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Fluoxetine + Selegiline

STOP — Contraindicated

FDA contraindication with 5-week washout requirement after fluoxetine discontinuation.

Evidence level: STRONG

What this interaction means

Selegiline and Prozac together can cause fatal serotonin syndrome. A 5-week waiting period is needed after stopping Prozac before starting selegiline because Prozac takes that long to leave your body.

How it works (mechanism)

Selegiline (MAO-B inhibitor) plus fluoxetine (SSRI). FDA contraindication. 5-week washout required after fluoxetine due to long half-life.

Practical advice

Wait at least 5 weeks after your last Prozac dose before starting selegiline. This is not optional — it is a safety requirement.

Timing

Take Fluoxetine at the same time each day — morning is most common to avoid sleep disruption. Selegiline follows its prescribed schedule. SSRIs have a long half-life, so consistency matters more than the exact hour.

Risk factors

Higher risk for: elderly, those on multiple serotonergic drugs, people with liver impairment, CYP2D6 poor metabolizers, recent dose changes, or concurrent use of MAOIs or triptans.

Symptoms to watch for

Severe agitation, high fever, seizures, muscle stiffness, rapid heartbeat, blood pressure crisis, coma

What to tell your doctor

Plan the 5-week washout carefully. Consider switching to a shorter-acting SSRI first if time is a factor. Ensure both prescribers coordinate.

Safer alternatives

Discuss this combination with your prescriber. They may adjust timing, dosing, or switch to an alternative with fewer interaction risks. Never stop an antidepressant abruptly — taper under medical guidance.

Frequently asked questions

Can I take Fluoxetine and Selegiline together?

Selegiline and Prozac together can cause fatal serotonin syndrome. A 5-week waiting period is needed after stopping Prozac before starting selegiline because Prozac takes that long to leave your body.

When should I take Fluoxetine vs Selegiline?

Take Fluoxetine at the same time each day — morning is most common to avoid sleep disruption. Selegiline follows its prescribed schedule. SSRIs have a long half-life, so consistency matters more than the exact hour.

What symptoms should I watch for if I combine Fluoxetine and Selegiline?

Severe agitation, high fever, seizures, muscle stiffness, rapid heartbeat, blood pressure crisis, coma

Are there safer alternatives to combining Fluoxetine with Selegiline?

Discuss this combination with your prescriber. They may adjust timing, dosing, or switch to an alternative with fewer interaction risks. Never stop an antidepressant abruptly — taper under medical guidance.

What should I tell my doctor about taking Fluoxetine and Selegiline?

Plan the 5-week washout carefully. Consider switching to a shorter-acting SSRI first if time is a factor. Ensure both prescribers coordinate.

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