Prozac: Fluoxetine

unhappy girl

Mental health conditions can cause serious problems in mood, thinking, and behavior. The antidepressant fluoxetine, also known by its brand name Prozac, is effective in treating a number of psychological disorders.

How Fluoxetine Works

Fluoxetine is commonly used to treat obsessive-compulsive disorder (OCD), depression, panic disorder, bulimia nervosa, and premenstrual dysphoric disorder (PMDD). It is a selective serotonin reuptake inhibitor (SSRI) and contains the active ingredient fluoxetine. It is believed that lower amounts of the brain chemical serotonin may cause feelings of sadness. Prozac works by boosting serotonin levels to lift your mood while also helping with other problems, such as anxiety and obsessive-compulsive disorder.

Forms and Dosing

Fluoxetine comes in a variety of forms and dosages. This medicine can be taken with or without food. You may be prescribed this medication as a:

  • Capsule
  • Delayed release capsules
  • Tablet
  • Syrup
  • Solution

If you are taking the delayed release capsule, this pill must be swallowed whole. Do not chew, break, or crush the pill because this will alter the release rate. If you are taking the liquid solution, always measure the dose carefully by using the measuring device provided.

Dosing for Conditions

According to UptoDate, an evidence-based clinical decision support tool, the amount of Prozac prescribed will vary depending on the condition being treated.

  • Depression: An initial dose of 5 to 10mg daily may be prescribed to treat your depression. The most common dosage, however, is 20mg daily, normally taken in the morning. Your healthcare provider may gradually increase your dose 20mg at a time after several weeks to a maximum of 80mg a day. Doses larger than 20mg are either given once or twice daily.
  • Bulimia nervosa: You may be instructed to take 60mg of Prozac daily. Your healthcare provider may titrate the dose up to 60mg over several days.
  • Obsessive-compulsive disorder: Generally, an initial dose of 20mg per day is prescribed. Your provider may increase your dose after several weeks if your symptoms are not improving. The recommended range is 20 to 60 mg daily with a maximum dose of 80 mg per day.
  • Panic disorder: You may be prescribed an initial dose of 10mg daily. Your prescription may increase to 20mg daily after several weeks.
  • Premenstrual dysphoric disorder: Known by the brand name Sarafem, you may be instructed to take 20mg every day continuously, or 20mg each day starting 14 days prior to your menstrual period and through the first full day of menses. Dosing starting 14 days prior to your period should be repeated monthly with each cycle.

It is important you take your medication as instructed by your healthcare provider. You should see some improvements in 1 to 2 weeks, but it may take 4 to 5 weeks before you gain the full benefit of the medicine. Do not stop taking your medication. Stopping your antidepressant that has been used for 6 weeks or longer can lead to withdrawal syndrome, a condition that creates nausea, diarrhea, vomiting, or a reduced appetite. Tremors, increased sweating, and headaches can also occur as a result of stopping your medication suddenly. It is important for you and your provider to discuss how to stop using fluoxetine safely. Talk to your healthcare provider if you have questions or concerns about your treatment.

Side Effects

Fluoxetine is safe and effective in the treatment of depression. Many people taking fluoxetine do not experience any side effects, while others may only have minor side effects.

Some common side effects include:

  • Strange dreams
  • Decreased sex drive and trouble having an orgasm
  • Decreased appetite
  • Anxiety and nervousness
  • Weakness
  • Diarrhea
  • Dry mouth
  • Indigestion
  • Flu-like symptoms
  • Erectile dysfunction
  • Trouble sleeping
  • Nausea
  • Sore throat
  • Rash
  • Watery nasal discharge
  • Sleepiness
  • Sweating and hot flashes
  • Tremors
  • Yawning

Rare Side Effects

Although uncommon, some people may experience serious side effects with fluxotene. Adverse side effects may include serotonin syndrome, abnormal bleeding, mania, and low salt levels.

Symptoms include:

  • Agitation
  • Change in balance or coordination
  • Hallucinations
  • woman taking her temperature
  • Fast or abnormal heartbeat
  • Muscle twitching or stiffness
  • Nausea or vomiting
  • Bruising or bleeding more easily than normal
  • Decreased energy
  • Trouble sleeping
  • Racing thoughts
  • Excessive happiness or irritability
  • Seizures
  • Headache
  • Weakness
  • Confusion
  • Problems with memory

Call your doctor and seek medical attention right away if you experience any of these side effects.

According to UptoDate, your initial dose of Prozac may be lower but increased gradually over time to reduce the risk of side effects. If you are on a higher dose of the medication, your provider may also reduce your dose to help alleviate any problems you may be currently experiencing. Dividing doses during the day may also help lessen side effects.

Benefits and Drawbacks

A study conducted in 2004 indicated fluoxetine was effective in treating OCD symptoms, anxiety, and depression. Patients treated with this medication had better depression scores and fewer depression symptoms when compared to patients treated with a placebo drug. Patients taking fluoxetine also had better depression outcomes compared to those taking placebos.

A 2013 study indicated Prozac was as effective as tricyclic antidepressants (TCA) in treating depression. The researchers also noted fluoxetine was better tolerated by study participants when compared to individuals taking TCAs. Some patients stopped taking fluoxetine because of side effects or ineffectiveness at the same rate as other drugs in the SSRI class. When compared with new generation drugs, such as sertraline and mirtazapine, fluoxetine was found to be less effective. Prozac was however, better tolerated than reboxetine.

Medication for Improved Mental Health

Prozac is a drug with a long history. When taken correctly it can improve a number of psychological conditions and help you regain the happy and independent life you once lived.

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Prozac: Fluoxetine