what does any of this half to do with obama and legalization?
i duno ... but if this is legal,pot should be
"
[edit] Adverse effects
http://en.wikipedia.org/wiki/File:Fluoxetine_20mg_with_Packet.jpg
Fluoxetine capsules (20 mg), as sold in the
United Kingdom
According to the manufacturer of Prozac brand of fluoxetine
Eli Lilly, fluoxetine is
contraindicated in individuals taking
monoamine oxidase inhibitors,
pimozide (Orap) or
thioridazine (Mellaril).
[9] The prescribing information recommends that the treatment of the patients with liver impairment "must be approached with caution". The elimination of fluoxetine and its metabolite norfluoxetine is about twice slower in these patients, resulting in the proportionate increase of exposure to the drug.
[9]
Among the common
adverse effects associated with fluoxetine and listed in the prescribing information, the effects with the greatest difference from
placebo are
nausea (22% vs 9% for placebo),
insomnia (19% vs 10% for placebo),
somnolence (12% vs 5% for placebo),
anorexia (10% vs 3% for placebo),
anxiety (12% vs 6% for placebo), nervousness (13% vs 8% for placebo),
asthenia (11% vs 6% for placebo) and
tremor (9% vs 2% for placebo). Those that most often resulted in interruption of the treatment were anxiety, insomnia, and nervousness (1-2% each), and in pediatric trialsmania (2%).
[9]
In addition, rash or urticaria, sometimes serious, was observed in 7% patients in clinical trials; one-third of these cases resulted in discontinuation of the treatment. Postmarketing reports note several cases of complications developed in patients with rash. The symptoms included
vasculitis and
lupus-like syndrome. Death has been reported to occur in association with these systemic events.
[9]
Akathisia, that is inner tension, restlessness, and the inability to stay still, often accompanied by "constant pacing, purposeless movements of the feet and legs, and marked anxiety," is a common side effect of fluoxetine.
[22][23] Akathisia usually begins after the initiation of the treatment or increase of the dose and disappears after fluoxetine is stopped or its dose is decreased, or after treatment with
propranolol.
[24][25][22] There are case reports directly linking akathisia with suicidal attempts, with patients feeling better after the withdrawal of fluoxetine, and again developing severe akathisia on repeated exposure to fluoxetine. These patients described "that the development of the akathisia made them feel suicidal and that it had precipitated their prior suicide attempts."
[25] The experts note that because of the link of akathisia with suicide and the distress it causes to the patient, "it is of vital importance to increase awareness amongst staff and patients of the symptoms of this relatively common condition".
[26][27] The initiation of suicidal ideation with fluoxetine does not appear to be higher than that seen with other antidepressants.
[28] It is possible however, that individuals with a impulse control problems are more prone to paradoxical psyhiatric adverse effects of fluoxetine.
[29] More rarely, fluoxetine has been associated with related movement disorders acute
dystonia and
tardive dyskinesia.
[23][30][31]
Other side effects may occur, including
sexual dysfunction. Possible sexual side effects can include
anorgasmia, reduced
libido and impotence.
[32]
Fluoxetine taken during pregnancy also increases rate of poor neonatal adaptation.
[32] Because fluoxetine is excreted in human milk, nursing while on fluoxetine is not recommended.
[33] The American Association of Pediatrics classifies fluoxetine as a drug for which the effect on the nursing infant is unknown but may be of concern.
[34]
[edit] Discontinuation syndrome
Main article: SSRI discontinuation syndrome
Several case reports in the literature describe severe withdrawal or discontinuation symptoms following an abrupt interruption of fluoxetine treatment.
[35] It is generally believed that the side effects of the fluoxetine discontinuation are mild,
[35] and one of the recommended strategies for the management of discontinuation syndrome with other SSRIs is to substitute fluoxetine for the original agent.
[36][37] The
double-blind controlled studies support this opinion. No increase in side effects was observed in several studies when the treatment with fluoxetine was blindly interrupted for a short time (4-8 days) and then re-instated, this result being consistent with its slow elimination from the body. More side effects occurred during the interruption of sertraline in these studies, and significantly moreduring the interruption of paroxetine.
[38] In a longer, 6 week-long, blind discontinuation study, insignificantly higher (32% vs 27%) overall rate of new or worsened side effects was observed in the group that discontinued fluoxetine than in the group that continued treatment. However, significantly higher 4% rate of somnolence at week 2 and 5-7% rate of dizziness at weeks 4-6 were reported by the patients in the discontinuation group. This prolonged course of the discontinuation symptoms, with dizziness persisting to the end of the study, is also consistent with the long half-life of fluoxetine in the body.
[39]
[edit] Suicidality in antidepressant trials
The FDA requires all antidepressants, including fluoxetine, to carry a
black box warning stating that antidepressants may increase the risk of suicide in persons younger than 25. This warning is based on statistical analyses conducted by two independent groups of the FDA experts that found a 2-fold increase of the suicidal ideation and behavior in children and adolescents, and 1.5-fold increase of suicidality in the 1824 age group. The suicidality was slightly decreased for those older than 24, and statistically significantly lower in the 65 and older group.
[40][41][42] This analysis was criticized by Donald Klein who noted that suicidality, that is suicidal ideation and behavior, is not necessarily a good surrogate marker for completed suicide, and it is still possible that antidepressants may prevent actual suicide while increasing suicidality.
[43] This opinion goes against the general consensus that "suicidal ideation has been associated with suicide attempt in retrospective studies and with suicide in prospective studies."
[44]
[edit] Suicidality and fluoxetine
Suicidal ideation and behavior in clinical trials are rare. For the above analysis the FDA combined the results of 295 trials of 11 antidepressants for psychiatric indications in order to obtain
statistically significant results. Considered separately, fluoxetine use in children increased the odds of suicidality by 50% (not statistically significant),
[45] and in adults decreased the odds of suicidality by approximately 30% (statistically significant).
[41][42] Similarly, the analysis conducted by the UK
MHRA found a 50% increase of odds of suicide-related events, not reaching statistical significance, in the children and adolescents on fluoxetine as compared to the ones on placebo. According to the MHRA data, for adults fluoxetine did not change the rate of self-harm and statistically significantly decreased suicidal ideation by 50%.
[46][47]"
good for him.
http://en.wikipedia.org/wiki/File:Fluoxetine_20mg_with_Packet.jpg