Buy Fluoxetine Online
Fluoxetine is included in the list of the most important, safest and most effective drugs according to the world health organization. Fluoxetine is prescribed for the treatment of depression, obsessive-compulsive disorders, nervous bulimia.
Fluoxetine and Depression
Depression is called depression, the loss of interest in what used to cause joy in the patient. According to the international classification of diseases of ICD-10, the main criteria by which such a diagnosis can be made are depressed mood for more than two weeks, fatigue and consistently high fatigue (more than a month) and anhedony (inability to enjoy what used to bring joy). Additional criteria for depression doctors consider pessimism, low self-esteem, thoughts of death and suicide, appetite disorders (weight loss or overeating), sleep problems, constant fears and anxieties, feelings of uselessness and guilt, inability to concentrate, as well as a constant sweet taste in the mouth. These symptoms are unlikely to occur simultaneously (for example, in some cases, fatigue and apathy may prevail, and in others – anxiety and guilt), so in order to diagnose depression, the patient's condition must meet at least two main criteria and three additional ones. At the same time, according to the definition of the National Institute of mental health of the United States, this condition should last quite a long time (more than two weeks).
A severe form of depression (clinical) includes a complex set of symptoms, is called a large depressive disorder and sometimes may not be accompanied by a bad mood at all. However, because of it, the patient can not physically live and work normally, and the comments of others in the spirit of "he just can not pull himself together" or "enough sour that dissolved snot" sound like a mockery. Such phrases stigmatizing depression, blaming person in his condition, while he will not be able to cope and in need of treatment. For the diagnosis of major depressive disorder, there is a large depression questionnaire compiled by the world health organization. Also, depressive disorders include other conditions accompanied by depression – for example, dysthymia (daily bad mood and mild symptoms of depression for two years or more).
The causes of depressive States can be very different:
- Somatic (due to diseases on the part of the body);
- Psychological (after strong dramatic experiences, for example, the death of a relative);
- Iatrogenic (as a side effect of some drugs).
As it would be strange to provide first aid to the victim of an electric shock without removing the wire from it, and it is difficult to cure the symptoms of depression without eliminating its cause or changing the lifestyle that led the patient to such a state. If the patient lacks some necessary substances (for example, tryptophan), it is important to fill their shortage, and not only to fight with depressed mood with the help of drugs. If he has any psychological trauma, you will need the help of a psychotherapist. And a person whose depression is provoked by hormonal disorders, neurological diseases, heart disease, diabetes or even cancer (and this happens) is more important to cure the disease itself, and symptomatic treatment of depression will be a secondary goal.
When you can't stop
Obsessive-compulsive disorder, or OCD (also called obsessive-compulsive disorder), consists of two mandatory components: obsessions (obsessive-compulsive or frightening thoughts) and compulsions (obsessive-compulsive actions). A classic example is OCD, related to the topic of purity, when a person is afraid of contamination or infection by microorganisms. Such thoughts and fears, called obsessions. To protect themselves from them, people will worry too much about cleanliness, for example, constantly wash their hands. Any contact with a non-sterile, according to the patient, the subject, plunges such a person into horror. And if he can't wash his hands again, he'll be in real pain.
This "protective" behavior is called compulsion. The desire for cleanliness can be understood if a person is in conditions of complete unsanitary conditions or, conversely, wants to maintain sterile conditions somewhere in the operating room. But if the action loses its true meaning and becomes an obligatory ritual, it becomes a compulsion.
However, OCD can be manifested not only as a fear of pollution, but also as excessive superstition, fear of losing the necessary object, sexual or religious obsessions and related actions. Their causes may lie in several areas: biological and psychological. The first includes diseases and features of the nervous system, lack of neurotransmitters (biologically active substances that provide transmission of nerve impulses from one neuron to another, for example, dopamine or serotonin) genetic predisposition (mutations in the hSERT gene encoding the serotonin Transporter protein and located on the 17th chromosome).
There is also an infectious theory of OCD development associated with the fact that in children it sometimes occurs after infection with Streptococcus. This theory is called PANDAS – an abbreviation of the English Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections, which translates as "children's autoimmune neuropsychiatric Disorders associated with streptococcal infections." The cause of this syndrome may be an attack of own antibodies, developed against Streptococcus, on the nerve cells of the patient. However, this theory has not yet been confirmed.
For the diagnosis of obsessive-compulsive disorder, the Yale-brown scale is used. In the fight against OCD, the method of psychological persuasion is useful: patients are patiently explained that if you skip the "ritual" once, nothing terrible will happen. But medicines are also used in treatment.
When you're how you eat
Nervous bulimia (the third indication for the use of the drug Fluoxetine) is an eating disorder associated with overeating. The main signs of bulimia are uncontrolled eating in large quantities, obsession with excess weight (counting calories, trying to cause vomiting after eating, fasting, use of laxatives), low self-esteem, low blood pressure. Other symptoms – sudden changes in body weight, kidney problems and dehydration, increased salivary glands, heartburn after eating and inflammation of the esophagus. Due to the provocation of vomiting, hydrochloric acid from the stomach constantly enters the oral cavity of patients, which can lead to grinding of tooth enamel and ulcers on the mucous membrane. According to the classification of diseases DSM-5, uncontrolled absorption of large amounts of food and at the same time the use of various drastic measures to reduce weight — the main criterion for the diagnosis of nervous bulimia.
The causes of bulimia can be both biological (incorrect levels of hormones or neurotransmitters, including serotonin) and social. The importance of the latter is highlighted, for example, in a high-profile study among adolescent girls in Fiji, which showed a sharp increase in cases of intentional bowel cleansing for weight loss in just three years (from 1995 to 1998) after television appeared in the province. Perhaps the desire to be like the models on the screens and covers really push to this behavior.
Often bulimia nervosa can be associated with other mental disorders (depression, anxiety disorders, sleep disorders). According to a study by the new York state Psychiatric Institute and Columbia University, 70% of people with bulimia have ever experienced depression, while in the main population there were slightly more than 25%.
Bulimia itself is not too common, and it can be more difficult to diagnose than the same anorexia, because the changes in body weight in bulimia are less sharp and noticeable. The test is used to diagnose the relationship to food intake, was developed by Clarke Institute of psychiatry, University of Toronto, and other tests based on it. But (as in the above tests for OCD and depression) its result only shows the probability that the patient has developed a disorder, but does not allow to make a final diagnosis, especially to himself.
What is Fluoxetine
What is a drug that is prescribed for three types of disorders? Fluoxetine, discovered and marketed by Eli Lilly and Company, belongs to a group of antidepressants called selective serotonin reuptake inhibitors. This group is considered to be the third generation antidepressants, quite easily tolerated and without significant side effects.
Fluoxetine is easily absorbed into the blood, can bind to plasma proteins and accumulate in the tissues of the body. It also penetrates through the blood-brain barrier, which protects the nervous system and brain from many substances circulating in the blood. There, in the nervous system, it works in the already mentioned synaptic gap, preventing the excess serotonin ejected from the synapse back. Because of this, serotonin is longer present in the synaptic gap and can bind to receptors. How exactly fluoxetine achieves this effect is not clear even to manufacturers, but it is known that it affects the work of other neurotransmitters weakly. However, in high doses, fluoxetine increases levels of adrenaline and dopamine, as studies on rat brain tissue show.
Fluoxetine and its metabolite (the substance into which it is converted in the body) norfluoxetine can inhibit each other's action. Because of this, according to scientists from the Institute of research medicine in Barcelona, a constant concentration of fluoxetine in the blood is achieved only after four weeks of taking the drug. Similarly, the consequences of taking the drug are not immediately. This is associated with difficulties in selecting the required dose for a particular patient.
Serotonin itself, which is absolutely incorrectly called the "hormone of happiness" (hormones are produced in one organ of the body, and perform their function in another, serotonin in this context simply conducts nerve impulses in the parts of the brain responsible for good mood, and is produced in the same place), in fact, performs much more functions. Yes, it affects mood, sleep, and appetite, so some cases of depression, nervous bulimia, and OCD can be caused by insufficient production of this neurotransmitter and corrected by serotonin reuptake inhibitors. But in addition, it can actively capture platelets and affect blood clotting. Also serotonin is involved in the processes of memorization and learning. In this case, it can produce not only vertebrates: so according to the study of Chinese and American scientists, the pain from insect bites is largely due to the presence of serotonin in the poison, and dysentery amoeba, according to an article in Science, can cause diarrhea, releasing serotonin in our intestines.
Although in General the authors note that there is little data on this topic, fluoxetine (of which there were only five randomized double-blind controlled trials for 2003) is recognized as a leader in this direction. However, the authors refuse to recommend this drug in conclusion, arguing that not all clinical trial data are published and available for consideration.
The authors of the 2008 review, considering the benefits of serotonin reuptake inhibitors (including Fluoxetine) in obsessive-compulsive disorder, concluded that they help placebo better, and the associated side effects are much greater, among which nausea, insomnia, and headache are most common. According to a 2013 review, the usefulness of the same group of drugs in autism and related OCD is unclear, and data are insufficient to conclude.
In Conclusion
The most popular topic of reviews about Fluoxetine was the fight against depression. But the authors of most of them note the lack of data (for example, in this review of 2013). In a review with broad inclusion criteria, where the efficacy of fluoxetine against depression in adults was investigated in 1177 randomized controlled trials, the authors conclude that it is approximately as effective as other antidepressants, but less toxic. However, they caution against hasty decisions, since most studies were conducted on small groups of people (100 or less) and were funded by the manufacturer, which is more profitable to publish only positive results, hiding information about failures. Data on postpartum depression are also found to be insufficient and contradictory. The same concerns are highlighted by a review of articles on the effectiveness of antidepressants against dementia-related senile depression.
A large number of studies confirm the effectiveness of Fluoxetine, a key component of Prozac. But part of the reviews of the Cochrane collaboration notes that not all test data were published by manufacturers. And this accusation is not an empty phrase: according to internal documents of Eli Lilly, manufacturers in the course of tests often attributed suicide cases to increased depression or drug overdose.
- As a result, after numerous reports of suicides of patients who are prescribed this drug, the American Food and Drug Administration (FDA) has provided a warning sign to the packaging of the drug.
This does not mean that the harm from the drug always overpowers its benefits, but such unfair behavior of manufacturers does not allow to assess the risks more accurately. Given the complexity of the selection of individual doses and slow effect, adjust the dosage is really difficult.
In addition, Fluoxetine refers to serotonin reuptake inhibitors, but if the causes of your condition are in something else, you need to pay more attention to finding and eliminating them than fighting depression. As we have already mentioned above, somatic diseases (for example, cirrhosis of the liver, cancer or diabetes), and even a lack of vitamins can cause depression. In addition, depression or other disorder can be the result of psychological trauma, which will be difficult to cope with without psychotherapy.
All this suggests that the drug should be used under the supervision of a doctor (most likely, without a prescription and it will not sell), and that one of its actions may not be enough for a full recovery. And do not forget that serotonin is involved in many other processes in the body. Therefore, do not use the drug in violation of the liver and kidneys, increased risk of thrombosis, and not only during pregnancy and lactation. In manic conditions and suicidal sentiments, too, it is better to abandon the drug. If you notice allergic reactions or nausea and headache, you need to consult a doctor and clarify whether to stop taking the medicine.