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Antidepressant medications are prescribed to manage various conditions, such as depression and other mood disorders. These drugs can play a crucial role in preventing suicidal thoughts or attempts and offer several other key benefits. However, research indicates that a minor proportion of individuals, particularly those under 25, may experience an increase in depressive symptoms, other mood changes, or suicidal thoughts or actions when using antidepressants for any condition.

It is essential to discuss the benefits and risks of antidepressant therapy with your doctor, especially for individuals under 25, regardless of whether the treatment is aimed at a mood disorder.

• Immediately inform your doctor if you observe:
  • Worsening depression or other psychiatric symptoms.
  • Unusual behavioral changes, including potential suicidal thoughts or actions.
  • New or escalating anxiety, panic attacks, or sleep disturbances.
  • Increased irritability, hostility, impulsivity, severe restlessness, or rapid speech.

Particular vigilance is necessary when initiating a new antidepressant or adjusting the dosage.

Experiencing nausea, drowsiness, dizziness, anxiety, trouble sleeping, loss of appetite, tiredness, sweating, or yawning is common with this medication. These effects are typically mild, but if they persist or worsen, consult your healthcare provider. Many individuals tolerate this medication well without severe side effects.

However, it's important to be aware of more serious reactions. Contact your healthcare provider immediately if you experience unusual or severe mental changes, including agitation, unusually high energy, thoughts of suicide, easy bleeding or bruising, muscle weakness or spasms, tremors, decreased interest in sex, changes in sexual ability, or significant weight loss.

Seek urgent medical attention for very serious symptoms such as black stools, vomit resembling coffee grounds, seizures, signs of kidney issues like changes in urine output, eye pain, swelling, redness, widened pupils, or vision changes. Additionally, fluoxetine may affect blood sugar levels in individuals with diabetes, so monitor these levels closely.

This medication can increase serotonin levels, occasionally leading to a critical condition known as serotonin syndrome. Symptoms include a fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea, vomiting, diarrhea, twitching muscles, unexplained fever, or unusual agitation. In rare instances, males may experience a painful or prolonged erection lasting four or more hours; if this happens, discontinue use and seek immediate medical help to prevent long-term issues.

Though rare, serious allergic reactions can occur, characterized by a rash, itching, swelling (especially of the face, tongue, or throat), severe dizziness, or difficulty breathing. Immediate medical intervention is crucial if these symptoms appear. This overview does not cover all possible side effects; contact your healthcare provider if you observe any other unusual effects.

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 have used fluoxetine in the past 5 weeks before starting any new medication. Medications that may interact include those that increase bleeding or bruising risk, such as antiplatelet drugs (e.g., Clopidogrel), NSAIDs (e.g., Ibuprofen, Naproxen), and anticoagulants (e.g., Dabigatran, Warfarin).

Combining MAO inhibitors with fluoxetine can lead to a dangerous, possibly fatal reaction. Avoid using MAO inhibitors (e.g., isocarboxazid, Linezolid, phenelzine, Selegiline) while on fluoxetine. Most MAO inhibitors should not be taken for 2 weeks before and at least 5 weeks after stopping fluoxetine. Consult your doctor on when to begin or cease these medications.

Fluoxetine may slow the elimination of other drugs from your body, affecting their effectiveness. This includes medications like Pimozide, Thioridazine, vinblastine, certain antiarrhythmics (e.g., Propafenone, Flecainide), and tricyclic antidepressants (e.g., Desipramine, imipramine).

Aspirin can heighten bleeding risk when used with fluoxetine. However, if your doctor has recommended low-dose aspirin (81-162 mg daily) for heart attack or stroke prevention, continue taking it unless instructed otherwise.

The likelihood of serotonin syndrome or toxicity increases if you also take other serotonin-enhancing drugs, such as street drugs (e.g., MDMA), St. John's wort, certain antidepressants (e.g., SSRIs like Citalopram, SNRIs like Duloxetine), and Tryptophan. This risk is higher when starting or increasing doses of these drugs.

Inform your healthcare provider if you are using other products that cause drowsiness, including alcohol, marijuana, antihistamines (e.g., Cetirizine, diphenhydramine), sleep or anxiety medications (e.g., Alprazolam, Diazepam), muscle relaxants, and opioid pain relievers (e.g., codeine). Check all medication labels for drowsiness-inducing ingredients and consult your pharmacist on safe usage.

Fluoxetine may affect certain medical or laboratory tests, possibly leading to incorrect results. Ensure all your healthcare providers are aware that you are taking this medication.