Which medications in the drug class Antidepressants are used in the treatment of CREST Syndrome?

Updated: Oct 05, 2020
  • Author: Jeanie C Yoon, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Antidepressants

This class is for the treatment of Raynaud phenomenon.

Fluoxetine (Prozac)

Fluoxetine selectively inhibits presynaptic serotonin reuptake with minimal or no effect in the reuptake of norepinephrine or dopamine. It may cause more adverse GI effects than other SSRIs now currently available, which is the reason it is not recommended as a first choice.

Fluoxetine may be given as a liquid and a capsule. It may be given as 1 dose or in divided doses. The presence of food does not appreciably alter levels. Because of its long half-life (72 h), it may take up to 4-6 weeks to achieve steady state levels.

The long half-life is an advantage and a drawback. If it works well, an occasional missed dose is not a problem; if problems occur, eliminating all active metabolites takes a long time. The choice depends on adverse effects and drug interactions. Adverse effects of SSRIs seem to be quite idiosyncratic; thus, relatively few reasons exist to prefer one to another at this point if dosing is started at a conservative level and advanced as tolerated.


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