Φλουοξετίνη υδροχλωρική

It is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It is used to treat depression, generalized anxiety disorder, obsessive-compulsive disorder, panic disorder with or without agoraphobia, social phobia, and post-traumatic stress disorder, as well as bulimia nervosa and premenstrual dysphoric disorder. Its active metabolite is norfluoxetine ^{(Martindale, Larsen 2015)}. Oral administration in one daily dose.

It is excreted in breast milk in small amounts, with a relative dose (RD) <7%.  ^{(Lopes 2018, Weisskopf 2017, Salazar 2016, Tanoshima 2014, Kim 2006, Oberlander 2005, Berle 2004, Heikkinen 2003, Suri 2002, Hendrick 2001, Kristensen 1999, Yoshida 1998, Burch 1992, Isenberg 1990)}, although one study found RD of 13% and 20%  ^{(Pogliani 2019)}, and in general, its RD is higher than that of other SSRI antidepressants. ^{(Pogliani 2019, Sriraman 2015, Sachs 2013, Taddio 1996, Nordeng 2001)}

Plasma levels in infants whose mothers took fluoxetine were 3% to 10% of maternal plasma levels. ^{(Kim 2006, Oberlander 2005, Weissman 2004, Epperson 2003, Hendrick 2001, Hale 2001, Birnbaum 1999, Brent 1998, Yoshida 1998, Lester 1993)}. An infant whose mother took fluoxetine during pregnancy and breastfeeding had plasma levels of norfluoxetine that were 38% of the mother's levels at 15 days of age; these levels subsequently dropped to 6.5% at two months of age. ^{(Heikkinen 2003)}

Occasional colic, irritability, insomnia or drowsiness, anorexia and decreased weight gain have been reported ^{(Hale 2001, Kristensen 1999, Chambers 1999, Lester 1993)}, but problems have not been observed in most publications, especially outside the neonatal period ^{(Taddio 1996)}. There are many published cases with no short- or long-term adverse effects on infant weight or neurodevelopment. ^{(Heinonen 2025, Pogliani 2019, Gashlin 2016, Berle 2004, Epperson 2003, Heikkinen 2003, Hendrick 2003 & 2001, Nulman 2002 & 1996, Birnbaum 1999, Yoshida 1998)}

There may be adaptation problems during the immediate neonatal period or serotonin hyperstimulation or withdrawal syndrome in full-term or premature newborns born with high plasma levels because their mothers took fluoxetine during pregnancy ^{(Cantin 2024, Keymer 2023, Kieviet 2015, Morris 2015, Hale 2010, Nordeng 2001)}. Neonatal adaptation is worse when infants are not breastfed. ^{(Kieviet 2015)}

Fluoxetine, like other antidepressants, can cause problems of galactorrhea and/or hyperprolactinemia. ^{(Suthar 2018, Kaba 2017, Trenque 2011, Papakostas 2006, Peterson 2001, Egberts 1997, Arya 1995)}

Various medical societies and expert consensus consider the use of this medication safe during breastfeeding. ^{(Hale, Lactmed, Uguz 2021, Amir 2011, Berle 2011, Lanza 2009, ABM 2008, Pomp 2001)}

Known safer alternatives may be preferable during breastfeeding, especially during the neonatal period and in the case of prematurity. ^{(Larsen 2015, Davanzo 2011, Patil 2011, Gentile 2005, Rubin 2004, Weissman 2004, Gjerdingen 2003, Wisner 2002, Nordeng 2001, Wisner 1996)}

Women suffering from depression during pregnancy need more breastfeeding support due to their increased risk of problems and of early cessation of breastfeeding. ^{(Grzeskowiak 2018, Leggett 2017, Venkatesh 2017, Gorman 2012)}

 

See below the information of this related product:

• Maternal Depression (Safe product and/or breastfeeding is the best option.)