The capsule marked with “e 91” is a prescription medication identified as Fluoxetine Hydrochloride, at a strength of 20 mg. It is manufactured by Aurobindo Pharma and is characterized by its green and white capsule shell. This medication is the generic equivalent of the brand-name drug Prozac. As a prescription-only medicine, it must be prescribed and monitored by a qualified healthcare provider.
Medical Uses of Fluoxetine
Fluoxetine is prescribed for a range of mental health conditions. Its most common application is in the treatment of major depressive disorder (MDD) in adults and children, helping to alleviate persistent symptoms of sadness, low energy, and loss of interest. It is also frequently used to manage obsessive-compulsive disorder (OCD) in both adult and pediatric patients. For individuals with OCD, it can help reduce the frequency and intensity of intrusive thoughts and compulsive behaviors.
Another use for fluoxetine is in the treatment of bulimia nervosa, an eating disorder characterized by a cycle of binge eating and purging. The medication is also approved for treating panic disorder, which involves sudden and repeated episodes of intense fear. For some patients, fluoxetine is prescribed in combination with another medication, olanzapine, to treat depression associated with bipolar I disorder.
How Fluoxetine Works
Fluoxetine belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRIs). The brain uses chemical messengers called neurotransmitters to relay signals between nerve cells. Serotonin is one such neurotransmitter that plays a significant part in regulating mood, emotion, and sleep.
After a signal is sent, serotonin is reabsorbed by the nerve cells. Fluoxetine works by blocking this reabsorption, or reuptake, process. This action increases the amount of active serotonin available between neurons. This enhanced availability helps to improve neurotransmission and stabilize mood.
Common Side Effects and Risks
Treatment with fluoxetine can be associated with a range of side effects, which may improve as the body adjusts to the medication. Among the most frequently reported are difficulty sleeping, headaches, feelings of weakness, nausea, and diarrhea. Some individuals may also experience a loss of appetite, drowsiness, anxiety, a dry mouth, yawning, and a diminished sex drive.
There are also more serious risks that necessitate immediate medical consultation. These include the potential for an allergic reaction, which can manifest as hives, rash, or swelling of the lips and tongue. A rare but dangerous condition called serotonin syndrome can occur, with symptoms like a rapid heart rate, sweating, muscle stiffness, and confusion. Patients should also be monitored for any signs of an abnormal heart rhythm, unusual bleeding, or low blood sodium levels, which can present as confusion, fatigue, and headaches.
Important Safety Information and Interactions
Safe use of fluoxetine requires awareness of several important precautions and potential interactions. The medication should not be stopped abruptly, as this can lead to withdrawal symptoms such as nausea, headache, and trouble sleeping. A healthcare provider will recommend a gradual tapering of the dose to prevent this. There is also a noted risk for an increase in suicidal thoughts or behaviors, particularly in patients under the age of 24, which requires close monitoring by family and caregivers.
Fluoxetine can impair judgment and motor skills, so caution is advised when driving or operating heavy machinery until you know how the medication affects you. Combining fluoxetine with alcohol is not recommended, as it can worsen side effects like drowsiness and may exacerbate symptoms of depression. The medication can also interact with a long list of other drugs, particularly those that also increase serotonin levels, such as MAOIs, triptans, and other antidepressants, which can heighten the risk of serotonin syndrome.