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Fluoxetine 20mg
What is Fluoxetine
Fluoxetine is one of the most common antidepressants at the moment. It is used very often, especially in an outpatient setting. This prevalence is associated with the availability of the drug, its effectiveness and a relatively small number of side effects.
Pharmacological group
Fluoxetine belongs to the group of selective neuronal serotonin reuptake blockers. This is a group of drugs from the list of antidepressants. As the name implies, in most cases, fluoxetine is actually used to treat depressive conditions. However, it has a number of features in comparison with other means of its group.
Fluoxetine has increased selectivity for serotonin uptake. It practically does not affect the exchange of other mediators of the central nervous system. Unlike most representatives of the SSRI group, fluoxetine combines the properties of an antidepressant and a stimulant. It does not have anti-anxiety and sedative effects, but rather stimulates mental processes. A number of indications and contraindications are associated with this. In addition, the effect of the drug on eating behavior is special - fluoxetine significantly reduces appetite, which is also used for medical purposes.
Pharmacodynamics and pharmacokinetics
The main point of application of fluoxetine, like any other antidepressant, is the brain. Fluoxetine acts on the neurotransmitter structures of the central nervous system. First of all, for serotonin metabolism. Serotonin is a central nervous system mediator responsible for mood. The more serotonin in the central nervous system, the better the person’s mood.
Patients who suffer from depression have a reduced concentration of certain monoamines, primarily serotonin, to a lesser extent dopamine and norepinephrine. Fluoxetine increases the concentration of serotonin by blocking its entry into nerve cells and reducing destruction. In addition, this drug helps activate serotonin receptors in brain cells. All this helps to improve mood.
Fluoxetine practically does not affect the exchange of dopamine and norepinephrine. This determines its stimulating effect on the central nervous system. In addition, the more selective the drug acts on a certain mediator, the less side effects it has. Fluoxetine is also not affected by the autonomic nervous system, which allows it to be prescribed to people with various diseases.
This tool interacts with the centers of the hypothalamus, responsible for the feeling of hunger and satiety. When taking fluoxetine, appetite is significantly reduced, which allows it to be used to treat eating disorders. Also, this effect is often used by people who want to reduce their weight.
Fluoxetine has one negative property - with prolonged and frequent use, it causes the opposite effect. The drug begins to block serotonin receptors, which reduces the effectiveness of this mediator in the central nervous system. This effect causes addiction to the drug. With prolonged use, the dosage has to be increased in order to achieve the desired effect. In order to avoid this property, fluoxetine is taken for a not very long time.
Indications for use
Fluoxetine is used in the practice of psychiatrists and psychotherapists. In some cases, its appointment is acceptable by neurologists. This drug is used to treat the following pathological conditions:
- Depressive episode of any severity;
- Recurrent depressive disorder, current episode of any severity;
- Bipolar affective disorder, current depressive episode;
- Bulimia nervosa;
- Schizoaffective disorder depressive type;
- Schizophrenia with symptoms of depression;
- Obsessive-compulsive disorder;
- Alcohol dependence with symptoms of depression;
- Organic affective disorder.
The listed disorders are most often treated with fluoxetine in combination with other psychotropic drugs. The exception is moderate to mild depression, as well as bulimia. These diseases can be treated with fluoxetine alone. It is important that the clinic of these diseases does not have an alarming component. This drug may increase anxiety.
There are combinations of drugs with fluoxetine. For example, Symbiax is a combination of fluoxetine with the atypical antipsychotic olanzapine. This medication is used to treat schizophrenia, schizoaffective and bipolar affective disorder.
Contraindications
Fluoxetine, like any drug substance, has a number of contraindications. They can be absolute and relative. In the presence of at least one absolute contraindication, the drug is strictly prohibited. Relative contraindications do not imply a strict prohibition of the drug, taking it is allowed with optimal patient well-being and at the discretion of the doctor.
Absolute contraindications for fluoxetine include:
- Individual hypersensitivity to the components of the drug;
- Chronic renal failure, terminal stage of chronic kidney disease;
- Prostate adenoma;
- Atony of the bladder;
- Increased intraocular pressure;
- A history of epilepsy or seizures;
- Decompensated diabetes mellitus;
- Mania and hypomania;
- Bipolar affective disorder, current episode of mania.
In addition, fluoxetine is not recommended during pregnancy and lactation, this should be found out in more detail.
Relative contraindications include the following conditions:
- Extrapyramidal disorders, including Parkinson's disease;
- Renal failure in the stage of compensation, the initial stages of chronic kidney disease;
- Compensated liver failure;
- Anorexia Nervosa;
- Cachexia.
In addition, fluoxetine is not recommended for children under 15 years of age. Learn more about the use of this drug in children.
Instructions for use
Fluoxetine can be drunk regardless of food intake. The daily dose of the drug depends on what disease should be treated. To get rid of depression of any severity, the daily dose at the beginning of administration is 20 mg. You should drink the product in the morning, because it has a stimulating effect.
In the event that no significant result was achieved within four weeks, the daily dose is increased by 20 mg. Now they drink the drug in the morning and evening. Thus, once a month, the dose can be increased by 20 mg to a maximum of 80 mg. It is worth remembering that for the elderly and patients with compensated renal failure, the maximum dosage is 60 mg. The duration of treatment is one to two months.
In the treatment of bulimia nervosa, the initial dosage is 60 mg per day. It is divided into three doses - morning, afternoon and evening. It is impossible to take the drug for a long time in this mode. The duration of therapy is one to two weeks.
Therapy for obsessive-compulsive disorder also begins with a dosage of 20 mg per day, preference is given to morning medication. Then every week the dose is gradually increased. In the treatment of this disease, the maximum dose is 60 mg. The duration of therapy is 2-3 months.
If necessary, treatment can be extended, but exceeding the dosage of 80 mg per day is not recommended. After stopping the main symptoms of the disease, they switch to maintenance therapy. You can not quickly stop taking fluoxetine, since withdrawal syndrome may develop. Learn more about this symptom complex.
Side effects
In breast cancer, the daily dose is 20 mg, with the common form of the disease, the dosage will be 30-40 mg / day, and the maximum - 40 mg. Doctors note an objective response to therapy 4-10 weeks after the start of treatment, with metastases in bone tissues, the effect may occur several months after the accumulation of the active substance.
Tablets are not chewed, washed down with liquid, with the appointment of more than 2 pcs. can be divided into several methods. The course of treatment lasts until remission is achieved and is determined by the doctor. If necessary, the therapy is supplemented with the use of cytostatic agents, radiation treatment methods. If a single pill is indicated, the dose is taken in the morning.
Bodybuilding Application
Due to the fact that Tamoxifen increases the level of testosterone in the body, it is used in sports and bodybuilding. Taking the drug at 20 mg in a ten-day course increases the level of male hormones in the blood by 42%, and after a month and a half the effect will be 83%. The goals of using the medication are also to increase muscle mass, bumps, increase total body weight or reduce fat concentration, prevent gynecomastia, fluid accumulation, and fat deposits.
Tamoxifen does not allow iron deficiency anemia, jaundice, liver dysfunction, hepatonecrosis, hypocoagulation, masculinization in women to develop. The tool is used in post-cycle therapy. The dose is selected individually (10-40 mg / day), taking less than 30 mg / day is not accompanied by side effects. The full course is seven packs of 30 tablets.
Bodybuilding Application
Due to the fact that Tamoxifen increases the level of testosterone in the body, it is used in sports and bodybuilding. Taking the drug at 20 mg in a ten-day course increases the level of male hormones in the blood by 42%, and after a month and a half the effect will be 83%. The goals of using the medication are also to increase muscle mass, bumps, increase total body weight or reduce fat concentration, prevent gynecomastia, fluid accumulation, and fat deposits.
Tamoxifen does not allow iron deficiency anemia, jaundice, liver dysfunction, hepatonecrosis, hypocoagulation, masculinization in women to develop. The tool is used in post-cycle therapy. The dose is selected individually (10-40 mg / day), taking less than 30 mg / day is not accompanied by side effects. The full course is seven packs of 30 tablets.
How to take Tamoxifen after the course
The drug is taken after a course of steroids - in the second week of the steroid cycle. This feature is associated with an increase in estrogen levels by the end of the first week of the cycle. The end of the course occurs in the interval 2-4 weeks after the completion of steroid administration. The daily dose of the drug is 20-60 mg 2-3 times / day.
When comparing Tamoxifen with other drugs aimed at reducing side effects caused by anabolics and improving athletic performance, the drug in question wins or vice versa. Compared with Proviron, less is needed, but Proviron is an estrogen antagonist and suppresses the formation of hormones, preventing the aromatization of steroids and atherosclerosis. Men are advised to choose Proviron, it acts on the cause, and does not just mask and eliminate the symptoms of the problem.
If an athlete takes anabolic steroids that are not subject to aromatization, aromatase inhibitors are not necessary, Tamoxifen is included in the intake at the final stage of the course. Compared to Clomid, he is preferable. Tamoxifen acts less on the pituitary gland, but it equally well restores the level of endogenous testosterone, does not increase the level of globulin binding to testosterone, and is cheaper.
Special instructions
The use of the drug is associated with a number of rules, which are described in the paragraph of the special instructions. Excerpts from there:
- the medication is used with caution in the treatment of patients with kidney pathologies, diabetes mellitus, ophthalmic diseases, a history of thromboembolic lesions, leukopenia, thrombocytopenia, hypercalcemia;
- long-term use of the drug requires constant monitoring of the level of calcium, white blood cells, indicators of the coagulation system and platelets in the blood, observation by an ophthalmologist for studies of intracranial and eye pressure;
- it is unlikely that the drug reduces the speed and concentration of attention, clarity of vision, therefore, the medicine is approved for use while driving vehicles and dangerous mechanisms.
During pregnancy
During therapy with Tamoxifenum, caution should be exercised when prescribing other drugs. Combinations and risks:
- combination with other hormonal drugs, especially containing estrogen, is prohibited;
- coumarin agents that affect blood coagulation require dose adjustment of Tamoxifen;
- cytostatics, diuretics increase the risk of thrombosis;
- Bromocriptine increases the concentration of active substance and metabolites in blood plasma, its dopaminergic effect is enhanced;
- Allopurinol enhances the hepatotoxic effect, aminoglutetimide reduces the concentration of the substance in the plasma;
- the drug prolongs neuromuscular blockade caused by Atracuria;
- increases prothrombin time, causes hematuria and hematomas in combination with warfarin;
- Rifampicin reduces the concentration of the active component in blood plasma;
- antacids, antihistamines, provoke a premature loss of the effect of the tablet, so 1-2 hours should elapse between medications.
Alcohol compatibility
According to doctors, it is strictly forbidden to combine the drug with alcohol, alcohol-containing drinks and drugs. This leads to an increased load on the liver, the risk of poisoning and a decrease in the effectiveness of the medication.
Drug interaction
During therapy with Tamoxifenum, caution should be exercised when prescribing other drugs. Combinations and risks:
- combination with other hormonal drugs, especially containing estrogen, is prohibited;
- coumarin agents that affect blood coagulation require dose adjustment of Tamoxifen;
- cytostatics, diuretics increase the risk of thrombosis;
- Bromocriptine increases the concentration of active substance and metabolites in blood plasma, its dopaminergic effect is enhanced;
- Allopurinol enhances the hepatotoxic effect, aminoglutetimide reduces the concentration of the substance in the plasma;
- the drug prolongs neuromuscular blockade caused by Atracuria;
- increases prothrombin time, causes hematuria and hematomas in combination with warfarin;
- Rifampicin reduces the concentration of the active component in blood plasma;
- antacids, antihistamines, provoke a premature loss of the effect of the tablet, so 1-2 hours should elapse between medications.
Side effects
Therapy with this drug can lead to the development of side effects:
- From the side of the nervous system - headache, asthenia, dizziness, weakness, increased irritability, mania, anxiety, increased risk of suicide;
- From the digestive tract - decreased appetite, dyspepsia, dry mouth or vice versa increased salivation (salivation);
- On the part of other organs - decreased libido, increased sweating, weight loss, allergic reactions.
When using fluoxetine, side effects from the therapy often require its cancellation.
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