Fluoxetine hydrochloride (brands names include Prozac®, Fontex®, Symbyax®, and Sarafem®) is a drug used medically in the treament of depression, obsessive-compulsive disorder, bulimia nervosa, and 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 sold in pulvules containing 10 mg, 20 mg 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 has a wide range of interactions, notably with monoamine oxidase inhibitors. Common side-effects include anxiety, restlessness, trembling, weakness, skin rash, anorgasmia, itching and a decrease in sexual drive. In some studies, Fluoxetine also had the side effects of causing some child patients to become manic, others suicidal. Fluoxetine was introduced in the US in 1987 and was initially very popular, over a million Americans were prescribed the drug a year. In the late 1990s there was something of a backlash with accusations that the drug made users feel suicidal and other serious side effects.
There is a great deal of controversy surrounding Eli Lilly and Company, the producent of Prozac. A class action lawsuit has been filed recently against Eli Lilly after several people received free samples of Prozac Weekly in the mail.
In December 2003 the FDA approved Symbyax® to treat bipolar depression. Symbyax® 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 issues.
