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Antidepressant medications are commonly prescribed for treating depression and various mental health conditions. They can play a crucial role in reducing the risk of suicidal thoughts and attempts, along with providing other significant benefits. Nonetheless, research indicates that a small fraction of individuals, particularly those under 25, may experience an exacerbation of depression, mental health symptoms, or suicidal tendencies when on these medications. It is essential to discuss the potential risks and advantages of antidepressants with a healthcare provider, particularly for patients younger than 25, irrespective of whether the treatment is for a mental health condition.

• Promptly inform your doctor if you observe any intensification of depression or other psychiatric symptoms.
• Be vigilant for changes in behavior, such as emerging suicidal thoughts or attempts.
• Monitor for any mental or mood alterations, including increased anxiety, panic attacks, difficulty sleeping, irritability, feelings of hostility or anger, impulsive behaviors, severe restlessness, or rapid speech.
• Exercise extra caution when initiating a new antidepressant or adjusting the dosage.

Maintaining open communication with your healthcare provider is key to managing these potential side effects effectively.

Experiencing nausea, drowsiness, dizziness, anxiety, difficulty sleeping, loss of appetite, tiredness, sweating, or yawning is common. These are generally mild and often manageable. However, if they persist or worsen, it’s important to consult your healthcare provider.

Serious side effects, although less common, require immediate attention. These include significant mental or mood changes like agitation, heightened energy, or suicidal thoughts, as well as easy bleeding or bruising, muscle weakness or spasms, tremors, reduced sexual interest or ability, and unexpected weight loss.

Seek urgent medical care for very severe symptoms such as black stools, vomit resembling coffee grounds, seizures, signs of kidney issues (such as changes in urination), eye pain, swelling, redness, enlarged pupils, or vision changes like seeing rainbows around lights at night.

For individuals with diabetes, fluoxetine may influence blood sugar levels. Regular monitoring and communication with your healthcare provider are necessary to manage any required adjustments to your treatment plan.

Fluoxetine can increase serotonin levels, and rarely, this may lead to serotonin syndrome. This risk is higher if you are taking other serotonin-increasing drugs. Symptoms to watch for include rapid heartbeat, hallucinations, loss of coordination, severe dizziness, nausea, vomiting, diarrhea, muscle twitching, fever, and unusual agitation.

In rare cases, males may experience a painful or prolonged erection lasting four or more hours. This requires immediate medical intervention to prevent long-term complications.

Though very rare, severe allergic reactions can occur. Symptoms include rash, itching, swelling—particularly of the face, tongue, or throat—severe dizziness, and difficulty breathing. If these occur, seek emergency medical help.

This overview does not cover all possible side effects. If you notice any other concerning effects, discuss them with your healthcare provider.

Fluoxetine can remain in your system for several weeks after your last dose, potentially interacting with other medications. Inform your doctor or pharmacist if you've used fluoxetine in the past 5 weeks before starting any new medication. Drugs that may interact with fluoxetine include those that increase bleeding or bruising risk, such as antiplatelet agents like Clopidogrel, NSAIDs like Ibuprofen or Naproxen, and anticoagulants like Dabigatran or Warfarin.

Using MAO inhibitors with fluoxetine can lead to a serious, possibly fatal, interaction. Avoid MAO inhibitors (like isocarboxazid, Linezolid, Metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, Rasagiline, safinamide, Selegiline, Tranylcypromine) while on fluoxetine. Most MAO inhibitors should not be taken for 2 weeks prior to and at least 5 weeks following fluoxetine treatment. Consult your doctor about when to start or stop these medications.

Fluoxetine can slow the elimination of other drugs from your body, affecting their efficacy. This includes medications like Pimozide, Thioridazine, vinblastine, antiarrhythmics (such as Propafenone, Flecainide), and tricyclic antidepressants (such as Desipramine, imipramine).

Aspirin may heighten the risk of bleeding when combined with fluoxetine. However, continue low-dose aspirin (81-162 mg daily) for heart attack or stroke prevention if advised by your doctor unless otherwise directed.

The risk of serotonin syndrome or toxicity increases if you also take drugs that boost serotonin levels. These include recreational drugs like MDMA/"ecstasy," St. John's wort, certain antidepressants (other SSRIs like Citalopram, paroxetine, SNRIs like Duloxetine, Venlafaxine), and Tryptophan. The risk may rise when starting or increasing doses of these drugs.

Inform your doctor or pharmacist if you use products causing drowsiness, including alcohol, marijuana, antihistamines (like Cetirizine, diphenhydramine), sleep or anxiety medications (such as Alprazolam, Diazepam, Zolpidem), muscle relaxants, and opioids (like codeine). Check medicine labels as some may contain drowsiness-inducing ingredients. Ask your pharmacist for safe usage advice.

Fluoxetine might affect certain medical or lab tests, such as brain scans for Parkinson's disease, possibly leading to inaccurate results. Ensure all your healthcare providers and lab personnel are aware you are using this medication.