Prozac (fluoxetine) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. Fluoxetine affects certain chemical messengers (neurotransmitters) that communicate between brain cells and helps people with depression, panic, anxiety, or obsessive-compulsive symptoms.
Fluoxetine is a drug belonging to the class of selective serotonin reuptake inhibitors used, like other SSRIs, for the treatment of psychiatric disorders of various kinds such as major depression, anxiety disorders (obsessive-compulsive disorders and panic attacks) and bulimia; however, it is increasingly used off label also for other non-psychiatric pathologies such as premenstrual dysphoric disorder and premature ejaculation. Known commercially as Prozac, it was the first SSRI to be approved for medical use, coming on the market in 1986 in the US. It was first synthesized in the Eli-Lilly laboratories in 1972.
Fluoxetine is able to bind and block the activity of the serotonin transporter without showing, at therapeutic doses, significant affinities for those of noradrenaline and dopamine. This is believed to lead to increased serotonin concentrations in the synaptic wall which can thus stimulate its receptors for longer. Fluoxetine in high doses (60-80 mg), shows a non negligible affinity for the 5HT2C serotonin receptor, which could help to strengthen its therapeutic effects.
Fluoxetine and its metabolite nor-fluoxetine, as well as other SSRIs, have also been shown to increase brain concentrations of Allopregnanolone, a potent GABA-A receptor agonist known to mediate anxiolytic effects. Both then showed themselves capable of acting, in the same way, on this same receptor; this may mediate some of the therapeutic and side effects of fluoxetine. Furthermore, Fluoxetine acts as an agonist of the σ1 receptor with a potency greater than that of citalopram, but less than that of Fluvoxamine. However, the clinical relevance of this property is unclear.
Fluoxetine then acts as a blocker of anoctamine 1 channel, a calcium-activated chlorine channel. Other ion channels, such as the nicotinic acetylcholine receptor and the 5HT3 serotonin receptor, are inhibited at therapeutic concentrations by fluoxetine. Additionally, fluoxetine inhibits acid sphyengomyelinase, a key regulator of ceramide concentration.
Most common Fluoxetin’s side effects are:
Thoughts of self harm and / or suicide
Akathisia (restlessness), irritability, anxiety
Insomnia or sleepiness
Feeling of weakness
Alteration of taste
Gastrointestinal disturbances (nausea, diarrhea)
Sexual dysfunction (decreased libido, anorgasmia)
Emotional flattening (anhedonia)
Flu-like symptoms (rhinitis, pharyngitis, fatigue, muscle aches)
Tremors, involuntary movements
Swelling of the lips and difficulty in breathing
Skin problems (redness, blistering)
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