Once weekly fluoxetine, tolerability and safety according to use patterns in the psychiatric clinical practice

Abstract

Introduction. Treatment with selective serotonin reuptake inhibitors (SSRI) has become generalized in all the medical setting although its efficacy and good tolerability may be affected by long term non-compliance. Once weekly fluoxetine could improve compliance due to the comfort of its use. The objective is to evaluate the safety, tolerability and efficacy of once weekly fluoxetine (90 mg) in a sample of out-patients, following naturalistic criteria in the usual clinical practice.

Method. A total of 46 patients (age: 41.89 ±1.85) who received once weekly fluoxetine for at least 3 months (mean time: 135.24 days) were analyzed retrospectively. Clinical Global Impression of Severity (CGI-S) at the onset and end of the period evaluated, presence of adverse events, drop-out index and impression of patient's satisfaction with the treatment and use pattern were used.

Results. The mean of the final CGI-S was 2.09, compared with the onset 3.09 (p <0.02), indicating significant improvement in the efficacy with once weekly fluoxetine. The most frequent adverse effects were: anxiety (10.87 %), headache (8.69 %) and restlessness (8.69 %) related with once weekly fluoxetine. Compliance was very high at the onset (99 %) and at the end (96 %). Ten patients dropped-out of the treatment (27.74 %), 6 due to appearance of undesirable effects (anxiety, headache and insomnia), three due to voluntary wish and only one due to lack of efficacy. The CGI of satisfaction of clinical global efficacy on the final visit was 1.43 (satisfied-very satisfied) and the CGI of satisfaction for the treatment pattern was 1.17 (very satisfied).

Conclusion. Change to once weekly fluoxetine generally improves satisfaction of treatment efficacy and its use pattern, although some patients return to the initial regime after adverse effects appear.