Fluoxetine: Difference between revisions
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== Relevant anecdote == | == Relevant anecdote == | ||
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<anecdote slug="2026-05-12" perspective="provider" author="MDElliottMD"> | |||
I have found fluoxetine enormously useful in getting of other SxRI medicines, most particularly venlafaxine and duloxetine | |||
</anecdote> | |||
<!-- PCP_ANECDOTES_END --> | <!-- PCP_ANECDOTES_END --> | ||
Revision as of 23:05, 12 May 2026
SSRI, Anxiolytic, Antidepressant
Fluoxetine
Prozac
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.
none required
Sertraline, Duloxetine
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 attacks, social anxiety, as well as OCD, Depressive disorders, potentially PTSD
+ Add a problemTitration strategies
Standard adult or child+1
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
OCD+1
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)
Effects
Anxiolysis no reports yet ~33% +67.0 (n=1)
Classically starting at 3-4 weeks and improving for another 8-12
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How was it? (-100 worst, +100 best)How was it? (-100 worst, +100 best)
Delayed ejaculation no reports yet ~80% +0.0 (n=1)
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How was it? (-100 worst, +100 best)How was it? (-100 worst, +100 best)
Mood enhancement no reports yet ~5% +67.0 (n=1)
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How was it? (-100 worst, +100 best)How was it? (-100 worst, +100 best)
Nausea 100% -50.0 (n=2) ~33% -33.0 (n=1)
Common, often improves over 1-2 weeks.
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How was it? (-100 worst, +100 best)How was it? (-100 worst, +100 best)
Sexual dysfunction 100% -83.5 (n=2) — -67.0 (n=1)
Frequent; can persist long-term.
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How was it? (-100 worst, +100 best)How was it? (-100 worst, +100 best)
Monitoring
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Relevant Literature
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See also
Summary
Classes
SSRI, Anxiolytic, Antidepressant
Common uses
- Premature ejaculation2.1n=2
- Anxiety disorders broadly1.5n=2
- Panic disorder1.5n=2
- Depressive disorders1.1n=1
- Embarrassment0.5n=3
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
Legal status
Rx-only
Purported mechanism
TrkB/BDNF Fluoxetine is a selective serotonin reuptake inhibitor.+1
Relevant anecdote
⚕️ Provider 0
I have found fluoxetine enormously useful in getting of other SxRI medicines, most particularly venlafaxine and duloxetine