Clinical studies have supported and contradicted the effectiveness of fluoxetine. In the case of HIV-infected patients, fluoxetine had a measurable positive effect. In treating patients with anorexia nervosa, fluoxetine had no measurable effect. Fluoxetine clearly works in some cases, but not in others. Care must be taken in using fluoxetine in the appropriate cases; subjecting a patient to the side effects of fluoxetine with no measurable benefit is undesirable.

At face value, one might jump to the conclusion that popping a pill would be cheaper than partaking in expensive psychotherapy. This proves not to be the case. The study conducted by Antonuccio confirms that CBT is more cost effective than fluoxetine when the time frame is long term. From a managed care perspective, CBT should be the first choice of therapy because it will be the cheapest overall.

Fluoxetine should only be used in cases where its benefits have been clearly documented. Patients should not be subjected to the dangers of fluoxetine unless there is a high probability that they will receive some significant benefit. In cases where fluoxetine has not been well documented as an effective treatment, CBT should be employed. CBT costs less in the long run, has no physiological side effects, and has a longer average relapse period. Only in cases where CBT is not effective should fluoxetine be used, but only then if it is used concurrently with CBT.

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