The usual dosage of the drug is 20 mg orally once daily throughout the month10 .
Administration of fluoxetine during the late luteal phase alone has been investigated in a small study11 of 24 women with PMDD and no psychiatric history.
Selective serotonin reuptake inhibitors have become the drugs of choice in the treatment of depression, and they are also effective in the treatment of obsessive-compulsive disorder, panic disorder, and social phobia.
Mirtazapine, which is unrelated to the selective serotonin reuptake inhibitors, is unique in its action—stimulating the release of norepinephrine and serotonin.
This may be caused by fluoxetine's relative lack of selectivity over norepinephrine and serotonin-2C receptors (5-HT).3 These side effects are short-lived and may improve with a dose reduction or temporary co-administration of a beta-adrenergic blocker or long-acting benzodiazepine.7 Clinically important drug interactions are listed in Any drug that increases serotonin concentrations, including: MAOIs, tramadol (Ultram), sibutramine (Meridia), meperidine (Demerol), sumatriptan (Imitrex), lithium, St. In two studies, male and female outpatients with PTSD who were randomized to 12 weeks of treatment with sertraline experienced significantly more relief from symptoms of avoidance/numbing and hyperarousal than did patients treated with placebo.1314 [References 13 and 14—Evidence level A, RCTs] Intrusive thoughts/re-experiencing phenomena also improved, although the degree of improvement was not statistically significant for each symptom scale.
John's wort, ginkgo biloba, and atypical antipsychotic agents Adapted with permission from Kando JC, Wells BG, Hayes PE. Whether patients with PTSD will benefit from long-term treatment with sertraline or a combination of the drug and behavior therapy is presently unknown.
It is the only SSRI that is FDA-approved specifically for the treatment of depression in patients who are 65 years of age or older.6 A starting dose of 10 mg per day is preferred in elderly patients, with subsequent titration to 20 mg per day or more.
Dosages of 20 to 40 mg per day are commonly required for the treatment of depression; 60 to 80 mg per day may be necessary for the treatment of bulimia and OCD7 .
Ten to 20 percent of adults in the United States experience depression at some point in their lifetime.2 Many antidepressants have been released in the United States over the past two decades.
In January 2003, fluoxetine was approved by the FDA for the treatment of depression and OCD in children and adolescents who are seven to 17 years of age.6 Because fluoxetine has a half-life of two to four days and its active ingredient, norfluoxetine, has a half-life of seven to nine days, it is reasonable to wait four weeks between dose titrations.