Fluoxetine

Fluoxetine (often known by the brand name Prozac) is a common SSRI used for depression, OCD, panic disorder, bulimia, and some anxiety conditions. If you're starting it or helping someone who is, you want clear, practical info: what it treats, how to take it, what to watch for, and when to call the doctor.

What it does and how to take it

Fluoxetine boosts serotonin in the brain, which can lift mood and reduce anxiety and compulsions. Typical starting dose for adults with depression is 20 mg once daily. For some conditions or if the response is slow, doctors may raise the dose — up to 60–80 mg daily in some cases. Take it at the same time each day. If it makes you jittery or keeps you awake, try mornings. If it causes sleepiness (less common), try at night. You can take it with or without food, but food may help if it causes nausea.

Expect some changes within 1–2 weeks for energy or sleep, but mood and anxiety often take 4–6 weeks to show real improvement. Be patient and keep taking it unless your doctor tells you to stop.

Side effects, interactions, and safety tips

Common side effects: nausea, headache, trouble sleeping, sweating, dry mouth, and sexual side effects (reduced libido or difficulty reaching orgasm). Most side effects lessen over a few weeks. If they’re severe or last, talk to your prescriber.

Watch for serious but rare problems: serotonin syndrome (high fever, fast heartbeat, severe agitation, tremor), low sodium in older adults (confusion, weakness), and abnormal bleeding. If you see high fever, muscle stiffness, severe dizziness, or unexpected bruising/bleeding — seek urgent care.

Important drug interactions: avoid MAO inhibitors without a long washout (fluoxetine stays in your body for weeks; usually wait 5 weeks after stopping fluoxetine before starting an MAOI). Fluoxetine can reduce tamoxifen’s benefit, and it can raise bleeding risk when combined with warfarin or NSAIDs. Tell every doctor and pharmacist you’re on fluoxetine.

For teens and young adults, fluoxetine can increase suicidal thoughts early in treatment. Close monitoring during the first few months is essential. If you notice new or worsening depression, aggression, or suicidal thinking, contact your prescriber right away.

Stopping suddenly can cause withdrawal-like symptoms, though fluoxetine’s long half-life makes this less likely. Still, don’t stop or change the dose abruptly — work with your doctor to taper slowly.

Practical tips: set a daily alarm, keep pills out of reach of children, use a pill box if you take other meds, and carry a list of your medicines. If you miss one dose, take it when you remember unless it’s almost time for the next dose — don’t double up.

If you’re pregnant, planning pregnancy, or breastfeeding, discuss risks and benefits with your provider — sometimes staying on treatment is safer than stopping abruptly. Any time you’re unsure, call your clinician or pharmacist. They can help you weigh options and watch for problems.

Need personalized advice? Talk to your doctor — they know your full health picture and can guide dosing, monitoring, and safe stopping strategies.