Fluoxetine: Difference between revisions
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MDElliottMD (talk | contribs) Added effect: Temporary erectile dysfunction |
MDElliottMD (talk | contribs) Proposed effect: Persistent Sexual Dysfunction |
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<effect ref="temporary-erectile-dysfunction" author="MDElliottMD"/> | <effect ref="temporary-erectile-dysfunction" author="MDElliottMD"/> | ||
<effect ref="persistent-sexual-dysfunction" author="MDElliottMD"> | |||
Persistent sexual dysfunction, historically [https://pmc.ncbi.nlm.nih.gov/articles/PMC11450419/ associated with SSRIs] | |||
</effect> | |||
| contraindications = MAO-Is, history of severe mania (without a mood stabilizer) | | contraindications = MAO-Is, history of severe mania (without a mood stabilizer) | ||
| interactions = | | interactions = | ||
Revision as of 01:32, 13 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.
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, social anxiety, OCD), depressive disorders, potentially PTSD
+ Add a problemTitration 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).
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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Delayed orgasm/ejaculation 0% — (n=3) ~80% +33.0 (n=1)
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Mood enhancement no reports yet ~5% +67.0 (n=1)
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Nausea no reports yet ~5% -33.0 (n=1)
Common, often improves over 1–2 weeks.
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Decreased libido no reports yet ~33% -100.0 (n=1)
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How was it? (-100 worst, +100 best)How was it? (-100 worst, +100 best)
Temporary erectile dysfunction no reports yet ~20% -67.0 (n=1)
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How was it? (-100 worst, +100 best)How was it? (-100 worst, +100 best)
Persistent Sexual Dysfunction no reports yet ~0% -100.0 (n=1)
Persistent sexual dysfunction, historically associated with SSRIs
Did you experience this?
How often have you seen this?
How was it? (-100 worst, +100 best)How was it? (-100 worst, +100 best)
Monitoring
Relevant anecdote
⚕️ Provider 0
Fluoxetine is great for getting off other SxRIs! Especially venlafaxine and duloxetine.
Relevant Literature
No literature entries yet.
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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.0