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Fluoxetine


Presentation

  • We present case reports of 24-month-old twin girls, A and B, who presented to our clinic with food refusal and fear of feeding.[ncbi.nlm.nih.gov]
Weight Loss
  • INTRODUCTION: Pharmacotherapy for the management of obesity is primarily aimed at weight loss, weight loss maintenance and risk reduction (reduction in body fat, risk factors for cardiovascular disease and the incidence of diabetes mellitus).[ncbi.nlm.nih.gov]
  • Adverse Effects: General Activating on the sedation to excitation continuum Most activation or aggravation of all SSRI s Anxiety or nervousness Akathisia Insomnia Consider Trazodone ( Desyrel ) at bedtime Avoid in the elderly Weight loss may occur X.[fpnotebook.com]
  • loss—Fluoxetine may cause weight loss.[migraines.org]
  • loss, sexual dysfunction Contraindications MAOI therapy.[medical-dictionary.thefreedictionary.com]
  • Food and Drug Administration (FDA) for weight loss. Weight loss appears to be a side effect that occurs in up to 2 percent of patients taking Prozac.[everydayhealth.com]
Hyperthermia
  • The clinical features included coma, mydriasis, hyperthermia, tremor, hyperreflexia, rhabdomyolysis, renal failure and respiratory insufficiency.[ncbi.nlm.nih.gov]
  • Fenfluramine-induced hyperthermia and stimulation in the rabbit. Research Communications in Chemical Pathology and Pharmacology 13: 401–409, 1976 PubMed Google Scholar Reid LR, Threlkeld PG, Wong DT.[doi.org]
  • . • MAO inhibitors: Potential for severe reaction when used with MAO inhibitors; autonomic instability, coma, death, delirium, diaphoresis, hyperthermia, mental status changes/agitation, muscular rigidity, myoclonus, neuroleptic malignant syndrome features[web.archive.org]
  • Fluoxetine treatment of a depressed patient susceptible to malignant hyperthermia. Am J Psychiatry. 1989; 146:680. 171. Awad AG. New antidepressants—the serotonin reuptake inhibitors. Psychiatr J Univ Ottawa. 1987; 12:31-4. 172.[drugs.com]
Agonal Respiration
  • Emergency services was contacted, and responders found the patient unresponsive with agonal respirations, a pulse of 20 bpm, and no measurable blood pressure. Despite all resuscitative efforts, the patient expired.[ncbi.nlm.nih.gov]
Respiratory Insufficiency
  • The clinical features included coma, mydriasis, hyperthermia, tremor, hyperreflexia, rhabdomyolysis, renal failure and respiratory insufficiency.[ncbi.nlm.nih.gov]
Nausea
  • ., nausea, dizziness, headache) symptoms. Recent studies have shown that withdrawal symptoms are common with paroxetine, venlafaxine and fluvoxamine, but relatively rare and mild with fluoxetine cessation, likely as a result of its longer half-life.[ncbi.nlm.nih.gov]
  • Possible side effects include nausea, vomiting, diarrhoea, insomnia, anxiety, outbursts of violence, fever, skin rash and convulsions. This drug can interact dangerously, even fatally, with MAOI s. A brand name is Prozac.[medical-dictionary.thefreedictionary.com]
Polydipsia
  • Psychogenic polydipsia and fluoxetine-induced syndrome of inappropriate antidiuretic hormone secretion. Fluid restriction and discontinuation of fluoxetine.[ncbi.nlm.nih.gov]
Macula
  • The propositus, a male born from nonconsanguinous parents, had facial asymmetry with right microtia and mandibular hypoplasia; he also had bilateral hypoplastic macula, scoliotic deformity of the thoracic spine, and ventricular septal defect.[ncbi.nlm.nih.gov]
Suicidal Ideation
  • Hum Psychopharmacol 16: 495 – 505 Google Scholar Crossref Medline Hansen L, Wilkinson D ( 2001 ) Drug induced akathisia, suicidal ideation and its treatment in the elderly.[doi.org]
  • Suicide ideation acts and worsening in suicidal ideation. Binomial unconditional Mantel-Haenszel estimate. Mantel-Haenszel adjusted incidence difference. Pearson's chi-square test.[dx.doi.org]
  • Bo Fluoxetine (Prozac) The Worst Year of My Life rlmgo Fluoxetine My Life as a Suicidal Child Anonymous Fluoxetine (Prozac) & Sertraline (Zoloft) Violence and Suicide Ideation Lighty Fluoxetine (Prozac) Train Wrecks & Trip Disasters [2] Waiting Painfully[erowid.org]
Emotional Lability
  • Some of the signals, including emotional lability, myositis, spinal stenosis, paradoxical drug reaction, drug dependence, extrapyramidal disorder, adrenal insufficiency, and intracranial hemorrhage, were not labeled in the six countries.[ncbi.nlm.nih.gov]
  • . • Withdrawal syndrome: May cause dysphoric mood, irritability, agitation, dizziness, sensory disturbances, anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures.[web.archive.org]
  • Fluoxetine discontinuation symptoms include: dysphoric mood irritability fatigue weakness agitation dizziness sensory disturbances (paresthesias such as electric shock sensations) anxiety confusion headache lethargy emotional lability insomnia hypomania[emedexpert.com]
  • , 1 emotional lability 2 out of 104 1 uterine fibroids enlarged, 1 gall bladder disorder 2 out of 50 29060/448 (B), 2005 Paroxetine CR 3 emotional lability, 1 hepatocellular jaundice, 1 manic reaction 6 out of 102 1 dehydration, 1 accidental overdose[doi.org]
Headache
  • ., nausea, dizziness, headache) symptoms. Recent studies have shown that withdrawal symptoms are common with paroxetine, venlafaxine and fluvoxamine, but relatively rare and mild with fluoxetine cessation, likely as a result of its longer half-life.[ncbi.nlm.nih.gov]
  • Double-blind trial of fluoxetine: chronic daily headache and migraine. Headache. 1994 Oct;34(9):497-502. PubMed 17. Scahill L, Riddle MA, King RA, Hardin MT, Rasmusson A, Makuch RW, Leckman JF.[emedexpert.com]
  • […] attention if you experience any unusual bleeding or bruising, or have other signs and symptoms of bleeding such as dizziness; lightheadedness; red or black, tarry stools; coughing up or vomiting fresh or dried blood that looks like coffee grounds; severe headache[drugs.com]
  • Increased levels of the other stress hormone noradrenaline, also called norepinephrine, causes your blood vessels to constrict, which can cause your blood pressure to increase and can induce headaches.[livestrong.com]
Agitation
  • ., nervousness, anxiety, crying spells, psychomotor agitation, irritability, depersonalization, decreased mood, memory disturbances, confusion, decreased concentration, and/or slowed thinking) and somatic (e.g., nausea, dizziness, headache) symptoms.[ncbi.nlm.nih.gov]
  • It also causes you to feel jittery, anxious, nervous or agitated.[livestrong.com]
  • Tell your doctor right away if any of these unlikely but serious side effects occur: unusual or severe mental/mood changes (such as agitation, unusual high energy/excitement, thoughts of suicide ), easy bruising/bleeding, muscle weakness /spasm, shakiness[webmd.com]
Hyperactivity
  • Abstract Hyperactivity of the hypothalamic pituitary adrenocortical (HPA) axis is one of the main clinical findings in depression. The HPA axis is interrelated with glucocorticoid signaling via glucocorticoid receptors (GCRs).[ncbi.nlm.nih.gov]
  • For the treatment of hyperactivity and inattention, psychostimulants demonstrate some benefit.[doi.org]
  • Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more[drugs.com]
Hyperreflexia
  • The clinical features included coma, mydriasis, hyperthermia, tremor, hyperreflexia, rhabdomyolysis, renal failure and respiratory insufficiency.[ncbi.nlm.nih.gov]
  • .,. respiratory distress, cyanosis, apnea, seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia, hypo/hypertonia, hyperreflexia, tremor, jitteriness, irritability, constant crying).[drugs.com]
Dystonia
  • Here, we report a case of persistent dystonia, thought to be associated with short-term fluoxetine use, which required treatment with botulinum toxin type A.[ncbi.nlm.nih.gov]
  • Acute dystonia and fluoxetine. J Clin Psychiatry. 1990; 51:487. [IDIS 275539] [PubMed 2228987] 248. Halman M, Goldbloom DS. Fluoxetine and neuroleptic malignant syndrome. Biol Psychiatry. 1990; 28:518-21. [PubMed 2223920] 249. Jenike MA.[web.archive.org]
  • Acute dystonia and fluoxetine. J Clin Psychiatry. 1990; 51:487. 248. Halman M, Goldbloom DS. Fluoxetine and neuroleptic malignant syndrome. Biol Psychiatry. 1990; 28:518-21. 249. Jenike MA. Severe hair loss associated with fluoxetine use.[drugs.com]

Workup

QTc Interval Prolonged
  • . • Thioridazine: Fluoxetine may elevate plasma levels of thioridazine; increasing risk of QTc interval prolongation; this may lead to serious ventricular arrhythmias, such as torsade de pointes-type arrhythmias, and sudden death.[web.archive.org]
  • QTc interval prolongation associated with citalopram overdose: a case report and literature review. Clin Neuropharmacol. 2001; 24:158-62. 464. Fu K, Konrad RJ, Hardy RW et al. An unusual multiple drug intoxication case involving citalopram.[drugs.com]

Treatment

  • He failed to respond to standard treatment with high dose intravenous immunoglobulin, but showed stabilization and improvement following treatment with fluoxetine.[ncbi.nlm.nih.gov]
  • Heterogeneity of the treatment effect was tested by including a random treatment time interaction. Time was the number of days from treatment initiation.[doi.org]

Prognosis

  • CONCLUSIONS: In patients with ischemic stroke, early administration of fluoxetine may improve the neurological functional prognosis.[ncbi.nlm.nih.gov]

Etiology

  • As proinflammatory cytokines are involved in the etiology of depression, one may expect that antidepressants have negative immunomodulating effects.[ncbi.nlm.nih.gov]
  • The significance of life events as etiologic factors in the diseases of children: II. A study of a normal population. Journal of Psychosomatic Research, 16, 205–213. Google Scholar Compas, B. E. (1987).[doi.org]
  • Upon the appearance of rash or of other possibly allergic phenomena for which an alternative etiology cannot be identified, fluoxetine should be discontinued. A major depressive episode may be the initial presentation of Bipolar Disorder.[fluoxetine60.com]
  • Receptor sensitivity and the mechanism of action of antidepressant treatment: implications for the etiology and therapy of depression. Arch Gen Psychiatry. 1981; 38:1160-80. [IDIS 138923] [PubMed 6271089] 41. Bunney WE Jr, Garland BL.[web.archive.org]

Epidemiology

  • Some epidemiological studies suggest an increased risk of cardiovascular malformations; however, the mechanism is unknown.[drugs.com]
  • J Clin Psychiatry 57: 449 – 454 Google Scholar Crossref Medline Sachdev P ( 1995 ) The epidemiology of drug-induced akathisia: Part I. Acute akathisia.[doi.org]
  • A meta-analytical review of epidemiological studies concluded that the use of fluoxetine during the first trimester of pregnancy is not associated with significant teratogenic effects in humans [3].[obfocus.com]
Sex distribution
Age distribution

Pathophysiology

  • Evidence suggests that neurotrophic factors, inflammatory markers, and circadian rhythm dysfunctions could be involved in pathophysiology of major depressive disorder.[ncbi.nlm.nih.gov]
  • Our results suggest a potential clinical application for fluoxetine in amblyopia as well as new mechanisms for the therapeutic effects of antidepressants and for the pathophysiology of mood disorders. View Full Text[science.sciencemag.org]
  • The pathophysiology of PMDD is not fully understood.[thefreelibrary.com]
  • Several lines of evidence suggest that sigma-1 receptors play roles in the pathophysiology of psychiatric diseases, as well as in the active mechanisms of some selective serotonin reuptake inhibitors (SSRIs).[oadoi.org]

Prevention

  • Fluoxetine plasma levels cannot be used to guide relapse-prevention treatment.[ncbi.nlm.nih.gov]
  • Recognition and prevention of fluoxetine-associated drug interactions can improve patient safety and reduce preventable medication errors. References Latner AW. The Top 200 Drugs of 1999. The More Things Change, the More They Stay the Same.[crediblemeds.org]

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