Fluoxetine for ADHD
Fluoxetine is a selective serotonin reuptake inhibitor (SSRI).
Fluoxetine has no specific effect on ADHD symptoms and therefore should be used at most in cases of true comorbid anxiety disorder or depression.1
Since tricyclic antidepressants are also helpful in anxiety disorders and depression, and these can also significantly reduce ADHD symptoms, we consider them to have an advantage with regard to ADHD.
Fluoxetine is reported to be the only SSRI with a drive-enhancing effect.
Hyperactivity induced by the amphetamine drugs MDMA and MDBS, respectively, by means of (a 10-20 -fold higher dosage of) 5 mg and 10 mg per kilogram of body weight compared with the dosage of amphetamine drugs (here: Elvanse) as a drug could be suppressed by prior administration of 2.5 and 10 mg per kilogram of body weight of the selective serotonin reuptake inhibitor fluoxetine. Fluoxetine had the same effect with respect to the interactive effects of MDMA and P-chloroamphetamine. This confirms that amphetamines or amphetamine drugs act serotonergically and that motor hyperactivity can be induced by serotonin excess at appropriately high doses. Further, evidence emerged that increased serotonin release indirectly increases dopamine levels.2
Fluoxetine and its metabolite norfluoxetine induce apoptotic death of microglia, which may be the mechanism by which release of glutamate and D-serine from activated microglia is reduced. Citalopram, phenelzine, or imipramine showed no such effect.3
Regarding the entire group of serotonin reuptake inhibitors, there are concerns about their use in ADHD.
See ⇒ Notes on serotonin reuptake inhibitors (SSRIs) in ADHD In the article ⇒ Medications for ADHD - Overview.
Häßler (2009): substanzgebundene Alternativen in der Therapie von ADHS, Seite 175, in: Häßler (Hrsg) das ADHS Kaleidoskop – State of the Art und bisher nicht beachtete Aspekte von hoher Relevanz; medizinisch wissenschaftliche Verlagsgesellschaft ↥