Fluoxetine in its hydrochloride salt form is marketed as numerous drugs, the most popular ofwhich is Prozac. Prozac is prescribed for depression, obsessive-compulsive disorder, bulimia,agoraphobia, and premenstrual dysphoric disorder (premenstrual syndrome). Prozac andother fluoxetine medications belong to a class of drugs called selective serotonin reuptakeinhibitors (SSRIs). When a nerve signal is sent, a neurotransmitter, such as serotonin, travelsfrom a presynaptic neuron across the synaptic gap to a postsynaptic neuron. Receptors on thepostsynaptic neuron capture the neurotransmitter, resulting in the transmission of the signal.After performing its function, the neurotransmitter is released back to the presynaptic cellin a process called reuptake. SSRIs slow down the return of serotonin to presynaptic neurons,allowing for a higher serotonin concentration on postsynaptic neurons. Because depressionand other psychological disorders are associated with low serotonin levels, Prozac and otherSSRIs help maintain serotonin levels.
Prozac was thefirst SSRI antidepressant to be marketed. Because Prozac produced lesssevere side effects than other antidepressants, it became the drug of choice for treating depressionand was made available to a wider public. Its use exploded in the 1990s, with sales peakingin 2000 when revenues from Prozac reached $2.5 billion. Eli Lilly’s patent on fluoxetinehydrochloride expired in August 2001; its use continued into the 21st century but on a muchsmaller scale as generic fluoxetine hydrochloride products came on the market. Since its introductionin 1986, Prozac was the most prescribed drug for antidepressant until recent yearswhen it was replaced by Zoloft, Paxil, and Lexapro as the top three antidepressants prescribedin the United States, respectively.
Fluoxetine hydrochloride is most recognized as an antidepressant, but it is also used torelieve symptoms of premenstrual dysphoric disorder (PMDD) (premenstrual syndrome).Th ese symptoms include mood swings, tension, bloating, irritability, and breast tenderness. EliLilly began marketing fl uoxetine hydrochloride as Sarafem in 2000 for treating PMDD.
