Fluoxetine
Fluoxetine hydrochloride (brand names include ProzacÃÂî, SymbyaxÃÂî [compounded with olanzapine], SarafemÃÂî, and FontexÃÂî [Sweden]) is a drug used medically in the treatment of depression, obsessive-compulsive disorder, bulimia nervosa, premenstrual dysphoric disorder, and many other disorders. Chemically, fluoxetine is (N-methyl-3-phenyl-3-(α,α,α-trifluoro-p-tolyl)-oxypropylamine hydrochloride, C17H18F3NO·HCl) and, alone, it is a white crystalline solid. It is one of the selective serotonin reuptake inhibitors, and is marketed in capsules containing 10, 20, or 40 mg of active ingredient or in tablets containing 10 mg. Dosages in the range of 20-60 mg per day are standard, with 80 mg considered a maximum.
Fluoxetine was introduced in the US in 1987 and became very popular, with millions around the world having taken the medication. In the late 1990s there was something of a backlash. ProzacÃÂî's manufacturer, Eli Lilly and Company, Inc earned billions from its success, and became the target of numerous accusations. Lawsuits amounting to millions were instigated, alleging the drug made users feel suicidal and/or caused other serious side effects. The accusations and lawsuits have been unsuccessful in stemming the prescription and use of the medication, as well as in making the accusers some of Lilly's profits. The actual verified science that ProzacÃÂî is harmful has not been demonstrated. Currently (2/2004) the US FDA is considering similar controversial issues regarding ProzacÃÂî and its use in children and adolescents.
Fluoxetine has a wide range of published interactions, notably with monoamine oxidase inhibitors. Common side-effects include anxiety, restlessness, trembling, weakness, skin rash, anorgasmia, itching, and a decrease in sexual drive.
A more recent controversy embroiled Lilly, and a class action lawsuit has been filed after several people received in the mail free samples of ProzacÃÂî WeeklyÃÂÃÂ. The suit alleges that the samples' recipients' right to privacy was mishandled.
In December 2003 the FDA approved SymbyaxÃÂî to treat bipolar depression. SymbyaxÃÂî is a combination of fluoxetine and olanzapine.
The resources at the end of this article present a blend of views on this drug, some of which focus on the more controversial and unscientific issues.