Indication and dose
Major depression - By mouth
Adult
Initially 20 mg once daily, daily dose may be administered as a divided dose, increased if necessary up to 60 mg once daily, daily dose may be administered as a divided dose; dose may be increased after 3–4 weeks of initial dose, and at appropriate intervals thereafter.
Elderly
Initially 20 mg once daily, daily dose may be administered as a divided dose, increased if necessary up to 40 mg once daily, daily dose may be administered as a divided dose; dose may be increased after 3–4 weeks of initial dose, and at appropriate intervals thereafter, usual maximum dose is 40 mg per day but doses up to 60 mg per day can be used.
Indication and dose
Bulimia Nervosa - By mouth
Adult
60 mg once daily, daily dose may be administered as a divided dose.
Elderly
Up to 40 mg once daily, daily dose may be administered as a divided dose; usual maximum dose is 40 mg per day but doses up to 60 mg per day can be used.
Indication and dose
OCD - By mouth
Adult
20 mg once daily, daily dose may be administered as a divided dose, increased if necessary up to 60 mg once daily, daily dose may be administered as a divided dose, dose to be increased gradually, review treatment if inadequate response after 10 weeks.
Elderly
20 mg once daily, daily dose may be administered as a divided dose, increased if necessary up to 40 mg once daily, daily dose may be administered as a divided dose, dose to be increased gradually; usual maximum dose is 40 mg per day but doses up to 60 mg per day can be used, review treatment if inadequate response after 10 weeks.
Indication and dose
Menopause symptoms in women with breast cancer
By mouth
Adult
20 mg once daily.
Side effects for all selective serotonin re-uptake inhibitors
Common or very common
Anxiety; appetite abnormal; arrhythmias; arthralgia; asthenia; concentration impaired; confusion; constipation; depersonalisation; diarrhoea; dizziness; drowsiness; dry mouth; fever; gastrointestinal discomfort; haemorrhage; headache; hyperhidrosis; malaise; memory loss; menstrual cycle irregularities; myalgia; mydriasis; nausea (dose-related); palpitations; paraesthesia; QT interval prolongation; sexual dysfunction; skin reactions; sleep disorders; taste altered; tinnitus; tremor; urinary disorders; visual impairment; vomiting; weight changes; yawning
Uncommon
Alopecia; angioedema; behaviour abnormal; hallucination; leucopenia; mania; movement disorders; photosensitivity reaction; postural hypotension; seizure; suicidal behaviours; syncope
Rare or very rare
Galactorrhoea; hepatitis; hyperprolactinaemia; hyponatraemia; serotonin syndrome; severe cutaneous adverse reactions (SCARs); SIADH; thrombocytopenia
Frequency not known
Increased risk of fracture; withdrawal syndrome
Overdose
Symptoms of poisoning by selective serotonin re-uptake inhibitors include nausea, vomiting, agitation, tremor, nystagmus, drowsiness, and sinus tachycardia; convulsions may occur. Rarely, severe poisoning results in the serotonin syndrome, with marked neuropsychiatric effects, neuromuscular hyperactivity, and autonomic instability; hyperthermia, rhabdomyolysis, renal failure, and coagulopathies may develop.
Overdose - For fluxetine
Common or very common
Chills; feeling abnormal; postmenopausal haemorrhage; uterine disorder; vasodilation; vision blurred
Uncommon
Cold sweat; dysphagia; dyspnoea; hypotension; mood altered; muscle twitching; self-injurious behaviour; temperature sensation altered; thinking abnormal
Rare or very rare
Atelectasis; buccoglossal syndrome; interstitial lung disease; neutropenia; oesophageal pain; pharyngitis; serum sickness; speech disorder; vasculitis
