This is a selective serotonin reuptake inhibitor (SSRI).

Indications: depressive illness; compulsive obsession diseases; premenstrual dysphoric disorder; bulimia nervosa.

Cautions: hepatic impairment, renal impairment, epilepsy, pregnancy and breast-feeding; may impair performance of skilled tasks.

Should not be given to patients on MAOI's for at least 14 days after discontinuation; Conversely, MAOI's should not be used until at least 5 weeks after discontinuation of fluoxetine.

Contra-indications: severe renal impairment; poorly- controlled epilepsy.

Side Effects: rash and this entitles discontinuation of treatment; nausea, vomiting, diarrhea, anorexia with weight loss, headache, nervousness, insomnia, anxiety, tremor, dry mouth, dizziness, hypomania, drowsiness, convulsions, fever, sexual dysfunction, sweating; raised serum transaminases, depressed leucocyte counts. vasodilatation, postural hypotension, pharyngitis, dyspnea, chills, taste disturbances, sleep disturbances, euphoria, confusion, yawning, impaired concentration, changes in blood sugar, alopecia, urinary frequency.

Dose: initially, 20 mg in the morning is sufficient. If no clinical improvement is observed after several weeks, doses above 20 mg/day should be administered on twice- daily schedule.

Max. daily dose is 60 mg.