Fluoxetine lasts so long that it is a great choice for patients who forget, skip or start and stop their medication: give a higher dose, and the long half-life keeps an effective serum level through a few skipped doses a week. Many people call it the most weight neutral, but we do not see a significant difference.
When we reach for it
It lasts so long that it is great for patients who forget or skip doses: give a higher dose, and the long half-life still gives an effective serum level when they skip a few doses a week. Start-and-stop patients can get used to it and take it a few times a week (not as a PRN, just whenever they remember).
“if they are a start and stop type of patient, then fluoxetine is great because it's long-acting. Right? They They can kind of get used to it, take it a few times a week, not as a PRN again, but just whenever they can remember”
24:41Anxiety Medications Tier List: The Best and Worst Treatments for GADJul 2026 Also said in 2 more episodes
“if your patient tends to miss doses, skip doses, great medication. You can just give a higher dose and they skip a few doses a week. Long half-life still gives you effective serum level”
17:30Antidepressant Tier List: Psychiatrists Rank Depression Medications for MDDMay 2026 “We have our Prozac, which is nice for people who forget to take their medications because it lasts so long”
29:28Treating Depression: Practical Tips & Pearls for Anti-Depressant MedicationsJan 2025
Weight
Many people categorize it as the most weight neutral, and we think a study may even have shown some weight loss in the very short term, but we do not see a significant difference.
“a lot of people categorize fluoxetine as the most weight neutral. I think there was some study that in a very short term, there might have been some even weight loss. I don't see a significant difference”
20:36Antidepressant Tier List: Psychiatrists Rank Depression Medications for MDDMay 2026
It also comes up on
From these episodes
- Anxiety Medications Tier List: The Best and Worst Treatments for GADJul 2026 · 1 point
- Antidepressant Tier List: Psychiatrists Rank Depression Medications for MDDMay 2026 · 2 points
- Treating Depression: Practical Tips & Pearls for Anti-Depressant MedicationsJan 2025 · 1 point
Every point above is something said on the Psychofarm podcast, with the words as spoken and a link to the moment in the episode. It is education, not medical advice, and an episode reflects what we thought when we recorded it.