Prozac: Fluoxetine

About Antidepressants

Depression is caused by a chemical problem in the brain. Doctors don't fully understand why depression happens. But they have discovered that three brain chemicals, called norepinephrine, dopamine, and serotonin, influence people's moods. People who are depressed often feel better when they take medicine that affects these chemicals. Many of the same medicines can also help people with other problems, including anxiety and obsessive-compulsive disorder.

How Prozac: Fluoxetine Works

Prozac: fluoxetine acts primarily on serotonin. Normally, brain cells release serotonin into the spaces between cells. Receptors on nearby cells detect the serotonin. Meanwhile, the cells that released the serotonin continually reabsorb it as part of an ongoing cycle. People who are depressed may not make enough serotonin.

Prozac slows down the reuptake of serotonin back into the brain cells. When reuptake is slowed, more serotonin stays in the spaces between the cells and the receptors "see" an amount similar to what is normal. Drugs like Prozac are called "selective serotonin reuptake inhibitors," or SSRIs.

Prozac for Depression

Prozac: fluoxetine is not for people who occasionally feel sad or blue. It's a treatment for people whose lives are affected by ongoing or recurring depression. Symptoms of depression include:

• Feeling down, "blue," "low," or sad most of the day on most days for at least two weeks at a time
• Not enjoying activities that used to be fun or interesting
• Losing or gaining weight without meaning to
• Having trouble sleeping or sleeping too much
• Feeling tired much of the time
• Feeling worthless or guilty
• Feeling unable to think clearly, concentrate, or make decisions
• Thinking often about dying or thinking about committing suicide

Prozac is not the only treatment available to help with depression. There are other SSRIs, other types of drugs, and various types of counseling. If you think you are depressed, talk to your doctor. If you are feeling suicidal, you should seek medical help immediately.

Prozac for Other Disorders

Prozac is also approved to treat obsessive compulsive disorder, bulimia, and panic disorder.

• Obsessive Compulsive Disorder (OCD). People with OCD have repetitive thoughts or impulses that they can't control. For example, the person might wash his or her hands dozens of times a day, even though he or she understands that it's not necessary.
• Bulimia. Bulimia is the uncontrolled binge eating of large amounts of food over a short time. Some people with bulimia force themselves to vomit after eating.
• Panic Disorder. Panic Disorder involves recurrent, unexpected panic attacks, without another explanation, and with ongoing concern about having these attacks or about their implications. Panic attacks are sudden feelings of anxiety, accompanied by physical symptoms like trembling, sweating, dizziness, and a pounding heart.

The drug Sarafem, which treats premenstrual dysphoric disorder (a form of premenstrual syndrome or PMS), is the same medication as Prozac.

Taking Your Medication

Prozac is available as a daily or weekly pill. It usually does not begin to work right away. Doctors tell patients to wait four to six weeks before giving up on this medicine.

Prozac must be taken regularly. Taking an occasional pill won't help. Most doctors will prescribe this medicine for six months to one year at a time. People who become depressed again after stopping the medicine, or who have their OCD, bulimia, or panic disorder return, may need to continue on Prozac or a similar medicine for life.

Side Effects

Prozac tends to have more side effects than some of the newer SSRIs, although all of them can have side effects. Some people will notice:

• Nausea
• Trouble sleeping
• Sexual dysfunction, such as a lack of interest in sex or the inability to have an orgasm
• Tremors
• Weight loss or loss of appetite

You can find a more complete list of side effects and cautions at the Fluoxetine page of Medline Plus.

Prozac seems to increase the risk of suicide in children and teenagers under certain circumstances. Parents should discuss the risks and benefits with their child's doctor.

Prozac and Addiction

Some people consider this drug addictive because stopping Prozac: fluoxetine abruptly can cause uncomfortable symptoms such as agitation, confusion, headache, or nausea. If you are taking this medicine your doctor will probably have you reduce the dose gradually before stopping.

People who are addicted to drugs and alcohol often find that treatment for depression or anxiety helps them on the path to recovery. Used correctly, SSRI's can be a part of this treatment.

For More Information

• Prozac.com, the manufacturer's web site.
• The Fluoxetine page at MayoClinic.com.
• The Fluoxetine page at Medline Plus.