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Fluoxetine's chemistry is similar to diphenhydramine, but its pharmacological activity is very different. Its structure is unique among other antidepressants. However, like other SSRIs, fluoxetine appears to target the serotonin transporter, thereby inhibiting serotonin reuptake. Fluoxetine's inhibition decreases further release of serotonin, inhibits firing in the dorsal raphe nuclei, downregulates serotonin autoreceptors, and increases serotonergic transmission in the hippocampus. Fluoxetine does not have clinically significant noradrenergic or dopaminergic activity. Its binding at muscarinic, histaminergic, and alpha-1 adrenergic receptors is minimal and much less than that of TCAs (DeVane 1998).

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