How Does Flouxetine Work?

Fluoxetine is a medication that belongs to the class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). It works by increasing serotonin levels in the brain by blocking its reabsorption into nerve cells, improving communication between nerve cells that regulate mood.

Indications for Use

Fluoxetine is a medication that belongs to the class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). Here are some general indications for using fluoxetine:

• Major depression: It is the primary use of fluoxetine. It is prescribed to treat episodes of major depression, which is a serious condition that affects a person's mood, thoughts, and behavior.
• Obsessive-compulsive disorder (OCD): Fluoxetine is also used to treat OCD, a mental disorder characterized by recurrent thoughts (obsessions) and repetitive behaviors (compulsions).
• Bulimia Nervosa: In patients suffering from bulimia nervosa, fluoxetine may help reduce the frequency of binge eating and purging episodes.
• Post-Traumatic Stress Disorder (PTSD): Fluoxetine is sometimes used to treat symptoms of PTSD, especially when they are associated with depression.
• Premenstrual dysphoric disorder (PMDD): This condition is characterized by severe emotional and physical symptoms that occur in the second half of the menstrual cycle. Fluoxetine may be effective in relieving these symptoms.

Side Effects

• Nausea
• Insomnia
• Sleepiness
• Increased anxiety
• Loss of appetite
• Weight gain
• Sexual dysfunction (for example, decreased sexual desire, difficulty reaching orgasm)
• Tremors
• Dry mouth
• Diarrhea
• Constipation
• Changes in bowel habits
• Serotonin syndrome (potentially serious if combined with other medications)

Serious Side Effects

• Suicidal thoughts or changes in mood
• Agitation, confusion, hallucinations
• Fast or irregular heartbeat.
• Seizures.
• Coordination problems or tremors
• Feeling faint, symptoms of low sodium levels in the body (headache, confusion, severe weakness, vomiting, loss of coordination)
• Severe dizziness.
• Serious allergic reactions (skin rash, itching, severe swelling, difficulty breathing).

Contraindications and Precautions

Fluoxetine is a medication used primarily as an antidepressant in the treatment of major depression, obsessive-compulsive disorder (OCD), bulimia nervosa and post-traumatic stress disorder, among others. However, like any medication, it has contraindications and precautions that must be taken into account before use:

• People with known hypersensitivity to fluoxetine or to any of the components of the formulation should avoid its use.
• Fluoxetine should not be administered in combination with MAOIs or within 2 weeks after discontinuing MAOI treatment, due to the risk of serotonin syndrome, which can be life threatening.
• Fluoxetine is contraindicated in children and adolescents under 18 years of age, especially in the treatment of major depression, due to the increased risk of suicidal behavior.
• In patients with severe hepatic impairment, fluoxetine may accumulate in the body due to reduced hepatic metabolism. Therefore, the dose should be adjusted in these cases or therapeutic alternatives considered.
• The balance between potential benefits and risks should be carefully evaluated before administering fluoxetine to pregnant or lactating women, as it can cross the placental barrier and be excreted in breast milk.
• Although dose adjustment is usually not required in patients with mild to moderate renal impairment, it should be administered with caution and under medical supervision in cases of severe renal impairment.
• Fluoxetine can lower the seizure threshold, so it should be used with caution in patients with a history of seizures.
• Fluoxetine can trigger manic episodes in patients with bipolar disorders or a history of mania. These patients should be closely monitored during treatment.
• Fluoxetine may alter glycemic control in patients with diabetes mellitus, so it is necessary to adjust the dose of insulin or oral hypoglycemic agents as necessary.
• Combination with other medications that may increase serotonin levels (such as some antidepressants, triptans, tramadol, and others) should be avoided because of the risk of serotonin syndrome.

Interactions with Other Medications

Fluoxetine is an antidepressant in the class of selective serotonin reuptake inhibitors (SSRIs), and it can interact with other medications in a variety of ways:

• Monoamine oxidase inhibitors (MAOIs): The combination of fluoxetine with MAOIs can lead to a serious interaction known as serotonin syndrome, which can be potentially fatal. You must let go at least 14 days after stopping an MAOI before you start taking fluoxetine.
• Other antidepressants and serotonin medications: Fluoxetine may increase the risk of serotonin syndrome when combined with other antidepressants, such as other SSRIs, serotonin and norepinephrine reuptake inhibitors (SNRIs), and certain tricyclic antidepressants. Caution and medical monitoring should be used when these medications are combined.
• Anticoagulants (warfarin): Fluoxetine may increase the anticoagulant effects of warfarin, which may increase the risk of bleeding. It is important to monitor clotting times when these medications are used together.
• Drugs that affect liver metabolism: Fluoxetine is metabolized in the liver through the CYP450 enzyme system, especially by the CYP2D6 enzyme. Drugs that inhibit or induce this enzyme may affect blood levels of fluoxetine. For example, CYP2D6 inhibitors may increase fluoxetine levels, while inducers may decrease them.
• Non-steroidal anti-inflammatory drugs (NSAIDs) and acetylsalicylic acid: They may increase the risk of gastrointestinal bleeding when taken with fluoxetine.
• Medications that affect the heart rate (prolonged QT): Some medications, such as certain antibiotics, antipsychotics, and antihistamines, can prolong the QT interval in the heart. Fluoxetine can increase this risk when combined, which can lead to potentially serious cardiac arrhythmias.

How to Take Flouxetine

• You should always follow your doctor's specific instructions. The dosage and frequency of fluoxetine may vary depending on your medical condition and response to treatment.
• Fluoxetine is usually taken orally, with or without food. It's important to follow your doctor's instructions or the instructions in the medicine leaflet.
• Try to take fluoxetine at around the same time each day to help maintain consistent levels of the medication in your body.
• It may take several weeks before you start to notice an improvement in your symptoms. It's crucial to keep taking fluoxetine even if you feel better, unless your doctor tells you otherwise.
• As with any medication, fluoxetine can have side effects. Some of the most common include nausea, insomnia, nervousness, and decreased sexual desire. Tell your doctor if you experience significant side effects.
• Do not stop taking fluoxetine without consulting your doctor, as this can cause withdrawal side effects. Your doctor may recommend a gradual dose reduction to safely discontinue treatment.
• Schedule regular visits with your doctor to evaluate your response to treatment and adjust the dose if necessary.

Conclusion

Known for its efficacy in treating depression and other psychological disorders, fluoxetine remains a crucial option in modern medicine. Its ability to improve the quality of life of those who use it makes it an indispensable tool in the field of mental health, highlighting its role in alleviating symptoms and promoting emotional well-being.