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Fluoxetine: Effective Symptom Management for Mood and Anxiety Disorders - Evidence-Based Review
Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), stands as one of the most extensively studied and prescribed antidepressants globally. Initially approved by the FDA in 1987, it has fundamentally reshaped the landscape of psychiatric pharmacotherapy. Its significance extends beyond major depressive disorder, with robust evidence supporting its use across a spectrum of conditions from obsessive-compulsive disorder to premenstrual dysphoric disorder. The molecule’s unique pharmacokinetic profile, including a long half-life and an active metabolite, contributes to both its therapeutic benefits and its distinctive side effect and discontinuation syndrome profile.
abilify
Aripiprazole, marketed under the brand name Abilify, represents a significant advancement in the atypical antipsychotic class with its unique pharmacodynamic profile as a partial dopamine agonist. Unlike traditional antipsychotics that function primarily as dopamine antagonists, Abilify’s mechanism provides a stabilizing effect on dopaminergic and serotonergic systems, making it particularly valuable for conditions characterized by both hyperdopaminergic and hypodopaminergic states. We initially approached this compound with skepticism—another “me-too” antipsychotic, or so we thought during early team discussions.
amitriptyline
Amitriptyline is a tricyclic antidepressant (TCA) that has been a cornerstone in psychiatric and pain management for decades. Initially developed in the 1960s, it remains widely prescribed off-label for chronic pain conditions, migraine prophylaxis, and various neurological disorders, despite the development of newer drug classes. Its multifaceted mechanism involving serotonin and norepinephrine reuptake inhibition, along with anticholinergic and antihistaminic properties, creates a unique therapeutic profile that newer selective agents often can’t match.
bupropion
Bupropion represents one of the more fascinating psychotropic agents in our modern arsenal—an atypical antidepressant that defies easy classification. Unlike the SSRIs that dominated the 1990s, bupropion operates through a completely different pathway, acting primarily as a norepinephrine-dopamine reuptake inhibitor (NDRI) with minimal serotonergic activity. This unique mechanism not only explains its distinct side effect profile but also its expanding off-label applications beyond major depressive disorder. I remember when we first started using it more regularly in our practice back in the early 2000s—we had this 42-year-old patient, Mark, who had failed two previous SSRI trials due to sexual side effects and weight gain.
celexa
Celexa, known generically as citalopram hydrobromide, is a selective serotonin reuptake inhibitor (SSRI) antidepressant medication, not a dietary supplement or medical device. It’s prescribed primarily for major depressive disorder (MDD) but has several off-label uses. The drug works by increasing serotonin levels in the brain, which helps improve mood, sleep, appetite, and energy levels. Available in tablet and oral solution forms, it requires a prescription and careful medical supervision due to potential side effects and drug interactions.
coreg
Carvedilol, marketed under the brand name Coreg, represents a significant advancement in cardiovascular pharmacotherapy as a third-generation non-selective beta-blocker with additional alpha-1 adrenergic blocking properties. This unique dual mechanism distinguishes it from earlier beta-blockers and expands its therapeutic applications beyond conventional beta-blockade. Initially developed for hypertension management, carvedilol’s clinical utility has expanded to include heart failure with reduced ejection fraction, post-myocardial infarction management, and certain arrhythmias. The drug’s ability to simultaneously block β1, β2, and α1 receptors creates a hemodynamic profile that reduces peripheral vascular resistance while maintaining cardiac output—a distinct advantage over traditional beta-blockers that can reduce cardiac output through pure negative inotropic effects.
dapoxetine
Dapoxetine is a short-acting selective serotonin reuptake inhibitor (SSRI) specifically developed for the treatment of premature ejaculation (PE) in men aged 18-64 years. Unlike conventional SSRIs used for depression that require weeks of daily dosing to exert effects, dapoxetine’s rapid absorption and elimination profile makes it uniquely suited for on-demand use approximately 1-3 hours before anticipated sexual activity. The medication represents the first and only oral treatment approved specifically for PE in many countries, addressing a condition that affects approximately 20-30% of adult males globally and significantly impacts quality of life and relationship satisfaction.
DDAVP Spray: Effective Management of Diabetes Insipidus and Bleeding Disorders - Evidence-Based Review
Desmopressin acetate, more commonly known by its brand name DDAVP, is a synthetic analogue of the natural hormone arginine vasopressin. It’s primarily administered as a nasal spray for conditions involving water balance regulation and bleeding disorders. This monograph will explore its formulation, mechanism, and clinical applications in depth. 1. Introduction: What is DDAVP Spray? Its Role in Modern Medicine DDAVP spray represents a significant advancement in endocrine and hematological therapeutics. As a synthetic analogue of vasopressin, it mimics the action of the natural antidiuretic hormone while having minimal pressor effects.
dilantin
Phenytoin, known widely by its brand name Dilantin, is one of those foundational antiepileptic drugs that every neurologist and emergency physician has a deep, almost personal, relationship with. It’s a hydantoin derivative, a sodium channel blocker that’s been stabilizing neuronal membranes and preventing the spread of seizure activity since the 1930s. We’re talking about a drug that’s saved countless lives, but it’s also one that demands respect due to its narrow therapeutic index and complex pharmacokinetics.