Fluoxetine alternatives for depression and anxiety

In this article:

• What can I take instead of fluoxetine?
• Top 5 fluoxetine alternatives
• Over-the-counter depression or anxiety medications
• Natural alternatives to fluoxetine
• How to switch to a fluoxetine alternative

In this article

• What can I take instead of fluoxetine?
• Top 5 fluoxetine alternatives
• Over-the-counter depression or anxiety medications
• Natural alternatives to fluoxetine
• How to switch to a fluoxetine alternative

Most people know fluoxetine as the antidepressant medication Prozac, but that brand is no longer sold in the U.S. Fluoxetine is its generic name. The Food and Drug Administration (FDA) has approved its use for several mental health conditions. These include major depressive disorder, bipolar depression, anxiety, panic disorder, bulimia, premenstrual dysphoric disorder (PMDD), and obsessive compulsive disorder (OCD). Though it’s one of the most commonly prescribed antidepressants, fluoxetine may not work for some people because of ineffectiveness or side effects. The availability of alternatives will vary depending on the condition being treated. For some of the more specialized indications, doctors may need to use an off-label treatment. 

RELATED: What is fluoxetine? | Fluoxetine coupons

What can I take instead of fluoxetine?

Though commonly prescribed as a first-line treatment, fluoxetine isn’t always the right treatment option. It may not completely resolve the condition, or people may experience side effects they can’t live with. Additionally, fluoxetine has several worrisome drug interactions, so it may need to be changed if other drugs are needed more.

Luckily, there are several different alternatives available to treat depression or anxiety. A doctor’s first choice may be to try a different selective serotonin reuptake inhibitor (SSRI). Healthcare professionals could also choose a drug from a completely different antidepressant class, such as serotonin-norepinephrine reuptake inhibitors (SNRIs), atypical antidepressants, Wellbutrin (bupropion), tricyclic antidepressants (TCAs), or monoamine oxidase inhibitors (MAOIs). For anxiety conditions, healthcare providers can prescribe a different SSRI or choose an SNRI, buspirone, or a benzodiazepine. 

For other conditions, clinicians have fewer medication choices to relieve symptoms. Other drugs approved for OCD treatment are other antidepressants: Paxil (paroxetine), Zoloft (sertraline), fluvoxamine, and clomipramine. However, doctors often use other drugs off-label for OCD. Only fluoxetine and sertraline are FDA-approved to treat PMDD. Fluoxetine is the only drug approved to treat bulimia.

RELATED: What’s the best antidepressant for me? 

Prescription drug prices often change. These are the most accurate medication prices at the time of publishing in ZIP code 23666 as of 12/10/2025. The listed price without insurance references the price of brand-name drugs (unless otherwise specified). The listed SingleCare price references the price of generic drugs if available. Click the link under “Savings options” to see the latest drug prices.

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Fluoxetine 20 mg (30 Capsule)

23666 - Hampton, VA

$6.36

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RELATED: Going on antidepressants: A beginner’s guide to side effects

Top 5 fluoxetine alternatives

1. Zoloft (sertraline)

Zoloft is an antidepressant in the SSRI class. Zoloft is the brand version, and sertraline is the generic option. Major depressive disorder, obsessive-compulsive disorder, panic disorder, social anxiety disorder, premenstrual dysphoric disorder, and post-traumatic stress disorder are all managed with this medication. 50 to 200 mg of Zoloft can be taken daily to manage these conditions. There are many drug interactions associated with the use of Zoloft, and this should be reviewed with your healthcare specialist. The most common side effects include nausea, diarrhea, dry mouth, drowsiness, tremors, weight gain, and sexual problems. The most serious problem associated with Zoloft and other antidepressants is the risk of suicidal thoughts or behaviors in younger patients. Caretakers must monitor these patients carefully, particularly at the beginning of therapy.

2. Celexa (citalopram)

The antidepressant Celexa is a selective serotonin reuptake inhibitor (SSRI) used for the management of major depressive disorder. Celexa is associated with heart complications, so if there are any symptoms of chest pain, tell the prescriber. Some Celexa drug reactions are very serious, so make sure the prescriber has a thorough list of all current and past medications. Most people on Celexa are prescribed 20 to 40 mg once daily. Some common side effects include nausea, diarrhea, fatigue, flu syndrome, anorexia, anxiety, vomiting, impotence, agitation, abdominal pain, dizziness, yawning, and sexual dysfunction.

RELATED: Celexa vs. Prozac: Differences, similarities, and which is better 

3. Paxil (paroxetine)

Paxil is an SSRI used for major depressive disorder, generalized anxiety disorder, panic disorder, social anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. As with other antidepressants, suicidal thoughts will need to be closely monitored in younger patients. Anti-inflammatory medications such as aspirin, ibuprofen, or naproxen should be avoided because of the increased bleeding risk. Paxil is taken once daily in the morning, usually a 20 to 50 mg dose. Common side effects include sexual problems (impotence, anorgasmia), gastrointestinal disturbances (constipation, diarrhea), and neurological symptoms (dizziness, tremor, tingling). 

4. Duloxetine

Formerly known as brand-name Cymbalta, duloxetine is a selective serotonin and norepinephrine reuptake inhibitor (SNRI). It is FDA-approved as a treatment of depression, generalized anxiety disorder, and some nerve pain conditions. For depression or anxiety, the standard dosage is 60 mg daily. Common adverse reactions include nausea, headache, weight loss, abdominal pain, fatigue, constipation, appetite loss, insomnia, and sexual dysfunction.

5. Wellbutrin XL (bupropion ER)

One of the most common reasons people stop taking antidepressants—particularly SSRIs—is sexual dysfunction: loss of libido, erectile dysfunction, orgasm issues, or other problems. Though not as powerful as SSRIs at treating depression, Wellbutrin XL is a first-line antidepressant that does not affect sexual function as dramatically as other antidepressants. That’s because it doesn’t affect serotonin levels. The active ingredient, bupropion, is a norepinephrine and dopamine reuptake inhibitor (NDRI). These are neurotransmitters that make the brain more active. Dopamine in particular is a key part of the brain’s pleasure and reward pathway. Common side effects include dry mouth, nausea, sore throat, trouble sleeping, dizziness, anxiety, and agitation.

Over-the-counter depression or anxiety medications

There are many over-the-counter medications and supplements marketed as safe ways to improve mood or calm worry and anxiety. At least one of those over-the-counter remedies successfully improves the symptoms of depression: St. John’s wort. In a systematic review of its use in patients with major depressive disorder, St. John’s wort was almost equally effective as prescription antidepressants. The American Psychiatric Association recommends it as a stand-alone alternative treatment for major depressive disorder. However, St. John’s wort has health-threatening drug interactions, so get medical advice from a healthcare professional before starting the supplement.

Other OTC products that may help improve a depressed mood include S-adenosyl-L-methionine (SAMe), creatinine, carnitine, glycyrrhizic acid, omega-3 fatty acids, and zinc. None of these supplements is proven effective in ameliorating clinical depression or anxiety. 

Natural alternatives to fluoxetine

The only proven and APA-recommended natural treatment for depression and anxiety is cognitive behavioral therapy (CBT). It is so effective that the APA recommends it as a first-line treatment along with medications. However, CBT and other types of psychotherapy take time and commitment to show results. 

Other ways to improve mood include exercise, diets that include omega-3 fats and tryptophan, and light therapy. Always get medical advice from a healthcare professional before trying alternative treatments.

RELATED: The best diet to fight depression

How to switch to a fluoxetine alternative

Because of the many negative side effects associated with fluoxetine, some people may need to stop the medication altogether. Unfortunately, antidepressants cannot be stopped abruptly. Before discontinuation, the healthcare provider needs to slowly wean you off the medication to prevent antidepressant withdrawal. 

When switching to a different prescription drug, consider possible side effects and drug interactions. Cost is another consideration. All these can be discussed with the prescriber.

Choosing the right path for depression treatment

The right path for depression starts with talking to a healthcare professional. The experience is invaluable. Treatment usually starts with a first-line antidepressant medication like fluoxetine or Wellbutrin, but psychotherapy is a necessary part of treatment. Both the medication and the psychotherapy will take time to show results. The medication will relieve symptoms. Psychotherapy will teach skills to handle reactions, habits, and mood—a more permanent solution to a mood disorder.

The SingleCare prices in this article are the most accurate at the time of publishing in ZIP code 23666 as of 12/10/2025. Prices vary by pharmacy. Visit our fluoxetine coupon page for updated fluoxetine prices near you.