Fluoksetiini

Fluoksetiini (fluoxetine) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It is marketed under brand names such as Prozac and Sarafem and is available as a generic medical product. It was introduced in 1987 and has since become widely prescribed for mood and anxiety disorders.

Indications include major depressive disorder, obsessive-compulsive disorder, bulimia nervosa, panic disorder, and premenstrual dysphoric disorder. In some regions it is approved for additional indications, and it is commonly prescribed off-label for other anxiety disorders and mood conditions.

Fluoxetine works by blocking the serotonin transporter, increasing serotonin signaling in the brain. It has an active metabolite, norfluoxetine, and a long elimination half-life, which leads to gradual accumulation, slower washout after stopping, and a delayed onset of therapeutic effects.

It is taken by mouth, usually once daily. A common starting dose for adults is 20 mg, with adjustments made based on response and tolerability. Steady-state levels can take several weeks because of the long half-life.

Common side effects include nausea, headache, insomnia or sleepiness, dry mouth, dizziness, and sexual dysfunction. Hyponatremia risk is higher in older adults, and rare but serious risks include serotonin syndrome and increased suicidality in younger patients. Fluoxetine may unmask or trigger manic episodes in bipolar disorder.

Contraindications include concurrent use with monoamine oxidase inhibitors. Caution is advised with other serotonergic drugs and with anticoagulants. Pregnant and breastfeeding patients should discuss risks with a clinician, as the medication can affect fetal development or neonatal adaptation.