Fluoxetine is a widely-used psychiatric drug. Better known by its trade names, Sarafem, Fontex and, most notably, Prosac, the drug falls into the specific class of selective serotonin reuptake inhibitor (SSRI). Primarily used to treat clinical depression, it is also prescribed for other psychological disorders, including social anxiety, obsessive-complusive behavior and post-traumatic stress disorder.
Fluoxetine first became available on the market in 1986, and the following year was approved for use in the U.S. by the Food and Drug Administration (FDA). Along with the increased use of the drug in recent years, concern has been expressed about the possible negative affects of Fluoxetine on its users, particularly women and children.
Studies indicate that the use of an SSRI such as Fluoxetine can result in a higher rate of suicidal behavior among children and adolescents. One analysis conducted by the FDA found that both suicidal thoughts and behavior increased by some 80% within this group who had been prescribed the drug. The study also indicated that, within the same age group, angry or outwardly hostile behavior increased by approximately 130%. These findings prompted governing agencies in the U.S. and Great Britain to release warnings about aggressive behavior when the medications are administered to children and adolescents.
Other studies that were less comprehensive showed no indication of behavioral changes within this group. And evidence gathered elsewhere actually cited lower rates of suicide in children being administered the drug. A British study indicated a slight increase of suicidal thoughts and actions, but concluded that its effectiveness in the treatment of mental illnesses made the use of Fluoxetine worth the added risk.
Risks to infants associated with the use of Fluoxetine have been identified, one of which can be particularly serious. A significant number of infants born to women taking the drug were found to be suffering from neonatal abstinence syndrome, marked by convulsions and other withdrawal symptoms. Another neonatal complication caused by Fluoxetine usage is pulmonary hypertension, a rare but life-threatening disorder in which infants are deprived of sufficient oxygen.
An analysis of drug company data found no evidence of increased suicidal behavior among adult men or women who were prescribed SSRI-type anti-depressants. A subsequent review was even more positive, indicating that the widespread use of anti-depressants including those in the SSRI class led to a significant reduction in such behavior in countries with higher suicide rates. The decline was particularly noteworthy among women, who seek psychological services more often than men. One paradoxical finding indicated that SSRI drugs can increase suicidal thoughts while not increasing suicidal actions any more than earlier anti-depressants. The use of Fluoxetine has also been linked to sexual disorders such as anorgasmia, in which an orgasm is delayed or absent. This condition is far more common among women than among men. Another SSRI-related ailment among women that can reduce sexual satisfaction is reduced vaginal lubrication.
Despite its potential risks, Fluoxetine ranks in third place among the most prescribed anti-depressant drugs. In 2010, nearly 25 million prescriptions for the drug were filled in the U.S. alone.