Mixed anxiety and depression Panic Disorders Bulmia Nervosa Obessive compulsive disorder Premenstrual dysphoric disorder

Seen with monoamine oxidase inhibitors (MAO) Oral anticogulants Anti-convulsants Some Antifungals such as Ketoconazole and Itraconazole

Nervousness, anxiety, seizures, blurred vision, Jaundice, GI disturbances, Vertigo, Headache, elevation of hepaic enzymes

Severe renal or hepatic failure Hypersensitivity Pregnancy Lactation Respiratory depression Acute Narrow Angle Glaucoma

Pharmcology- Fluoxetine Fluoxetine HCl is an antidepressant of selective serotonin reuptake inhibitor ( SSRI) class. It inhibits central reuptake system ( CNS) neutronal uptake os serotin into human platelets. Alprozolam Alprazolam a triazolobenzadiazepine is a benzodiazepine with a triazolo- ring attached to its structure. Pharmacokinetics- Fluoxetine is slowly absorbed from the GIT with the peak with the peak plasma concentration occuring about 6-8 hrs after ingestion. It is extensively metabolised in the liver to nor-fluoxetine by de-methylation pathway.It is widely distributed in the body and is highly bound to plasma proteins, with a half life of 4-6 days. Alaprazolam is readily absorbed from the GI tract with a bioavailabilty of 80-90 % Peak Plasma concentration is acheived in 1-2 hrs. Rapidly absorbed triughout the body and bound to plasma proteins. Elimination half life is 10-11 hours.

Mixed anxiety and depression Panic Disorders Bulmia Nervosa Obessive compulsive disorder Premenstrual dysphoric disorder 20-40mg daily Max 80mg daily