Drug Comparison

For educational purposes only — a decision-support tool, not a substitute for clinical judgment.

Side-by-side rubric across 96 psychiatric medications. Every rating traces to a verbatim primary-source quote — click any cell to see it.

How to read this tool
Rating scale
Favorable / lower than class baseline
± Minimal / equivocal
+ Low / uncommon
++ Moderate / common
+++ High / very common
++++ Very high / class-outlier
Frequency vs severity
F = frequency, S = severity. Each gets its own pill colored on the same traffic-light scale: greenblueyelloworangered. Click any cell for incidence percentages and NNH.
Evidence tier
A Network meta-analysis / RCT / FDA label
B Cohort / registry / pooled label data
C Expert review / textbook / case series
Sourcing
Click any cell to see the verbatim source quote and citation. Missing data shows n/a.
Data depth
++ Graded — frequency + severity, primary-source traces
+ FDA label — §6 frequency only (dashed border). Click for sub-types.
  Blank — not yet checked (not “absent”)
±++++++++++ABCF = frequency · S = severity · Dashed border = FDA label only · Click cell for details
1 drug selected — Fluoxetine(click to collapse)
1/4 selected
Fluoxetine
Prozac
Selective Serotonin Reuptake Inhibitor
FDA-approved indications
  • MDD — acute and maintenance (adults; pediatric 8+)
  • OCD — acute and maintenance (adults; pediatric 7+)
  • Bulimia nervosa — acute and maintenance (adults)
  • Panic disorder — acute treatment (adults)
Off-label uses
  • Body dysmorphic disorder
  • Selective mutism
  • Premature ejaculation
Half-life1 to 3 days (norfluoxetine: 4 to 16 days)
Next:Taper Fluoxetine
Decision GuideWhen to pick each / when to consider an alternative
Fluoxetine
Consider when
  • Bulimia nervosa — only antidepressant with FDA approval for this indication (at 60 mg/day)
  • Pediatric depression (age 8+) — one of only two SSRIs with FDA-approved pediatric MDD indication
  • Adherence or discontinuation risk — longest SSRI half-life means missed doses and taper are forgiving
  • Bipolar depression or treatment-resistant depression — available as olanzapine-fluoxetine combination (Symbyax)
Consider an alternative when
  • Patient on CYP2D6 substrates — potent CYP2D6 inhibition persists 5 weeks after discontinuation
  • Anxiety or insomnia is prominent — most activating SSRI (insomnia 19%, nervousness 13%); start low in panic disorder
  • MAOI anticipated in treatment plan — long half-life requires 5-week washout before starting an MAOI (longest delay of any SSRI)
  • Elderly patient — most activating SSRI with longest half-life; higher rates of insomnia, nervousness, and prolonged drug accumulation in older adults
Efficacy & Acceptability (2 axes)— NMA efficacy & discontinuation data (not side effects)
Axis
Fluoxetine
📊 Efficacy (response rates)
MDDEfficacy
🛡️ Acceptability (all-cause discontinuation)
MDDAcceptability
Axis
Fluoxetine
SSRI
Boxed Warnings
Suicidality (boxed warning)
Mania / hypomania induction
CNS
Sedation / somnolence
Activation / insomnia
Emotional blunting
Seizure risk
Metabolic
Weight loss
Autonomic
Anticholinergic burden
Sweating
Angle-closure glaucoma
Cardiac
QTc prolongation
GI
Nausea / GI (general)
Electrolytes
Hyponatremia / SIADH
Sexual
Sexual dysfunction
Discontinuation
Withdrawal / discontinuation
Interactions
Serotonin syndrome risk
CYP interactions / DDI profile
Safety
Bleeding risk
Pregnancy
Lactation / breastfeeding safety

Safety: Every rating traces to a verbatim primary-source quote. Click any cell to audit. Stubs are disabled until calibrated. This tool surfaces published evidence — it does not replace clinical judgment.