Low-certainty evidence suggests that off-label fluoxetine may decrease weight compared with placebo .
However , low-certainty evidence suggests an increase in the risk for dizziness , drowsiness , fatigue , insomnia and nausea following fluoxetine treatment
BACKGROUND Fluoxetine is a serotonin reuptake inhibitor indicated for major depression .
It is also thought to affect weight control : this seems to happen through appetite changes result ing in decreased food intake and normalisation of unusual eating behaviours .
However , the benefit-risk ratio of this off-label medication is unclear .
OBJECTIVES To assess the effects of fluoxetine for overweight or obese adults .
Use of fluoxetine, a selective serotonin-uptake inhibitor, in the treatment of obesity: a dose-response study (with a commentary by Michael Weintraub).
Pharmacologic measures which increase serotonergic activity in the brain decrease food consumption and lead to decreased weight in animals .  Fluoxetine , an inhibitor of serotonin reuptake , decreases food intake in animals and is associated with weight loss in depressed and otherwise healthy obese patients . To determine the most effective daily fixed dose which causes weight loss in nondepressed obese patients , fluoxetine ( 10 , 20 , 40 or 60 mg ) or placebo was administered once daily for 8 weeks to 655 patients consisting primarily of women ( mean age 40 years , mean weight 95 kg ) .  Diet and activity were not controlled . The placebo-treated patients lost 0.6 + /- 2.3 kg . With the 60-mg fluoxetine dose , patients lost an average of 4.0 + /- 3.9 kg ( P less than 0.001 ) , with intermediate responses at the lower doses . Weight loss was proportional to the initial body mass index ( weight/height squared ) . There were no statistically significant differences between any fluoxetine treatment group and placebo for discontinuations from the study . There were statistically significant dose-dependent increases in reports of asthenia , somnolence and sweating . Thus , fluoxetine 60 mg daily appears to be potentially effective for use in weight reduction
Low-certainty evidence suggests that off-label fluoxetine may decrease weight compared with placebo .
However , low-certainty evidence suggests an increase in the risk for dizziness , drowsiness , fatigue , insomnia and nausea following fluoxetine treatment
BACKGROUND Fluoxetine is a serotonin reuptake inhibitor indicated for major depression .
It is also thought to affect weight control : this seems to happen through appetite changes result ing in decreased food intake and normalisation of unusual eating behaviours .
However , the benefit-risk ratio of this off-label medication is unclear .
OBJECTIVES To assess the effects of fluoxetine for overweight or obese adults .