Fluoxetine Pharmacology

Real Life Pharmacology - Pharmacology Education for Health Care Professionals

Eric Christianson, PharmD; Pharmacology Expert and Clinical Pharmacist

Education, Health & Fitness, Medicine

5 • 716 Ratings

🗓️ 26 December 2019

⏱️ 12 minutes

🔗️ Recording | iTunes | RSS

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Summary

Fluoxetine is an SSRI used in the management of depression, anxiety, OCD, PTSD, and other psychiatric conditions.

Fluoxetine has a very long half-life which can impact clinical management. I discuss how this matters in this podcast episode.

Fluoxetine inhibits CYP2D6 which can alter the concentrations of many drugs.

Prodrugs like codeine and tamoxifen can have their effects reduced because of fluoxetine. I explain this further in the episode.

By inhibiting CYP2D6 concentrations of many drugs can be raised by the use of fluoxetine.

Transcript

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0:00.0	Hey all, welcome back to the Real Life Pharmacology podcast. I am your host, Eric Christensen,
0:05.8	pharmacist. Definitely go track me down at LinkedIn. Connect with me there. You can also shoot me an
0:12.3	email message at reallife pharmacology.com where you can also subscribe and get email updates
0:18.9	when we've got a new episode or new things coming out for sure.
0:21.9	So which I am really excited about a new drug interaction book I'm putting together.
0:27.6	So stay tuned to that and you can find the link to that at MedEd 101.com slash store when that's out in around the first of January in 2020 is my goal.
0:43.8	So by the end of January 2020, that drug interaction book should be out.
0:49.9	Anyway, let's get into the drug we're going to talk about today, and that is fluoxetine.
0:57.1	So I went into a general overview regarding selective serotonin reuptake inhibitors.
1:04.1	You can go back, get a little bit more broad view of this class of medication in general, if you like. I wanted to break these down
1:13.8	further because there are differences when we're determining whether we're going to select
1:18.9	one SSRI versus another. So I want to highlight some of those differences today for sure.
1:25.2	So SSRI, obviously it can increase basically the effects of serotonin within the brain,
1:34.3	which helps manage depression, anxiety. These drugs have been shown to be helpful in OCD, PTSD,
1:43.8	some eating disorders as well. So lots of potential clinical uses,
1:48.8	which is why you see fluoxetine and a lot of the other SSRIs so frequently in practice.
1:58.1	Of course, the box warning is a class effect, so increased risk of suicidal thinking
2:03.8	and behavior. That boxed warning does remain in effect there. Adverse drug reactions, again,
2:12.7	kind of across the board with SSRIs, you've got sexual dysfunction, that serotonin syndrome risk. Again,
2:20.8	extremely low does not happen in practice hardly ever. I mean, I've only seen or heard of
2:27.6	really a couple of cases. Not that it isn't something we shouldn't pay attention to or be on the lookout for, but again,
2:36.2	just in context, it is extremely rare, not something that you're going to see on a weekly basis
	...

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