by Dr. Manura Nanayakkara

Created on: September 01, 2010

Selfemra is a brand of Fluoxetine. It is a selective serotonin reuptake inhibitor. Another popular brand name is Prozac®. Selfemra ® is prescribed in depression, obsessive compulsive disorders, panic and anxiety disorder.

Selective serotonin reuptake inhibitors act by inhibiting serotonin reuptake pump in certain synapses. Inhibition of reuptake increases the levels of serotonin in those nerve endings. Increased serotonin initiates a cascade of reactions which ultimately results in the therapeutic action. Increased serotonin in unfavorable regions results in the side effects.

What are the common conditions Selfemra prescribed for?

Major depression

Selfemra is most commonly used in clinical depression. Depression is characterized by persistent low mood, lack of enjoyment in life, suicidal thoughts and sleep problems. This medication must be taken for more than two weeks to see an effect. But side effects such as tremors and insomnia occurs early. But they usually wane after two to three months. Usual starting dose is 20mg in the morning. This medication should not be taken in the night due to sleep problems.

Obsessive compulsive disorder

This disorder is characterized by persistent useless repetitive thoughts, rituals and actions.  Patients know that these are their own actions and they internally resist them. They are usually causing tremendous suffering to the patient. E.g. Religious person may get repetitive blasphemous thoughts, which causes distress to the patient.

Selfemra is prescribed in this condition. But to be effective, there should be psychological treatment methods in addition to the drug management. Compared to the response seen in depression, obsessive compulsive disorder is relatively resistant to the treatment.

Anxiety disorders

Selfemra is also prescribed in anxiety disorders such as generalized anxiety disorder. It is usually prescribed in addition to the psychological treatment. It also takes two to three weeks to act. Usually to cover that window doctors prescribe benzodiazepines. They are known to act quickly, but is habit forming in long term use.

Panic disorder

Panic disorder is characterized by sudden onset feeling of doom, increased heart rate and shortness of breath. Selfemra is effective in this disorder and as mentioned earlier it is co prescribed with psychological treatment methods.

Increased suicidal risk?

Even though this is an anti-depressant, this medication is known to increase suicidal risk in susceptible individuals. Usually depressed people tend to have lack of energy. It prevents them from harming themselves. Selfemra increases energy level in the patient before relieving depression. This is the main cause for increased suicidal risk.

Sources

BNF

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