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What Are the Differences between Fluoxetine and Sertraline?

By Jay Leone
Updated Mar 03, 2024
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Both fluoxetine and sertraline fall into the Selective Serotonin Reuptake Inhibitor (SSRI) class of prescription drugs, which means they affect how the body processes neurotransmitters, such as serotonin. Fluoxetine and sertraline are each prescribed to treat many of the same conditions, but can also be used to treat different conditions. Manufacturers offer different forms of both fluoxetine and sertraline, each with different dosing instructions. Each of these medications is also linked with several of the same but also many different possible side effects.

Doctors prescribe both medications to treat symptoms linked with obsessive-compulsive disorder and premenstrual dysphoric disorder. Both medications however, are ideal treatment for several other conditions. Fluoxetine is often taken to treat bulimia, resistant depression, as well as depression linked with bipolar disorder.

Manufacturers produce 10, 20, and 40 milligram fluoxetine capsules as well as 90 milligram delayed release capsules. Doctors can also prescribe 10, 15, or 20 milligram fluoxetine tablets. Sertraline is available in 25, 50, or 100 milligram tablet form. Liquid forms of fluoxetine and sertraline can be taken instead of tablets in most cases. The liquid form of fluoxetine offers 20 milligrams of fluoxetine per 5 milliliter of solution while liquid sertraline offers 20 milligrams of sertraline in each milliliter of solution.

While adults are given between 20 and 80 milligrams of fluoxetine daily to treat depression, the average dose for children is between 10 and 20 milligrams. The average daily dose of fluoxetine to treat obsessive-compulsive disorder is between 20 and 60 milligrams for adults and children. The recommended dose for treating premenstrual dysphoric disorder is 20 milligrams of fluoxetine taken each day of a woman’s menstrual cycle.

The usual sertraline regimens differ slightly from those involving fluoxetine. Treating depression and obsessive-compulsive disorder with sertraline involves taking between 25 and 50 milligrams of the medication daily. The average doctor-recommended daily dose of sertraline to treat premenstrual dysphoric disorder is between 50 and 150 milligrams each day in the menstrual cycle.

Fluoxetine and sertraline can cause several of the same side effects including nausea, loss of appetite, skin rashes, and insomnia. Some of the other possible side effects of fluoxetine are seizures, increased blood pressure, and blood vessel inflammation. Weight loss, dry mouth, and irregular heartbeat symptoms may be experienced while taking sertraline.

Taking either of these medications for long enough could cause a patient to become dependent on the medication. Nausea and other withdrawal symptoms may occur after abruptly discontinuing fluoxetine use. Abruptly discontinuing sertraline use could result in experiencing flu-like symptoms, abdominal cramps, and memory impairment. Gradually decreasing a patient’s dosage of either of these medications over time helps decrease the likelihood of he or she experiencing withdrawal symptoms.

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Discussion Comments

By literally45 — On Feb 05, 2014

@SarahGen-- I wouldn't say that one is better per se , but one may be more suitable for you based on your symptoms and needs. So you need to decide this with your doctor, not based on opinions from other people.

I personally had better results with sertraline because I didn't just have depression, I also had anxiety. I'm not saying that other people will have the same experiences as me. Everyone has slightly different experiences with the same drugs. But fluoxetine did nothing for my anxiety, while sertraline pretty much got rid of it. So even though they are in the same group of antidepressants, I think they work differently and may be better for different types of symptoms. Even though I felt better on sertraline, I should add that both drugs caused me to gain weight. So some of the side effects may be the same.

Talk to your doctor about your issues and allow him or her to help you make a decision when it comes to drug treatment.

By SarahGen — On Feb 05, 2014

Which of these is the better drug? Which one should I take?

By bear78 — On Feb 04, 2014

I'm not sure if this applies to sertraline, but fluoxetine is safe to use by young adults. I used fluoxetine when I was in middle school and high school. My doctor told me at the time that fluoxetine is one of the few safe antidepressants for children. Of course, children and young adults take lower doses than adults.

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