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Fluoxetine is a psychotropic substance. Myths about fluoxetine

Fluoxetine is an antidepressant that belongs to the group of selective inhibitors. This remedy is prescribed for obsessive and depressive conditions.

Increases the amount of serotonin in the brain, thereby prolonging its stimulating effect on the nervous system. Increases the transmission of serotonin, prevents its reuptake in platelets. Improves mood, relieves tension, anxiety, eliminates irritability and hostility to the environment.

It is recommended for use in depressive states accompanied by a feeling of fear, eating disorders (bulimia), mental disorders, as well as in cases of ineffectiveness of other drugs with antidepressant action.

Clinical and pharmacological group

Antidepressant, a propylamine derivative.

Terms of sale from pharmacies

Can buy by prescription.

Price

How much does fluoxetine cost in pharmacies? The average price in 2018 is at the level of 90 rubles.

Composition and form of release

Fluoxetine is available in the form of hard gelatin capsules of 10 or 20 mg. Capsules have a white body and a white (10 mg) or green (20 mg) cap. Inside are white or white with a yellowish tint granules and powder.

The drug is packaged in blisters (5 or 10 capsules) or polymer cans (20, 30, 50 or 100 capsules) and packed in cardboard boxes (2 or 4 blisters of 7 capsules, 2, 3, 5 or 10 blisters of 10 capsules or 1 bank in a pack).

The composition of 1 capsule includes:

active ingredient: fluoxetine - 10 or 20 mg;
excipients: povidone, lactose monohydrate, potato starch, calcium stearate;
shell composition: water, titanium dioxide, gelatin; additionally for 20 mg capsules - indigo carmine, yellow iron oxide.

Pharmacological effect

The drug is a derivative of propylamine. pharmachologic effect is to partially suppress the reuptake of serotonin. As a result, there is an increase in the concentration of the drug in the synaptic cleft and an increase in its action.

The active substance of the drug eliminates anhedonia, reduces tension, anxiety and feelings of fear. Fluoxetine does not have a toxic effect on the human body and does not provoke the appearance of orthostatic hypotension. The desired therapeutic effect occurs in one to two weeks.

The drug has a minimal effect on the metabolism of acetylcholine, dopamine and norepinephrine. It is especially effective in obsessive-compulsive disorders and endogenous depressions. After taking it, dysphoria is eliminated and mood improves. A pronounced therapeutic effect in depression is observed after 2-4 weeks of admission, and in compulsive disorders - after 5 weeks.

The drug is well absorbed from the gastrointestinal tract. During the first passage through the liver, all components undergo a weak process of metabolism. The process of eating does not affect the degree of absorption, but slows down its speed. The highest degree of saturation of the drug in the blood plasma is reached six to eight hours after its use. In this case, the medication should be continuous (for several weeks).

The level of protein binding capacity is 94%. The process of metabolism takes place in the liver in the form of demethylation, with the formation of norfluoxetine (the main active metabolite). The half-life of the drug is 2-3 days after a single dose. With prolonged use of Fluoxetine, this period is 5-6 days.

The drug is excreted mainly by the kidneys: 11.6% is excreted unchanged, 7.4% is in the form of fluoxetine glucuronide, 46% is in the form of other compounds, and 20% is in the form of hippuric acid. With improper functioning of the kidneys, the process of excretion of metabolites slows down significantly. During dialysis, the drug is not excreted at all. This is due to the huge volume of distribution and a high degree binding to plasma proteins.

The effectiveness of the drug was noted even in disorders such as: anorexia nervosa and diabetic neuropathy.

The mechanism of action of the drug is based on selective inhibition of the reverse blocking of serotonin at the sites of transmission of neurotransmitters. The drug is able to have a thymoanaleptic and stimulating effect. After a single dose, the feeling of anxiety and fear decreases, but the drug does not have a complete calming effect.

Indications for use

Fluoxetine can only be used on the advice of a doctor in case of the following indications for admission:

depressive conditions of various origins;
bulimic neuroses;
obsessive-compulsive disorders.

Contraindications

According to the instructions, Fluoxetine is contraindicated in the following cases:

Individual intolerance to the drug;
Bladder atony;
Angle-closure glaucoma;
Severe liver or kidney failure;
Treatment with MAO inhibitors;
Pregnancy and lactation;
Increased suicidal tendencies;
Prostate hypertrophy.

The use of fluoxetine in patients with Parkinson's syndrome, epilepsy, diabetes or severe exhaustion requires special care.

Appointment during pregnancy and lactation

The safety of the drug in pregnant women has been little studied, the results of individual published epidemiological studies are contradictory. Some randomized and cohort studies have not found an increase in the likelihood of congenital anomalies.

A prospective study conducted by ENTIS suggests an increased likelihood of developing congenital anomalies in the structure of large vessels or the heart in children whose mothers took fluoxetine in the 1st trimester of pregnancy, compared with children whose mothers did not receive this drug.

A reliable relationship between taking the drug in early pregnancy and the formation of malformations in the fetus could not be established. A specific group of CCC anomalies has also not been identified.

The use of SSRIs in the last weeks of pregnancy contributes to the development of complications in newborns, in particular, an increase in the duration of mechanical ventilation and tube feeding and the duration of hospitalization.

There are references to the development of apnea, respiratory distress syndrome, seizures, hypoglycemia, lability of body temperature and blood pressure, tremor, hyperreflexia, vomiting, cyanosis, difficulty with adequate nutrition, constant crying, excitability, nervous irritability.

The listed pathological conditions may be a consequence of the withdrawal syndrome of SSRIs or a manifestation of their toxic effects.

Dosage and method of application

As indicated in the instructions for use, Fluoxetine capsules are intended to be taken by mouth, regardless of food. They are not chewed and washed down with a sufficient amount of water. The mode of administration of the drug and dosage depend on medical indications:

Obsessive Compulsive Disorder - The recommended therapeutic dosage is 20-60 mg per day.
Bulimic neurosis - Fluoxetine capsules are used at a dosage of 60 mg, divided into 2-3 doses during the day.
Depression of various origins - the initial dosage is 20 mg (1 tablet) 1 time per day, preferably before lunch. If necessary, it increases to 40-60 mg per day and is divided into 2-3 doses. Maximal daily dose should not exceed 80 mg. The therapeutic effect develops no earlier than 1-2 weeks after the start of the course of therapy.

There is usually no need to reduce the dosage for elderly patients, provided that the functional activity of the liver or kidneys is normal. The doctor sets the duration of the course of therapy individually.

withdrawal syndrome

In many cases, upon discontinuation of fluoxetine treatment (especially with abrupt discontinuation of the drug), withdrawal symptoms are noted. The results of clinical studies indicate that approximately 60% of patients with the abolition of therapy developed various side effects. These data are true both for the fluoxetine group and for the placebo group: in the first case, 17% of events were severe, in the second case - 12%.

Several factors influence the risk of developing a withdrawal syndrome (including the duration of the course of therapy and the rate of dose reduction). Most often, patients complain of dizziness, sensory disturbances (including paresthesia), asthenia, agitation, anxiety, sleep disturbances (including deep sleep and insomnia), nausea, vomiting, headaches, tremor. Usually these episodes are mild or moderate, but in some patients they are more pronounced.

In most cases, the withdrawal syndrome resolves on its own within two weeks, but in some cases, its manifestations may be longer (from 2 to 3 months or more). Cancellation of fluoxetine should be gradual, taking into account the patient's condition (usually this process takes 1-2 weeks).

Suicidal risks while taking fluoxetine

In patients with depression, the likelihood of committing suicide attempts increases (may be relevant until the onset of stable remission). As with other antidepressants, isolated cases of suicidal thoughts and behavior have occurred during fluoxetine therapy or shortly after its completion. That is why it is necessary to carefully monitor patients at risk and convince them of the need to immediately report to the doctor about any unpleasant feelings and thoughts that cause concern.

Studies in adults with major depressive disorder identified the following risk factors for suicide in both groups (fluoxetine and placebo):

before the start of therapy - a more severe course of depression, the presence of thoughts about death;
during therapy - the development of insomnia, worsening of depression.
One of the risk factors in the treatment of fluoxetine was the development of severe psychomotor agitation (eg, panic, akathisia, agitation).

The occurrence or presence of these conditions before or during treatment is a reason to enhance clinical control or correction of ongoing treatment.

Adverse reactions

The use of the drug Fluoxetine can cause the following side effects:

From the digestive system: dry mouth, nausea, diarrhea, vomiting, dyspepsia.
On the part of the musculoskeletal system, muscle twitching may occur.
On the part of the sense organs with the systematic use of Fluoxetine, the side effect of the drug may manifest itself as blurred vision.
From the side of the central nervous system: sleep disturbance, headaches, anxiety, drowsiness, nervousness, dizziness, psychomotor agitation, tremor, hyperactivity, impaired attention or coordination, ataxia, lethargy.
Since the cardiovascular system: hot flashes, hypotension, atrial flutter, vasculitis.
From the genitourinary and reproductive system: frequent urination, decreased libido, erectile dysfunction, impaired ejaculation, gynecological bleeding.
From the side of metabolism: hypoglycemia, increased sweating, hyponatremia.
On the part of the skin: polymorphic skin rash, hyperhidrosis, tendency to bruising, pruritus, cold sweat, alopecia, urticaria, ecchymosis.

It is also possible to increase body temperature, shortness of breath, pain in the muscles and joints. When using Fluoxetine, the side effects of the drug often require its withdrawal.

Overdose

In case of accidental or intentional intake of a large dose of fluoxetine, the patient needs urgent medical care. There is no specific antidote, so it is carried out symptomatic treatment. To accelerate the excretion of the drug from the body, gastric lavage is carried out and sorbents are given inside.

special instructions

Before you start using the drug, read the special instructions:

Avoid drinking alcohol during treatment.
Elderly patients require correction of the dosing regimen.
The safety of fluoxetine in children has not been established.
Use with extreme caution in patients with impaired liver and kidney function, with a history of epileptic seizures, cardiovascular diseases.
In patients with diabetes, a change in blood glucose levels is possible, which requires correction of the dosing regimen of hypoglycemic drugs. When used in debilitated patients while taking fluoxetine, the likelihood of developing epileptic seizures increases.
With the simultaneous use of fluoxetine and electroconvulsive therapy, prolonged epileptic seizures may develop.
Fluoxetine can be used no earlier than 14 days after the abolition of MAO inhibitors. The period after the abolition of fluoxetine before the start of therapy with MAO inhibitors should be at least 5 weeks.

Compatibility with other drugs

When using the drug, it is necessary to take into account the interaction with other drugs:

There are reports of an increase in the effects of warfarin when it is used simultaneously with fluoxetine.
With simultaneous use with haloperidol, fluphenazine, maprotiline, metoclopramide, perphenazine, periciazine, pimozide, risperidone, sulpiride, trifluoperazine, cases of extrapyramidal symptoms and dystonia have been described; with dextromethorphan - a case of the development of hallucinations is described; with digoxin - a case of an increase in the concentration of digoxin in the blood plasma.
With simultaneous use with lithium salts, an increase or decrease in the concentration of lithium in the blood plasma is possible.
With simultaneous use, it is possible to increase the concentration of imipramine or desipramine in the blood plasma by 2-10 times (may persist for 3 weeks after the abolition of fluoxetine).
With simultaneous use with drugs that have a depressant effect on the central nervous system, with ethanol, a significant increase in the inhibitory effect on the central nervous system is possible, as well as an increase in the likelihood of convulsions.
With simultaneous use with MAO inhibitors, furazolidone, procarbazine, tryptophan, serotonin syndrome may develop (confusion, hypomania, restlessness, agitation, convulsions, dysarthria, hypertensive crisis, chills, tremor, nausea, vomiting, diarrhea).
With simultaneous use, fluoxetine inhibits the metabolism of tricyclic and tetracyclic antidepressants, trazodone, carbamazepine, diazepam, metoprolol, terfenadine, phenytoin, which leads to an increase in their concentration in blood serum, an increase in their therapeutic and side effects.
With simultaneous use, it is possible to inhibit the biotransformation of drugs metabolized with the participation of the CYP2D6 isoenzyme.
With simultaneous use with hypoglycemic agents, their action may be enhanced.
With simultaneous use with propofol, a case is described in which spontaneous movements were observed; with phenylpropanolamine - a case is described in which dizziness, weight loss, hyperactivity were observed.
With simultaneous use, it is possible to enhance the effects of flecainide, mexiletine, propafenone, thioridazine, zuclopenthixol.

Fluoxetine belongs to the group of antidepressants. It is produced by a Russian pharmaceutical company, unlike its foreign counterpart, Prozac. The latter is the brainchild of the British Pharmaceutical Corporation. Therefore, it costs an order of magnitude more expensive, and its effectiveness is comparable to the domestic drug.

How does fluoxetine work?

Fluoxetine (Prozac) blocks the return of serotonin to neuronal synapses (junctions between nerve cells). As a result, the content of this mediator (a substance involved in the transmission of nerve impulses) in the connecting elements increases significantly, therefore, over a long time period, it manages to influence the postsynaptic areas, causing characteristic changes. This manifests itself:

Stimulating effect on the nervous system
Mood improvement
Activation of mental processes
Suppression of anxiety and worry
Decreased appetite, ultimately leading to weight loss.

In addition to inhibiting serotonin uptake in the nervous tissue, fluoxetine has a similar effect on platelets, reducing their aggregation (gluing) ability. This positive effect helps to prevent thrombosis in patients at risk. But as the main therapeutic effect, this property is not used, it is a "pleasant" addition to antipsychotic influences.

An important advantage of this antidepressant is the absence of a sedative effect. Therefore, Fluoxetine (Prozac) can be used by people involved in precision work requiring care:

Drivers
Jewelers
Aviation industry, etc.

Consequences of fluoxetine - existing risks of taking

Taking the drug can lead to side effects. They are polysystemic, i.e. can affect any system of the body. Clinically expressed by the following conditions:

manic pursuit
suicidal tendencies
Dizziness
Shiver
convulsions
poor appetite
Diarrhea
Increased salivation
Violation heart rate
Urinary retention or incontinence
sexual dysfunction
Allergic rashes.

Therefore, any discomfort and deviations in habitual behavior during treatment with Fluoxetine is a need for consultation with a doctor. Such patients may need to adjust the dose of the antidepressant or change it to another drug.

Allergic rashes are a common side effect of fluoxetine.

Indications for use

Indications for taking Fluoxetine (Prozac) should only be determined by a doctor. Self-treatment with these antidepressants is prohibited, because. they have a number of contraindications and side effects. The need to use fluoxetine and its substitutes exists when a person suffers from certain mental disorders, namely:

Depression (regardless of its cause)
Neurosis, manifested by a strong increase in appetite, leading to obesity
Obsessive states with constant checking of what has been done.

Symptoms of an overdose of fluoxetine

Exceeding the dose of the drug recommended by the doctor and the frequency of its administration leads to the appearance of a number of symptoms indicating an overdose. In this case, an immediate appeal to a specialist is required, because. the likelihood of death due to complications is high. The main signs indicating fluoxetine poisoning are:

Mental arousal
Increased motor activity that does not have any purposefulness
Convulsions resembling epileptic seizures
Arrhythmias of a different nature
Cardiopalmus
Nausea, the apogee of which is repeated vomiting.

Nausea and vomiting are signs of fluoxetine overdose

Patients should know that it is impossible to exceed the recommended dose, and even more so, prescribe the drug on their own, because. There is no effective specific antidote. In case of an overdose, it is possible to carry out only symptomatic therapy - this is the fight against clinical signs poisoning, and not the elimination of its cause (binding of Fluoxetine molecules). The required components are:

gastric lavage
the appointment of enterosorbents (activated carbon, Enterosgel and others), anticonvulsants and antiarrhythmic drugs.

Fluoxetine (Prozac) scandal

Recently, the press discussed the possibility of prescribing fluoxetine in psychiatry. In Europe, in connection with this, a scandal erupted, which resulted in a ban on treatment with this remedy and withdrawal from the pharmacy network. IN Russian Federation no similar actions followed - it remained in the Register of Medicinal Products approved for use in medicine.

To avoid the negative consequences of fluoxetine treatment, it is necessary to use it only on the recommendation of a doctor.

Therefore, in modern conditions in the pharmacy network, this antidepressant can only be purchased by prescription. But there is also the other side of the coin - Internet pharmacies prohibited by law. In them, the drug is sold illegally - over-the-counter. It should be remembered that when purchasing a drug without consulting a doctor, the risk of developing fluoxetine dependence is very high. It is manifested by serious symptoms that a person cannot cope with on his own. An overdose can lead to cardiac arrest and death.

The effectiveness of the drug

Considering existing risks treatment with Fluoxetine, a number of studies have been conducted that have evaluated the therapeutic efficacy of this drug and the validity of its appointment. They showed that he showed a good ability to relieve anxiety and depression. Therefore, fluoxetine is widely used in complex therapy many neuropsychiatric disorders. However, there are conflicting data indicating a high danger of the drug and low effectiveness, comparable to placebo (dummy). Therefore, the drug should be taken seriously and not taken without a doctor's recommendation.

Fluoxetine - medicinal product from the group of antidepressants, which is available in the form of capsules for internal use. The active ingredient is fluoxetine hydrochloride.

Fluoxetine contributes to the provision of antidepressant, stimulant and anorexigenic effects. Pos exposure to the drug reduces appetite, which can lead to weight loss. Under the influence of Fluoxetine, there is no sedative effect.

If you use the drug in an average therapeutic dose, then the active ingredient has almost no effect on the functioning of the cardiovascular system.

After oral administration, almost complete absorption is observed. active substance Fluoxetine from the gastrointestinal tract. If you take the capsule with a meal, this may slightly slow down the absorption of the active ingredient. After 6-8 hours, the maximum concentration of fluoxetine in the blood plasma is reached. The drug has the ability to accumulate in tissues, can penetrate the blood-brain barrier. Removing most of active component carried out by the kidneys, insignificant - by the organs of the gastrointestinal tract. The elimination half-life can take from 48 to 72 hours. At kidney failure elimination half-life may be prolonged.

Indications and contraindications

Fluoxetine can only be used on the advice of a doctor in case of the following indications for admission:

depressive conditions of various origins;
bulimic neuroses;
obsessive-compulsive disorders.

Contraindications

Fluoxetine is not used for intolerance to the active ingredient, severe violations of the functioning of the liver and kidneys, with lactase deficiency and lactose intolerance, during pregnancy and lactation. Capsules are not used in the treatment of people who have not reached the age of 18 years.

Use with extreme caution

The use of Fluoxetine capsules in case of suicidal risks requires special care. This is due to the fact that with depression, the thought of suicide may arise, which persists until a stable remission is achieved.

There is a description of individual cases of suicidal thoughts and attempts that occur during treatment with fluoxetine and other drugs from the antidepressant group. Patients who fall into the risk group should be constantly monitored by qualified medical personnel. The doctor should convince the patient of the need to immediately report such thoughts and the appearance of feelings of discomfort or fear.

Fluoxetine is also used with extreme caution in people with a history of epileptic seizures.

If it is necessary to use fluoxetine capsules during the treatment of patients with diabetes mellitus, it may be necessary to adjust the dosage of drugs to reduce sugar or insulin. During therapy, hypoglycemia may occur at the beginning of treatment and hyperglycemia after the end of treatment.

In some cases, taking the drug may contribute to the development of hyponatremia. Similar cases were detected during the treatment of patients of older age groups and in people taking diuretic drugs.

Patients with severe hepatic impairment may be advised to adjust the dosage of fluoxetine.

Mode of application

Fluoxetine capsules should be taken orally, regardless of food, at any time convenient for the patient.

The doctor determines the exact initial and maintenance dose, taking into account the indications for taking the capsules, the presence of concomitant pathologies and the patient's response to the drug. The use of the medicine can be divided into several doses during the day.

Clinical efficacy of fluoxetine can be observed 7-14 days after the start of treatment, and in some cases later.

Patients with a history of severe impairment of the functioning of the liver and kidneys may be recommended the minimum effective dose of Fluoxetine, as well as lengthening the interval between taking the capsules.

In case of an overdose, there is a possibility of developing psychomotor overexcitation, tachycardia, convulsive seizures, drowsiness, cardiac arrhythmias, nausea, and vomiting.

Requires symptomatic therapy, gastric lavage, the use of activated charcoal. With the development of seizures, the patient may be recommended to take Diazepam, as well as support for breathing and heart rate, and normalization of body temperature.

Adverse reactions

Fluoxetine may cause cardiovascular, digestive, musculoskeletal, immune, genitourinary, central nervous system. It is also possible a metabolic disorder, the development of mental disorders and side effects from the senses.

The most frequently reported information about the development of such adverse reactions:

It is also possible to develop hypomania or mania, increased suicidal tendencies, anxiety, increased irritability, agitation, convulsions.

In the course of post-marketing studies, violations of the endocrine system were revealed: insufficiency of antidiuretic hormones.

The described reactions were observed at the beginning of taking the capsules or with an increase in the dose of Fluoxetine. The development of any adverse reactions should be reported to the doctor immediately.

Interaction with other drugs

Fluoxetine should not be used in conjunction with:

drugs from the group of MAO inhibitors, as well as for 2 weeks after stopping their use;
Thioridazine, pimozide, and also for 5 weeks after discontinuation of the drug Fluoxetine.

If necessary, combinations with carbamazepine, diazepam, propafenone should be used drugs in the minimum effective doses.

The combination with fluoxetine can block the metabolism of drugs from the group of tricyclic and tetracyclic antidepressants, which can lead to an increase in their concentration and the manifestation of symptoms of intoxication.

With simultaneous use with lithium salts, an increase in the concentration of lithium in the blood is possible. With the interaction of fluoxetine and hypoglycemic drugs, their effectiveness may be enhanced.

During treatment with Fluoxetine, the use of alcoholic beverages is not allowed.

If fluoxetine capsules are taken by patients with low body weight, the anorexigenic effect of the drug, which can lead to even greater weight loss, should be taken into account.

When taking the drug Fluoxetine, you should refrain from performing work that requires increased attention and control of transport mechanisms.

When conducting electroconvulsive therapy, there is a risk of developing a prolonged epileptic seizure.

It should be taken into account that in the treatment of children and adolescents with a history of depression and other mental disorders, the risk of suicidal thoughts and related behavior increases. In this case, the ratio of the possible benefit of Fluoxetine and the potential risk should be taken into account.

Fluoxetine capsules should be stored in a place that is protected from light and out of the reach of children. Storage temperature - no more than 25 degrees.
The drug is dispensed from pharmacies after presenting a prescription from a doctor.

Analogues, cost

The cost of the drug Fluoxetine is formed depending on the manufacturer of the drug:

capsules 20 pcs., 10 mg (Russia, Ozon) - 35-45 rubles;
capsules 30 pcs., 20 mg (Russia) - 60-65 rubles;
capsules 20 pcs., 20 mg (Austria) - 120-130 rubles;
capsules 20 pcs., 20 mg (Vector-Medica) - 140-145 rubles.

Analogues of the drug Fluoxetine are: Prozac, Framex, Profluzak, Deprex, Portal. Replacement drugs should be discussed with the doctor in advance, specifying the dosage of the capsules.

Fluoxetine is a drug indicated for the treatment of pathological conditions like depression, manifested by anxiety and fear. Reviews about the drug Fluoxetine are different. This tool belongs to pharmacological group antidepressants. The appointment of this drug is advisable to eliminate the feeling of anxiety, fear, melancholy and apathy, normalize sleep, improve mood, mental activity and appetite. The drug is also used to treat bulimia, anorexia, alcohol addiction.

Consider the reviews of patients who used the drug Fluoxetine in their treatment, and the opinion of doctors about the effectiveness of this drug.

Patient reviews

“I suffered from frequent headaches for a long time. I was at the appointment with a neurologist, who explained that these symptoms are due to prolonged depression.

I was immediately prescribed fluoxetine. I took it strictly according to the recommendations of the doctor, however, instead of improving general condition, the opposite was observed. All the time of treatment she was in some kind of inhibited state, drowsiness was present, her appetite completely disappeared (as a result of which she noticeably lost weight). The doctor said that this is a normal reaction of the body. However, the headaches never went away. She stopped taking the drug after 3-4 weeks from the start of treatment.

Natalia

“Most recently I turned to a neurologist for health reasons. The doctor diagnosed me with depression and prescribed me fluoxetine. I took it according to the instructions. Now I feel much better, I have returned to my usual rhythm of life again.

Valentine

“I took fluoxetine for depression. Any side effects I didn't notice the drug. After 2-3 weeks, the mood improved noticeably, it became less frustrating because of the little things.

Olga

“This drug was prescribed to me for the treatment of depression. I really hoped that the drug would return me to my normal life again. However, against the background of taking fluoxetine, the situation only worsened. Not only did I feel nauseous for several hours after taking the pill, but my mood did not improve at all. On the contrary, she was either in a state of complete indifference to everything around her, or she lit up like a match from the slightest trouble. After a few more weeks of treatment, I began to notice that some colleagues simply avoid any contact with me. Stopped taking the drug. Everything returned to normal about 2 weeks later. The remedy is not for everyone.

Oksana

“I took fluoxetine lannacher (Austrian production). Satisfied with the result. Now I plan to repeat the course of treatment, since about 10 months have already passed. However, for some reason I can’t find Fluoxetine Lannacher, but I don’t dare to take the domestic one yet. ”

Nina

“I was prescribed fluoxetine 1 tablet three times a day. I drank only 6 days.

During this time, her appetite noticeably decreased, but she began to sleep very badly, nightmares appeared (which she had not complained about before). In addition, I noticed that most of the products somehow taste differently, I often felt nausea (more in the first 1.5-2 hours after taking the pill). Only on the sixth day I connected all this with fluoxetine. Last night I didn’t take the pill, in the morning too. I categorically do not want to take the drug anymore, but it seems to be impossible to cancel it abruptly. ”

barbarian

“I took fluoxetine tablets according to the recommendations of a psychotherapist in order to eliminate panic attacks. In the first weeks of taking the drug, I noticed some drowsiness, which, however, then disappeared. In addition, there was a noticeable decrease in appetite, which contributed to some weight loss. The emotional state has improved markedly. Taken concomitantly with fluoxetine hormonal preparations prescribed by a gynecologist. Everything was fine, however, after stopping fluoxetine, after 3 months, hot flashes reappeared. Apparently, this remedy still affects the concentration of other drugs in the blood while taking it. I didn’t feel the withdrawal syndrome, although I stopped taking the drug quite abruptly (I didn’t get to my psychotherapist on time).

Marina

“I first encountered fluoxetine a year ago. At that time, a psychotherapist diagnosed me with mild depression. The drug really helped me cope with my problem, and quite quickly (only 6-7 weeks). The drug is well tolerated. Of the side effects, periodically I was worried about discomfort in the upper abdomen, but I had problems with the stomach before that.

Ekaterina

« Fluoxetine has become my faithful assistant in the fight against anxiety and dizziness. For the past 10 years, I regularly take fluoxetine treatment once a year for 2-3 months. While taking the drug, my appetite slightly increases, from which I gain a few extra pounds. However, compared to anxiety, it’s not a problem at all.”

Irina

“I took canon fluoxetine for only 1 month for depression. After 2 weeks, I began to notice that my appetite increased noticeably. The emotional state has improved markedly. I wanted to live and develop again, I became much more sociable. After the end of the course of treatment, I didn’t fall into depression again, of course, but I feel for myself that it was necessary to prolong the intake of this drug a little more. ”

Marina

“Fluoxetine, to be honest, I prescribed myself. However, she soon regretted it. Already on the second day of taking at night, it increased a lot arterial pressure, there were strong and painful cramps in the legs, there was a strong heartbeat, a feeling of fear and panic. This remedy must be prescribed by a doctor.”

Alina

“A few years ago I had a severe depression in my life. To cope with it was not immediately possible and it took a lot of time and effort. Now I periodically take preventive courses with antidepressants. Fluoxetine is the only drug in this group that does not cause me any unpleasant side effects. I’m completely afraid to refuse these funds, since I simply can’t stand the second such depression. ”

Darya

“Over the past 6 months, my life has been quite busy. There was practically no time for rest.

Over time, I began to notice that I was lashing out at others for any little thing, not only at work, but also at home. After another scandal at home, I realized that I needed to do something so as not to lose my family. I got into the Internet, where I found reviews about fluoxetine. Of course, it would be right to see a doctor, but I didn’t have time for that. Started taking the drug. The first week there was no effect at all, but then I began to notice that I was becoming a little calmer. The mood improved markedly over time, at home and at work everything also returned to normal. However, I think to take it no longer than 1.5-2 months.

Dmitry

“I was diagnosed with moderate depression. I took fluoxetine for 2 months. Two weeks after the start of treatment, life began to improve. The emotional state of taking the drug has improved markedly. None side effects I did not notice. However, on the second or third day headache, but I'm not sure if it was related to the drug."

Irina

“Started the second course of treatment with fluoxetine. It was attributed to me by a neurologist from my irritability. During the time of taking the drug, she lost about 12 kg of weight, since the appetite practically disappeared from the pills. After 4-5 weeks of treatment, frequent diarrhea appeared. I connected this phenomenon with the drug, and therefore finished the treatment ahead of schedule. By the end of the first week after stopping treatment, irritability, insomnia, and obsessions (often lice appear) reappeared. I had to go back to taking the pills.”

Tamara

« I got fluoxetine on the advice of a friend. A few months after giving birth, I began to notice that something was wrong with me. I thought it was postpartum depression. Since I did not have milk, I could take any medication without any fear of harming the child. However, I still did not dare to drink this drug for a long time, since the instructions describe too many side effects. But it was not possible to do without medicine. I started taking fluoxetine in minimal doses once a day. Two weeks later, relatives and friends noticed its effectiveness. I think I will bring the course of treatment to 2 months.

The antidepressant fluoxetine was synthesized in 1972 as a selective serotonin reuptake inhibitor (SSRI). It is widely used in clinical practice.

This drug is a common and frequently prescribed antidepressant in the world, due to its high activity and effectiveness, low risk of side effects. If you have been prescribed Prozac, then this is the same thing.

The drug is available in the form of tablets for oral use, it has a relatively long half-life, is well resorbed (absorbed), absorbed (absorbed) and distributed in the body.

Anatomical Therapeutic Chemical Classification System ATC: N06AB03

In the liver, it is metabolized and converted into secondary metabolites, enzymes responsible for reactions that show significant individual differences due to genetic characteristics.

The mechanism by which the drug achieves its effect is selective inhibition of serotonin reuptake, does not affect norepinephrine and dopamine.

How this medicine works is still not completely understood. It is believed to have a positive effect on the connections between nerve cells in the central nervous system and restore the chemical balance in the brain.

The drug fluoxetine is sometimes used along with another drug called olanzapine to treat the depression that caused bipolar disorder, manic depression. This combination is also used to treat depression, after at least 2 drugs have been tried without successful treatment of symptoms.

Pharmacological action: selectively inhibits the neuronal uptake of serotonin in the axoplasm of the brain.

Depressive episode - depression;
Major depressive episode with psychotic symptoms;
Mixed anxiety-depressive disorder;
Obsessive Compulsive Disorder - OCD;
bulimia;
panic disorder;
Trichotillomania - an uncontrollable desire to pluck hair from the body, mainly from the scalp, eyelashes, eyebrows;
Premenstrual tension syndrome

The drug is used in patients with narcolepsy and cataplexy, eating disorders, obesity, in complex therapy for the treatment of alcohol dependence. Used with moderate success on a subset of patients with autism.

Depending on the patient's condition, the dose is determined individually, starting with the lowest effective dose.

The duration of the therapeutic course depends on the patient's condition and response to treatment. When using this antidepressant, a severe pronounced withdrawal syndrome is not observed, in contrast to paroxetine, venlafaxine and fluvoxamine, but when treatment is stopped, it is recommended to gradually reduce the dose.

According to some studies, this drug may increase the risk of suicidal thoughts and actions in people under 25 years of age.

With obsessive-compulsive disorder, the initial dose is 20 mg per day, the dose can be increased to 60 mg.

Treatment of bulimia - 60 mg per day, divided into two doses. For elderly patients, maximum dose- 60 mg per day. For children, the dose is determined by the doctor.

Take the medicine exactly as prescribed by your doctor. Follow your doctor's directions and instructions for use. Your doctor may change the dosage periodically for better results. Do not take the drug in larger or smaller amounts, and for longer than recommended.

Of the drugs available for sale, fluoxetine can be replaced by any antidepressant that does not require a doctor's prescription.

Gastrointestinal: changes in appetite and weight, nausea and vomiting, enteritis, colitis, hepatitis, liver enlargement, mouth ulcers, dry mouth, other diseases of the gastrointestinal tract;
Allergic manifestations: rash, urticaria, itching;
Psychoneurological changes: headache, migraine, sleep disturbance, apathy, euphoria, convulsions, hallucinations, hysteria, speech disturbance;
Cardiovascular disorders: arrhythmia, heart failure, hypertension;
Changes in clinical indicators: increased levels of cholesterol, liver enzymes, urea

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The use of this drug during pregnancy and lactation is not recommended, since it carries the risk of developing various disorders of the cardiovascular and nervous system of the fetus and newborn.

The use of SSRI antidepressants during pregnancy can cause serious lung problems or other complications in the baby. However, you may experience a relapse of depression if you stop taking antidepressants. If you are taking fluoxetine, tell your doctor right away that you are pregnant. Do not start or stop taking this medicine during pregnancy without your doctor's advice.

Fluoxetine may pass into breast milk and hurt to an infant. Tell your doctor if you are breastfeeding your baby. back to contents

Taking with other medicines

With the simultaneous use of fluoxetine with other drugs, the development of adverse drug interactions of varying degrees of severity is possible. For this reason, it is recommended to avoid use with other antidepressants, lithium, benzodiazepine, carbamazepine, haloperidol, warfarin.

Contraindications

Do not use fluoxetine if you have taken MAO inhibitors within the last 14 days. There will be dangerous drug interactions. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine. Wait at least 14 days after you stop taking MAO inhibitors before you start taking fluoxetine.

To make sure fluoxetine is safe, check with your doctor if you have:

Cirrhosis of the liver;
kidney disease;
If you are diabetic;
Hyponatremia (low sodium in the blood);
Hypokalemia (low potassium in the blood);
Narrow angle glaucoma;
Seizures or epilepsy;
Bipolar disorder (manic depression);
Have abused drugs in the past;
Treated with electroconvulsive therapy (ECT)

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The antidepressant fluoxetine works almost immediately. Within one hour after taking the first dose, physical and functional changes are noticeable in the human brain.

However, it is important not to confuse the first effect with efficiency. How quickly it will help varies greatly, depending on people and situations.

Some people feel changes almost immediately after the first dose. Others do not notice changes for several weeks or even after a month or two.

After the standard 4-6 weeks, the doctor will usually increase the dose, supplement the drug, or change if you do not notice significant relief from fluoxetine.

IN clinical research fluoxetine, weight loss occurred in 2% of people taking the drug, after how long - it is not known, it is possible that the treatment was too long.

The drug fluoxetine often leads to decreased appetite, nausea, and diarrhea, which contribute to weight loss.

Some women gain weight due to cortisol in their bodies produced during times of stress. By reducing stress and anxiety, an antidepressant can help reduce the presence of this hormone, making it easier to lose weight.

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fluoxetine and alcohol

Alcohol enhances the effect of antidepressants, which is why it is not recommended to consume it during the course of treatment.

Some people like to drink on a special occasion. Others drink more often to relieve stress. No matter why or how much you drink, alcohol affects everyone the same. It is a depressant that affects brain function. Drinking alcohol slows down and even blocks the brain. What happens if you mix fluoxetine with alcohol:

Problems in thinking and impaired judgment;
Fatigue;
Anxiety;
Depression;
Hearing and vision problems;
Impaired coordination of movements

The ingredients in fluoxetine are designed to balance mood. One of the side effects of the drug is fatigue. The drug can interfere with normal movement and concentration, as alcohol does. Combining fluoxetine with alcohol will quickly lead to increased sedation. Will lead to drowsiness, even one glass of wine while taking the drug. This effect will lead to potentially dangerous situations. These include poor decision making, impaired movement, and an increased risk of falls and injury.

Mixing alcohol and antidepressants can also lead to other side effects:

Dizziness;
sudden fatigue and weakness;
Feeling of hopelessness;
Suicidal thoughts

If you are taking this drug, do not drink alcohol. Mixing will endanger your health.

There is little evidence to suggest that an antidepressant helps alcohol dependent people to abstain from drinking alcohol. This does not mean that fluoxetine should be used to treat alcoholism. But this suggests that the drug reduces the desire to drink.

It is important to note that the consequences of combining alcohol with fluoxetine may occur after the end of treatment. Fluoxetine is a long term treatment, it stays in the body for a long time after you have taken it. Waiting a few days after taking the drug and drinking alcohol will not reduce the likelihood of negative consequences. If your doctor stops treatment with fluoxetine, ask him when you can drink alcohol. How long the drug remains in your body depends on the dose and duration of use, and how long you have been taking fluoxetine without a break.

The drug is dispensed by prescription and after consultation with a specialist, as it is necessary individual approach to every patient. In 2017 In the Russian Federation, it is impossible, in accordance with the current legislation, to buy fluoxetine in an online pharmacy without a prescription.

onedieta.ru

Antidepressants are drugs that can be taken only after prior consultation with a neurologist or psychiatrist. It is to this class that the drug "Fluoxetine" belongs. Patient reviews can be found very different: after treatment with this remedy, someone started a new and high-quality better life, while others, on the contrary, experienced a persistent deterioration in their condition. Why it happens?

The action of the drug

It is designed to relieve the feeling of fear, reduce apathy and cheer up. Normalization of sleep and appetite are also included in this list. The effect of the drug directly depends on the state of mental health of a person. The patient may feel a surge of energy, a thirst for vigorous activity, an improvement in mood. A healthy person who, for some reason, decides to take it (in order to increase efficiency or lose weight), on the contrary, can turn into a real “vegetable” that does not have the strength and any desires. For this reason, the drug "Fluoxetine" receives the most controversial reviews.

Pharmacokinetics

The main effect of the drug is to normalize the production of serotonin (a chemical, a hormone that is directly related to appetite, mood, libido, social behavior and brain function). If its natural production is reduced, a person experiences depression, apathy, and a depressed mood prevails. The drug helps to restore interest in life. Does not affect the work of the cardiovascular system and blood pressure, does not cause drowsiness and lethargy.

special instructions

You can evaluate the full result of taking the drug two weeks after the start of the course. Be sure to follow the recommendations of your doctor. The dosage should be reduced gradually: this way you will finish the course of treatment as comfortably as possible. Caution should be taken when taking funds for persons whose work requires maximum accuracy and coordination of actions.

Fluoxetine and weight management

Doctors prescribe the drug in cases of anorexia and bulimia. Both a complete refusal of food and uncontrolled gluttony are nothing more than a reaction of our psyche to the world around us, full of stress and difficult situations.

This is due to low levels of serotonin. The drug acts on the brain and helps to solve the problem. Let us not be seduced by the words about weight loss in the instructions for the drug APO-Fluoxetine. The reviews contain information about serious side effects and a difficult exit from the course of treatment, from which we can conclude that this is far from a safe drug for weight loss. It can be used only as prescribed by a doctor and in the case when it is really necessary, when there are real mental problems, and not 3-5 extra pounds.

Indications for use

Dosage

The standard dose is one tablet (20 mg) per day. The doctor who is treating you may adjust the doses depending on how he assesses the condition.
Protracted depression often requires taking two pills a day. With bulimia, the dose rises to 60 mg per day, and the maximum allowable ranges from 60 to 80 mg. The duration of treatment is also individual, it can take from a month to six months. Only an experienced doctor can choose the optimal treatment regimen and, if necessary, correct it. From patients who took the drug "Fluoxetine Lannacher", the reviews contain information about a fairly rapid improvement in the condition during the first three weeks of admission. However, after the withdrawal of the remedy, not everyone has the achieved result, which is also a reason for consulting a doctor.

Side effects

The same, desired by many, weight loss effect is actually a side effect, but it does not always appear and not for everyone. A powerful antidepressant, this drug activates the production of serotonin, which raises the mood, improves performance and at the same time suppresses appetite. Other side effects please much less.

Reviews received from people suffering from depression and taking the drug "Fluoxetine" confirm that dizziness and loss of appetite are most often felt after taking it.

Contraindications

This is a very important point on which everyone should focus their attention. If you have kidney or liver failure, severe kidney dysfunction, serious cardiovascular disease, then you need to find another treatment. It is forbidden to use the drug during pregnancy and lactation, so postpartum depression will have to be dealt with in other ways.

Another category of people who are contraindicated in the treatment of this antidepressant are patients with epilepsy and diabetes mellitus. Alcohol is prohibited during treatment: interaction with the drug will result in poor health, vomiting and headache, and with minimal alcohol intake. If the patient had a history of suicidal tendencies, for him medicine"Fluoxetine" is contraindicated. Officially registered figure: in 3% of cases, taking the drug ends in suicide. This is not affected by the dosage or duration of the medication, it is an individual reaction of the nervous system.

Specifications for application

If you are taking other antidepressants, then you must first complete the course, and only then switch to Fluoxetine. With caution, you need to prescribe it to patients with anorexia. Despite the fact that this violation is included in the list of indications, the drug can stimulate weight loss, which is dangerous for an emaciated person. If there is a need to prescribe this remedy to a patient with diabetes mellitus, then constant monitoring of blood sugar levels is necessary. With modern devices for home use it's easy enough.

Overdose

It is highly undesirable to exceed the prescribed doses, since poisoning develops. Symptoms are typical - diarrhea or vomiting. Mental excitement or convulsions may be added. Symptomatic treatment: gastric lavage, intake of activated charcoal or other sorbents, control of the condition.

Results

This is a serious drug that gives good results, but requires a responsible attitude to your health. Although it can be bought without a prescription, doing so and taking it on your own is highly discouraged. Only those patients who were treated by experienced doctors (using the drug "Fluoxetine") reviews indicate a positive trend and a minimum of side effects.

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Reviews about the drug Fluoxetine patients and doctors

Fluoxetine is a drug intended for the treatment of pathological conditions such as depression, manifested by anxiety and fear. Reviews about the drug Fluoxetine are different. This drug belongs to the pharmacological group of antidepressants. The appointment of this drug is advisable to eliminate the feeling of anxiety, fear, melancholy and apathy, normalize sleep, improve mood, mental activity and appetite. The drug is also used to treat bulimia, anorexia, alcohol addiction.

Consider the reviews of patients who used the drug Fluoxetine in their treatment, and the opinion of doctors about the effectiveness of this drug.

Patient reviews

“I suffered from frequent headaches for a long time. I was at the appointment with a neurologist, who explained that these symptoms are due to prolonged depression.

I was immediately prescribed fluoxetine. I took it strictly according to the recommendations of the doctor, however, instead of improving the general condition, the opposite was observed. All the time of treatment she was in some kind of inhibited state, drowsiness was present, her appetite completely disappeared (as a result of which she noticeably lost weight). The doctor said that this is a normal reaction of the body. However, the headaches never went away. She stopped taking the drug after 3-4 weeks from the start of treatment.

Valentine

Important fact:

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“I took fluoxetine for depression. I did not notice any side effects from the drug. After 2-3 weeks, the mood improved noticeably, it became less frustrating because of the little things.

“I took fluoxetine lannacher (Austrian production). Satisfied with the result. Now I plan to repeat the course of treatment, since about 10 months have already passed. However, for some reason I can’t find Fluoxetine Lannacher, but I don’t dare to take the domestic one yet. ”

“I was prescribed fluoxetine 1 tablet three times a day. I drank only 6 days.

“I took fluoxetine tablets according to the recommendations of a psychotherapist in order to eliminate panic attacks. In the first weeks of taking the drug, I noticed some drowsiness, which, however, then disappeared. In addition, there was a noticeable decrease in appetite, which contributed to some weight loss. The emotional state has improved markedly. In parallel with fluoxetine, she took hormonal drugs as prescribed by a gynecologist. Everything was fine, however, after stopping fluoxetine, after 3 months, hot flashes reappeared. Apparently, this remedy still affects the concentration of other drugs in the blood while taking it. I didn’t feel the withdrawal syndrome, although I stopped taking the drug quite abruptly (I didn’t get to my psychotherapist on time).

Ekaterina

« Fluoxetine has become my faithful assistant in the fight against anxiety and dizziness. For the past 10 years, I regularly take fluoxetine treatment once a year for 2-3 months. While taking the drug, my appetite slightly increases, from which I gain a few extra pounds. However, compared to anxiety, it’s not a problem at all.”

“Fluoxetine, to be honest, I prescribed myself. However, she soon regretted it. Already on the second day of taking at night, blood pressure increased greatly, strong and painful cramps appeared in the legs, there was a strong heartbeat, a feeling of fear and panic. This remedy must be prescribed by a doctor.”

“Over the past 6 months, my life has been quite busy. There was practically no time for rest.

Over time, I began to notice that I was lashing out at others for any little thing, not only at work, but also at home. After another scandal at home, I realized that I needed to do something so as not to lose my family. I got into the Internet, where I found reviews about fluoxetine. Of course, it would be right to see a doctor, but I didn’t have time for that. Started taking the drug. The first week there was no effect at all, but then I began to notice that I was becoming a little calmer. The mood improved markedly over time, at home and at work everything also returned to normal. However, I think to take it no longer than 1.5-2 months.

“I was diagnosed with moderate depression. I took fluoxetine for 2 months. Two weeks after the start of treatment, life began to improve. The emotional state of taking the drug has improved markedly. Didn't notice any side effects. True, on the second or third day there was a headache, but I'm not sure that this was due to the drug.

“Started the second course of treatment with fluoxetine. It was attributed to me by a neurologist from my irritability. During the time of taking the drug, she lost about 12 kg of weight, since the appetite practically disappeared from the pills. After 4-5 weeks of treatment, frequent diarrhea appeared. I connected this phenomenon with the drug, and therefore finished the treatment ahead of schedule. By the end of the first week after stopping treatment, irritability, insomnia, and obsessions (often lice appear) reappeared. I had to go back to taking the pills.”

“I got fluoxetine on the advice of a friend. A few months after giving birth, I began to notice that something was wrong with me. I thought it was postpartum depression. Since I did not have milk, I could take any medication without any fear of harming the child. However, I still did not dare to drink this drug for a long time, since the instructions describe too many side effects. But it was not possible to do without medicine. I started taking fluoxetine in minimal doses once a day. Two weeks later, relatives and friends noticed its effectiveness. I think I will bring the course of treatment to 2 months.

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Fluoxetine is a psychotropic substance. Myths about fluoxetine

Clinical and pharmacological group

Terms of sale from pharmacies

Price

Composition and form of release

Pharmacological effect

Indications for use

Contraindications

Appointment during pregnancy and lactation

Dosage and method of application

withdrawal syndrome

Suicidal risks while taking fluoxetine

Adverse reactions

Overdose

special instructions

Compatibility with other drugs

Consequences of fluoxetine - existing risks of taking

Indications for use

Symptoms of an overdose of fluoxetine

Fluoxetine (Prozac) scandal

The effectiveness of the drug

Indications and contraindications

Contraindications

Use with extreme caution

Mode of application

Adverse reactions

Interaction with other drugs

Analogues, cost

Patient reviews

Taking with other medicines

Contraindications

Related video: Losing weight with Fluoxetine

fluoxetine and alcohol

The action of the drug

Pharmacokinetics

special instructions

Fluoxetine and weight management

Indications for use

Dosage

Side effects

Contraindications

Specifications for application

Overdose

Results

Reviews about the drug Fluoxetine patients and doctors

Patient reviews