The most common overdose adverse effects included drowsiness, tremor, tachycardia, nausea and vomiting, and providing the patient with aggressive supportive care was the recommended intervention.ĭespite this evidence, more severe adverse effects have been linked to fluoxetine ingestion although most of these reports involved co-ingestion with other substances or drugs as well as other factors. In a report that included 234 fluoxetine overdose cases, it was concluded that symptoms resulting from fluoxetine overdose were generally minor and short in duration. Extine is also used in dosage of 60 mg daily for the management of bulimia nervosa. Maintenance treatment: It is generally agreed among expert psychopharmacologists that acute episode of depression requires several months or longer sustained pharmacologic therapy. A recommended maximum dose for elderly patients is 60 mg per day. As with many other medications, a lower or less frequent dosage should be used in patients with renal and/or hepatic impairment.Ī lower or less frequent dosage should also be considered for patients, such as elderly, with concurrent disease or on multiple medication. Extine saying airshot full#As with other antidepressants, the full antidepressant effect may be delayed until 4 weeks of treatment or longer. morning and noon) and should not exceed a maximum dose of 80 mg/day. Dosage above 20 mg/day, should be administered on a bid schedule (i.e. Consequently, a dose of 20 mg/day administered in the morning is recommended as the initial dose.Ī dose increase may be considered after several weeks if no clinical improvement is observed. Initial treatment: Recent studies suggest that 20 mg/day of Extine may be sufficient to obtain satisfactory antidepressant response. Further, fluoxetine has high affinity for 5-HT transporters, weak affinity for noradrenaline transporters and no affinity for dopamine transporters indicating that it is 5-HT selective.Įxtine interacts to a degree with the 5-HT 2C receptor and it has been suggested that through this mechanism, it is able to increase noradrenaline and dopamine levels in the prefrontal cortex. As a result, levels of 5-hydroxytryptamine (5-HT) are increased in various parts of the brain. As a result of this hypothesis, drugs that modulate levels of serotonin such as fluoxetine were developed.Įxtine is a selective serotonin reuptake inhibitor (SSRI) and as the name suggests, it exerts it's therapeutic effect by inhibiting the presynaptic reuptake of the neurotransmitter serotonin. Indeed, low levels of serotonin have been observed in the cerebrospinal fluid of patients diagnosed with depression. The monoaminergic hypothesis of depression emerged in 1965 and linked depression with dysfunction of neurotransmitters such as noradrenaline and serotonin. However, fluoxetine binds with relatively poor affinity to 5-HT, dopaminergic, adrenergic, cholinergic, muscarinic, and histamine receptors which explains why it has a far more desirable adverse effect profile compared to earlier developed classes of antidepressants such as tricyclic antidepressants. This results in numerous functional changes associated with enhanced serotonergic neurotransmission.Įxtine appears to have no effect on the reuptake of norepinephrine and dopamine and does not exhibit antihistaminic or alpha1 adrenergic blocking activity at usual therapeutic doses.Įxtine blocks the serotonin reuptake transporter in the presynaptic terminal, which ultimately results in sustained levels of 5-hydroxytryptamine (5-HT) in certain brain areas. Extine Hydrochloride is a phenylpropylamine derivative antidepressant for oral administration, it is chemically unrelated to tricyclic, tetracycline or other available antidepressants.Įxtine has been shown to selectively inhibit the reuptake of serotonin (5-HT) at the presynaptic neuronal membrane which causes increased synaptic concentration of serotonin in the CNS.
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