The Efficacy and Safety of Fluoxetine Delayed-Release 90 mg/Weekly in Psychiatry: An Evidence-Based Mini-Review

Context: Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), is widely used in the treatment of various psychiatric disorders. While the standard therapeutic dose of fluoxetine is typically 20 - 60 mg per day, slow-release higher doses, such as 90 mg/weekly and more recently 180 mg/weekly, have been explored to assess their potential benefits in certain psychiatric conditions. This mini-review aims to evaluate the evidence regarding the effects, efficacy, and safety profile of fluoxetine at a dosage of 90 mg in psychiatry. Evidence Acquisition: A comprehensive literature search was conducted using electronic databases (PubMed and Embase) to identify relevant studies published until July 2023. Studies investigating the use of fluoxetine at a dosage of 90 mg/week in psychiatric conditions were included. The identified studies were critically appraised for their methodology and quality. Results: Limited research has specifically examined the effects of fluoxetine at a dosage of 90 mg/week in psychiatry. However, some studies have investigated this dosage form and provided insights into its potential efficacy in treating certain psychiatric conditions, such as major depressive disorder (MDD), obsessive-compulsive disorder (OCD), premature ejaculation, and premenstrual dysphoric disorder. These studies have shown that compliance with weekly fluoxetine was better than with once-daily dosing. Conclusions: Once-weekly dosing may be effective in psychiatry, improving compliance and enhancing psychological well-being.