Chemical structure of fluoxetine
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Fluoxetine

Fluoxetine hydrochloride is an antidepressant drug used medically in the treatment of depression, obsessive-compulsive disorder, bulimia nervosa, premenstrual dysphoric disorder and panic disorder. Fluoxetine is also used (off-label) to treat many other conditions, such as ADHD. more...

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It is sold under the brand names Prozac®, Symbyax® (compounded with olanzapine), Sarafem®, Fontex® (Sweden), Foxetin® (Argentina), Ladose® (Greece), Fluctin® (Austria, Germany), Prodep® (India), Fludac*® (India) and Lovan® (Australia). Fluoxetine was derived from diphenhydramine, an antihistamine found to inhibit reuptake of the neurotransmitter serotonin.

Compared to other popular selective serotonin reuptake inhibitors, fluoxetine has a strong energizing effect. This makes fluoxetine highly effective in treatment of clinical depression cases where symptoms like depressed mood and lack of energy prevail. Although stimulating, it is also approved for a variety of anxiety disorders, including panic disorder and obsessive compulsive disorder.

Eli Lilly's Prozac was approved by the FDA on December 29, 1987 and introduced in the US at the beginning of 1988. The drug became very popular, with millions around the world having taken the medication. In the fall of 2001, Eli Lilly lost a patent dispute with Barr Laboratories and now fluoxetine hydrochloride is manufactured by many companies.

Uses

Approved

Fluoxetine hydrochloride is approved in the United States to treat depression, obsessive-compulsive disorder, bulimia nervosa, premenstrual dysphoric disorder and panic disorder. In the United Kingdom, it is approved to treat depression with or without anxiety, bulimia nervosa, and obsessive-compulsive disorder.

In December 2003 the FDA approved Symbyax® to treat bipolar depression. Symbyax is a combination of fluoxetine and olanzapine. (However, the pure form of fluoxetine can cause mania, mixed-states, rapid cycling and psychosis in bipolar patients, particularly if the patient is not also taking a mood stabilizer.)

Unapproved/Off-label/Investigational

In 2003, Michel Harper, Fukodome Takayasu, and Andrew G. Engel reported that fluoxetine given over a period of three years at doses of up to 80-120 mg/day to two patients with slow-channel congenital myasthenic syndrome who were allergic to quinidine resulted in substantial subjective and objective improvement in muscle strength.

Mechanism of action

Recent research indicates that fluoxetine may increase the production of new neurons (brain cells) in adult brain (adult neurogenesis), and that it interacts with the system of "clock genes", the transcription factors involved in drug abuse and possibly obesity ,.

Read more at Wikipedia.org


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Hypericum perforatum versus fluoxetine in the treatment of mild to moderate depression - Brief Article
From Alternative Medicine Review, 8/1/02 by K Behnke

Behnke K, Jensen GS, Graubaum HJ, Gruenwald. J Adv Ther 2002; 19:43-52.

In a randomized, controlled, double-blind trial, 70 patients (mean age, 49.7 years) suffering from mild to moderate depression received one tablet of either St. John's Wort (Hypericum perforatum) extract (Calmigen) or fluoxetine hydrochloride (Prozac) twice a day for 6 weeks. Efficacy was determined according to the 17-item Hamilton Rating Scale for Depression (HAMD), the von Zerssen depression scale (DS), Clinical Global Impression (CGI), and patients' overall evaluation. Significant decreases (P<.001) of 50% in the Hypericum group and 58% in the fluoxetine group in the HAMD score and of 42% and 52% on the DS spoke to the efficacy of both medications. The Hypericum extract achieved 83% of the efficacy of fluoxetine on the HAMD and 78% on the DS. Assessments by physicians (CGI) and patients indicated considerable improvement with no between-treatment differences. Of the 9 dropouts (13%), 2 in the Hypericum group and 2 in the fluoxetine group were due to adverse reactions. Safety evaluations demonstrated only minor changes. The Hypericum preparation tested in this study is therapeutically equivalent to fluoxetine and is therefore a rational alternative to synthetic antidepressants.

COPYRIGHT 2002 Thorne Research Inc.
COPYRIGHT 2002 Gale Group

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