Prozac Fluoxetine effectiveness

The older generation of drags are less desirable than the new selective serotonin reuptake inhibitors, because they have many actions in the body other than their antidepressant effect. Prozac (fluoxetine hydrochloride) is among this group. Other trade names in this group are Celexa, Paxil, and Zoloft. 

SSRI antidepressants, which include Prozac (fluoxetine), Zoloft (sertraline), and Paxil (paroxetine), usually decrease the effects of LSD when they are taken together. However, taking an SSRI antidepressant can bring on disturbing flashbacks in someone who has taken LSD in the past. 

More dramatic examples of how a change in chirality can affect the biological properties of a molecule are found in many drugs, such as fluoxetine, a heavily prescribed medication sold under the trade name Prozac. Racemic fluoxetine is an extraordinarily effective antidepressant but has no activity against... 

Intellectual property rights (IPRs) are an important asset for the pharmaceutical industry. Most successful companies have suites of patents to protect their IPRs. The effect of IPR protection is amply demonstrated by the Prozac case. Fluoxetine (Prozac, Eli Lilly) was a blockbuster drug for many years. During... 

Tricyclic drugs have, as the name implies, a three-ring structure, and interfere with reuptake of norepinephrine and/or serotonin into axon terminals. Tricyclic drugs include imipramine (Tofranil), amitriptyline (Elavil), clomipramine (Anafranil), and nortriptyline (Pamelor, Aventil). Tricyclics have the occasional but unfortunate cardiovascular side effects of arrhythmia and postural hypotension. Newer, nontricyclic antidepressants have been developed that are collectively referred to as SSRIs. These have a potent and selective action on serotonin, and lack the cardiovascular side effects of the tricyclics. These include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), and fluvoxamine (Luvox). A fifth SSRI, citalopram (Celexa) has been used in Europe and has recently been approved in the United States. Venlafaxine (Effexor) blocks reuptake of norepinephrine and serotonin, while bupropion (Wellbutrin) acts on both dopamine and norepinephrine. 

Other Antidepressants. Antidepressant refinements for the next 30 years primarily consisted of the development of new TCAs. However, in 1988, a novel antidepressant class, the selective serotonin reuptake inhibitors (SSRIs), was introduced in the United States. The chief innovation of the SSRIs was that they afforded the comparable effectiveness of the TCAs with fewer side effects and minimal toxicity. The debut of the SSRIs coincided with the reworking of the nosology of the anxiety disorders in DSM-III and DSM-IV. As a result, the SSRIs have been studied extensively in each of the respective anxiety disorders and in many cases have obtained FDA approval for the treatment of one or more of these anxiety syndromes. The SSRIs currently available in the United States include citalopram (Celexa), escitalo-pram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft). 

Specific Serotonin Reuptake inhibitors (SSRis). To date, the only SSRI studied in AN is fluoxetine (Prozac). During the acute refeeding phase of treatment, fluoxetine shows modest improvement in weight gain while a larger controlled study during the maintenance phase of treatment demonstrated effectiveness in the prevention of relapse. From the standpoint of side effects and toxicity, the SSRIs are clearly... 

Serotonin-Boosting Antidepressants. Antidepressants that enhance serotonin activity in the brain have also been studied in ADHD. In particular, fluoxetine (Prozac) and the serotonin-selective TCA clomipramine (Anafranil) have been the most extensively evaluated, with mixed success. They provide some benefit for aggression and impulsivity but don t significantly improve the poor attention of ADHD. As a result, the SSRls and other serotonin-boosting antidepressants do not appear to be effective first-line treatments for ADHD. Conversely, depressed patients without ADHD often show improvements in symptoms of concentration and attention when treated with a SSRI. Although SSRls are not widely used in the treatment of ADHD, they may be worthy of consideration in ADHD patients whose impulsivity is not controlled by stimulants alone. Those with comorbid conduct disorder or ODD who are prone to agitation and at times violent outbursts may be helped by the addition of a SSRI. 

The efficacy of fluoxetine in treating patients with moderate depression is comparable to the efficacy of tricyclic antidepressants. It is capable of elevating mood and removing feelings of fear and stress. It does not have a sedative effect. Fluoxetine is used in depression as well as in bulemic neuroses. Use of fluoxetine is preferred in cases when sedative, hypotensive, and anticholinergic side effects caused by other antidepressants are con-traindicative to patients. Prozac is a synonym for fluoxetine. 

It is of note that Hypericum, often described as the natural Prozac, has the opposite effect of fluoxetine— and selective serotonin reuptake inhibitors (SSRIs) in general—on the CYP system. Fluoxetine inhibits several CYP isoenzymes, potentially resulting in increased blood levels of drugs metabolized through this pathway (See Chapter 22). 

Tricyclic antidepressants are still prescribed today, but some patients experience side effects such as dry mouth, blurry vision, constipation, and other uncomfortable conditions. Other antidepressants have since been found that induce fewer side effects. One of the most popular is fluoxetine, which is marketed under the trade name Prozac. This drug, along with Zoloft and other antidepressants, are known to inhibit reuptake proteins specifically for serotonin. As a result, these drugs are called selective serotonin reuptake inhibitors, or SSRIs. Although some concerns have appeared because of a possible risk of suicide in young patients who take Prozac, these drugs are commonly prescribed and have proved highly effective in millions of patients. 

The problem is that all drugs exert a number of different effects, some of which are wanted and some of which are not (the side effects). In researching the activity of fluoxetine (Prozac), scientists noticed a discrepancy between the time the drug acts on serotonin transporters and the time at which the patient s symptoms are relieved. Many patients do... 

Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac) begin to be used as antidepressants. These medications are generally effective and have fewer side effects than earlier drugs. 

In the case of social anxiety disorder, research suggests that some of the antidepressants that are effective in other anxiety disorders do not work to ease the symptoms of social anxiety disorder. This is true of the tricyclic antidepressant imipramine and fluoxetine (Prozac). The first line of treatment for the generalized form of social anxiety disorder is an SSRI such as paroxetine or sertraline. 

Fluoxetine, commonly known as Prozac , as a racemic mixture is an antidepressant drug, but has no effect on migraine. The pure 5-enantiomer works remarkably well in the prevention of migraine and is now under clinical evaluation. 

The most widely known SSRIs are fluoxetine hydrochloride (4, Prozac , Lilly), sertraline hydrochloride (5, Zoloft , Pfizer) and paroxetine hydrochloride (6, Paxil , GSK). Fluoxetine (4, Prozac ) was the first SSRl approved and effected a revolutionary change in the treatment of depression. In 2000, it was the most widely prescribed antidepressant drug in the United States with worldwide sales of 2.58B. Sertraline (5, Zoloft ) has been available in the United States since 1992 and had worldwide sales of 2.14B in 2000. Compared to fluoxetine (4), it has a shorter duration of action and fewer CNS activating side-effects such as nervousness and anxiety. Paroxetine (6, Paxil ) generated worldwide sales of 2.35B in 2000 and has a relatively benign side-effect profile, which favors its use with elderly patients. 

Fluoxetine (Prozac] Moderate, selective inhibition of serotonin reuptake No sedative, anticholinergic, or cardiovascular side effects helpful in obsessive-compulsive disorder May cause anxiety, nausea, insomnia long half-life can lead to accumulation... 

If the patient has a pre-existing mood disorder, such as depression or anxiety disorder, antidepressant medication may also be prescribed. Studies have shown that the selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac) and sertraline (Zoloft) are effective in people with bulimia and anorexia. These medications reduce depression by increasing levels of serotonin, a neurotransmitter. 

Amitriptyline is usually the treatment of choice for neuropathic pain. Some selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac ),paroxetine (Paxil ),sertraline (Zoloft ), and clomipramine (Anafranil ) can be used, but they don t appear to be as effective as TCAs. The doses for TCAs in treating neuropathic pain are usually lower than those for treating depression, and the drugs usually start to take effect more quickly in relieving pain than they do in relieving depression. It is interesting that people who suffer from chronic pain often experience symptoms of depression, so TCAs can benefit these people by helping to ease not only their pain but also their depressed mood. 

The following year, the British National Formulary, a joint publication of the British Medical Association and Royal Pharmaceutical Society of Great Britain (1991), listed suicidal ideation and violent behavior as fluoxetine side effects. Also in 1991,1 published Toxic Psychiatry, in which I observed for the first time that Prozac was producing a continuum of overstimulation that included akathisia, agitation, anxiety, insomnia, depression and mania, and, in the extreme, suicide and violence. I drew on previously sequestered FDA premarketing data on Prozac, the scientific literature, and my own clinical and forensic cases. 

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