Is increasing Fluoxetine from 20mg to 40mg safe? (3 factors)
By
Dr Drielli Vital-Fujii (PhD)
Author bio
Dr Drielli Vital-Fujii, PhD, is a Pharmacist with expertise in Drug Design and Development, Enzymes, Molecular Modelling, and Photodynamic Therapy. She writes and reviews content on these topics.
Dr Drielli Vital-Fujii’s Highlights:
- Postdoctoral fellow at the Department of Biochemistry at the University of São Paulo, emphasizing therapy of neglected diseases using light.
- PhD in Pharmaceutical Sciences focusing on drug design and development at the Faculty of Pharmaceutical Sciences of the University of São Paulo.
- Six months as an international researcher at the Center for Discovery and Innovation in Parasitic Diseases (University of California San Diego)
- Master’s degree in Pharmaceutical Sciences focusing on drug design and development at the Faculty of Pharmaceutical Sciences of the University of São Paulo.
- Bachelor of Pharmacy at the University of Mogi das Cruzes – São Paulo / Brazil
Professional Experience:
2012 – 2018 Project manager at University of São Paulo – Pharmacy Department
Dr Drielli Vital-Fujii has worked with computational studies, synthesis, biological evaluation, design, and development of new inhibitor candidates for Chagas Disease and Leishmaniasis.
2017 – 2017 International research fellow at University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences – Center for Discovery and Innovation in Parasitic Diseases.
She used Virtual Screening (VS) and High-Throughput Screening (HTS) Integration in the Discovery of new drugs against neglected tropical diseases (NTDs).
2018 – 2019 Faculdades Oswaldo Cruz
Dr Drielli Vital-Fujii was a professor in the Faculty of Pharmacy, teaching the subjects of Pharmaceutical Chemistry and Drug Development.
2019 – 2021 Researcher in Biochemistry University of São Paulo – Biochemistry Department
She applied Photodynamic Therapy in Leishmaniasis Treatment, mentored undergraduate students in scientific activities, and wrote, executed, translated, and reported scientific projects with funding agencies.
2023-2023 UniPiaget – University Center.
Dr Drielli Vital-Fujii was a Biology, Nutrition, Physiotherapy, and Pharmacy professor.
Education:
2018 -2021 Postdoctoral at the Department of Biochemistry at the University of São Paulo
2013 -2018 PhD of Science: Drugs and Medicines at Department of Pharmacy at University of São Paulo
2012 -2013 M.Sc. of Sciences: Drugs and Medicines at the Department of Pharmacy at the University of São Paulo
2005-2008 Bachelor of Pharmacy at the University of Mogi das Cruzes
The leading publications of Dr Drielli Vital-Fujii are:
Vital-Fujii, D.G, Baptista, M.S. (2021). Progress in the photodynamic therapy treatment of Leishmaniasis. Brazilian Journal of Medical and Biological Research, 54, 1-11.
Gatti, F. M., Gomes, R.A., da Fonseca, A.L., Lima, E.J.C., Vital-Fujii, D.G., Taranto, A.G., Varotti, F.P., Trossini, G.H.G. (2020). Antiplasmodial activity of sulfonylhydrazones: in vitro and in silico approaches. Future medicinal chemistry, 13, 233-250.
Silva, E.J., Bezerra-Souza, A., Passero, L.F., Laurenti, M.D., Ferreira, G.M., Fujii, D.G.V., et al. (2018). Synthesis, leishmanicidal activity, structural descriptors and structure-activity relationship of quinoline derivatives. Future medicinal chemistry, 10, 2069-2085.
Leite, F.H.A., Froes, T.Q., da Silva, S.G., de Souza, E.I.M., Vital-Fuji,i D.G., Trossini, G.H.G., et al. (2017). An integrated approach towards the discovery of novel non-nucleoside Leishmania major pteridine reductase 1 inhibitors. European Journal of Medicinal Chemistry, 132, 322-332.
Vital, D.G., Damasceno, F.S., Rapado, L.N., Silber, A.M., Vilella, F.S., Ferreira, R.S., et al. (2017). Application of bioisosterism in design of the semicarbazone derivatives as cruzain inhibitors: a theoretical and experimental study. Journal of Biomolecular Structure and Dynamics, 35, 1244–1259.
Mello, J. F.R., Gomes, R.A., Vital-Fujii, D.G., Ferreira, G.M., Trossini, G.H.G. (2017). Fragment-based drug discovery as alternative strategy to the drug development for neglected diseases. Chemical Biology & Drug Design, 90, 1067-1078.
Pantaleao, S.Q., Fujii, D.G.V., Maltarollo, V.G., da C. Silva, D., Trossini, G.H.G., Weber, K.C., et al. (2017). The Role of QSAR and Virtual Screening Studies in Type 2 Diabetes Drug Discovery. Medicinal Chemistry, 13, 706-720.
Vital, D., Arribas, M., Trossini, G. (2014). Molecular Modeling and Docking Application to Evaluate Cruzain Inhibitory Activity by Chalcones and Hydrazides. Letters in Drug Design and Discovery, 11, 249-255.
Blau, L., Menegon, R.F., Trossini, G.H.G., Molino, J.V.D., Vital, D.G., Cicarelli, R.M.B., et al. (2013). Design, synthesis and biological evaluation of new aryl thiosemicarbazone as antichagasic candidates. European Journal of Medicinal Chemistry, 67, 142-151.
You can view some of Dr Drielli’s work below and links to her professional profile.
Orcid: https://orcid.org/0000-0001-9270-0466
Research Gate: https://www.researchgate.net/profile/Drielli-Gomes-Vital-Fujii
Scopus: https://www.scopus.com/authid/detail.uri?authorId=55829534000
Google Scholar: https://scholar.google.com/citations?user=F9U50AEAAAAJ&hl=pt-BR
Linkedin: linkedin.com/in/driellivital
Escavador: https://www.escavador.com/sobre/6101380/drielli-gomes-vital
CDIPD: https://cdipd.org/index.php/about-us/visiting-scientists
In this article, we’ll address the safety of increasing Fluoxetine from 20mg to 40mg. We’ll delve into the reasons for this adjustment and provide insights into what to expect from this dosage change.
Is increasing Fluoxetine from 20mg to 40mg safe?
Yes, it is safe and often necessary to increase your Fluoxetine dosage for optimal treatment. Fluoxetine, commonly known as Prozac, is a prescription medication used to manage mood, anxiety, and depressive disorders.
Like all SSRIs (Selective Serotonin Reuptake Inhibitors), Fluoxetine therapy typically begins at a low dose and is gradually increased.
Fluoxetine treatment is started at 10-20mg. If your body tolerates the initial dose and your symptoms have not improved, your doctor may consider increasing your dosage to 40mg.
The increase in dose is expected to improve the psychological symptoms. This dose adjustment is made when it is clear that the 20mg dosage isn’t sufficiently effective for your condition.
However, increasing the dose from 20 mg to 40 mg can lead to side effects, much like when initiating Fluoxetine treatment. But these side effects usually improve over time as your body adjusts to the higher dosage.
When Fluoxetine dose is increased from 20 mg to 40mg?
The decision to increase your Fluoxetine dosage from 20mg to 40mg should be made by your healthcare provider. This decision is made to enhance the management of your conditions, which may include depression, anxiety, and extreme mood swings.
The doctor will assess your response to Fluoxetine doses. Once you’ve adapted to the 20mg dose with minimal side effects, it’s assessed whether your psychological symptoms have improved or not.
If they do not improve, it becomes clear that a higher dose of Fluoxetine might be required to enhance your quality of life. You should not alter your dose on your own.
You may wonder why your doctor didn’t initiate your treatment with a 40mg dose directly. The reason is a gradual titration process is commonly used for SSRIs like Fluoxetine.
SSRIs are prescribed at lower doses to allow your body to adapt to increased serotonin levels without causing overstimulation. It typically takes 2-4 weeks for your body to reach a steady level of serotonin in the brain.
If, after this period of taking Fluoxetine 20mg, you observe no significant improvement in your condition, it may indicate you need a higher dose. Your healthcare provider will guide you through this process. You must communicate openly with them.
What to expect when your Fluoxetine dose is increased?
When your Fluoxetine dose is increased from 20mg to 40mg, several changes can occur. You will likely experience both improvements in your condition and potential side effects.
Improvement in condition
Fluoxetine functions by elevating serotonin levels in the brain. Serotonin is a neurotransmitter responsible for enhancing mood, appetite, and alleviating symptoms of depression.
With the increase in your Fluoxetine dose, you can anticipate a positive transformation in your mental state. This may manifest as: (2)
- Improved mood
- Better sleep
- Healthier appetite
- Improved focus
- Improved motivation
It may take 2-4 weeks following the dose adjustment to fully experience these benefits. Try to remain patient with your treatment and do not discontinue it abruptly just because immediate improvements aren’t observed.
Potential side effects
An increase in Fluoxetine dose can bring about certain side effects. These side effects are typically temporary and tend to diminish over time.
However, if they persist or become intolerable, your doctor may consider reducing your dosage and reviewing your prescription.
Potential side effects associated with a high Fluoxetine dosage include: (2)
- Heartburn
- Upset stomach
- Irregular heart rate
- Sexual dysfunction
- Nausea
- Insomnia
- Fatigue
- Headaches
- Suicidal thoughts
- Abnormal bleeding
What to do if your dose of Fluoxetine is too high?
If you notice that your Fluoxetine dose is too high and you’re experiencing side effects, the first thing you should do is contact your healthcare provider.
Although it is a common practice to increase the dose of Fluoxetine after your body has adjusted to the lower dose, some people may be unable to tolerate it. You should express your concerns and specific side effects to your doctor.
Your doctor will conduct a thorough assessment to understand your condition and may recommend a change in your Fluoxetine dosage based on this evaluation.
Conclusion
As a bottom line, I would suggest that it is safe to increase the dosage of Fluoxetine from 20 mg to 40 mg. This is a common and necessary practice for achieving optimal treatment outcomes.
However, this decision must be made under the guidance of your healthcare provider. Attempting to independently adjust your dosage is discouraged, and can have adverse effects.
Always consult your healthcare provider to ensure that your antidepressant treatment is managed safely and effectively.
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