Fluoxetine Guide, Meaning , Facts, Information and Description
Fluoxetine hydrochloride (brand names include Prozac®, Symbyax® [compounded with olanzapine], Sarafem®, Fontex® [Sweden], Fluctine (Austria, Germany) is an antidepressant drug used medically in the treatment of depression, obsessive-compulsive disorder, bulimia nervosa, premenstrual dysphoric disorder, and many other disorders. Chemically, fluoxetine is (N-methyl-3-phenyl-3-(α,α,α-trifluoro-p-tolyl)-oxypropylamine hydrochloride, C17H18F3NO·HCl) and, alone, it is a white crystalline solid. It is one of the selective serotonin reuptake inhibitors, and is marketed in capsules containing 10, 20, or 40 mg of active ingredient or in tablets containing 10 mg. Dosages in the range of 20-60 mg per day are standard, with 80 mg considered a maximum.Eli Lilly's Prozac was approved by the FDA on December 27th 1987 and introduced in the US at the beginning of 1988. The drug became very popular, with millions around the world having taken the medication. In the late 1990s there was something of a backlash. Prozac®'s manufacturer, Eli Lilly and Company, Inc earned billions from its success, and became the target of numerous accusations (see David Healy affair). Lawsuits amounting to millions were instigated, alleging the drug made users feel suicidal and/or caused other serious side effects. The accusations and lawsuits have been unsuccessful in stemming the prescription and use of the medication, as well as in making the accusers some of Lilly's profits. The actual verified science that Prozac® is harmful has not been demonstrated. Currently (2/2004) the US FDA is considering similar controversial issues regarding Prozac® and its use in children and adolescents.
Fluoxetine has a wide range of published interactions, notably with monoamine oxidase inhibitors. Common side-effects include anxiety, restlessness, trembling, weakness, skin rash, anorgasmia, itching, and a decrease in sexual drive.
Fluoxetine is eliminated very slowly by the body. The half-life of fluoxetine after a single dose is 2 days and after multiple dosing 4 days. The liver then metabolizes fluoxetine into norfluoxetine, a desmethyl metabolite, which is also a serotonin reuptake inhibitor; norfluoxetine has an even longer half-life, i.e. 8.6 and 9.3 days for single and repeated dosage respectively.
A more recent controversy embroiled Lilly, and a class action lawsuit has been filed after several people received in the mail free samples of Prozac® Weekly™. The suit alleges that the samples' recipients' right to privacy was mishandled.
In December 2003 the FDA approved Symbyax® to treat bipolar depression. Symbyax® is a combination of fluoxetine and olanzapine.
The resources at the end of this article present a blend of views on this drug, some of which focus on the more controversial and unscientific issues.
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