Fluoxetine

Why have I been prescribed fluoxetine?

Fluoxetine is licensed to treat major depressive disorder, obsessive-compulsive disorder and bulimia nervosa in adults. You may wish to discuss this with your prescriber who will be able to give you more information on which illness they are prescribing the fluoxetine for.

It is also licensed to treat moderate to severe major depressive disorder in children and adolescents aged 8 years and above if psychological therapy is ineffective alone.

Medication is just a part of the management of these illnesses. Other therapies are also helpful; you may wish to discuss these with your prescriber.

What exactly is fluoxetine?

Fluoxetine is an antidepressant. It is not a tranquilliser or sleeping tablet. It comes both as a tablet and a liquid that would normally be taken once a day.

Is fluoxetine safe to take?

It is usually safe to take as prescribed by your prescriber but like many medicines will not suit everyone. Let your prescriber know beforehand if any of the following apply to you:

  • Have kidney disease, epilepsy, liver problems or glaucoma
  • Have a history of heart disease
  • Have a history of mania
  • Have a history of diabetes
  • Currently receiving ECT
  • Have a history of any bleeding disorders
  • Had an allergic reaction in the past to fluoxetine
  • If you are taking other medication; this includes prescribed medication or any medicines bought over the counter from your pharmacy, including herbal remedies
  • If you are pregnant, breast feeding, or wishing to become pregnant

Your prescriber may wish to carry out some blood tests before starting this medication.

What is the usual dose of fluoxetine?

The starting dose of fluoxetine is 20mg daily. This may be gradually increased to 60mg over a period of several weeks if indicated. In obsessive compulsive disorder (OCD) the normal dose in initially 20mg, increased up to 60mg if needed. In bulimia nervosa the usual dose is 60mg.

How should I take my fluoxetine?

Follow the directions on the label. If you have any questions, ask your pharmacist, nurse or prescriber. You should also read the information leaflet supplied with the medication. Normally fluoxetine is taken as a single dose in the morning, but can be taken in the evening if it makes you feel drowsy.

What should I do if I miss a dose?

If you miss a dose and it is within four or five hours of the normal time, continue to take it as normal. If it is longer, miss the dose and continue as normal when the next dose is due. Never double up on the dose.

When I feel better, can I stop taking fluoxetine?

No, if you stop your fluoxetine too early, your symptoms may return. To reduce the chances of this happening, it is advised you should continue to take it for at least 6 months after you become well and sometimes longer. You should discuss this with your prescriber.

You should not stop taking fluoxetine suddenly as it may cause some unpleasant ‘withdrawal’ effects – see next section.

Is fluoxetine addictive?

Fluoxetine is not addictive but it can cause ‘withdrawal’ or discontinuation effects if stopped suddenly. These effects can include anxiety or agitation, dizziness, feeling sick, problems sleeping, tremor and headaches. Other people describe feeling confused or ‘out of sorts’. To help reduce the chance of this happening the fluoxetine should be slowly stopped over a period of weeks. You may wish to speak to your prescriber, pharmacist or nurse about this.

What will happen to me when I start taking fluoxetine?

All antidepressants work slowly. Although some people notice a change in the first week, normally it will take several weeks for the antidepressant to have its full effect. It is important to continue to take the antidepressant, as long as you are able to tolerate it, for long enough so that its full effects can be seen, generally 6 weeks for depression and 10 weeks for OCD.

As with all medication fluoxetine does have side effects. You may well experience these before you start feeling the benefits. Most side effects are short lived and will pass with time. The following table contains some of the more common and more important side effects of fluoxetine and what to do about them. It is not a complete list and not everyone will get all of those listed. Ask your pharmacist, nurse or prescriber if you are worried about anything else you notice that you think might be a side effect.

For details of the side effects table, please follow this link: Fluoxetine

Fluoxetine can also occasionally cause changes in your liver enzymes and sodium levels. These will be checked periodically by your prescriber and will be discussed with you if there are any problems.

As with all antidepressants, it is known that when first starting treatment there is an increase in suicidal thoughts and events. This may be due to existing thoughts still being present combined with an increase in general levels of motivation, seen early in treatment. In patients with a history of bipolar disorder (mood swings) there is a risk of your mood suddenly becoming high (switching). As a result of these effects, careful observations need to be made in the first few weeks of treatment.

What about alcohol?

Ideally, do not drink alcohol when taking this medication. This is because taking them together can make you more drowsy, sometimes severely. There is no safe drink and drive limit when taking this medication. Once people have been taking this medication for some time, they may be able to take small amounts of alcohol. Try a small amount in a safe environment and see how you feel. Ideally get someone else to tell you.

Fluoxetine stays in the body for a long time, so there is no point missing a tablet to have a drink.

Useful information

talking-shop-leafletPlease click on the image to the left or follow this link to download a copy of our Fluoxetine leaflet.