <effect ref="decreased-libido" author="MDElliottMD"/>
* <effect ref="temporary-erectile-dysfunction" author="MDElliottMD"/>
* <effect ref="persistent-sexual-dysfunction" author="MDElliottMD">Historically [https://pmc.ncbi.nlm.nih.gov/articles/PMC11450419/ associated with SSRIs].</effect>

<effect ref="anorgasmia" author="MDElliottMD"/>
| pk_absorption = 70–90%<ref name="statpearls">S3</ref> oral bioavailability.
| pk_distribution = Fluoxetine has plasma protein binding of approximately 94.5%, bound to albumin and alpha-1 glycoprotein. Fluoxetine readily crosses the blood–brain barrier, with a brain-to-plasma ratio of 2.6:1 in humans. The volume of distribution (Vd) of fluoxetine and its metabolite ranges between 20 to 42 L/kg. Some studies report that fluoxetine has the maximum volume of distribution (Vd) of any SSRI (between 14 and 100 L/kg).<ref name="statpearls"/>
| pk_metabolism = Fluoxetine's active metabolite is norfluoxetine, produced when the cytochrome P450 enzyme (CYP2D6) acts on it. Prescribers must remember that fluoxetine has several med-med interactions due to its metabolism through the CYP2D6 isoenzyme. Additionally, norfluoxetine can have an inhibitory effect on CYP3A4. Fluoxetine has a half-life of 2 to 4 days, and its active metabolite norfluoxetine has a half-life of 7 to 9 days. Approximately 7% of individuals definitively exhibit poor metabolism of fluoxetine due to reduced activity of CYP2D6.<ref name="statpearls"/>
| pk_elimination =
| pharmacodynamics =
| interactions = <pharmaInteractions/>
| pregnancy_details =
| monitoring = None required
| counseling =
| anecdotes = <anecdote slug="2026-05-12" perspective="provider" author="MDElliottMD">
Fluoxetine is great for getting off other SxRIs! Especially venlafaxine and duloxetine.
</anecdote>
| seealso = [[Sertraline]], [[Duloxetine]]
| references = <references/>
}}

[[Category:Selective Serotonin Reuptake Inhibitors (SSRIs)]]
[[Category:Antidepressants]]
[[Category:Medicines]]

Pharmacopedia - User contributions [en]

Psilocybin

Fluoxetine