Fluoxetine
Brand: Prozac
Boxed warning
Suicidal thoughts and behaviors in children, adolescents, and young adults.
- Caution
- Serotonin syndrome; long half-life means a 5-week washout before starting an MAO inhibitor.
- Pregnancy
- Use only if clearly needed; third-trimester exposure can cause neonatal adaptation symptoms.
Common side effects
- Nausea
- Insomnia
- Headache
- Sexual dysfunction
- Nervousness
Key interactions
- Avoid MAO inhibitors
- Combining serotonergic drugs risks serotonin syndrome
- May increase bleeding risk with NSAIDs
Counseling points
- May take several weeks to work
- Take in the morning to reduce insomnia
- Do not stop suddenly
- Report worsening mood or suicidal thoughts
- Report agitation, fever, or shivering
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