In Germany alone, several million 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. Often fatigue, nervousness, headache, dizziness or thought disorders occur after ingestion. 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 increase the serotonin concentration in the brain. According to current 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 agreed with a doctor and individually tailored to the patient.
Increased suicidal risk in the first few weeks
Characteristic of the effect of Fluoxetine is that it not only mood-enhancing, but also has an activating effect on 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 increased suicidal 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. In severe cases, the serotonin syndrome can be life-threatening. 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 to switch to MAO inhibitors.
Interactions may also occur with the use of phenytoin, lithium salts, L-tryptophan, as well as serotonergic drugs (e.g., tramadol, triptans). In patients with hepatic impairment, diabetes or acute heart disease, the use of fluoxetine should be monitored and, if necessary, discontinued. Even when taking herbal medicines, such as St. John's Wort, it can cause interactions.