PsychRounds: The Psychiatry Podcast [SSRI] - Fluoxetine (Prozac)
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Dec 3, 2023 Discover the fascinating world of Fluoxetine, commonly known as Prozac. This discussion reveals its unique properties as an SSRI, including its long half-life and FDA-approved uses. Learn about optimal dosing for conditions like major depressive disorder and obsessive-compulsive disorder, as well as considerations for polypharmacy in older adults. The podcast tackles potential side effects, including gastrointestinal issues and sexual dysfunction, while also emphasizing its effectiveness across various age groups and conditions such as PMDD.
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Prozac Dosing Advice
- Start Prozac at 20mg daily for MDD and OCD, typically in the morning.
- Consider higher doses (up to 80mg or more) for OCD and 60mg for bulimia, adjusting based on individual needs and tolerance.
Prozac's Activating Properties
- Prozac, unlike other SSRIs, weakly inhibits NET, increasing norepinephrine and dopamine.
- This makes it more activating and potentially less suitable for anxiety, favoring morning doses due to its long half-life.
Symbyax for Bipolar Depression
- Symbyax, a combination of olanzapine and fluoxetine, is effective for bipolar depression.
- Both drugs potently inhibit 5-HT2C, thought to improve mood through this synergistic effect.