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Thus, it was suggested that fluoxetine can regulate estrogen synthesis/signaling and cause dysregulation of the estrous cycle, thereby causing sexual dysfunction (Figure 3) ( Figure 3) ( 5 Effects of SSRIs on the reproductive system of aquatic organisms SSRIs are a major class of drugs of environmental concern, and fluoxetine, a psychoactive agent, is one of the best-selling prescription antidepressants in the world, which increases the likelihood of aquatic environmental contamination through municipal, industrial, and hospital discharges, potentially inducing sublethal effects in non-target species

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