Talk:Fluoxetine

Fluoxetine (Hydrochloride)

This article uses the names "fluoxetine" and "fluoxetine hydrochloride" throughout. I'm assuming these are one and the same in chemical structure and simply a shortened/extended name? If so, can I suggest that the article use only the one term, but note it can also be called (insert other name). This would eliminate any confusion arising from the two names. ju'iblex 04:40, 5 July 2006 (UTC)

Fluoxetine refers to the actual chemical entity and hydrochloride is a salt that is put with the fluoxetine to stabalize the compound in a capsule/tablet/solution form. Therefore, they both refer to the same thing. I would prefer to change it to fluoxetine hydrochloride because fluoxetine isn't marketed by itself. PharmerJess 20:20, 27 July 2006 (UTC)

but flouxetine is the actual active compound in the thing you swallow. i think i prefer the use of flouxetine alone. very few journals will refer to it as flouxetine hydrocholoride anyway.

Prozac as a personality modifier

don't know if this should be included in the new edit, but there is evidence to suggest prozac modifies personality. The problem being here that there is little quantifiable data measuring personality. to my knowledge there are no papers about this aspect but there have been a few books about it as well as anecdotal accounts from psychiatrists. i think this should be included due to the interesting issues it raises about personality and the underlying neural basis for it. It is also relevant in explaining prozac's widespread use even after the symptoms of depression have been curtailed. i can't remember the source, but i will put it up as soon as i find it in the library again.

any med perscribed to alter mood will either bring out your true personality or create another one. It's all dependant on how depressed someone is and why. if someone with bi-polar is giving an ssri it will get rid of there depression but make there mania more frequent and more intense. also seratonin isnt the only chemical in the brain that effects mood. but yes prozac is definatly personality modifying.... mood and personality are very related. also prozac takes a while before it takes any effects and those effects can range from off the walls manic to suicidal. and mixing ssri's with any other meds that in anyway effect serotonin can be dangerous. im on prozac for clinical depression. It helps alot with the depression but I can also notice a change in brain chemical lvls, it boosts both seratonin and dopamine, and it gives me a feeling similar to CNS stimulants where im very outgoing, analytical, want to fix things and help people, and become very talkitive.

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Just my personal opinion, but I must say that prozac and other drugs just like it are way over-prescribed. While it is true that it does indeed have it's uses, I do not believe in diagnosing a 3rd grader with ADD and putting him/her on Prozac. To say the least, a 3rd grader is a child, and as such, has by very nature a short attention span, and is highly active. Instead of telling the parents to control their children like they should, the doctor will rescribe them prozac. You see, in a world where physical punishment is frowned upon ( I do not mean abuse! I would say a spanking is in order. I got spanked quite often when I messed up a child, and I turned out just fine, and there are millions like me)the kid is left with very little tangible consequences. He gets sent to his/her room, where they will most likely play video games, or call their friends to tell them what a drag their parents are. In retaliation, the parents send their children to a doc who will 9 out of 10 times, perscribe them prozac. Parents at that point no longer control their childrens erratic behaviour, but the drug does. Now fast forward to 10 yeard later. The child is sick of taking med's and wants to try life without them. I hate to say it people, but an addiction is an addiction. Every major depression they would have felt growing up was masked by the prozac, so they never really learned how to deal with the harshness of everyday life. Many of them will turn to other drugs to ease this feeling. This is wrong, and only happens because the parents failed to control their children. This in turn creates an even bigger problem when the child grows up, because they have no way to control their emotions. On the flip side, if someone is suffering from depression so bad, or they find that they cannot concentrate on the job at hand at all, then you call the doc, and should be given a drug like prozac. What it all comes down to, is people inability to cope with something. We all have problems coping from time to time, and from time to time, would be justified in something to take the edge off. But to constantly use it, even when it is not necessary, will only cloud things up worse. A lack of discipline is also a major factor. I welcome arguments to my point, and will check up regularly :-)—Preceding unsigned comment added by 204.194.77.3 (talk)

I agree they are over-perscribed. so are disorders like ADHD, Bi-Polar, and autism spectrum disorders. I wanna be a psychiatrist and I think that psychiatrists should try finding the root of problems like depression instead of just a quick chat and a perscription, I guarantee that 50% of people on anti-depressents just havnt figured out the root of the depression and all they need is therapy instead of medication, and medications arnt as safe and harmless on the body as people think. also I wish i could slap every pschiatrists who diagnosis kids with ADHD because a 7 year old is hyper and doesnt wanna listen to adults talking... its called be 7 years old.

Scientology and Prozac

I hear about scientologists being behind the Prozac Truth website, can anyone confirm?

My guess is yes, since they cite absolutely no research papers on the subject or provide otherwise meaningful data. --Iosif 23:31, 13 October 2005 (UTC)

If Scientologists are the only people who put stuff on the Net without citing their sources, then the Wikipedia is OT III. (Joke.) Anville 13:50, 29 October 2005 (UTC)

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According to Prozac.com, Prozac is the best thing since sliced bread

According to ProzacTruth.com, Prozac is a creation of Devil.

Prozac.com is, of course, strongly biased. It's just an advertisement. But is ProzacTruth.com biased as well, only from a different angle? Is the real truth somewhere between prozac.com and prozactruth.com?

I also am about to start taking this drug. I am a Diabetic and take insulin. I also have High Blood Pressure. Will this help me or make things worse? I am so scared to take alot of the meds my Dr. wants me to because i read so much about the side affects. They also want me to take Bupropion. Is this not the same type of drug? I will wait for any answers you might have. Ken from Massachusetts. —The preceding unsigned comment was added by 141.154.32.95 (talk • contribs) .

Hi Ken. Please understand that Wikipedia can not give medical advice. We are wikipedians, not physicians. Feel free to read this article and bupropion, but do not consider them medical advice and they shouldn't take the place of your physician. I really must urge you to speak with your doctor frankly about the concerns you have, since he/she is the only one able to give you advice and explain or modify the treatment you are currently receiving. Thanks --Bk0 (Talk) 17:44, 16 April 2006 (UTC)

I am about to treat my depression with Fluoxetine hydrochloride and it is very important to me to have as objective knowledge as possible, before I start any treatment. -- Unknown author, Jan 2003

If it's objectivity you need, you're in the wrong place ;^) Jordan Langelier

Why? And better yet, what would you recommend as a balanced alternative? (for an opinion, obviously.) --Gutza 21:33, 18 Jul 2004 (UTC)

Just in case someone else comes along with the same questions... Studies show that the highest efficacy for clinical depression is in using both anti-depressants and cognitive therapy. The idea is that the anti-depressants help with the immediate "fog", but the cognitive therapy will help treat underlying issues or behavior that may increase or cause depressive feelings. Cognitive therapy on its own has a better one year success rate than antidepressants alone, but the best bang for the buck is supposed to be both. YMMV. I had clinical depression about twenty years ago, dislike drugs, and found CBT to be more helpful. 67.10.133.121 02:38, 12 February 2006 (UTC)

If you want balanced and objective information on Fluoxetine and the other SSRIs then look to the large body of research papers published in reputable, peer-reviewed journals. There are about 400 papers on fluoxetine and about 25 of these are meta-analyses. If you don't want to be beholden to other's possibly biased opinions then you will have to do your own secondary research. The least you will have to do is study at least a couple of the meta-analyses. You can find the abstracts on PubMed and the full articles in a large reference libarary. It is important to bear in mind that fluoxetine entered clinical use for depression in 1988 and has given to literally millions of people around the world since then. People that have obtained relief from their depression on fluoxetine and other SSRIs don't set-up websites or blogs pouring scorn and vitriol on pharmaceutical manufacturers and pschiatrists and they don't loiter on message boards whining about withdrawal or adverse reactions. Those that have benefiited from SSRIs are busy living their lives. Certainly some people do experience serious adverse responses to SSRIs and withdrawal can be harsh especially with SSRIs that have a short half-life (fluoxetine has the longest half-life of all the SSRIs) and this can be very debilitating. However, depression itself is debilitating. SSRI withdrawal typically lasts for 2-4 weeks and it can involve a relapse in depressive symptoms. The use of the SSRI -- assuming you have found one that works for you -- though will typically give you many months or even years of low-level depression or no-depression life. If your depression does have a psychological basis (not all depresssions do) then you may benefit from CBT. CBT is the only psychotherapy with any evidence of efficacy for the treatment of depression. A common occurence with people on SSRIs is to forget what they felt like prior to commencing treatment with SSRIs after a few months and to begin attributing the residual symptoms of the depression (eg. apathy, fatigue) to the SSRI. This often prompts an abrupt cessation of SSRI usage and the consequent withdrawal symptoms. If you are suffering from depression it is useful to keep a diary. Take note of how you feel before commencing with the SSRI and record how you symptoms are changing with the SSRI. With the benefit of your diary you are better able to determine if the SSRI is causing some particular symptom or if it is something due to the depression. Stay away from all the Scientology front websites and organisations. The Scientologists are only interested in taking your money and enslaving you. The CoS has the blood of Lisa McPherson on its grasping hands[1]. flavius 12:16, 19 March 2006 (UTC)

"If your depression does have a psychological basis (not all depresssions do)" I'm not aware of any empirical evidence to back this statement up. The so-called "chemical imbalance" theory is just that, a possible unproven explanation for the unknown mechanisms that contribute to the clinical efficacy of antidepressant drugs. Of course I completely agree with your assessments of the Scientology cult, however. --Bk0 (Talk) 19:28, 19 March 2006 (UTC)

here here! someone else who thinks CBT is an effective treatment. of course it must be given along side pharmochological treatments as well. It doesn't matter which comes first though. for suicidal patients obviously a blast of SSRIs is paramount asap. but if they are into homeopathy for instance, it's often worth holding back on the antidepressants and presenting them as a last chance once the homeopathy doesn't work. Not sure why scientologist have a crusade against prozac... seems a bit wierd though.

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"The controversial Prozac approval process described, as well as side effects of other SSRIs and other types of medication, can be found on Prozac Truth, The Untold Story website."

I am not about to treat anything with Prozac, I was just curious about the drug, and the quotation above looks pretty POV to me, that site doesn't look so trustworthy as to invest it with such a powerful statement from Wikipedia. Other thoughts? --Gutza 22:59, 4 Dec 2003 (UTC)

Me again. I went ahead and edited, removing that paragraph altogether and replacing it with a NPOV pointer to the resources. I have no bias whatsoever regarding this drug, feel free to revert if you think that was too drastic. --Gutza 23:06, 4 Dec 2003 (UTC)

Truth is not the averaging of polarized opinions. Truth is just truth. If you value your health and your sanity, seek the truth and don't settle for less - there is a road out of mental illness. However, the solution to depression does not include side effects such as suicide and depression.

" Lawsuits amounting to millions were instigated, alleging the drug made users feel suicidal and/or caused other serious side effects." You may want to look into rewording this phrase. I could be wrong but I'm pretty sure I read that their was a link between suicide and prozac, not that it caused suicidal feelings. The latter implies that it physically made users feel suicidal which might be true, but I thought that the issue was that it numbed the emotions and social attachment in already depressed people. \

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This is real late in coming, but I will never take any of those drugs again. I will take street drugs before I take any of the SSRI's. Those things are the worst thing in the world, I will jump in front of a speeding train first.

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There seems to be a logical fallacy in the above post. SSRI's are street drugs, aren't they? ;)

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I have been taking fluoxetine and had very little in the way of side effects - just a small amount of nausea at the start. It has been very successful in treating my depression so far and I'm feeling good for the first time in ages. I just wanted to add this as I'm sure there are others who it has helped and as mentioned above they don't tend to speak out. I think that an explanation in part of why there is such a broad range of reactions to drugs like these is the limited understanding of the basis of the disease. In my opinion what we know as depression could have many causes each presenting with similar symptoms explaining why some treatments only work for some individuals.

Spamming on sexual dysfunction issues all over

Many articles have been edited pasting the same statements over and over again. Warnings were not attended. This modus operandi is vandalism. Perhaps, this article needs to be reverted and temporarily blocked. --Octavio L 06:16, 14 October 2005 (UTC)

This user is promoting his own research, but fails to cite a credible source. The source he alludes to does not support his assertions. Revert on sight. I will block if he carries on. JFW | T@lk 08:25, 14 October 2005 (UTC)

Glandular fever

Does fluoxetine cure glandular fever?

No, it doesn't. It's used in chronic EBV, though, or what we tend to call chronic fatigue syndrome. JFW | T@lk 07:35, 28 October 2005 (UTC)

'chronic' ebv is not exactly the same thing as CFS/what might be better here referred to as 'post-viral fatigue syndrome'. Might be better to say that fluoxetine is often used to treat the low mood commonly associated with glandular fever & it's aftermath. (Claired88 14:42, 4 April 2007 (UTC))

Prozac weekly vs generic question

"4 or 5 regular 20mg doses taken at once will have a similar effect to Prozac Weekly with significantly lower costs, especially when using generic versions." Is it really true that the weeklong dose of prozac is no different than taking a larger dose of ordinary prozac? I'm pretty sure that withdrawal symptoms start within a day or two with ordinary prozac, so it seems like a once-a-week dosage would be inappropriate unless it has some extended release mechanism. (unsigned by 140.247.144.121)

Quoting from the drug monograph:

[Fluoxetine has an] elimination half-life of 1 to 3 days after acute administration and 4 to 6 days after chronic administration and its active metabolite, norfluoxetine [has an] elimination half-life of 4 to 16 days after acute and chronic administration [respectively] ... The long elimination half-lives of fluoxetine and norfluoxetine assure that, even when dosing is stopped, active drug substance will persist in the body for weeks. (rxlist.com monograph)

The Prozac Weekly formulation is enteric-coated primarily to avoid GI irritation from the larger dose. The coating delays absorption but does not signficantly prolong it, meaning that the total dose is absorbed after 1-2 hours rather than 20-45 minutes. Fluoxetine can be taken weekly due to its extremely long half-life, not due to any mechanical extended release formulation. In fact, I am not aware of any possible formulation that could extend oral absorption over 5-7 days. Typically material passes through the GI tract over no longer than 48-72 hours, usually closer to 24 hours. --Bk0 (Talk) 23:19, 15 December 2005 (UTC)

Prozac in popular culture

This article does not mention that Prozac is a fashion drug. It is so often referenced in books, songs, films, that this deserves some statement. I could cite a few examples, but i'm not sure what exactly to say about the "vibes" connected with it in general. I mean along the lines of, extacy is a drug popular with ravers, cocaine popular with high society and rappers, prozac with ... yuppies, housewives and goths, perhaps? gbrandt 11:56, 27 April 2006 (UTC)

No, it is wrong for an encyclopedic entry to have such generalizations as 'goths take it', not in those exact words but that is basically what it would be saying and this can not be proven as fact, same with housewifes and yuppies as you so put it.

Pfft. Goths are given zoloft on sight where I live. (doctors are getting paid off by drug companies) 144.131.139.111 00:08, 27 February 2007 (UTC) User:Ragnarokmephy

Fluoxetine for dysthymia

Is it a recommended drug for dysthymia?

Answer: It is what I was diagnosed with and I take it, so yeah I guess it is

Pregancy category C?

Several other reputable sites are reporting that Prozac has been classified category C. I've changed this page to reflect this data, although I was unable to personally verify.

Change

I changed the listing of dosage forms, as there is no 60 mg capsule available and 20 mg tablets are available. I also removed: "Dosages in the range of 20-60 mg per day are standard, with 80 mg considered a maximum." Because the dosage of a medication depends on what it is being used to treat. PharmerJess 20:27, 27 July 2006 (UTC)

Mechanism

Somebody needs to flesh this out. Some mention of the monoamine theory of depression, downregulation of receptors, etc needs to be mentioned. 203.5.70.1 11:23, 9 November 2006 (UTC)

The mechanism of Fluoxetine is not strictly related to the MAOI family of antidepressants, but mostly based on his actions as reuptake inhibtor and agonist of serotonine (hence is in the SSRIs family of antidepressants).
- It would be useful to include/expand the "side effects" section with usual and rare side effects and also suspected ones.
- Have a precise list of generic brandings other than Eli Lilly's Prozac and related dosages and preparations (Ie. weekly, XR, etc.).
- Very Very important is to include in both the dosage/mechanism and side effects section the importance of the Ceiling effect of this drug.
While it's true that Wikipedia is not a GP, it would be good to include to clarify to people that certain medications do not have a constant increase of effect with increase of dosage.--nicowalker 14:11, 5 April 2007 (UTC)

Side Effects

The complete list of side effects for Prozac could take up three pages. It is best to keep short, simple and sweet. —The preceding unsigned comment was added by 67.82.232.151 (talk) 01:00, 14 January 2007 (UTC).

what about the neurotrophic theory about mechanism, BDNF, Glucocortidoids etc there are many emerging ideas about how prozac and other ADs actually work. probably best to expound on the basic monoamine premise and then mention that there are other possible Modes of action, and the whole thing is really poorly understood... huh welcome to neuroscience...

Surely the side effects section should list more than just adverse affects? For example, this SSRI has been known to cause gastrointestinal side effects such as nausea, vomiting and diarrhoea.

Positive View of Prozac

Should not there be a section on the positive things that Prozac does? I don't think that this would violate neutrality if it was handled correctly. If I had read this article before I was proscribed this medication I would NEVER have taken it, no part of the article addresses what this drug does positively for some people. (Prozac saved my life, I have been suicidal since puberty (am now 25). I was always leery of drugs, just relied on therapy. Finally, two years ago I agreed to try Prozac, it literally saved my life, not to mention my marriage.) I wanted to address this in the "talk" before I tried to write up a section on the positive response that some patients have. Any thoughts? BonnieJosephine 17:54, 25 January 2007 (UTC)

I NPOV tagged it because there is nothing positive about it. From reading this article, one would think prozac is poison and eli lilly is an evil corporation bent on destroying lives in the name of profits. Lets have a fair article.67.167.130.247 17:10, 19 March 2007 (UTC)

• I'm going to bring this up with the Wikipedia:WikiProject Pharmacology folks, so the article can be reviewed. I agree that the NPOV tag should stay as there definitely appears to be 1) bias and 2) a noted lack of cites and references - Alison^☺ 17:26, 19 March 2007 (UTC)

Wikis on antidepressants tend to attract a large amount of cruft, conspiracy theorism, soapboxing, hang-wringing, and outright quackery. I keep an eye on most of them, but a lot of this stuff can slip by undetected. The price of NPOV, I suppose, is eternal vigilance. Cheers, Skinwalker 17:32, 19 March 2007 (UTC)

I have removed the entire following section from the "Children" subsection, as it is a total, copy-and-paste copyvio from this website.

The research, conducted over three years at 12 medical centers, was funded and coordinated by the National Institute of Mental Health (NIMH) at a cost to U.S. taxpayers of US$17 million. A total of 439 adolescents aged 12–17 were given fluoxetine, fluoxetine plus cognitive behavioral therapy (CBT), placebo plus CBT, or placebo alone. After 12 weeks, 71% of those treated with fluoxetine and CBT showed improvement (defined by the therapists and the subjects' responses to questionnaires). Improvement was reported by 60% of those taking fluoxetine without CBT, 43% getting CBT alone, and 35% taking placebo alone.

NIMH Director Thomas Insel told the media it was a "landmark study" because "it's the largest publicly funded study and the only study this size that doesn't have pharmaceutical funding", but lead investigator John March of Duke University Medical Center was on the Eli Lilly payroll.

Data to which March et al did not draw attention showed a higher incidence of harmful behavior among teens taking Prozac (11.9%) compared to those on placebo (5.4%) and CBT alone (4.5%). Few stories mentioned that teenagers to whom suicidal thoughts had occurred had been excluded from the study before it began. According to FDA documents posted on the FDA website on September 25, 2003, at least 2 of 48 children treated with Prozac in the NIMH-sponsored trial attempted suicide. NIMH's role in funding a study with taxpayer money was subsequently used by Eli Lilly as court evidence to extend its Prozac patent exclusivity and to obtain FDA approval for treating depression in children.

I'll check the page history on the off chance the website "cited" WP, but it seems highly unlikely, as it's a 2004 article. What should we do about this? Fvasconcellos 23:51, 19 March 2007 (UTC)

How about a contraindications section

We need the aforementioned sectiom. Also, some of the serious but rare side effects such as activation of mania or psychosis. —The preceding unsigned comment was added by Joel2016 (talk • contribs) 23:58, 8 March 2007 (UTC).

Copyright violations

Found various chunks of this to be copied verbatim from various sources, some are papers published via PubMed (verbatim copy/pastes, not just cites). The article needs extensive review before this issue can be cleared. The team at WP:PHARM have been informed, so we'll see what happens - Alison^☺ 00:39, 20 March 2007 (UTC)

• rebuilding here - feel free to have a go - Alison^☺ 02:02, 20 March 2007 (UTC)

Page Reconstruction

The whole page was taken down? That seems like censorship, not partnership? Dispute over copyright and source material should be verified, not deleted until further notice. —The preceding unsigned comment was added by 67.82.232.151 (talk) 18:53, 22 March 2007 (UTC).

This is disgusting. I remember the Prozac page had a plethora of information for those considering taking a look at pros/cons of this medication.

"Allison" - while I understand your worry of infringement, don't take down material until you have replaced with an equal amount of knowledge. I'm starting Prozac, and I NEED to be able to view the information on this medication (as we all know, many psychiatric medications are used off label, information that can not be found from the manufacturer). I need a comparison chart to see if this is the right med for me. What you did was pure vandalism, and utimately hurt the community and those needing severe help.

Kudos. Kudos. —Preceding unsigned comment added by Wikiwouldhave (talk • contribs)

• It's not quite so simple, "Wikiwouldhave". Firstly, I wouldn't rely on Wikipedia for my medical/drug information. Anyone can edit it so don't consider it a definitive source of medical information. Secondly, and importantly, the text was a blatant copyright violation of somone else's work. That a pretty serious statement and is something that can put Wikipedia in jeopardy. See WP:COPY, WP:CV and Wikipedia:Copyright FAQ for more information. The fact that it was copyright text means by definition that it's available elsewhere. Thus, you should be able to view the information you need elsewhere.
• As an administrator, I'm probably under more scrutiny than non-admin editors. Copyright violations should be reviewed, tagged and deleted if proven. Exactly that has been done. Furthermore, I reported the matter to WP:PHARM. I'm personally annoyed that the article should be gutted, as it has been. A lot of the work that I and other editors had put into this was effectively damaged by the editor who used someone else's work, mis-appropriated it and called it their own. I'm sure you'll agree that's just not on. - Alison^☺ 05:22, 14 April 2007 (UTC)

Pharmaceutical Discoverer's Award from NARSAD?

I deleted the following: "Fuller was later awarded the Pharmaceutical Discoverer's Award from NARSAD (National Alliance for Research on Schizophrenia and Depression) for his work.[5][6]" Both references lead nowhere. I checked the NARSAD website, there is no mention of Pharmaceutical Discoverer's Award or Ray Fuller. I was not able to find any primary sources on the web, which would mention this award.Paul gene 20:24, 21 April 2007 (UTC)

Fair enough. This article was already deleted due to copyvio concerns, we shouldn't leave uncited/inaccurate statements in. Please feel free to help with the article's reconstruction, if you wish—this is a very important page, we need all the help we can get. Fvasconcellos (t·c) 20:49, 21 April 2007 (UTC)

Laughable: Fluoxetine is an atypical SSRI

I have to delete reference to fluoxetine being an atypical SSRI. At fault are the authors of the original paper (Bymaster, Frank P.; Wei Zhang et. al. (April 2002). "Fluoxetine, but not other selective serotonin uptake inhibitors, increases norepinephrine and dopamine extracellular levels in prefrontal cortex.". J. Psychopharmacology (Berl) 160 (4): 353-361)) The way they spinned the results of their paper in the abstract is nothing short of misinformation. The paper comes from Lilly and is a regrettable, albeit a typical example, of how science in perverted in some pharmaceutical companies. Not only the results are put in the most favorable light but most outrageous and unsubstantiated claims are made. The main claim is that "Amongst the SSRIs examined, only fluoxetine acutely increases extracellular concentrations of norepinephrine and dopamine as well as serotonin in prefrontal cortex, suggesting that fluoxetine is an atypical SSRI." Putting aside the errors in methodology and reasoning, if you read the original article you find that every other antidepressant they tried (fluvoxamine, sertraline and paroxetine) for the exception of citalopram increased the peak level (approximately 30 min after injection) of dopamine or norepinephrine or both of these neurotransmitters. The following numbers are taken directly from the article. Over the 4-hour period after administration, which is the authors definition of "sustained", fluvoxamine increased dopamine (DA) levels to 100+-7%, and norepinephrine (NE) levels to 133+-7%; paroxetine: DA 86+-3% and NE 103+-4%; sertraline: DA 116+-3 and 117+-3%. Although fluoxetine increased DA to 150+-5% and NA to 189+-4%, which is a larger increase, there is nothing atypical about it.Paul gene 21:03, 21 April 2007 (UTC)

Prozac for dogs

FYI - Lilly has now released a Fluoxetine chew-tab for canine use called Reconcile.

• News article: http://www.medicalnewstoday.com/medicalnews.php?newsid=68990

The CyberSlug 18:25, 27 April 2007 (UTC)

• .... just ... wow! Canine SSRIs - Alison ☺ 19:34, 27 April 2007 (UTC)

The world has gone mad... Eve 19:36, 27 April 2007 (UTC)

I am not sure we want to mention veterinary applications in the very beginning of the article about the drug, which is used mostly in humans. Most of the pharmacology articles in Wikipedia do not mention veterinary use of human drugs. There was also no reference in the main text of the article confirming this application. So I deleted it. If somebody thinks it necessary, I would suggest restoring at the end under miscellaneous applications.Paul gene 01:54, 7 May 2007 (UTC)

I do know that the article talks about human usages. However, should we only limit ourselfs to.. us? Maybe we should make this Humanpedia instead of Wikipedia. Many articles, for example, the article on sleep, primairy discuss human sleep, and just slightly mention sleep in other animals. Another article, such as the pesticide article, discusses the negative effects on humans.. but what about wildlife? The beggening of the article mentions what Fluoxetine is approved for treating, and some off label treatments. It was never just approved and possible human treatments.

Perhaps we could move all of the possible/approved treatments to it's own part of the article, not the beggening. Think outside the box. Let's have a vote.. I vote for including canine treatments. --Moop stick | (Talk) 22:48, 8 May 2007 (UTC)

I think it warrants inclusion, but not in the lead. WP:MEDMOS suggests a section for Veterinary uses in drug articles when applicable. Remember, this article is being rewritten from scratch, and still has a long way to go; in time, what now appears to be undue weight (the addition of an animal indication) will be balanced out eventually, as more information is added. Fvasconcellos (t·c) 23:07, 8 May 2007 (UTC)

Can the prescribing information be copied verbatim?

Parts of the side effects chapter were copied from the prescribing information. PI: "The following symptoms, anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, and mania, have been reported in adult and pediatric patients being treated with antidepressants for major depressive disorder as well as for other indications, both psychiatric and nonpsychiatric." and from table of side effects - names of the side effects are in the same order: "Asthenia Flu syndrome Vasodilatation

Nausea Diarrhea Anorexia Dry mouth Dyspepsia

Insomnia Anxiety Nervousness Somnolence

..."

Is that acceptable?Paul gene 22:08, 9 May 2007 (UTC)

No, thank you for noting this. I'll remove this tomorrow, unless you beat me to it; this constitutes a copyright violation. Fvasconcellos (t·c) 03:57, 10 May 2007 (UTC)

Removed. This article has previously been plagued with copyright violations. Good catch! - Alison ☺ 04:21, 10 May 2007 (UTC)

Well, I am not sure that prescribing information is a copyrighted content since it is developed in collaboration with the FDA and is freely copied on multiple websites. That is why I asked. On the other hand, what is the point in repeating it?Paul gene 10:02, 10 May 2007 (UTC)

Hmm. If you're right and it isn't violating any copyrights, then I think we should have it in, albeit with the source made clearer. It's useful and important information. If not, then I think we should include the important bits re-worded with appropriate citation. Does that sound reasonable, in terms of potential copyvio problems? Eve 10:14, 10 May 2007 (UTC)

I think that's reasonable. I'll try to dig up more information on the copyright status of PIs, but even if they are not protected, we should at least reword what we do include as per WP:MEDMOS. I admit this article is desperately in need of more content, and it will be hard to completely steer clear of sounding like a package insert at points. Fvasconcellos (t·c) 14:55, 10 May 2007 (UTC)

Well, I haven't been able to find anything. If prescribing information is indeed not copyright-protected, I stand corrected. Either way, I'd err on the side of caution and reword the information before returning it to the article. Fvasconcellos (t·c) 19:48, 11 May 2007 (UTC)

I've reinstered side effects and dosing. It is not copyrighted info, it sourced info as long as source cited. —The preceding unsigned comment was added by 70.198.185.24 (talk) 21:48, 11 May 2007 (UTC).

Fluoxetine assists with Premature Ejaculation in Men

My urologist prescribed this to me to assist with increasing the time it takes before I ejaculate during sex. According to the doctor studies have shown that mild doses of the medication can improve longevity 3-5x the time it usually takes. Not sure if it will work for me, but time will tell. —Preceding unsigned comment added by 76.185.36.170 (talk) 14:00, 6 July 2007

This is what most people prescribed it for depression would call a side effect...pretty sure it will work as it has the required effect :-) SmUX 22:51, 1 August 2007 (UTC)

Ibuprofen

I notice that there's no mention of the side effects of taking ibuprofen or other similar drugs with fluoxetine. From what I've read from a few sources, it is a very long shot but Fluoxetine can increase the risk of bleeding if taken with it. http://www.drugdigest.org/DD/DVH/Uses/0,3915,552813%7CFluoxetine+and+Olanzapine,00.html has some info, but even the pamphlet that comes with fluoxetine advises against it. As I said above, it's low risk but it's a risk and something which should be avoided and possibly also included in the page. I'll leave it up to someone else to add it if they feel it is sourceable enough. I think in this case it is specifically for the mix of Fluoxetine and Olanzapine with Ibuprofen, so maybe a minor mention rather than making it look important. SmUX 15:02, 31 July 2007 (UTC)

It is a misconception that ibuprofen somehow increases bleeding, and it has been proven false by clinical research. Therefore, the warning about ibuprofen + fluoxetine danger is unnecessary.Paul gene 00:48, 1 August 2007 (UTC)

Yup. Probably a mix-up with aspirin, which is a know anticoagulant - Alison ☺ 04:37, 1 August 2007 (UTC)

Many thanks for confirming that. Maybe aspirin might be something to be added or is it *just* with Olanzapine and Fluoxetine together? SmUX 22:46, 1 August 2007 (UTC)

Weight gain?

I've heard from a few people that fluoxetine causes weight gain. I noticed it isn't listed here, was I misinformed? Thanks! 134.53.26.177 04:36, 30 August 2007 (UTC)

Important Points to be Made Concerning the Article

The article (and, perhaps, the research community researching Fluoxetine as a whole) might be well-advised to consider the following points. Of course, some of the below questions would answer themselves if there were more numerical data/quantitive data released with some of the academic research papers being cited within the article.

1) Fluoxetine symptoms will affect different people to differing extents. The fact that the side-effects of Fluoxetine are given without an indication of the degree to which those side-effects are prevalent in `normal' human populations overlooks this fact. There is also the distinct possibility (or likelihood?) that, if the extent of the side affects for each individual could be quantitatively analysed (assigning a side-effect vector to each individual, say for a principal components analysis), some subsets of side-effects would occur in some patients and not in others (or vice versa).

2) There seems to be some `contradiction' between Fluoxetine's ability to affect human memory after depression, whilst interfering with human sleep patterns (which one would intuitively think has the effect of affecting memory in a negative way). Is it the case that the sleep disruption affects are only temporary?

I have noticed, when searching for relevant research to answer the above points, that there is contradictory information available concerning Fluoxetine. Many papers state that memory in depressed patients is improved using Fluoxetine - though a few state that there are individuals for whom Fluoxetine will degrade memory performance. Does anyone have any information which would shed light on this?

3) Fluoxetine and IQ. If someone suffers from severe depression and subsequently takes Fluoxetine - would not the Fluoxetine treatment improve IQ scores (or, at least, subtests of those scores)?

InTheInterestsOfTruth 19:33, 21 October 2007 (UTC)

Gay man's brain responds differently to fluoxetine? - Come on...

I would argue for removing this peace of information because it is useless trivia and as such is not encyclopedic; in addition it is not quite true.

The way the study was set up makes any generalization difficult. The authors: "tested only individuals who differed maximally in their sexual orientation. We selected a total of 16 men without physical illness or psychiatric history: (a) eight of whom self-identified as exclusively homosexual and eight as exclusively heterosexual on the Kinsey Scale [7]; and (b) who attested that their past and present sexual behavior, desires, and fantasies were directed entirely toward men or women, respectively." Since the extremes of homosexual and heterosexual behavior were taken, the results of the study would not be applicable to most heterosexual or homosexual men. In other words, although the extremes may differ, the median of homosexual may not be different from heterosexual. Besides, the Kinsey scale is very old (1948) and it probably was not validated properly, and it is not clear what it measures.

Secondly, the authors state: "Both groups, however, did exhibit similar widespread lateralized metabolic responses to fluoxetine (relative to placebo), with most areas of the brain responding in the same direction. Results are generally consistent with those in the much smaller study of Cook et al. who reported that large areas of the limbic system were affected by fluoxetine. Our groups did not differ on behavioral measures or blood levels of fluoxetine (pharmacodynamics were not assessed)."

The authors then subtracted homosexual from heterosexual data and found some scattered differences in the brain glucose metabolism. Considering the small group size, those could be due to chance.

Even if they are not due to chance it is unclear whether they carry any significance and how to interpret them. The authors discuss the hypothesis that the homosexual man brain is more female-like. So one would expect that similar difference should exist in the response of female vs male brain to fluoxetine. But there have been no such study, so there is nothing to compare the authors' data with!

What a pointless and stupid exercise is this paper. Paul gene 02:08, 3 November 2007 (UTC)

• Hello Paul!

Not being a medical researcher myself I stumbled on the paper published in the USA. It was inter alia mentioned in the article on homosexuality on Wikipedia. As a gay man these things are of some interest to me.
I could not check the validity of their claims. It seems hat you can.
The system of Wikipedia is that we can not post our own opinions here. We need sources. If a serious review discredited the published article on Fluoxetine and it's supposed effects om gay men this should be mentioned. If your comments are just your own opinion we have a problem. Being a sceintist myself, I am an art-historian, I understand your misgivings. I merely mentioned the article, you have obviously read it. Is there a published source of criticism of the "pointless and stupid paper"?

As far as "useless trivia" is concerned, a discredited theory or an article in a paper that was later found out to be untrue or unfounded has a tendency to surface again and again like a bad penny. A well documented rebuke of the article on Fluoxetine and sexual identity/behaviour should be a usefull adittion to the article, wouldn't it?

Did you delete (or enhance)the text on Fluoxetine in the "Homosexuality" article on the various Wiki's? These things often spread like wildfire....

Faithfully yours,

Robert Prummel (talk) 15:58, 8 December 2007 (UTC)

I agree that I cannot post my opinion in the body of the WP article. However, I can still use my opinion to determine whether the fact deserves mentioning in the article. I argued here that it does not. Two other editors appeared to agree with me. However, since everything in WP is done by consensus, and you insist on including this factoid, then OK. I'll just add a correction to it. Paul gene (talk) 17:56, 8 December 2007 (UTC)

Cleanup

I added a cleanup tag because this article has numerous expressions of opinion that are not sourced. Some examples: "As with all cases which raise strong human emotion, scientists must--as much as possible--remove the subjective emotion from the equation to come to an objective conclusion. It also should be noted that correlation does not imply causation, and doing so is a logical fallacy." and "However, it should be noted that there is not a drug known to man, which, when administered to healthy human beings, causes people to commit suicide in any statistically significant number so as to imply causation beyond a reasonable doubt." and "However, the conclusion that societal suicide rate decreases are due to antidepressant prescription is extraordinarily dubious given the plethora of confounding variables." --agr (talk) 19:50, 5 December 2007 (UTC)

The unsourced speculations were added just recently; I reverted them. Paul gene (talk) 01:32, 6 December 2007 (UTC)

Side effect/suicide controversy

The citations supporting the purported lack of danger of fluoxetine seemed absurd to me, and were re-inserted after I deleted them. So I put in the counter-argument with, to be fair, some equally absurd studies and citations, and tried to balance this section out. Given Eli Lily's legal issues and incentive to obscure this controversy, it might be good to be attentive of keeping this section and controversy balanced and objective. --Xris0 (talk) 22:14, 29 November 2007 (UTC)

I think the bit about prozac reducing suicide rates based on national suicide statistics should be deleted because a causal link is not established. The "prozac reduces suicide" POV articles should speak for themselves, without even more absurdly specious presentation of unrelated suicide data before it. Also, the primary sources should be obtained re the NY times article and this reference be deleted. It may be a "reputable" source, but with regard to the science it is completely irrelevant. If there is no discussion re the national suicide statistics I will take that data out. Thanks to Paul gene for attempts to keep parts of this article unbiased. --Xris0 (talk) 01:55, 6 December 2007 (UTC)

I think that that paragraph should be moved to the article Antidepressant since it discusses antidepressants taken as a group. Different antidepressants have very different pharmacology. Imagine a hypothetical case that thorough epidemiological studies over many years and in many countries, and taking into consideration all the possible confounding variables, did show that prescription of antidepressants decrease the suicide rate. What would it tell us about fluoxetine–nothing! First, because its pharmacology is different. Second, because it amounts to barely 20% of all prescribed antidepressants. Paul gene (talk) 02:41, 6 December 2007 (UTC)

This needs to be cleared up ASAP: ie, citations given. Without a useful section on suicidal ideation, a possible major useful indication of this otherwise antiquated drug is lost. Other articles like [bupropion] cite Flu as having a statistically meaningful trend to reduce suicidal ideation, a unique ability in SSRIs... if it exists. 58.170.96.182 (talk) 15:27, 21 December 2007 (UTC)

OMGGGGGG IT'S RITALINDEATH.COM

Cardiac side effects for prozac according to ritalindeath.com: hemorrhage, hypertension, angina, arrhythmias, congestive heart failure, heart attack, rapid heart beat, atrial fibrillation, cerebral embolism, heart block.

Do these type of sites just think of the worst possible side effects and then mix them in with a copule real ones? Didn't see any of these in the article. Ok, I know this has an obvious answer I think. —Preceding unsigned comment added by 71.191.51.145 (talk) 05:12, 10 December 2007 (UTC)

The chance of each side effect is recorded _somewhere_ based on clinical study statistics. It would be good if this information is added to the article but very rarely do statistical reports of effects vs placebo make it to mainstream media. As Fluvox is one of the oldest SSRI drugs the information should be out there, it just needs research. There has been a huge media backlash against this drug (Prozac), largely based on myth and sensationalist journalism that talks about endogenous/clinical depression as if it were nothing worse than a nasty cold to be gotten over (the depression == weakness myth): thus drug manufacturers are making the disease up to make money. See the ridiculous and damaging AIDS conspiracy theory for a similar pattern. How people confuse ignorance for insight... 58.170.96.182 (talk) 15:46, 21 December 2007 (UTC)

Use of Cquote and RQquote templates in articles is discouraged

Template:Rquote is a is a variant of the {{Cquote}} quotation template. According to Template:Cquote, "this template should not be used for block quotes in article text." This point of view is supported by WP:MOS—"Block quotes are not enclosed in quotation marks (especially including decorative ones such as those provided by the {{cquote}} template, used only for "call-outs", which are generally not appropriate in Wikipedia articles). Use a pair of <blockquote>...</blockquote> HTML tags." Paul gene (talk) 11:32, 14 December 2007 (UTC)