It is frequently used to treat major depressive disorder, obsessive compulsive disorder (OCD), post traumatic stress disorder (PTSD), bulimia nervosa, panic disorder, premenstrual dysphoric disorder, and trichotillomania. It has also been used for cataplexy, obesity, and alcohol dependence, as well as binge eating disorder.

Fluoxetine seems to be ineffective for social anxiety disorder.
Studies do not support a benefit in children with autism, though there is but tentative evidence for its benefit in adult autism.

Fluoxetine is considered a first line medication for the treatment of impulsive aggression of low intensity. It reduced low intensity aggressive behavior in patients in intermittent aggressive disorder and borderline personality disorder. Fluoxetine also reduced acts of domestic violence in alcoholics with a history of such behavior.

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