Fluoxetine

General Information

Fluoxetine (Oxactin, Prozac) is an atypical antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. The drug has structural similarities to methamphetamine and fenfluramine and has been used for the management of depression in the United States since 1987. Fluoxetine is biotransformed to the active metabolite, norfluoxetine, both compounds may undergo O-dealkylation with release of p-trifluoromethylphenol. 

Adverse reactions to fluoxetine therapy include nausea, insomnia, anxiety and headache. Less frequently, manic behavior and suicidal ideation have been reported, encephalopathy with seizures may occur if the drug is used in combination with lithium, tranylcypromine or the tricyclic antidepressants. Serotonin syndrome may occur when fluoxetine is used alone or in combination with other drugs such as buspirone, mirtazapine, nefazodone or tramadol. Acute overdosage with up to 1500 mg of fluoxetine often results in relatively benign symptoms including lethargy, tachycardia and hypertension.