Which of the following SSRIs is indicated as a strong CYP2D6 inhibitor?

Fluoxetine is recognized as a strong inhibitor of the CYP2D6 enzyme. This characteristic is important for healthcare providers to consider because CYP2D6 plays a crucial role in the metabolism of various drugs, including many antidepressants and other psychiatric medications. By inhibiting this enzyme, fluoxetine can lead to increased levels of co-administered medications that are also metabolized by CYP2D6, potentially resulting in enhanced efficacy or increased risk of side effects from those medications.

In the context of pharmacotherapy, understanding the interactions that can arise from such inhibition is essential for patient safety and effective treatment planning. For instance, clinicians must monitor for signs of toxicity or therapeutic failure in drugs metabloized by CYP2D6, if they are co-prescribed with fluoxetine.

Citalopram, escitalopram, and duloxetine have varying effects on CYP2D6, but they do not exhibit the same level of inhibition as fluoxetine. Citalopram and escitalopram are considered to have minimal or no significant inhibition of CYP2D6, while duloxetine is a moderate inhibitor. Therefore, fluoxetine's strong inhibitory effects distinguish it in this context, making it the correct choice in identifying a strong CYP2D