Mr X suffering from depression is currently on Fluoxetine (Prozac) therapy. Which of the following side effects does the nurse need to suspect in the client?

Appeared in: UPUMS Nsg officer-2023

Explanation

Fluoxetine (Prozac) is a Selective Serotonin Reuptake Inhibitor (SSRI), a first-line treatment for depression.
A primary and very common side effect of all SSRIs is sexual dysfunction, which includes decreased libido (reduced sexual desire), delayed orgasm, or anorgasmia.
This effect is attributed to the increased levels of serotonin in the central nervous system, which can interfere with the pathways that control sexual response.
Because sexual side effects are a major reason for patients stopping their medication, it is a critical assessment point for nurses.

Why Other Options Were Wrong

Option A: SSRIs like fluoxetine are known to suppress libido, not increase it.
Option B: Urinary incontinence is not a recognized or common side effect of fluoxetine.
Option D: This is a classic anticholinergic side effect. SSRIs like fluoxetine have minimal to no anticholinergic properties.

Related Visual

Clinical Relevance

Nursing practice connection: Use the key finding related to Pharmacology: Side effects of Selective Serotonin Reuptake Inhibitors (SSRIs) to guide bedside assessment, documentation, and the next nursing action.
Nurses must proactively and sensitively assess for sexual dysfunction, as it is a leading cause of non-adherence to antidepressant therapy, which can lead to relapse of depression.
Educating the patient that these side effects are common and manageable can encourage them to report issues rather than abruptly stopping the medication.
What if? If the patient were taking amitriptyline (a TCA) instead of fluoxetine, the nurse's primary concern for side effects would shift to anticholinergic effects like dry mouth, constipation, blurred vision, and urinary retention.

How to Approach the Question

First, identify the drug mentioned in the question: Fluoxetine (Prozac).
Next, classify the drug based on your pharmacology knowledge. Fluoxetine is a Selective Serotonin Reuptake Inhibitor (SSRI).
Recall the common side effect profile for the SSRI class. The name itself tells you it affects serotonin, which is linked to mood, but also gut function and sexual response.
Evaluate each option against the known side effects of SSRIs. Sexual dysfunction (decreased libido, anorgasmia) is a hallmark side effect.
Eliminate the distractors. Increased libido is the opposite of the known effect. Urinary retention is a classic anticholinergic effect, strongly associated with older Tricyclic Antidepressants (TCAs), not SSRIs.

Concept Tested & Keywords

Concept Tested: Pharmacology: Side effects of Selective Serotonin Reuptake Inhibitors (SSRIs)
Stem keywords: depression, Fluoxetine, Prozac, side effects
Lead-in keywords: suspect

Question ID

Q44NAwDyF61IRym8bRFRGH

Reference Book

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 6575-6577, 6574-6576

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 1983-1985

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