Fluoxetine agitation from

Nervousness and agitation in some patients early in treatment are characteristic side effects of the SSRIs. These too have been reported to be dose related. In the fluoxetine database, these side effects were more common with the 60-mg dose than with the 20-mg dose and were associated with some insomnia (G. L. Cooper 1988]. Although in general the various SSRIs differ little one from the other, there appear to be some differences in their propensity for producing nausea and nervousness. 

Residential treatment appeared the most likely way of making an impact on Carl s crack cocaine use, and plans were made for an admission. This could not happen immediately, and in the meantime Carl was prescribed fluoxetine 20mg per day, and diazepam 20-30mg per day. He was keen to try to withdraw himself from crack without going into hospital, and he and his mother were instructed about his use of the two medications. They were advised that diazepam would reduce anxiety and agitation, and might help relieve craving for crack. 

Severe stimulation reactions were reported in four of six fluoxetine-treated patients with posttraumatic stress disorder, requiring three of them to withdraw from the study Two experienced agitation and worsening of hyperarousal symptoms one patient s panic symptoms markedly... 

Aside from these pharmacokinetic changes two cases of parkinsonism developed within 3 and 9 days of adding fluoxetine to carbamazepine treatment. In both cases carbamazepine levels were unaffected. A case of the serotonin syndrome (shivering, agitation, myoclonic-like leg contractions, diaphoresis etc.) has also been seen, in a woman taking carbamazepine 200 mg daily and fluoxetine 20 mg daily. ... 

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