Cost to patient will be higher depending on filling fees Costs are average wholesale prices for 30 days of the lowest-dose therapy from Red Book. J.: Medical Economics Data, 2002, rounded to the nearest dollar.Cost to patient will be higher depending on filling fees Numerous double-blind, placebo-controlled trials have demonstrated the efficacy of SSRIs in the treatment of depression.In January 2003, fluoxetine was approved by the FDA for the treatment of depression and OCD in children and adolescents who are seven to 17 years of age.6 Because fluoxetine has a half-life of two to four days and its active ingredient, norfluoxetine, has a half-life of seven to nine days, it is reasonable to wait four weeks between dose titrations.Fluoxetine is now available in a special form taken once-weekly for continuation therapy of depression.This may be caused by fluoxetine's relative lack of selectivity over norepinephrine and serotonin-2C receptors (5-HT).3 These side effects are short-lived and may improve with a dose reduction or temporary co-administration of a beta-adrenergic blocker or long-acting benzodiazepine.7 Clinically important drug interactions are listed in Any drug that increases serotonin concentrations, including: MAOIs, tramadol (Ultram), sibutramine (Meridia), meperidine (Demerol), sumatriptan (Imitrex), lithium, St. In two studies, male and female outpatients with PTSD who were randomized to 12 weeks of treatment with sertraline experienced significantly more relief from symptoms of avoidance/numbing and hyperarousal than did patients treated with placebo.1314 [References 13 and 14—Evidence level A, RCTs] Intrusive thoughts/re-experiencing phenomena also improved, although the degree of improvement was not statistically significant for each symptom scale.John's wort, ginkgo biloba, and atypical antipsychotic agents Adapted with permission from Kando JC, Wells BG, Hayes PE. Whether patients with PTSD will benefit from long-term treatment with sertraline or a combination of the drug and behavior therapy is presently unknown.It is the only SSRI that is FDA-approved specifically for the treatment of depression in patients who are 65 years of age or older.6 A starting dose of 10 mg per day is preferred in elderly patients, with subsequent titration to 20 mg per day or more.
Administration usually begins with 20 mg per day, taken in the morning because of its potential for central nervous system activation early in the treatment course.Augmentation with lithium or triiodothyronine may be useful in patients who are partially or totally resistant to antidepressant treatment.Finally, tapering anti-depressant medication may help to avoid discontinuation syndrome or antidepressant withdrawal.Prozac Weekly is a capsule with pellets containing 90 mg of fluoxetine hydrochloride.The enteric coating prevents dissolution of the pellets until they have passed into the portion of the gastrointestinal tract where the p H exceeds 5.5.6 In a study8 of 500 patients with depression, the percentage of patients relapsing during continuation treatment with a 90-mg weekly dose was not significantly different from those taking a 20-mg daily dose. Weekly dosing is recommended to begin seven days after the last daily dose of 20 mg .