Depression patient summary

Maria takes the advice of the maternal and child health nurse and goes to see her doctor about her mood. She’s diagnosed with postnatal depression, and started on Fluoxetine, 20 milligrammes daily. There are some important effects that Maria needs to know about Fluoxetine before she starts to take it. Generally, most patients tolerate Fluoxetine well, but it is important to know that it can cause headache, difficulty sleeping, agitation, nausea, and other gastrointestinal or gut symptoms. It is unknown exactly how most of these side effects occur, but it highlights how serotonin affects many body processes. The occurrence of gut side effects is not surprising, as 95% of the body’s serotonin is found in the gut.

Unfortunately for Maria, although fluoxetine’s beneficial effects often take two to four weeks to become apparent, the side effects can be experienced immediately. It’s important for Maria to know that she may actually feel worse initially due to side effects before the benefits are seen. The other important thing for Maria to know is that Fluoxetine and other medicines in the same class have lots of drug interactions. This means there are many medicines which generally should not be taken at the same time as Maria is on Fluoxetine. In particular, these are medicines which, like Fluoxetine, work on serotonin pathways, where the combination of medicines can cause too much circulating serotonin.

This can increase the risk of serious side effects and in severe cases, can be life threatening.