The purpose of this report is to research the facts surrounding the antidepressant drug fluoxetine, as well as outline how fluoxetine may influence a student’s education and school life. Education is an essential step in life and a step that much of the world’s population goes without. By teaching individual’s science, math, English, humanities etc., we are influencing them to affect change in the world or to follow life aspirations, whether that may be solving world hunger and poverty or getting a PhD in biochemistry and following on to become a surgeon. The opportunities and possibilities of education are endless. Education is fundamental in our growth as a society and helps us to understand who we are, how we came to be and perhaps what our purpose is.

This report will include a description of how fluoxetine is made which will include the drugs starting product and finishing product. A close look at the drugs basic chemical properties, how fluoxetine enters the bloodstream and what organs it interferes with. As well as a thorough description of how the drug affects education, how depression can affect a student’s schooling and what side effects can either improve or worsen concentration in the classroom.

Background

Fluoxetine works as a selective serotonin reuptake inhibitor (SSRI) it is used for severe mental disorders ranging from depression, bipolar disorder, bulimia nervosa, panic disorder, obsessive compulsive disorder (OCD), premenstrual dysphoric disorder. Fluoxetine sometimes is also used to treat cases of PTSD (post-traumatic stress disorder) as well as severe alcoholism and borderline personality disorder. It was first introduced in 1987 after several testings with the FDA (food and drug administration medical oncology). Doctors began to prescribe their depressed patients with fluoxetine and were shocked with how well the results were. Fluoxetine became a new fast achieving antidepressant. 

There are numerous chemical pathways that can be taken to produce fluoxetine, however all fluoxetine pathways are complicated but can be broken down into steps. To begin, the synthesis has a starting product of 3-dimethylaminopropiophenone, this then gets reduced (gains electrons from) with diborane that has been chlorinated with thionyl chloride. After this it is condensed (changes vapour into liquid) with 4-trifluoromethylphenol, it then goes through a stage of demethylation which strips the molecule of its methyl group (CH3). Cyanogen bromide and potassium hydroxide in ethylene glycol is used for the demethylation process, finally fluoxetine is the ending product. 

The molecular structure of fluoxetine is 17 carbons, 18 Hydrogen, 3 fluorine, 1 nitrogen and 1 oxygen and Its molecular mass sits at 309.332 g/mol (grams per mole). Fluoxetine has a melting point between temperatures of 179-182 degrees C. In terms of the chemical’s solubility, it is soluble in water and dichloromethane. Fluoxetine has a range of functional groups, there is an ether group, an amine group and there are two phenyl groups (benzene rings).


Figure 1.  structure of Fluoxetine retrieved from: https://commons.wikimedia.org/wiki/File:(R)-Fluoxetine_structure.svg

Fluoxetine may only be taken by mouth, however there are a number of ways that it can be administered. There are dosage tablets that can be taken in 10, 20 or 40 mg, immediate-release capsules in enteric coated pellets, or Prozac weekly which is a delayed-release capsule that is taken in 90mg. Most doctors recommend that fluoxetine is taken in a smaller dose to begin with before increasing to a higher dosage. This is so the body can develop awareness of the drug and take time to get used to it. Around eighty percent of fluoxetine is absorbed by the gastrointestinal tract before it interferes with the liver where the drug is metabolized or broken down into other compounds that are either excreted in the kidneys, where it becomes waste and no use to the body or it becomes ‘biologically active’. These are called ‘active metabolites’ and fluoxetine has one active metabolite called nor fluoxetine. Nor fluoxetine increases fluoxetine’s half-life (the period of time it takes for a drugs concentration in the body to be reduced by half) significantly making the drug last longer. This means that it can take weeks for Fluoxetine to be fully out of the body’s system.

Serotonin is active in narrowing smooth muscle tissue, transmitting signals between nerve endings and controlling mood balance, this is why when the brain has an imbalance of serotonin it can lead to depression which is where fluoxetine may be used.

Between 80 – 90 percent of the human body’s serotonin is stored in the gastrointestinal tract, it is also found in the central nervous system and in blood platelets. An amino acid called L-TRYPTOPHAN is what produces serotonin.

In our brains we  have neurons that communicate with each other. A synapse occurs between the axon terminal and the dendrites of the receiving neuron, after an action potential reaches the synapse the serotonin will be released by a neurotransmitter. After the providing neuron has released its serotonin, the remaining serotonin is usually absorbed by an uptake pump called the sodium-dependant serotonin transporter (SERT protein). However, fluoxetine blocks that pump off which therefore increases the amount of active serotonin that will be transferred to the receiving nerve cell. This allows the brain to become biochemically balanced. The brain responds to this and within 2-3 weeks the receiving cell will be highly aware and sensitive to the serotonin. At this stage the antidepressant effects will start to take place. 

Discussion

Depression is a crippling mental disorder that is highly common among the adolescent age group. In fact, before they reach adulthood 20 percent of teenagers will be affected by depression. That means in a school of 1000 students 200 of them will suffer with depression, that’s almost a whole year level of kids. So how does depression affect education? It can be a real issue, a student suffering with depression may find it increasingly hard to concentrate which can cause their grades to slowly drop. It may stop an individual from trying their hardest which may mean they stop caring about school completely. Unfortunately, this can create misunderstanding between their peers and teachers which will only worsen the case. By being put on an antidepressant like fluoxetine and going to continual therapy these problems can be turned around, an antidepressant will balance mood and have the individual regain positive thoughts and feelings so that they will once again feel a desired drive and want to succeed. 

Fluoxetine has a range of side effects, some of course that work to improve mental health, but there are others that can cause physical or psychological side effects that may make it hard for a student to concentrate on school. For example, one side effect that could possibly make education harder is insomnia. Fluoxetine has the potential to cause sleeplessness and restlessness which can increase stress and decrease concentration. There have been many reports of fluoxetine causing suicidal thoughts and ironically depression and anxiety, it was previously stated how such mental disorders may affect academics. The horrible factor is that these side effects are more common in young people which means that there is a higher risk for students to worsen their mental health by taking fluoxetine. 

Despite these facts fluoxetine also has the potential to make the life of a depressed student much better, fluoxetine can truly turn a person’s life around. By bringing the chemical balance in the brain back to a stable level, a student in school will be able to learn through the eyes of a mentally healthy person and pull all of their concentration and effort towards school. Although the side effects can be damaging they do vary from person to person. Some may experience none and others may not be so lucky. Either way most fade off after undergoing the treatment for a while. Fluoxetine is like all pharmaceutical drugs, it has pros and cons which balance each other out. Whether it is wise or not for a student to be under the influence of fluoxetine completely comes down to an individual’s opinion.   

Conclusion

Throughout the entirety of this report the background of fluoxetine was uncovered and its overall effect on mental health was discussed. The chemical properties were revealed as well as the drugs pathway, how it enters the bloodstream as well as what organs it interferes with as it passes through the body. The effects on education were discussed and how it can either diminish or improve the concentration in school. One may say that this debate ended in a stalemate as whether fluoxetine is a wise choice for high school students or not comes down to opinion. It was seen that although fluoxetine can have dangerous and possibly life threatening effects it is balanced out by the way it can improve and completely turn a person’s life around in a positive way. Fluoxetine effects the brain by balancing the chemicals to increase the release of certain hormones to improve mental health and it affects education in both damaging and reviving ways. Overall fluoxetine has a lasting effect that can either change a person’s life for the better or for the worse.

Public Education Piece

My public education piece is a poster to advise the general public of the information learned during this research assignment.

References

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