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Side Effects of Long-Term Treatment With Fluoxetine

Buchman, Nili; Strous, Rael D.; Baruch, Yehuda

Brief Reports

Depressive disorders are frequently managed with long-term use of antidepressant medication. Even though the newer generation of selective serotonin reuptake inhibitor antidepressants exhibits a more favorable short-term, side-effect profile, effects of chronic use of such drugs remain unknown. Considering the limited data available on long-term, selective serotonin reuptake inhibitor management, we report for the first time on two cases of late-onset adverse effects occurring 6 and 10 years after chronic-fluoxetine treatment in which patients experienced symptoms of restlessness, tension, agitation, and sleep disturbances. Symptoms resolved after reduction or cessation of the medication. Our case reports suggest the existence of a late-onset side-effect profile, which appears similar to acute side-effect symptomatology. Super sensitivity of the serotonin-related receptors may develop over the long-term and account for the phenomenon. Careful clinical monitoring is recommended to detect any late-onset, medication-related side effects.

Beer Yaakov Mental Health Center, Sackler School of Medicine, Tel Aviv University, Beer Yaakov, Israel

Address correspondence and reprint requests to Dr Rael Strous, Beer Yaakov Mental Health Center, PO Box 1, Beer Yaakov 70350, Israel; Email:

© 2002 Lippincott Williams & Wilkins, Inc.