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Fluoxetine: Difference between revisions

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| brand            = Prozac
| brand            = Prozac
| structure        = Fluoxwhite.svg
| structure        = Fluoxwhite.svg
| classes             = SSRI, Anxiolytic, Antidepressant
| classes           = SSRI, Anxiolytic, Antidepressant
| uses              = Anxiety, premature ejaculation, low mood
| uses              = Anxiety, premature ejaculation, low mood
| starting_dose    = 10 mg
| starting_dose    = 10 mg
Line 10: Line 10:
| onset            =  
| onset            =  
| duration          = Very long
| duration          = Very long
| halflife          = 1-4 days (7-15 days for norfluoxetine)
| halflife          = 1–4 days (7–15 days for norfluoxetine)
| bioavailability  = 70-90% (Oral)
| bioavailability  = 70–90% (oral)
| pregnancy        = [https://www.ncbi.nlm.nih.gov/books/NBK501186/ Category C]
| pregnancy        = [https://www.ncbi.nlm.nih.gov/books/NBK501186/ Category C]
| legal            = Rx-only
| legal            = Rx-only
| mechanism        = [https://pmc.ncbi.nlm.nih.gov/articles/PMC9666396/ TrkB/BDNF] <vote slug="test1">Fluoxetine is a selective serotonin reuptake inhibitor.</vote>
| mechanism        = [https://pmc.ncbi.nlm.nih.gov/articles/PMC9666396/ TrkB/BDNF] <vote slug="ssri-claim">Fluoxetine is a selective serotonin reuptake inhibitor.</vote>
| intro            = Fluoxetine was the first to be released of a long line of subsequent SSRIs. It is remarkable in its extremely long half life and relative lack of withdrawal syndrome. It can also be very useful it helping taper and terminate other SxRI medicines.
| 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 medicines.
| pharmacokinetics  =  
| pharmacokinetics  =  
| pharmacodynamics  =  
| pharmacodynamics  =  
| indications      = Anxiety disorders broadly, including panic attacks, social anxiety, as well as OCD, Depressive disorders, potentially PTSD
| indications      = Anxiety disorders broadly (including panic, social anxiety, OCD), depressive disorders, potentially PTSD
| dosing = <titration slug="standard" title="Standard adult or child">
| dosing           = <titration slug="standard" title="Standard adult or child">
Start no higher than 10 mg for first dose! Participant may increase by 10 mg every 2-12 weeks, or never increase if they are satisfied with the 10 mg effect, up to a total of 40 mg to start. 80 mg absolute max
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>


<titration slug="OCD" title="OCD">
<titration slug="ocd" title="OCD">
Start at 10 mg daily, increase by 10-20 mg every 2-6 weeks up to 80 mg. Typically requires elevated doses are required (60 or 80mg)
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>
</titration>
| effects          = <effect slug="anxiolysis" label="Anxiolysis">Classically starting at 3-4 weeks and improving for another 8-12</effect>
| effects          = <effect slug="anxiolysis" label="Anxiolysis">Classically starting at 3–4 weeks and improving for another 8–12.</effect>
<effect slug="delayed-ejaculation" label="Delayed ejaculation"></effect>  
<effect slug="delayed-ejaculation" label="Delayed ejaculation"/>
<effect slug="mood-enhancement" label="Mood enhancement">
<effect slug="mood-enhancement" label="Mood enhancement"/>
</effect><effect slug="nausea" label="Nausea">Common, often improves over 1-2 weeks.</effect>
<effect slug="nausea" label="Nausea">Common, often improves over 1–2 weeks.</effect>
<effect slug="sexual-dysfunction" label="Sexual dysfunction">Frequent; can persist long-term.</effect>
<effect slug="sexual-dysfunction" label="Sexual dysfunction">Frequent; can persist long-term.</effect>
| contraindications = MAO-is, history of severe mania (without mood stabilizer)
| contraindications = MAO-Is, history of severe mania (without a mood stabilizer)
| interactions      =  
| interactions      =  
| pregnancy_details =  
| pregnancy_details =  
| monitoring        = none required
| monitoring        = None required
| counseling        =  
| counseling        =  
| anecdotes        =  
| anecdotes        =  
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| references        =  
| references        =  
}}
}}
== Relevant anecdote ==
<!-- PCP_ANECDOTES_BEGIN -->
<anecdote slug="2026-05-12" perspective="provider" author="MDElliottMD">
Fluoxetine has been great in my hands for transitioning off various other SxRIs, most especially venlafaxine and duloxetine
</anecdote>
<!-- PCP_ANECDOTES_END -->

Revision as of 23:08, 12 May 2026

SSRI, Anxiolytic, Antidepressant
Fluoxetine
Prozac
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 medicines.

Experience

👥 No personal reports yet
⚕ 1 provider report · avg efficacy 40.0/100 · avg side-effect burden 40.0/100 · 150 patients managed total

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Problems

Anxiety disorders broadly (including panic, social anxiety, OCD), depressive disorders, potentially PTSD

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Titration strategies

Standard adult or child+1
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.
OCD+1
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).

+ Add a titration strategy

Effects

Anxiolysis👤 no reports yet⚕️ ~33% +67.0 (n=1)
Classically starting at 3–4 weeks and improving for another 8–12.
Delayed ejaculation👤 no reports yet⚕️ ~80% +0.0 (n=1)
Mood enhancement👤 no reports yet⚕️ ~5% +67.0 (n=1)
Nausea👤 100% -50.0 (n=2)⚕️ ~33% -33.0 (n=1)
Common, often improves over 1–2 weeks.
Sexual dysfunction👤 100% -83.5 (n=2)⚕️ — -67.0 (n=1)
Frequent; can persist long-term.

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Monitoring

None required

Relevant anecdote

No anecdotes yet. Share a relevant one.

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Relevant Literature

No literature entries yet.

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See also

Sertraline, Duloxetine
Structure of Fluoxetine
Summary
Classes
SSRI, Anxiolytic, Antidepressant
Common uses
+ 3 more uses →
Pharmacy
Starting dose
10 mg
Preparations
10 mg, 20 mg, 40 mg caps
Pharmacology
Routes
Oral
Duration
Very long
Half-life
1–4 days (7–15 days for norfluoxetine)
Bioavailability
70–90% (oral)
Pregnancy
Category C
Legal status
Rx-only
Purported mechanism
TrkB/BDNF Fluoxetine is a selective serotonin reuptake inhibitor.0
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