Fluoxetine Alcohol

Gorelick DA, Paredes A Effect of fluoxetine on alcohol consumption in male alcoholics. Alcohol Clin Exp Res 16 261-265, 1992... 

Kahel DI, Petty F A double blind smdy of fluoxetine in severe alcohol dependence adjunctive therapy during and after inpatient treatment. Alcohol Clin Exp Res 20 780-784, 1996... 

Kranzler HR, Del Boca F, Korner P, et ah Adverse effects limit the usefulness of flu-voxamine for the treatment of alcoholism.] Subst Abuse Treat 10 283-287, 1993 Kranzler HR, Burleson JA, Del Boca FK, et ah Buspirone treatment of anxious alcoholics a placebo-controlled trial. Arch Gen Psychiatry 31 720—731, 1994 Kranzler HR, Burleson JA, Korner P, et ah Placebo-controlled trial of fluoxetine as an adjunct to relapse prevention in alcoholics. Am] Psychiatry 152 391-397, 1995 Kranzler HR, Burleson JA, Brown J, et al Fluoxetine treatment seems to reduce the beneficial effects of cognitive-behavioral therapy in type B alcoholics. Alcohol Clin Exp Res 20 1534-1341, 1996... 

Naranjo CA, Sellers EM, Chater K, et al Non-pharmacological interventions in acute alcohol withdrawal. Clin Pharmacol Ther 34 214—219, 1983 Naranjo CA, Sellers EM, Roach CA, et al Zimelidine-induced variations in alcohol intake hy nondeptessed heavy drinkers. Clin Pharmacol Ther 35 374-381, 1984 Naranjo CA, Sellers EM, Sullivan ]T, et al The serotonin uptake inhibitor citalopram attenuates ethanol intake. Clin Pharmacol Ther 41 266-274, 1987 Naranjo CA, Sullivan ]T, Kadlec KE, et al Differential effects of viqualine on alcohol intake and other consummatory behaviors. Clin Pharmacol Ther 46 301 -309,1989 Naranjo CA, Kadlec KE, Sanhueza P, et al Fluoxetine differentially alters alcohol intake and other consummatory behaviors in problem drinkers. Clin Pharmacol Ther 47 490 98, 1990... 

Cornelius JR, Salloum IM, EhlerJG, et al Fluoxetine in depressed alcoholics a doubleblind, placebo-controlled trial. Arch Gen Psychiatry 54 700—705, 1997 Cornelius JR, Salloum IM, Haskett RF, et al Fluoxetine versus placebo for the marijuana use of depressed alcoholics. Addict Behav 24 111—114, 1999 Cui S-S, Bowen RC, Gu G-B, et al Prevention of cannabinoid withdrawal syndrome by lithium involvement of oxytocinergic neuronal activation. J Neurosci 21 9867— 9876, 2001... 

Schmitz JM, Averill P, Stotts AL, et al Fluoxetine treatment of cocaine-dependent patients with major depressive disorder. Drug Alcohol Depend 63 207-214,2001 Schottenfeld RS, Pakes JR, Oliveto A, et al Buprenorphine vs methadone maintenance treatment for concurrent opioid dependence and cocaine abuse. Arch Gen Psychiatry 54 713-720, 1997... 

Tomoxetine and fluoxetine are antidepressants. Both enantiomers of each compound can be prepared enantiospecifically starting from cinnamyl alcohol. Give a reaction sequence that will accomplish this objective. 

Cornelius, 1., Salloum, I., Ehler, 1. et al. Double-blind fluoxetine in depressed alcoholic smokers. Psychopharmacol. Bull. 33 165, 1997. 

Like sertraline, these two drugs are selective serotonin reuptake inhibitors. Fluoxetine is prescribed for depression, bulimic binge-eating and vomiting, obsessive-compulsive disorder, obesity, alcoholism, and anorexia among other ailments. Paroxetine is used for depression and obsessive-compulsive disorder. Interestingly the three top antidepressants are chemically unrelated to each other, except for being amines, and are unrelated to earlier tricyclic antidepressants. 

Drugs that may be affected by dronabinol include amphetamines, cocaine, sympathomimetics, anticholinergics, antihistamines, tricyclic antidepressants, alcohol, sedatives, hypnotics, psychomimetics, disulfiram, fluoxetine, and theophylline. 

Drugs that may affect benzodiazepines include alcohol, antacids, barbiturates, cimetidine, disulfiram, fluoxetine, isoniazid, ketoconazole, metoprolol, oral contraceptives, narcotics, probenecid, propoxyphene, propranolol, ranitidine, rifampin, scopolamine, theophylline, and valproic acid. 

Drugs that may affect duloxetine include inhibitors of CYP1A2 (eg, fluvoxamine, guinolone antibiotics), inhibitors of CYP2D6 (eg, fluoxetine, guinidine, paroxetine), and alcohol. 

Fraser, A.G. (1997) Pharmacokinetic interactions between alcohol and other drugs. Clin Pharmacokinet 33 79—90. Friedman, E.H. (1994) Re bradycardia and somnolence after adding fluoxetine to pimozide regimen. Can/ Psychiatry 39 634. 

Cornelius et ah, also openly evaluated the efficacy of fluoxetine (Prozac) (20 mg) in 13 adolescents with MDD and alcohol abuse or dependence (Cornelius et ah, 2001). The fluoxetine (Prozac) was well tolerated throughout the entire 12 week duration of outpatient treatment and was associated with a significant reduction in MDD symptoms (p <.001) for all subjects. Overall, there was a significant reduction drinking days (p <.08) and drinks per drinking day (p <.005) with 7/13 subjects having their SUD rated as much improved. 

Cornelius, J., Bukstein, O., Birmaher, B., Salloum, O., Lynch, K., Pollock, N., Gershon, S., and Clark, D. (2001) Fluoxetine in adolescents with major depression and alcohol use disorder an open-label trial. Addict Behav 26 735—739. 

London E, Fanelh RJ, Kimes A, et al Effects of chronic nicotine on cerebral glucose utilization in the rat. Brain Res 520 208-214, 1990 Lonnqvist J, Sihvo S, Syvalahti E, et al Moclobemide and fluoxetine in atypical depression a double-blind trial. J Affect Disord 32 169-177, 1994 Loo H, Malka R, Defance R, et al Tianeptine and amitriptyline controlled double-blind trial in depressed alcoholic patients. Neuropsychobiology 19 79-85, 1988... 

Covi L, Hess JM, Kreiter NA Haertzen CA (1995). Effects of combined fluoxetine and counselling in the outpatient treatment of cocaine abusers. American Journal of Drug Alcohol Abuse, 21, 327-44 Craig RJ, Olson R Shalton G (1990). Improvement in psychological functioning among drug abusers inpatient treatment compared to outpatient methadone maintenance. Journal of Substance Abuse Treatment, 1, 11-19... 

When drugs are administered orally, they typically are absorbed in the small bowel, enter the portal circulation, and pass through the liver. Both CYP enzymes in the bowel wall and in the hepatocytes can metabolize a fraction of the drug before it reaches the systematic circulation (i.e., first-pass metabolism or first-pass effect). The extent of this effect can be broadly altered by diseases (e.g., cirrhosis, portacaval shunting, persistent hepatitis, congestive heart failure), and by some drugs (e.g., alcohol, ketaconazole, fluoxetine) influencing the peak concentrations achieved and the ratio of the parent compound to metabolites ( 11, 19, 20). 

In contrast to anticonvulsants and alcohol, drugs such as bupropion, fluoxetine, fluvoxamine, nefazodone, quinidine, paroxetine, and some antipsychotics can inhibit specific CYP enzymes (7, 11, 36, 37, 41, 42, 43 and 44). Thus, TCAs, certain BZDs, bupropion, some steroids, and antipsychotics can all have their metabolism inhibited by drugs such as fluoxetine. For example, fluoxetine at 20 mg/day produces on average a 500% increase in the levels of coprescribed drugs which are principally dependent on CYP 2D6 for their clearance. That can lead to serious or even life-threatening toxicity if the drug has a narrow therapeutic index and the dose is not adjusted for the change in clearance caused by the coadministration of fluoxetine. 

In comparison with TCAs, SSRIs cause fewer pharmacodynamic drug-drug interactions but some (i.e., fluvoxamine, fluoxetine, paroxetine) cause more CYP enzyme mediated pharmacokinetic drug-drug interactions. Unlike TCAs, SSRIs do not potentiate alcohol and perhaps even slightly antagonize its acute CNS effects. Nevertheless, there are some important adverse interactions. 

Kranzier HR, Burleson JA, Korner P, et al. Placebo-controlled trial of fluoxetine as an adjunct to relapse prevention in alcoholics. Am J Psychiatry 1995 152 391-397. 

Janiri L, Gobbi G, Mannelli P, et al. Effects of fluoxetine at antidepressant doses on short-term outcome of detoxified alcoholics. Int Clin Psychopharmacol 1996 11 109-117. 

Kranzier HR, Burleson JA, Brown J, et al. Fluoxetine treatment seems to reduce the beneficial effects of cognitive-behavioral therapy in type B alcoholics. Alcohol Clin Exp Res 1996 20 1534-1541. 

Cornelius JR, Salloum IM, Ehler JG, et al. Fluoxetine in depressed alcoholics a double-blind, placebo-controlled trial. Arch Gen Psychiatry 1997 54 700-705. 

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