TOP 5 best analogues and substitutes for Fluoxetine

Fluoxetine-based drugs are prescribed to treat not only depression, but also many other related disorders. However, sometimes the question arises of what can replace Fluoxetine capsules, and it is not possible to quickly consult a doctor. In the article we will talk about modern analogues of Fluoxetine and the features of their use.

During pregnancy

The product is prohibited for use during pregnancy and lactation.
According to research, if women in the first trimester of pregnancy received treatment with the drug, the children developed congenital anomalies in the structure of blood vessels or the heart. Taking Fluoxetine in the last trimester can lead to an increase in the duration of artificial ventilation in newborns, tube feeding, and hospitalization. Infants develop convulsions, constant crying, hypoglycemia, nervous irritability, excitability, distress syndrome, lability of body temperature and pressure, tremor, cyanosis, vomiting, hyperreflexia, and feeding difficulties. Taking capsules during feeding is also prohibited.

• Drug interactions
• Fluoxetine for weight loss
• Prescription for fluoxetine
• Medicines containing fluoxetine
• TOP best analogues
• Why do people look for fluoxetine analogs?
• Use of PROZAC® during pregnancy and breastfeeding
• special instructions
• pharmachologic effect
• Why are people looking for fluoxetine analogs?
• How to replace Fluoxetine
• Side effects of Fluoxetine
• First acquaintance with the medicine
• Instructions for use
• Drug interactions

Amitriptyline

Amitriptyline is the main representative of tricyclic antidepressants, discovered in 1960. It is an analogue of the drug Fluoxetine.

Treatment with amitriptyline is prescribed only in a hospital setting. A minor overdose poses a high risk of death.

Amitriptyline has been proven to be compatible with pain medications, so it is often prescribed as an addition to them.

Drug interactions

Prozac should not be co-administered with MAO inhibitors and for at least 14 days after stopping treatment with MAO inhibitors. After discontinuation of fluoxetine and initiation of treatment with MAO inhibitors, there should be an interval of at least 5 weeks. If long-term treatment with fluoxetine was carried out and/or the drug was used in high doses, then this interval should be increased. Among patients who had previously taken fluoxetine and started taking MAO inhibitors at a shorter interval, serious cases of serotonin syndrome (manifestations of which may be similar to NMS), including death, have been reported.

Fluoxetine has the ability to inhibit the CYP2D6 isoenzyme. Therefore, treatment with drugs that are metabolized by this system and that have a narrow therapeutic index should be started with the lowest doses if the patient is concurrently receiving fluoxetine or has taken it within the previous 5 weeks. If fluoxetine is included in the treatment regimen of a patient already taking a similar drug, a reduction in the dose of the first drug should be considered.

When used concomitantly with Prozac, changes in blood concentrations of phenytoin, carbamazepine, haloperidol, clozapine, diazepam, alprazolam, lithium, imipramine and desipramine are observed, and in some cases toxic effects were observed. When taking fluoxetine in combination with these drugs, conservative dosage selection should be provided and the patient's condition should be monitored.

Fluoxetine is tightly bound to plasma proteins. Therefore, when prescribing fluoxetine while using another drug that binds tightly to plasma proteins, changes in the plasma concentrations of both drugs are possible.

When fluoxetine was used concomitantly with warfarin, an increase in bleeding time was observed. Changes in anticoagulant action (laboratory values ​​and/or clinical signs and symptoms) were inconsistent. As with warfarin in combination with many other drugs, close monitoring of blood clotting parameters should be performed when fluoxetine is initiated or discontinued during warfarin therapy.

If it is necessary to prescribe other drugs after discontinuation of Prozac, the long half-life of fluoxetine and its active metabolite norfluoxetine and, therefore, the possibility of drug interactions should be taken into account.

There have been rare cases of increased duration of seizures in patients taking fluoxetine during electroconvulsive therapy.

Instructions:

Clinical and pharmacological group

02.002 (Antidepressant)

pharmachologic effect

Antidepressant, propylamine derivative. The mechanism of action is associated with selective blockade of neuronal reuptake of serotonin into the central nervous system. Fluoxetine is a weak antagonist of cholinergic, adrenergic and histamine receptors. Unlike most antidepressants, fluoxetine does not appear to cause a decrease in the functional activity of postsynaptic β-adrenergic receptors. Helps improve mood, reduces feelings of fear and tension, eliminates dysphoria. Does not cause sedation. When taken in average therapeutic doses, it has virtually no effect on the functions of the cardiovascular and other systems.

Pharmacokinetics

Absorbed from the gastrointestinal tract. Poorly metabolized during the “first pass” through the liver. Food intake does not affect the degree of absorption, although it may slow down its rate. Cmax in plasma is achieved after 6-8 hours. Css in plasma is achieved only after continuous administration for several weeks. Protein binding 94.5%. Easily penetrates the BBB. Metabolized in the liver by demethylation to form the main active metabolite, norfluoxetine.

T1/2 of fluoxetine is 2-3 days, norfluoxetine is 7-9 days. 80% is excreted by the kidneys and about 15% through the intestines.

Dosage

Initial dose: 20 mg 1 time/day in the morning; if necessary, the dose can be increased after 3-4 weeks. Frequency of administration: 2-3 times/day.

The maximum daily oral dose for adults is 80 mg.

Drug interactions

When used simultaneously with drugs that have a depressant effect on the central nervous system, ethanol may significantly enhance the depressant effect on the central nervous system, as well as increase the likelihood of developing seizures.

When used simultaneously with MAO inhibitors, furazolidone, procarbazine, tryptophan, the development of serotonin syndrome (confusion, hypomanic state, motor restlessness, agitation, convulsions, dysarthria, hypertensive crisis, chills, tremor, nausea, vomiting, diarrhea) is possible.

With simultaneous use, fluoxetine inhibits the metabolism of tricyclic and tetracyclic antidepressants, trazodone, carbamazepine, diazepam, metoprolol, terfenadine, phenytoin, which leads to an increase in their concentration in the blood serum, increasing their therapeutic and side effects.

With simultaneous use, it is possible to inhibit the biotransformation of drugs metabolized with the participation of the CYP2D6 isoenzyme.

When used simultaneously with hypoglycemic agents, their effect may be enhanced.

There are reports of increased effects of warfarin when used simultaneously with fluoxetine.

When used simultaneously with haloperidol, fluphenazine, maprotiline, metoclopramide, perphenazine, pericyazine, pimozide, risperidone, sulpiride, trifluoperazine, cases of the development of extrapyramidal symptoms and dystonia have been described; with dextromethorphan - a case of the development of hallucinations has been described; with digoxin - a case of increased concentration of digoxin in the blood plasma.

When used simultaneously with lithium salts, an increase or decrease in the concentration of lithium in the blood plasma is possible.

With simultaneous use, it is possible to increase the concentration of imipramine or desipramine in the blood plasma by 2-10 times (may persist for 3 weeks after discontinuation of fluoxetine).

When used simultaneously with propofol, a case was described in which spontaneous movements were observed; with phenylpropanolamine - a case is described in which dizziness, weight loss, and hyperactivity were observed.

With simultaneous use, it is possible to enhance the effects of flecainide, mexiletine, propafenone, thioridazine, zuclopenthixol.

Use during pregnancy and lactation

Contraindicated for use during pregnancy and lactation.

Side effects

From the side of the central nervous system: anxiety, tremor, nervousness, drowsiness, headache, sleep disturbances are possible.

From the digestive system: diarrhea, nausea are possible.

From the metabolic side: increased sweating, hypoglycemia, hyponatremia are possible (especially in elderly patients and with hypovolemia).

From the reproductive system: decreased libido.

Allergic reactions: possible skin rash, itching.

Other: joint and muscle pain, difficulty breathing, increased body temperature.

Indications

Depression of various origins, obsessive-compulsive disorders, bulimic neurosis.

Contraindications

Glaucoma, bladder atony, severe renal dysfunction, benign prostatic hyperplasia, simultaneous administration of MAO inhibitors, convulsive syndrome of various origins, epilepsy, pregnancy, lactation, hypersensitivity to fluoxetine.

special instructions

Use with extreme caution in patients with impaired liver and kidney function, a history of epileptic seizures, and cardiovascular diseases.

In patients with diabetes mellitus, changes in blood glucose levels may occur, which requires adjustment of the dosage regimen of hypoglycemic drugs. When used in weakened patients while taking fluoxetine, the likelihood of developing epileptic seizures increases.

With the simultaneous use of fluoxetine and electroconvulsive therapy, the development of prolonged epileptic seizures is possible.

Fluoxetine can be used no earlier than 14 days after discontinuation of MAO inhibitors. The period after discontinuation of fluoxetine before starting therapy with MAO inhibitors should be at least 5 weeks.

Elderly patients require dosage adjustment.

The safety of fluoxetine in children has not been established.

During the treatment period, avoid drinking alcohol.

Impact on the ability to drive vehicles and operate machinery

During the treatment period, you should refrain from potentially hazardous activities that require increased attention and rapid psychomotor reactions.

Preparations containing FLUOXETINE

• FLUOXETINE caps. 20 mg: blisters of 7, 10, 14 or 20 pcs., containers of 7, 10, 14, 20, 28, 30, 40, 50 or 100 pcs. • FLUVAL caps. 20 mg: 14, 28 or 700 pcs. • PRODEP caps. 20 mg: 60 pcs. • FLUOXETINE HEXAL tab. 10 mg: 10, 20, 30, 40, 50 or 100 pcs. • FLUOXETINE-KANON caps. 20 mg: 10, 15, 20, 30, 45 or 50 pcs. • FLUOXETINE LANNACHER caps. 20 mg: 20 pcs. • FLUOXETINE HEXAL tab. 20 mg: 10, 20, 30, 40, 50 or 100 pcs. • FLUOXETINE HEXAL tab. 40 mg: 10, 20, 30, 40, 50 or 100 pcs. • FLUOXETINE caps. 10 mg: 7, 10, 14, 20, 21, 28, 30, 35, 40, 42, 50, 56, 60, 70, 80, 84, 90, 100, 200 or 500 pcs. • APO-FLUOXETINE caps. 20 mg: 14, 20 or 28 pcs. • PROZAC® caps. 20 mg: 14 or 28 pcs. • PORTAL (PORTAL) caps. 20 mg: 7, 14 or 28 pcs. • FLUOXETINE caps. 10 mg: 20, 30 or 50 pcs. • FLUOXETINE caps. 20 mg: 20, 30 or 50 pcs. • APO-FLUOXETINE caps. 20 mg: 7 or 10 pcs., vial. 14, 20, 28, 30, 35, 50, 100, 200 or 500 pcs. • FLUOXETINE caps. 10 mg: blisters of 7, 10, 14 or 20 pcs., containers of 7, 10, 14, 20, 28, 30, 40, 50 or 100 pcs. • PROFLUSAK® caps. 20 mg: 20, 30 or 50 pcs. • FLUOXETINE caps. 20 mg: 14, 20 or 28 pcs. • FLUOXETINE caps. 20 mg: 10, 20, 30, 500, 1000, 2000, 3000, 4000 or 5000 pcs. • FLUOXETINE caps. 20 mg: 7, 14 or 21 pcs. • FLUNISAN tab. 20 mg: 30 pcs. • FLUOXETINE caps. 10 mg: 10, 20, 30, 40 or 50 pcs. • FLUOXETINE caps. 20 mg: 10, 20, 30, 40 or 50 pcs.

Fluoxetine for weight loss

Fluoxetine tablets are often used to treat bulimic syndrome, a mental disorder in which there is no feeling of satiety and uncontrolled overeating occurs. Taking the drug reduces appetite, relieves constant hunger, and helps you lose weight if the cause of excess weight gain is bulimia. Decreased appetite and weight loss are side effects, but the medication is not intended for losing extra pounds.

If you take the drug uncontrolled, anaphylactic reactions, damage to the lungs, kidneys, skin, and liver may develop. To get rid of bulimia and lose weight, take 1 tablet. per day, if well tolerated - 2 pcs. (morning and evening), but no more than 4 pcs. per day. The drug acts within 4–8 hours and is completely eliminated from the body within a week. In 1–3 months of use you can lose 5–13 kg.

Prescription for fluoxetine

Fluoxetine is dispensed from pharmacies by prescription, since the decision to prescribe antidepressants and other psychoactive drugs can only be made by a qualified specialist after personal consultation with the patient.

Can I buy fluoxetine without a prescription?

However, it is quite possible to buy fluoxetine even without a prescription. Since this drug does not produce a euphoric effect and is not suitable for use for recreational purposes, and is not a precursor for the manufacture of narcotic drugs, it is not included in the list of drugs for medical use subject to subject-quantitative registration.

How to buy fluoxetine without a prescription

To purchase fluoxetine without a prescription, you need to give the impression of a sane adult who controls himself and understands what he is doing.

It should be understood that the decision to dispense a particular drug without a prescription is primarily a matter of morality. Therefore, it is likely that a pharmacy pharmacist will want to refuse to sell to a person who can be mistaken for a teenage boy or a young girl - because it is no secret that girls tend not to fully understand the consequences of such behavior, which can lead to negative results.

Well-groomed appearance, age over 25 years, a calm voice and lack of nervousness in behavior will with an 80% probability ensure the purchase of any prescription drug, even in the absence of a paper prescription in hand.

Phenibut

Phenibut is a nootropic drug synthesized at Leningrad University. In 1975, the drug was included in the first aid kit of astronauts.

The drug stimulates memory, improves the learning process and performance. It works as a tranquilizer without reducing psychomotor reactions, relieves tension (like fluoxetine), fatigue, and has an antiepileptic effect.

Used as an adjuvant for delirium tremens

Strengthens the effect of sleeping pills. It is registered as a medicinal product only in Russia. In America it is sold as a dietary supplement.

Medicines containing fluoxetine

There are currently many fluoxetine-based antidepressants available in the market under different brand names.

• Prozac
• Prodep
• Profluzak
• Fluval
• Fluoxetine
• Fluoxetine-Acree
• Fluoxetine-Canon
• Fluoxetine Hexal
• Flunisan
• Fluoxetine hydrochloride
• Fluoxetine Lannacher
• Apo-Fluoxetine
• Fluxen

The best fluoxetine-containing drug

Which of the drugs available on the market is the best? In fact, this is a difficult question, because all of them are based on the same active substance - fluoxetine, and it is not clear how, apart from the trade name, one drug differs from another. Therefore, it is recommended to start with one of the two most common brands in Russia - Fluoxetine-Canon or Fluoxetine Lannacher. Both drugs have many positive reviews. In rare cases, it may turn out that the purchased drug is subjectively “not for you” - this is completely normal, and in such a situation it is worth trying to simply change fluoxetine from one brand to another.

And in order not to feel the agony of choice, you can immediately give preference to Prozac, the oldest drug based on fluoxetine, which was brought to the market by Eli Lilly, which originally discovered and registered the substance fluoxetine in 1974. The only disadvantage of Prozac is its higher cost compared to analogues.

Fluoxetine analogues

Analogs of fluoxetine include other antidepressants from the SSRI group.

• Sertraline (Zoloft)
• Paroxetine (Paxil)
• Citalopram
• Escitalopram (Cipralex)
• Alaproclat
• Fluvoxamine (Fevarin)
• Etoperidone
• Zimelidin
• Dapoxetine
• Indalpin
• Vilazodone
• Venlafaxine
• Desvenlafaxine
• Duloxetine
• Milnacipra
• Levomilnacipran
• Atomoxetine
• Bupropion

Their action is based on the same principle, but different active ingredients. In case of individual intolerance to fluoxetine or insufficient effect, it is necessary to try other drugs.

In no case should you start taking a new SSRI drug less than 2 weeks after stopping the previous SSRI drug or MAO inhibitor antidepressants. Ignoring this prescription will result in the interactions of several different active substances of the SSRI group superimposing on each other, which can provoke serotonin syndrome - a very unpleasant and potentially fatal phenomenon.

For weight loss

Let’s say right away that no self-respecting doctor will prescribe antidepressants for weight loss. Antidepressants by themselves do not burn fat. Weight loss in obese patients occurs against the background of the fact that appetite decreases and the person takes in fewer calories.

But, despite all the warnings from doctors, antidepressants are taken for the purpose of losing weight:

1. Fluoxetine and Prozac come out on top. Overdose has consequences, often fatal. When buying medications at a pharmacy, remember Michael Jackson. He had a personal doctor.
2. Sertraline - used for gluttony (bulimia) associated with stress or depression. In Russia it is known as Zoloft.

Here it is appropriate to talk about originals and generics.

The original is the drug Fluoxetine, registered in 1974. Patent protection ended in 2001.

After patent protection expires, analogues - generics - copies that have similar active ingredients enter the market. A patent is not required to register them. Documents are collected to prove the similarity of the chemical formula to the original molecule. The active ingredient should be similar, but the auxiliary ingredients may differ. The generic version of Fluoxetine is Depres.

Analogues of fluoxetine by indication and method of use:

• Sevpram;
• Serenata;
• Adepres;
• Surlift;
• Zalox;
• Misol;
• Sertraloft;
• Actaparoxetine;
• A-depressin;
• Fevarin;
• Zoloft;
• Paxil;
• Cipramil;
• Cipralex;
• Ezopram;
• Stimuloton;
• Retsita;

Fluoxetine analogues according to indications, but have different compositions:

• Amitriptyline;
• Cymbalta;
• Trittico;
• Melitor;
• Coaxil.

TOP best analogues

We bring to your attention the five best antidepressants that can successfully replace Fluoxetine, and in some cases even perform better than it:

1. Selectra contains escitalopram as an active ingredient, which (like Fluoxetine) has a stimulating effect. Due to the narrower focus of the therapeutic effect, Selectra is less likely to provoke adverse reactions, does not cause suicidal thoughts and can be used for depression of any severity.
2. Cipralex also includes escitalopram, but has a wider spectrum of action. In addition to depression, it is prescribed for obsessive-compulsive, panic and anxiety disorders.
3. Paxil is indicated for the same conditions as Cipralex, although it contains a different active ingredient - paroxetine. The frequency of undesirable effects associated with its use is lower than that of Fluoxetine, but its negative effect on the fetus during pregnancy has been proven, whereas such risks have not been identified for Fluoxetine.
4. Valdoxan is an antidepressant that primarily acts on melatonin. It is used for all types of depression, normalizes sleep and is well tolerated. Valdoxan does not affect the cardiovascular system, the genitourinary system, and does not cause addiction or withdrawal symptoms.
5. Zoloft differs from Fluoxetine in its balanced effect on the nervous system - it does not cause obvious stimulation. Zoloft has a wider list of possible adverse reactions than Fluoxetine, but the actual incidence is lower.

There are contraindications. Before starting use, consult your doctor.

Commercial names abroad (abroad) - Prozac, Sarafem, Fontex (USA), Zactin, Lovan, Fluohexal, Auscap (Australia), Depreks (Turkey), Floxet (Hungary), Flunil, Prodep, Fludac (India), Flutine, Affectine (Israel), Fluox (New Zealand), Fluoxetina (Colombia), Fluzac (Ireland), Fluxen (Ukraine), Fluoxin (Romania), Fontex (Denmark, Norway, Sweden), Ladose (Greece), Philozac (Egypt), Biozac, Deprexetin, Fluval, Biflox, Deprexit, Sofluxen, Floxet, Ranflutin (Bulgaria), Flunisan, Orthon, Refloksetin, Fluoksetin (Macedonia), Seronil (Finland), Lorien (South Africa).

All drugs used in neurology and psychiatry.

or you can leave a review about the medicine (please, do not forget to indicate the name of the drug in the text of the message).

Preparations containing Fluoxetine (ATC code N06AB03):

Why do people look for fluoxetine analogs?

There are situations when you have to quickly look for an adequate replacement for Fluoxetine: when the medicine is not at hand or its use is impossible for some reason.

Price issue

Fluoxetine cannot be classified as an expensive drug. A Russian-made drug can be found at a price of 30-50 rubles for 20 capsules. However, they are not always available in pharmacies, and imported synonyms of domestic Fluoxetine cost many times more.

Side effects

The main problem when taking Fluoxetine is the risk of developing severe side effects. Among them:

• overexcitement, insomnia;
• hand tremors, convulsions;
• nausea, vomiting, diarrhea;
• suicidal tendencies;
• headaches, balance problems;
• loss of appetite, weight loss;
• decreased sex drive;
• menstrual irregularities;
• allergic reactions.

There are analogs for the correction of depressive disorders that are less likely to cause side effects, although this primarily depends on the individual sensitivity of the body to the active substance.

Lack of the drug in pharmacies

Fluoxetine is usually available in pharmacies. However, due to the high demand and affordable price, the cheapest antidepressant options are quickly sold out, leaving only the expensive Fluoxetine. In addition, small pharmacies rarely sell prescription drugs, which include Fluoxetine.

No prescription

Lack of a prescription is another major problem for patients requiring Floxetine treatment. Even if a person receives an antidepressant on the recommendation of a doctor, he is not always able to come to the clinic on time to pick up a prescription. Sometimes you have to wait a month for an appointment with a doctor, but you need the drug right now. In such cases, you have to get out of the situation by buying over-the-counter substitutes for Fluoxetine.

Reviews

Many patients who have taken various antidepressants and sedatives still prefer Fluoxetine.

“I have chronic depression. I took Fluoxetine for several years with good results. Then the psychotherapist said that this was an old drug that would be better replaced with a more modern analogue, and prescribed Fevarin. I didn’t notice much of a difference, only Fevarin causes drowsiness and is several times more expensive. I took it for 3 months and returned to Fluoxetine.”

“While on Fluoxetine, I was often bothered by decreased appetite, nausea, and headaches. I tried switching to Valdoxan. There were no side effects, but the effect was much weaker. As a result, I take Fluoxetine again, and over time it has become better tolerated.”

“I tried to switch from Fluoxetine to Cipralex because there were adverse reactions. It is well tolerated, helps normally, and the reviews for it are mostly good, but the price is like gold. I took it for 4 months and realized that I couldn’t handle it any longer. Still, Fluoxetine is several times cheaper, even if you take the original Prozac.”

Thus, reviews indicate that modern antidepressants are well tolerated, but fluoxetine is not inferior to them in effectiveness. In addition, it is more affordable.

Use of PROZAC® during pregnancy and breastfeeding

Experimental studies on animals did not reveal direct or indirect negative effects of fluoxetine on the development of the embryo or fetus or on the course of pregnancy. There is no evidence of mutagenicity or impairment of fertility from in vitro or animal studies. Because animal reproduction studies do not always predict human response, Prozac should be used during pregnancy only when absolutely necessary.

Fluoxetine is excreted in breast milk, so the drug should be administered with caution to nursing mothers. The effect of fluoxetine on labor in humans is unknown.

The effect of fluoxetine on labor in humans is unknown.

special instructions

There are reports of skin rashes, anaphylactic reactions and progressive systemic disorders involving the skin, lungs, liver, and kidneys in the pathological process in patients taking fluoxetine. If a skin rash or other possible allergic reaction occurs, the etiology of which cannot be determined, Prozac should be discontinued.

As with other antidepressants, Prozac should be used with caution in patients with a history of epileptic seizures. When using fluoxetine, there have been cases of hyponatremia (in some cases, the level of sodium in the blood was less than 110 mmol/l)

Mostly, such cases were observed in elderly patients and in patients receiving diuretics, due to a decrease in blood volume

When using fluoxetine, there have been cases of hyponatremia (in some cases, the level of sodium in the blood was less than 110 mmol/l). Mostly, such cases were observed in elderly patients and in patients receiving diuretics, due to a decrease in blood volume.

In patients with diabetes mellitus, hypoglycemia was observed during treatment with Prozac, and hyperglycemia was observed after discontinuation of the drug. At the beginning and after the end of treatment with fluoxetine, dose adjustments of insulin and/or oral hypoglycemic drugs may be required.

Experimental results

There is no evidence of carcinogenicity from in vitro or animal studies.

pharmachologic effect

Fluoxetine is not intended to normalize body weight or eliminate the causes of obesity: it is an antidepressant. As a serotonin reuptake inhibitor, fluoxetine affects serotonin-dependent processes in the body: it takes part in physical activity, regulates hormonal levels and vascular tone, and also affects a person’s mental state.

Therefore, Fluoxetine capsules and tablets are not used for weight loss - supporters of various weight loss methods thought of using them for such purposes.

The fact is that lack of appetite is one of the possible, but not guaranteed, side effects of the drug. At the same time, unfortunately, those losing weight do not take into account more serious adverse reactions that occur while taking the drug.

Mechanism of action of "Fluoxetine"

At the moment, in medicine it is believed that depression and other nervous disorders are caused precisely by a deficiency of serotonin: due to pathologies in the metabolism of the mediator, disruptions in the sleep and wakefulness cycles occur, metabolism and hormone secretion are disrupted. Therefore, by restoring the amount of serotonin, the patient has the opportunity to eliminate the pathological deficiency and restore the functions of the body systems.

Fluoxetine indirectly affects the reduction of appetite: by causing the reuptake of serotonin in the presynaptic cleft, this drug allows the body to “save” the amount of neurotransmitter produced. That is, the drug affects the human nervous, endocrine, and cardiovascular systems, in some cases actually influencing eating behavior.

It should be understood that since the direct goal of fluoxetine is to normalize the body’s serotonin-dependent reactions, decreased appetite is just a side effect of the drug. And it is not a fact that the body will react to the substance in this way: no one can predict the effects of the drug. It is therefore likely that in individual cases, fluoxetine will, on the contrary, cause increased food intake or cause tissue swelling, which is often mistaken for obesity.

Prozac

Prozac is the most controversial drug of all antidepressants with the active ingredient fluoxetine. It was originally intended as a medicine for high blood pressure, and later became the most famous antidepressant.

Synonym for Prozac - Fluoxetine, Fluval, Fluxen.

Gives energy, encourages action, relieves hunger.

Found illegal use as a means of losing weight. When taken uncontrolled, it leads to anorexia.

The difference between fluoxetine (Prozac) and a traditional antidepressant is that it has an effect closer to a stimulant than to a sedative.

Why are people looking for fluoxetine analogs?

Fluoxetine is a popular and well-established drug that people have been purchasing for many years. But today, more and more often, patients are looking for substitute analogues of this remedy. This is due to the following reasons.

Price issue

Fluoxetine is not the cheapest drug (its price is about 300 rubles) and in order to save money you have to look for more affordable analogues.

Among them are Framex and Flunat - these are more affordable medications that cost from 100 to 150 rubles, and their low price is due to their less famous name.

By-effect

Fluoxetine is a high-quality and proven drug, but it has certain disadvantages, or rather a number of side effects:

• bowel dysfunction;
• infrequent headaches that appear an hour after administration;
• increased heart rate, which can lead to tachycardia;
• overdrying of the mucous membrane;
• blurred vision;
• increased sweat secretions;
• general malaise;
• Women who took the drug experienced pain in the mammary glands and menstrual irregularities (up to several weeks);
• nausea and vomiting;
• noise in ears;
• constant feeling of fatigue;
• sleep disorders;
• depression;
• acne and allergic irritations;
• broken bones;
• sexual apathy (loss of interest in sex).

The list of contraindications is quite long and that is why most people are looking for more harmless analogues. For example, it could be Flunat or Deprex. The drugs have a natural composition and a less aggressive effect on the patient’s body.

No choice

Of course, the last reason why people turn to analogues of this drug is simply its absence on the shelves in pharmacies, since Fluoxetine is a sought-after medication.

If this medicine is not in the pharmacy, then you should turn your attention to Profluzac and Fluval, which are identical in their action and composition

How to replace Fluoxetine

Let us consider in more detail the main options for replacing Fluoxetine.

Analogs for the active substance

Direct analogues of Fluoxetine, which have almost identical instructions for use, are Prozac, Apo-Fluoxetine, Fluoxetine-Canon, Fluoxetine Lannacher. Fluoxetine Lannacher, Prozac and Apo-Fluoxetine are European analogues of higher quality. Prozac is the trade name of the original Fluoxetine, which has undergone a full range of clinical trials and is considered the safest. Its significant disadvantage is the high price - about 500 rubles. for 14 capsules.

Analogs by pharmacological group

Antidepressants - serotonin reuptake inhibitors also include Fevarin, Zoloft, Selectra, Serenata, Cipralex, Paxil. All of them are used in the treatment of depression, but they act differently on the body. Fevarin has a predominant calming effect, while Cipralex and Selectra (as well as Fluoxetine) have a stimulating effect. A balanced effect is typical for Paxil, Zoloft, Serenata.

Analogues without prescriptions

All synthetic antidepressants in Russia are sold with a prescription. Therefore, only their herbal analogues (Doppelhertz Nervotonic, Negrustin, Gelarium), freely available in pharmacies, can be classified as over-the-counter substitutes for Fluoxetine. They contain dry extract of St. John's wort, which also affects the exchange of serotonin and melatonin (a substance that normalizes sleep). Drugs in this group are used to treat mild or moderate depression, neuroses (mental instability), and low mood.

Plant-based sedatives (Persen, Dobrocam, Novo-Passit) can replace Fluoxetine in cases of anxious depression, obsessive-compulsive disorder, menopause and other changes accompanied by irritability and bad mood.

Conditional analogues of Fluoxetine, which can be bought without prescriptions, also include homeopathic sedatives: Tenoten, Nevrosed, Calm. They contain microdoses of the active substance, therefore they are completely harmless and can be used in children's practice. However, the effectiveness of homeopathic medicines has not been scientifically proven.

Russian

Fluoxetine is produced by many Russian companies.

The commercial name of the drug with the active substance fluoxetine is Profluzac.

Analogs are produced by:

• Escitalopram – Berezovsky Pharmaceutical Plant;
• Paroxetine – Berezovsky Pharmaceutical Plant;
• Citalopram – ALSI Pharma.

According to the RBC website dated May 15, 2022, the sale of antidepressants in Russia has doubled over the past five years, which is explained by the alleged partial abandonment of sleeping pills and, of course, illegal prescriptions from doctors.

Side effects of Fluoxetine

During treatment with the drug, side effects may develop:

• sleep disturbance, anxiety, headache, tremor, drowsiness, nervousness;
• diarrhea, nausea;
• increased sweating (hyperhidrosis);
• hypoglycemia, hyponatremia;
• decreased libido;
• suicidal thoughts, anxiety;
• arterial hypotension;
• metabolic acidosis, hepatitis, bruxism;
• allergies, itching, skin rash, alopecia, dermatitis, psoriasis, erythema;
• hyperuricemia;
• hypercholesterolemia, hypokalemia, hypocalcemia, hypothyroidism;
• lymphadenopathy;
• joint, muscle pain, arthralgia, arthritis;
• difficulty breathing, increased body temperature (hyperthermia), anorexia, chills.

First acquaintance with the medicine

The active ingredient of the drug is fluoxetine hydrochloride.

The pharmacological properties of Fluoxetine are based on its ability to inhibit the reuptake of serotonin into the central nervous system, the main neurotransmitter called the hormone of pleasure (or happiness).

It is he who is responsible for a good mood, the absence of tearfulness, pickiness, and boredom. The therapeutic effect of the drug improves the patient’s psycho-emotional activity and does not affect blood pressure, functional activity of the heart, and does not cause drowsiness or lethargy.

The drug is prescribed for:

• obsessive-compulsive obsessive-compulsive disorder;
• various depressions;
• sleep disorders;
• bulimia nervosa;
• anorexia;
• premenstrual dysphoria;
• alcoholism.

Pros and cons of the drug

The main advantages of the drug are:

• lack of hypnotic effect and cardiotoxic effect;
• availability in the pharmacy network;
• democratic price.

The disadvantages of the drug include the following side effects:

• dizziness and headache;
• asthenia;
• increased sweating;
• decreased libido;
• the appearance of pain in the bones and mammary glands;
• noise in ears;
• stool instability;
• rashes on the skin;
• dry mouth;
• disturbances of taste and olfactory sensations;
• decreased vision.

Fluoxetine is strictly contraindicated for:

• allergic reaction to the main component of the drug;
• pregnancy;
• breastfeeding a baby;
• pathological processes in the liver and kidneys;
• diabetes mellitus;
• epileptic conditions.

This predominance of “cons” over “pros” is a consequence of the fact that this drug is already outdated. Today, the pharmacological industry provides patients with modern analogs of Fluoxetine, which have the ability to selectively affect the human body.

Brief description of the medicine

Fluoxetine is an antidepressant that belongs to the group of serotonin reuptake inhibitors (the main “happy hormone” in our body). This means that it increases the concentration of the hormone in the nervous tissue and improves the psycho-emotional state of the patient. The medicine is prescribed for:

• depression;
• obsessive-compulsive disorders (obsessive states);
• early ejaculation in men;
• bulimia (overeating in stressful situations);
• mood disorders in women during menstruation or menopause.

Instructions for use

The antidepressant Fluoxetine is taken orally. It is recommended to take the tablets with water before, during or after a meal.

To relieve symptoms of depression, the drug is taken once a day, twenty milligrams in the morning.

Gradually, the dose is increased to 60 or 80 milligrams and divided into several doses. This is how pills are taken for bulimic neurosis.

Visible improvement occurs approximately fourteen days after taking the tablets regularly. Increasing the dose makes the side effects more pronounced.

The duration of the therapeutic course depends on several factors:

• degree of disease;
• patient's condition;
• a person’s susceptibility to the action of the drug;
• the presence of concomitant pathologies.

It will take at least six months to eliminate depressive symptoms. For manic disorders, the patient is given pills for 70 days.

To avoid withdrawal symptoms, you should slowly reduce the dosage of the medication.

The deterioration of the condition and the intense manifestation of side effects indicate that it is necessary to reduce the daily norm in a different way.

Zoloft

Zoloft is the trade name of an antidepressant with the active ingredient sertraline hydrochloride, an analogue of fluoxetine.

When compared with similar drugs, we can say that the effectiveness is similar to paroxetine and alprazolam; which is 1.4 times better than fluoxetine, and has fewer side effects.

Zoloft is a long-acting drug - the effect occurs after a month.