If none-is noted, than work with your doctor to cease and turn to another more helpful preventive medication. In November 1996, the FDA approved the use of fluoxetine in the treatment of bulimia nervosa, the first drug to be approved for this condition. The levo-isomer of fluoxetine is currently undergoing continuing investigation for preventive treatment of Migraine. SSRIs have less sedative, anticholinergic, and cardiovascular effects than do the tricyclic antidepressant drugs due to dramatically decreased binding to receptors of histamine, acetylcholine, and norepinephrine. Monoamine oxidase is not inhibited by any of the SSRIs.
Anticholinergic activity is virtually absent.
Fluoxetine is metabolized to norfluoxetine which is also active. The presence of food can delay the rate of absorption, but not the extent. There may be some first-pass metabolism. Both fluoxetine and the active metabolite, norfluoxetine, exist as enantiomers. Since these four compounds differ in kinetics and potency, no relationship between serum concentrations and clinical effect has been defined.