The longest-acting SSRI — which makes discontinuation gentler and its interactions last for weeks after stopping.
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Fluoxetine is an SSRI, and the one most people have heard of — it was marketed as Prozac. It increases the serotonin available between nerve cells in the brain.
Its defining characteristic is how long it stays in the body. Fluoxetine and its active metabolite have a half-life measured in days to weeks, where most SSRIs are measured in hours.
That single property explains most of what is distinctive about it:
It is also the only antidepressant licensed for depression in children and adolescents in the UK.
Four to six weeks for a proper effect, and sometimes longer than other SSRIs because levels build slowly.
Fluoxetine is more activating than most — people often feel restless or wired rather than drowsy in the first weeks, and sleep can be disturbed. That is why it is usually taken in the morning.
The first two weeks can feel worse before better. Knowing that is the difference between continuing and stopping on day ten.
Care in significant liver impairment, where a lower dose or alternate-day dosing is used.
In pregnancy this is a genuine risk-benefit discussion rather than a prohibition. Fluoxetine has extensive safety data, and untreated depression in pregnancy carries substantial risks of its own. Sertraline is often preferred in breastfeeding because less passes into milk.
These interactions persist for weeks after the last dose, because the drug is still in your system. Anyone prescribing for you in the month after stopping fluoxetine needs to know you were on it.
Yes for adults where clinically appropriate. Mental health assesses well by video and twenty minutes allows a proper conversation.
What a consultation involves: full assessment including risk, a discussion of medication versus talking therapy versus both, bloods where a physical cause is possible, a careful medicines review given fluoxetine's interaction profile, and planned follow-up in the first few weeks.
Where fluoxetine is often the right choice: where someone has struggled to come off other antidepressants, since its long half-life makes discontinuation far gentler; and where daily adherence is difficult.
Where it is often not: if you are already anxious and agitated, since it is the most activating of the SSRIs.
What we will not manage remotely: anyone under 18 — despite fluoxetine being the licensed choice in that age group, initiation belongs with CAMHS and in-person care. Also severe depression with significant risk, psychosis, and bipolar disorder.
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Fluoxetine is a very cheap generic — long off patent, and there is no reason to pay for branded Prozac. On a private prescription it typically costs less than the England NHS prescription charge. NHS prescriptions are free in Wales.
Therapy, and the best version is free. NHS Talking Therapies takes self-referrals without a GP appointment. CBT has strong evidence in depression, anxiety and OCD — and for OCD specifically, ERP therapy is at least as important as medication.
Fluoxetine is the easiest SSRI to stop, because it tapers itself. Its long half-life means levels fall gradually over weeks, and discontinuation symptoms are correspondingly mild — often absent.
That is a genuine advantage, and it is why fluoxetine is sometimes used as a bridge for people struggling to come off a shorter-acting antidepressant.
Fluoxetine stays in the system for weeks. Switching to another antidepressant — particularly an MAOI, which needs a five-week gap — must account for that. This is not something to improvise.
Yes. Prozac is the original brand name; fluoxetine is the drug. The generic is identical and far cheaper.
Because it stays in your body for weeks after the last dose, so levels fall gradually on their own. Most SSRIs clear within a day, which is what produces the abrupt discontinuation symptoms people describe.
Fluoxetine is the most activating of the SSRIs. Restlessness, agitation and disturbed sleep are common early on, which is why it is usually taken in the morning. It generally settles.
If you were already very anxious, a different SSRI may suit you better, and that is worth raising.
Four to six weeks, sometimes longer than other SSRIs because levels build slowly. The first fortnight often feels worse.
It is the only antidepressant licensed for depression in under-18s in the UK, from age 8. But it should be started by specialist child and adolescent services, in person, with close monitoring — not remotely.
Often a little early on, because it reduces appetite. That usually settles, and it is not a weight-loss treatment. Weight tends to return to baseline.
Yes. Fluoxetine's interactions persist for weeks after the last dose. Any prescriber seeing you within a month or so of stopping needs to know.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
September 5, 2026
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It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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