Fluoxetine alternatives: What can I take instead of fluoxetine?

Creator: SingleCare
Published: 2022-08-10T15:43:34-04:00

Fluoxetine doesn't work for everyone. Celexa, Cymbalta, Lexapro, Paxil, and Zoloft are some fluoxetine alternatives. Get the full list here.

By Marquissa Beverly, DPM | Aug. 10, 2022

Fluoxetine is a prescription antidepressant approved by the United States Food and Drug Administration (FDA) for the management of several mental health conditions, which include major depression, anxiety, panic disorders, bulimia nervosa, premenstrual dysphoric disorder, or obsessive-compulsive traits. It is also useful with bipolar symptoms but is found to be more effective when combined with the medication olanzapine (Zyprexa) to treat manic depression. This combination is usually reserved for use when other initial prescription treatments have failed. Fluoxetine is the generic name. Prozac, Sarafem, Rapiflux, and Selfemra are the brand names available. Fluoxetine is classified as a selective serotonin reuptake inhibitor (SSRI) that works by preventing the neurotransmitter serotonin from reabsorbing into the nerve cells. This causes an abundance of serotonin levels in the brain and improves the messages between neurons. These are some of the most commonly prescribed antidepressant medications on the market.

Although fluoxetine is a popular FDA-approved antidepressant, there are some potential side effects that may occur with its use which may be temporary or to the point where you and your healthcare provider may want to consider an alternative therapy. Some of the more serious complications associated with its use include suicidal thoughts, worsening symptoms of depression, mania, heart complications, torsades de pointes, serotonin syndrome, bleeding, severe allergic reactions, vasculitis, pulmonary fibrosis, glaucoma, seizures, low blood sugars, and withdrawal symptoms with abrupt discontinuation of the medication.

What can I take in place of fluoxetine?

Fluoxetine may not be the best treatment option available for certain people. There are several drug interactions associated with this medication and different antidepressants may need to be considered. Luckily there are several different alternatives available for use. These may include a different selective serotonin reuptake inhibitor (SSRI) or a completely different antidepressant class such as serotonin-norepinephrine reuptake inhibitors (SNRIs), atypical antidepressants, tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs).

Medical advice from a psychiatry specialist is best when prescribing antidepressant drugs.

Compare fluoxetine alternatives
Drug name	Uses	Dosage	Coupons
Fluoxetine (Prozac, Prozac Weekly, Sarafem, Rapiflux, Selfemra)	Major depressive disorder, obsessive-compulsive disorder (OCD), bulimia nervosa, panic disorder, bipolar disorder, premenstrual dysphoric disorder	20-80 mg by mouth in the morning	Fluoxetine coupons
Amitriptyline	Major depressive disorder	50-150 mg by mouth at bedtime	Amitriptyline coupons
Celexa (citalopram)	Major depressive disorder	20-40 mg by mouth daily	Celexa coupons
Cymbalta (duloxetine)	Major depressive disorder, generalized anxiety disorder, diabetic neuropathic pain, fibromyalgia, and chronic musculoskeletal pain	60 mg daily	Cymbalta coupons
Doxepin	Major depressive disorder, insomnia, anxiety	150-300 mg by mouth at bedtime	Doxepin coupons
Emsam (selegiline transdermal)	Major depressive disorder	Patches: 6 mg, 9 mg, 12 mg Apply 1 patch daily	Emsam coupons
Lexapro (escitalopram)	Major depressive disorder and generalized anxiety disorder	10 mg by mouth daily	Lexapro coupons
Fluvoxamine	Obsessive-compulsive disorder	50-150 mg by mouth twice a day	Fluvoxamine coupons
Marplan (isocarboxazid)	Major depressive disorder	20-60 mg per day	Marplan coupons
Nardil (phenelzine)	Major depressive disorder	15 mg every other day – 30 mg three times a day	Nardil coupons
Pamelor (nortriptyline)	Major depressive disorder	25-50 mg by mouth at bedtime	Pamelor coupons
Paxil (paroxetine)	Major depressive disorder, obsessive-compulsive disorder, panic disorder, social anxiety disorder, generalized anxiety disorder, post-traumatic stress disorder	20-50 mg by mouth in the morning	Paxil coupons
Pexeva (paroxetine)	Major depressive disorder, obsessive-compulsive disorder, panic disorder, generalized anxiety disorder	20-50 mg by mouth in the morning	Pexeva coupons
Symbyax (olanzapine/fluoxetine)	Major depressive disorder, treatment-resistant and bipolar disorder	CAP forms: 3 mg/25 mg, 6 mg/25 mg, 6 mg/50 mg, 12 mg/50 mg Take one cap in the evening	Symbyax coupons
Trazodone	Major depressive disorder	50-100 mg by mouth divided two to three times per day	Trazodone coupons
Venlafaxine	Major depressive disorder, generalized anxiety disorder, panic disorder, social anxiety disorder	75-225 mg by mouth a day divided two to three times per day	Venlafaxine coupons
Zoloft (sertraline)	Major depressive disorder, obsessive-compulsive disorder, panic disorder, social anxiety disorder, premenstrual dysphoric disorder, post-traumatic stress disorder	500-200 mg daily	Zoloft coupons

Other alternatives to fluoxetine

amoxapine
Anafranil (clomipramine)
bupropion hydrochloride
clomipramine
Drizalma Sprinkle (duloxetine)
Fetzima (levomilnacipran)
Khedezla (desvenlafaxine)
Limbitrol (chlordiazepoxide/ amitriptyline)
Limbitrol DS (chlordiazepoxide/ amitriptyline)
maprotiline
Norpramin (desipramine)
Parnate (tranylcypromine)
Paxil CR (paroxetine)
perphenazine/ amitriptyline
Pristiq (desvenlafaxine)
Remeron (mirtazapine)
Remeron SolTab (mirtazapine)
Spravecto (esketamine).
Tofranil (imipramine)
Tofranil PM (imipramine)
Trimipramine
Viibryd (vilazodone)
Vivactil (protriptyline)

Top 5 fluoxetine alternatives

1. Celexa (citalopram)

The antidepressant Celexa is a selective serotonin reuptake inhibitor (SSRIs) used for the management of major depressive disorder. Celexa is the brand name, and citalopram is the generic version of the medication. It is associated with heart complications so if there are any symptoms of chest pain, your psychiatry specialist should be made aware immediately. Certain drug reactions may be fatal when combined with Celexa; therefore, a thorough list of all current and past medications should be reviewed, especially if an MAO inhibitor has been taken in the last 14 days. It is prescribed 20 to 40 mg daily by mouth. Some common side effects associated with its use include nausea, diarrhea, fatigue, flu syndrome, anorexia, anxiety, vomiting, impotence, agitation, abdominal pain, dizziness, yawning, and sexual dysfunction.

2. Cymbalta (duloxetine)

Cymbalta is another antidepressant that is used to treat many different conditions. The conditions include major depressive disorder, generalized anxiety disorder, diabetic neuropathic pain, fibromyalgia, and chronic musculoskeletal pain. It is a selective serotonin and norepinephrine reuptake inhibitor antidepressant (SSNRI). The generic version is duloxetine. Like with many antidepressants, Cymbalta is linked to suicidal thoughts and should be closely monitored when initially starting the medication. MAO inhibitors should not be taken five days before or 14 days after starting Cymbalta. Cymbalta is prescribed 60 mg daily. Common reactions when taking this antidepressant are nausea, headache, weight loss, abdominal pain, fatigue, constipation, anorexia, insomnia, and many others.

3. Lexapro (escitalopram)

Another SSRI antidepressant approved for the treatment of major depressive disorder and generalized anxiety disorder is Lexapro. Escitalopram is the generic name. If an MAO inhibitor has been used recently, Lexapro should be avoided. Lexapro is available for anyone showing depression symptoms over the age of 12, but suicidal thoughts are linked with taking this prescription antidepressant by younger populations. Lexapro is taken by mouth in a 10 or 20 mg tablet. Headaches, nausea, insomnia, fatigue, dizziness, constipation, flu syndrome, impotence, anorexia, abnormal dreams, tingling, and yawning are all possible reactions from taking Lexapro.

Related: Celexa vs. Lexapro

4. Paxil (paroxetine)

Paxil is an SSRI used for major depressive disorder, obsessive-compulsive disorder, panic disorder, social anxiety disorder, generalized anxiety disorder, and post-traumatic stress disorder. Just like many other antidepressants, the combination of MAO inhibitors and Paxil is not recommended. Suicidal thoughts will need to be closely monitored like with most SSRI antidepressants in younger patients. Anti-inflammatory medications such as aspirin, ibuprofen, or naproxen should be avoided if possible due to increased bleeding when combined with Paxil use. In the morning, Paxil is taken in a 20 to 50 mg dose. There are many common side effects seen while taking Paxil that includes sexual disturbances (impotence, anorgasmia), gastrointestinal disturbances (constipation, diarrhea), and neurological symptoms (dizziness, tremor, tingling).

5. 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. MAO inhibitors cannot be taken 14 days prior to or after the use of Zoloft. There are many drug interactions associated with the use of Zoloft, and should be reviewed with your healthcare specialist. Common symptoms with use of Zoloft include nausea, diarrhea, tremors, and sexual problems. More serious complications include vision changes, seizures, and manic episodes (unusual behavior, unusual happiness, and irritability).

Natural alternatives to fluoxetine

Prescription antidepressants may not be tolerable or desired as an initial treatment by some. For many, they may prefer more natural approaches as an alternative. Serotonin levels can be increased by other measures such as exercise, sunlight/light therapy, and a diet with complex carbohydrates (vegetables, fruits, legumes, and whole grains) containing tryptophan which all naturally increase serotonin levels. Some supplements are considered a potential replacement for a prescription antidepressant which include St. John’s wort, S-adenosyl methionine, and Omega-3 fatty acids. Additionally, vitamins that may improve depression symptoms are Vitamin D, Vitamin B12, Folate, Vitamin B, Niacin, Magnesium, Zinc, Calcium, and Iron. Other supplements like tyrosine (the precursor for dopamine and norepinephrine) and the herb Rhodiola rosea are also linked to reducing depression symptoms. Besides the treatments discussed above, talk therapy remains a major non-pharmaceutical therapeutic option for the management of depression and other mental health conditions.

How to switch to a fluoxetine alternative

Because of the many negative side effects associated with fluoxetine, there may be a need to discontinue the medication altogether. Unfortunately, antidepressants can not be stopped abruptly. Careful planning to slowly wean off the medication should be discussed with your healthcare provider in order to prevent antidepressant withdrawal. These symptoms include signs of anxiety or depression that occur a few weeks or months after discontinuing the medication and may present with physical complaints not seen with depression (nausea, vomiting, sweating, and dizziness), symptoms will improve immediately after taking a dose of medication, and symptoms will resolve after a few weeks.

Luckily, fluoxetine has a longer half-life and is known to have fewer complications when tapering off this medication. If you are in the market for an antidepressant, make sure you are getting the best price available. SingleCare has great discount coupons available when filling your antidepressant prescription at local pharmacies.