Fluoxetine: help with depression

In Germany alone, millions of people suffer from depression. The antidepressant fluoxetine promises them help: By increasing the serotonin content in the brain, fluoxetine provides an artificial exhilaration and gives the affected person new impetus. In addition to the treatment of depression, the antidepressant is also used in OCD and bulimia. Taking fluoxetine may cause side effects such as vomiting and nausea.

Side effects of Fluoxetine

Because fluoxetine, unlike other antidepressants such as tricyclic antidepressants, has little effect on receptors in the brain and nervous system, fluoxetine also has fewer side effects. Similar to the other selective serotonin reuptake inhibitors (SSRIs), nausea and vomiting are among the very common side effects of fluoxetine. Frequently fatigue, nervousness, headache, dizziness or thought disorders after taking before. Occasionally, muscle and joint pain, drop in blood pressure or itching occur.

Fluoxetine may also have an effect on weight: weight gain is possible, but some patients also report weight loss. Recent studies also suggest that the intake of fluoxetine may lead to an increased risk of osteoporosis.

On the effect of fluoxetine

The active ingredient fluoxetine belongs to the group of SSRIs (selective serotonin reuptake inhibitors). SSRIs ensure that the serotonin concentration in the brain is increased. According to recent findings of the research is a lack of the messenger substances norepinephrine and serotonin in the brain as a cause of depression. A higher serotonin content in the brain has a mood-enhancing and activating effect on those affected. In its effect, fluoxetine thus clearly differs from other antidepressants such as mirtazapine, which has a rather dampening effect.

Fluoxetine increases the serotonin concentration in the brain by inhibiting the carriers that bring the serotonin back to its storage sites. Thus, the reuptake of serotonin is slowed down and the messenger can remain longer in the synaptic cleft. The dosage of Fluoxetine should be discussed with a doctor and tailored to the individual patient.

Increased suicidal risk in the first few weeks

It is characteristic of the effect of Fluoxetine that it not only enhances mood but also activates the patient. The activating effect begins shortly after ingestion, but the antidepressant effect only develops fully after about two to three weeks.

As a result, the use of fluoxetine, as well as other drugs of the SSRI class such as citalopram, fluvoxamine, paroxetine and sertraline is a further risk: Especially in the first few weeks is warned against an increased suicide risk. Particularly at risk are young adults. Experts recommend that patients control their moods and sensations themselves, but are also closely monitored by the attending physician and relatives or acquaintances.


Taking fluoxetine and a monoamine oxidase inhibitor (MAOI) at the same time may cause severe physical reactions such as serotonin syndrome. This poisoning causes seizures, nausea, diarrhea and confusion due to a severely elevated and difficult to control serotonin level. Serotonin syndrome can be life-threatening in severe cases. Due to the long half-life of fluoxetine, which ranges from 4 to 16 days, it is recommended to wait at least five weeks after weaning until switching to MAO inhibitors.

Interactions may also occur with the intake of phenytoin, lithium salts, L-tryptophan as well as drugs with serotonergic activity (eg tramadol, triptans). In patients with hepatic impairment, diabetes or acute heart disease, the use of fluoxetine should be monitored and stopped if necessary. Even when taking herbal medicines, such as St. John's Wort, it can lead to interactions.

More information

  • If allergic or hypersensitive to the active substance, Fluoxetine should not be taken.
  • During treatment with the antidepressant should be dispensed with alcohol, since the alcohol effect can otherwise be increased.
  • The use of fluoxetine may adversely affect the ability to react and the ability to drive.
  • For children and adolescents under the age of 18, the antidepressant fluoxetine is generally unsuitable.
  • Likewise, pregnant and breastfeeding women are advised not to take it. Caution is advised, especially in the last months of pregnancy, as fluoxetine may also have effects on the newborn. These include tremors, low muscle tension and problems sucking and sleeping.
  • Fluoxetine may cause headache, nausea, dizziness and anxiety after discontinuing.
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