Fluoxetine

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Definition
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Half-life
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Fluoxetine has a half-life of 4-6 days, its active metabolite (norfluoxetine) has a half-life of about 4-16 days.

Pharmacodynamics (Effect)
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The selective serotonin reuptake inhibitors(SSRI) act specifically on the messenger substance serotonin and lead to a significant alleviation of depressive symptoms. In dermatology, fluoxetine is used to treat Raynaud's syndrome in combination with depression.

Indication
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  • Depressive illnesses
  • Obsessive-compulsive disorders
  • Bulimia (only as a supplement to psychotherapy, to reduce self-induced vomiting).

Pregnancy/nursing period
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There is insufficient experience of its use in humans. Embryotoxic and teratogenic effects could not be detected in animal experiments. The substance is detectable in breast milk. Damage to infants is not known to date.

Dosage and method of use
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  • Fluoxetine (20 mg/day) has been successfully used in studies for the treatment of Raynaud's syndrome.
  • Depression: 20 mg/day; obsessive-compulsive disorder: initial 20 mg/day, possibly up to 60 mg/day; bulimia: 60 mg/day; maximum dose 80 mg/day.

Undesirable effects
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Itching, urticaria, anaphylactoid reactions, vasculitis, angioedema, chills, serotonin syndrome, hypersensitivity to light, toxic epidermal necrolysis, gastrointestinal problems, dry mouth, hepatitis, headaches, sleep disorders, sexual dysfunction, priapism, hair loss, sweating, ecchymosis, bleeding tendencies (e.g., allergic reactions, hypersensitivity to light, toxic epidermal necrolysis, dry mouth, hepatitis, headaches, sleep disorders, sexual dysfunction, priapism, hair loss, sweating, ecchymosis, bleeding tendencies (e.g., allergic reactions to light, sweating, eczema, etc.).e.g. gynaecological bleeding, mucosal bleeding).

Interactions
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  • Drugs with a narrow therapeutic range metabolized by cytochrome enzymes (e.g. flecainide, encainide, carbamazepine and tricyclic antidepressants): the amount to be administered should be at the lower end of the dose range.
  • Oral anticoagulants: modification of anticoagulant effects possible, increase in bleeding.
  • St. John's wort: increase in side effects possible.

Preparations
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Fluctin, Fluoxe-Q, Fluoxetine AL

Literature
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  1. Coleiro B (2001) Treatment of Raynaud's phenomenon with the selective serotonin reuptake inhibitor fluoxetine. Rheumatology 40: 1038-1043
  2. Nieuwstraten C et al (2006) Systematic overview of drug interactions with antidepressant medications. Can J Psychiatry 51: 300-316
  3. Steinberg M et al (2007) Mild serotonin syndrome associated with concurrent linezolid and fluoxetine. At J Health Syst Pharm 64: 59-62

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Last updated on: 29.10.2020