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Aug 17, 2022

Mental Health

Most Common Questions About Fluoxetine

Fluoxetine is a type of medication called an antidepressant. Like its name implies, it is often prescribed to treat depressive disorders. Fluoxetine is a first-line treatment, as it is very effective and has relatively minor side effects for most people.

How Does Fluoxetine Work?

Fluoxetine is a type of antidepressant called a serotonin reuptake inhibitor (SSRI). SSRIs work by increasing the amount of time a chemical called “serotonin” is available to send messages in your brain. Serotonin has a variety of responsibilities throughout your body, such as regulating digestion, wound healing, and sexual desire. However, in the brain it is a “happy chemical” and works mainly to regulate your mood, decreasing feelings of depression and anxiety.

“Reuptake” of serotonin occurs after it is released from one cell in the brain and sent to signal to another to regulate mood. This reuptake then removes the serotonin so that no extra signals are sent. However, in certain mental health conditions it’s thought that there may not be enough serotonin available. Therefore, increasing the amount of time the serotonin can send those signals may help alleviate some negative mental health symptoms.

Who Should be Prescribed Fluoxetine

Fluoxetine is a very versatile medication. It has been approved by the FDA to treat a number of mental health conditions, including:

  • Major depressive disorder (MDD)
  • Obsessive compulsive disorder
  • Bulimia nervosa (BN)
  • Panic Disorder (PD)
  • Depressive episodes associated with Bipolar I Disorder (only taken in combination with an antipsychotic, olanzapine)
    When taking any antidepressant for treatment of bipolar disorder it is essential to watch for medication-induced mania/hypomania. If you are taking an antidepressant and are experiencing any form of mania, it’s essential to speak with your healthcare provider.
  • Treatment resistant depression (only taken in combination with an antipsychotic, olanzapine)

This medication is especially effective for those with comorbidities of any conditions listed above. However, for each mental health condition, the dosage of fluoxetine will differ based on the required concentration required for individualized symptom relief. The specific mechanism of symptom relief, though consistently related to serotonin, differs for each condition. For example, in MDD the increased serotonin will increase contentedness and improve mood, while in OCD the increased serotonin will calm obsessive thoughts and decrease anxiety.

It is important to note that it may take 2–4 weeks for you to notice any major improvements in your mood from taking fluoxetine.

Will I Have Side Effects From Taking Fluoxetine?

There is not a clear answer to this question, as everyone responds slightly differently to each medication. However, side effects are relatively uncommon with fluoxetine. When side effects do occur, they are commonly experienced most severely in the first few weeks of taking the medication and improve as time goes on.

Learn more about the first few weeks of taking antidepressants.

When side effects are experienced, those most commonly reported include:

  • Weakness and lack of energy
  • Nausea
  • Weight loss
  • Dry mouth
  • Trouble sleeping
  • *increased thoughts of hurting yourself or suicide
*if you experience any thoughts of hurting yourself at any time, it is essential that you immediately seek medical attention.

Can I Take Fluoxetine if I Am Taking Other Medications?

This depends on the medication(s) you are taking. Some medications, such as olanzapine, are prescribed specifically in combination with fluoxetine for conditions such as bipolar I disorder. However, some medications may possibly interact with fluoxetine in a negative way and require treatment adjustment for you to take the medication. Some of these medications include:

  • Monoamine oxidase inhibitors (MAOIs)
    It is essential to avoid the combination of MAOIs and fluoxetine as it can lead to serious, even fatal, consequences.
  • Medications that increase serotonin (triptans, other antidepressants)
    Combining these medications with fluoxetine can lead to something called serotonin syndrome, which occurs when there is too much serotonin in your body at one time. In the most serious cases, this can lead to seizures.
  • Blood clotting medications (warfarin, NSAIDs, aspirin)
    These medications, in combination with fluoxetine, can sometimes lead to an increased risk of bleeding, so they should be monitored when used in combination.

This list is in no way extensive, as there are many medications that can possibly interfere with the effect of fluoxetine, and vice versa. It is very important to disclose all prescription medications, over the counter drugs, and natural health products you are taking to your healthcare provider. This ensures the best possible treatment efficacy and safety for you.

Can I Take Fluoxetine If I Am Pregnant or Breastfeeding?

Fluoxetine should only be used during pregnancy if deemed necessary for the maintenance of health for the pregnant individual. There is a possible risk to the fetus when the mother is taking fluoxetine while pregnant, as the medication will cross from the mother’s bloodstream into the fetus’. However, the actual risk of exposure to the fetus is not well known, due to limited studies in the area. If you are taking fluoxetine and are pregnant or planning to become pregnant, it is essential to speak with your healthcare provider about the decision to stay on fluoxetine or to possibly switch to a different medication. There is a balance between safety to the fetus with limiting drug exposure versus safety of the mother and fetus with maintaining a mental health condition as well as possible with a medication. This is a difficult decision, and one that should be individualized to each specific case.

Fluoxetine should typically be avoided while breastfeeding. This is because the medication is excreted in breastmilk and will then be consumed by the infant. It is unclear if the minor concentration of fluoxetine in the breastmilk will have adverse effects on the infant, however it is typically best to avoid the risk if possible.

How Much Does Fluoxetine Cost?

Fluoxetine is typically taken long-term. Because of this, it’s most convenient to take out your prescription in a longer supply. At Marley Drug, you can get a 6-month supply of fluoxetine for only $37, or a full 12-month supply for $70. This is both cost effective and convenient. Not only will you not have to go to the trouble of going to the pharmacy at all, since your medication will be delivered at no cost directly to your door, but you will also not have to pay multiple pharmacy dispensing fees that are paid from each refill you pick up from the pharmacy.

At Marley Drug, we are able to price our medications so low because we get our drugs directly from medication wholesalers, rather than from insurance companies. Insurance companies typically charge arbitrary “service fees”, which then leads to increased medication costs for you. However, cutting out this insurance middleman allows us to price our medications as low as possible for you.

To learn more about how you can get your fluoxetine prescription from Marley Drug, just call us at 1-800-810-7790.

Prices mentioned in this article are based on average retail price at major box chain pharmacy in the U.S. as of August 10, 2022.
References:
  1. Prozac (fluoxetine) – Access data FDA-Approved Drugs [Internet]. Amended 01/2017; accessed 08/2022].
  2. Prozac: generic fluoxetine – GoodRx (https://www.goodrx.com). Accessed 2022-08-10.
  3. Sonawalla SB, Farabaugh A, Johnson MW, Morray M, Delgado ML, Pingol MG, Rosenbaum JF, Fava M. Fluoxetine treatment of depressed patients with comorbid anxiety disorders. J Psychopharmacol. 2002 Sep;16(3):215-9. doi: 10.1177/026988110201600304. PMID: 12236627.

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