Fluoxetine

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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.

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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Titration 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).

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Effects

Anxiolysis👤 no reports yet⚕️ ~33% +67.0 (n=1)

Classically starting at 3–4 weeks and improving for another 8–12.

Delayed orgasm/ejaculation👤 0% — (n=3)⚕️ ~80% +38.0 (n=1)

Mood enhancement👤 no reports yet⚕️ ~5% +67.0 (n=1)

Nausea👤 no reports yet⚕️ ~5% -33.0 (n=1)

Common, often improves over 1–2 weeks.

Decreased libido👤 no reports yet⚕️ ~33% -100.0 (n=1)

Temporary erectile dysfunction👤 no reports yet⚕️ ~20% -67.0 (n=1)

Persistent Sexual Dysfunction👤 no reports yet⚕️ ~0% -100.0 (n=1)

Persistent sexual dysfunction, historically associated with SSRIs

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Monitoring

None required

Relevant anecdote

⚕️ Provider by MDElliottMD0

Fluoxetine is great for getting off other SxRIs! Especially venlafaxine and duloxetine.

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Relevant Literature

No literature entries yet.

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