MAOIs must be discontinued at least how many days before starting Fluoxetine?

The correct answer is based on the need to avoid potentially dangerous interactions between monoamine oxidase inhibitors (MAOIs) and selective serotonin reuptake inhibitors (SSRIs) like fluoxetine. MAOIs can greatly increase serotonin levels in the brain, and when combined with fluoxetine, this may lead to serotonin syndrome, a potentially life-threatening condition characterized by symptoms such as agitation, confusion, rapid heart rate, and increased blood pressure.

To safely switch from an MAOI to fluoxetine, the recommendation is to have a washout period of 14 days. This duration allows the effects of the MAOI to diminish adequately and serotonin levels to return to a safer baseline, minimizing the risk of adverse reactions when fluoxetine is introduced.

The other options represent shorter washout periods that do not sufficiently ensure the reduction of MAOI's effects, thereby increasing the risk of serotonin syndrome if fluoxetine is started too soon after discontinuing MAOIs. This understanding of the required washout period is crucial for safely managing patient transitions between these classes of antidepressants.