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ACUTE EXPOSURE INFORMATION
- USES: Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) and is used for depressive disorder, obsessive-compulsive disorder, panic attack, and bulimia nervosa.
- PHARMACOLOGY: Fluoxetine and its active metabolite norfluoxetine inhibit reuptake of serotonin from the synaptic cleft, therefore increasing serotonergic neurotransmission.
- TOXICOLOGY: Severe toxicity is not common, but may develop from excessive serotonergic effects, particularly when fluoxetine is ingested with another agent that increases CNS serotonin.
- EPIDEMIOLOGY: Poisoning with fluoxetine and other SSRIs are common. Life threatening toxicity is rare, and patients usually recover without sequelae.
- WITH THERAPEUTIC USE
- ADVERSE EFFECTS: Somnolence, dizziness, insomnia, nervousness, headache, nausea, vomiting, and diarrhea are often reported. Hyponatremia, due to inappropriate secretion of antidiuretic hormone (SIADH), may be observed.
- WITH POISONING/EXPOSURE
- MILD TO MODERATE POISONING: Somnolence, dizziness, nausea, and vomiting are common; QTc prolongation may occur even in therapeutic or mild overdose.
- SEVERE POISONING: Significant CNS depression, seizures, and QTc prolongation. Ventricular dysrhythmias have rarely been reported. Serotonin toxicity (autonomic instability, altered mental status, seizures, muscle rigidity, hyperreflexia, and hyperthermia) may occur; however, most reported cases involve patients using multiple serotonergic agents.
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