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Sarafem fluoxetine is sometimes also used with another medication called zyprexa olanzapine to treat depression caused by bipolar disorder manic depression and depression if unsuccessful treatments attempts with a minimum of 2 other medications were used .

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Five patients receiving fluoxetine in combination with tryptophan experienced adverse reactionsincluding agitationrestlessnessand gastrointestinal distressThe concomitant use with tryptophan is not recommendedsee WARNINGS AND PRECAUTIONS

All patients being treated with antidepressants for any indication should be monitored appropriately and observed closely for clinical worseningsuicidalityand unusual changes in behaviorespecially during the initial few months of a course of drug therapyor at times of dos e changeseither increases or decreases

This drug may make you dizzy or drowsyAlcohol or marijuana can make you more dizzy or drowsyDo not driveuse machineryor do anything that needs alertness until you can do it safelyAvoid alcoholic beveragesTalk to your doctor if you are using marijuana.

If you are taking fluoxetine for premenstrual problemsyour doctor may direct you to take it every day of the month or just for the 2 weeks before your period through the first full day of your periodTo help you remembermark your calendar.

Infants exposed to SSRIs in pregnancy may have an increased risk for persistent pulmonary hypertension of the newbornPPHNPPHN occurs in 1 to 2 per 1,000 live births in the general population and is associated with substantial neonatal morbidity and mortalitySeveral recent epidemiological studies suggest a positive statistical association between SSRI useincluding fluoxetinein pregnancy and PPHNOther studies do not show a significant statistical association.

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