Active ingredient and effect | Fluoxetine

Active ingredient and effect

Fluoxetine acts as a selective serotonin reuptake inhibitor (SSRI) at the synapses between two nerve cells of the central nervous system. To transmit signals, a nerve cell releases various neurotransmitters into the synaptic cleft, which bind to receptors of another nerve cell and transmit the signal. The remaining neurotransmitters are then broken down and reabsorbed into the nerve cells via the transporters.

Fluoxetine blocks these serotonin transporters and selectively inhibits the reuptake of serotonin. Due to the increased serotonin levels in the synaptic cleft, the signal transmission between two nerve cells is prolonged and strengthened. The exact cause and development of depression is not yet fully understood.

However, a deficiency of the neurotransmitters serotonin and norepinephrine seems to play a significant role in the development of depression. Increasing serotonin levels in the central nervous system during treatment with fluoxetine therefore has an anxiety-reducing, mood-lifting and stimulating effect. When treating with Fluoxetine, it should be noted that an anxiety-reducing and mood-lifting effect occurs after 1 to 2 weeks at the earliest.Depending on the patient, a slight increase in anxiety attacks may even occur within this period.

Instead, the stimulating and activating effect on the patient begins shortly after taking the drug. For this reason, patients are warned of an increased risk of suicide during the first weeks after the start of therapy. Children, adolescents and young adults are particularly at risk.

The patient should therefore be monitored regularly by a doctor, especially during this period. In the course of a therapy with Fluoxetine, the effect can diminish depending on the patient. The body develops a kind of slight tolerance to the drug and gets used to the permanently elevated serotonin levels.

In consultation with a doctor, a higher dosage can counteract the diminishing effect. The maximum daily dose can be increased up to 60 mg. However, it should be adjusted individually and increased only slowly.

A changed dosage must always be discussed with a doctor. In addition, the preparation can also be changed and a different antidepressant prescribed. The five preparations of selective serotonin reuptake inhibitors (SSRIs) available on the market can have different effects depending on the patient. Even in this case, a change should only be made in consultation with the treating physician.