Fluoxetine
From Pharmacopedia
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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.
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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
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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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Sexual dysfunction no reports yet no reports yet
Frequent; can persist long-term.
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Decreased libido no reports yet ~33% -100.0 (n=1)
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Monitoring
Relevant anecdote
⚕️ Provider 0
Fluoxetine is great for getting off other SxRIs! Especially venlafaxine and duloxetine.
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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