Medication and Treatment Reviews

Prozac

Generic Name: Fluoxetine hydrochloride

Uses

Prozac is a selective serotonin reuptake inhibitor (SSRI) medication taken orally that is primarily used to treat major depressive disorder (MDD) in patients over age eight. It can help relieve the sadness, difficulty sleeping, and changes in appetite and mood associated with depression. Physicians may recommend a reduced dose for adults over age 65.

Prozac can also be used to treat obsessive-compulsive disorder (OCD) in patients over age seven, bulimia nervosa in adults, and panic disorder in adults. Prozac can be used in combination with olanzapine to treat depressive episodes that come with Bipolar I Disorder, and treatment-resistant depression in patients over age 10.

How to Use Prozac

Before starting or refilling a Prozac prescription, read the medication guide included with your pills, as it may be updated with new information.

This guide should not replace a conversation with your doctor, who has a holistic view of your medical history, other diagnoses, and other prescriptions. If you have questions, ask your doctor or pharmacist before you begin taking the medication.

Dosage

As with all medications, follow your Prozac prescription instructions exactly. The optimal dosage varies by condition treated, age, and patient health. If you are over 65 years of age, or have certain health conditions, your doctor may recommend a lower dosage.

Prozac is available in two formulations:

  • Pulvules: Available in 10mg, 20mg, and 40mg doages. Taken orally with or without food, once or twice daily.
  • Weekly Capsules: Available in 90mg dosage. Taken orally with or without food, once weekly.

Patients should experience some improvement in symptoms within the first one to two weeks, but full effectiveness may not be reached for up to five weeks.

Your doctor may incrementally adjust your daily dosage until you experience the best response – that is, until you find the lowest dosage at which you experience the greatest improvement in symptoms without side effects.

Limit your use of alcohol while taking this medication.

When discontinuing treatment, or decreasing dosage, patients should work with a doctor to gradually taper the level of medication. Stopping Prozac suddenly can create serious symptoms including anxiety, irritability, changes in mood, feelings of restlessness, difficulty sleeping, headache, sweating, nausea, dizziness, electric shock-like sensations, shaking, or confusion.

Side Effects

The most common side effects of Prozac are similar to those associated with other SSRIs, like Lexapro, and are as follows: nausea, weakness, dizziness, feeling anxious, difficulty sleeping, sexual problems, sweating, shaking, change in appetite, dry mouth, flu symptoms, hot flashes, and rash.

Children and adolescents may experience increased thirst, muscle spasm, nose bleeds, frequent urination, heavy menstruation, or slowed growth rate or weight gain. People with diabetes may have difficulty controlling blood sugar, and need to adjust treatment when starting or stopping Prozac.

Other serious side effects include increased risk of suicidality or manic episodes, high fever, uncontrolled muscle spasm, stiff muscles, rapid heart rate, confusion, or fainting. Contact your doctor immediately if you experience these symptoms. Patients should be monitored and observed closely for worsening depression, changes in behavior, or suicidality, especially when starting treatment or changing dosage.

Taking Prozac may impair your ability to drive, operate machinery, or perform other potentially dangerous tasks. This side effect usually wears off with time. If side effects are bothersome, or do not go away, talk to your doctor.

Most people taking this medication do not experience any of these side effects.

Disclose to your physician all mental health issues including any family history of suicide, bipolar disorder, mania, or depression. The FDA recommends evaluating patients for bipolar disorder prior to the administration of Prozac to avoid inducing a manic episode. Prozac may create new or exacerbate existing behavior problems, bipolar disorder, or suicidal ideation, especially in the first few months of treatment or after a dosage change. Call your doctor immediately if you experience new or worsening mental health symptoms including reckless behavior, panic, or sudden excessive happiness or irritability.

Prozac increases serotonin levels in the brain, and can rarely lead to life-threatening serotonin syndrome, or toxicity. If you experience changes in mental status, coordination problems, muscle twitching, racing heartbeat, high or low blood pressure, sweating, vomiting or diarrhea, seek medical help immediately.

Discuss any bleeding disorders or irregular sodium levels with your doctor. Prozac can cause abnormal bleeding for some patients, and low salt concentration in the blood. The elderly may be at greater risk for these problems.

The above is not a complete list of potential side effects. If you notice any health changes not listed above, discuss them with your doctor or pharmacist.

Precautions and Safety

Store Prozac in a secure place out of the reach of children, and at room temperature. Do not share your Prozac prescription with anyone, even another person with depression or anxiety. Sharing prescription medication is illegal, and can cause harm.

You should not take Prozac if you have an allergy to fluoxetine hydrocholoride or any of the other ingredients in Prozac.

You should not take Prozac if you have taken a monoamine oxidase inhibitor (MAOI) within five weeks; as this can cause a serious, even life-threatening reaction.

You should not take Prozac if you are taking the antipsychotic medication Orap or Mellaril (thioridazine), or have taken it within five weeks, because it can cause serious heart rhythm problems or even death.

You should use caution when taking any SSRIs, including Prozac, and speak with your doctor if you have liver or kidney problems, heart problems, glaucoma, seizures, bipolar disorder, low blood sodium levels, a history of stroke or high blood pressure, or a history of bleeding problems.

If you’re thinking of becoming pregnant, discuss the use of Prozac with your doctor. It is not known if Prozac can cause fetal harm during pregnancy. It is recommended that mothers do not nurse while taking Prozac, as its safety for infants is unknown, and Prozac passes into breastmilk.

Interactions

Before taking Prozac, discuss all other active prescription medications with your doctor. Prozac can have a dangerous, possibly fatal, interaction with antidepressants including MAOIs, the antipsychotic medication Orap, and Mellaril (thioridazine).

Taking Prozac while taking blood thinners like Coumadin, ibuprofen, or aspirin can increase the risk of abnormal bleeding. Using Prozac concurrently with medication that increases serotonin – like St. John’s wort, SSRIs, tryptophan, or street drugs like MDMA – can increase the risk of serotonin syndrome.

Prozac can impact how your body processes certain drugs including atomoxetine, other antidepressants, cimetidine, fentanyl, metoprolol, pimozide, procyclidine, and tamoxifen. This may affect how they work.

Share a list of all vitamin or herbal supplements, and prescription and non-prescription medications, you take with the pharmacist when you fill your prescription, especially any drugs that cause drowsiness. Let all doctors and physicians know you are taking Prozac before having any surgery or laboratory tests.

The above is not a complete list of all possible drug interactions.

Sources:

http://www.accessdata.fda.gov/drugsatfda_docs/label/2017/018936s108lbl.pdf#page=28
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c88f33ed-6dfb-4c5e-bc01-d8e36dd97299

 

8 reviews

  1. My 9-year-old daughter had a lot of anxiety also so our psychologist prescribed Prozac. She was already on Daytrana but the addition of the Prozac was wonderful. She became a new person, more confident, more outgoing etc. The only thing you have to watch for is that if you get too much Prozac, it cancels out the effects of the Daytrana. Then she does not pay attention or focus enough. So we sat her down and told her that she needs to make sure she is paying attention in school. The meds only do so much, she still has to learn to control herself. The pills are not magic…so she now makes more of an effort to pay attention in school and the 2 medicines are working wonders every day. She would not be where she is today without the medicines, she can’t do it on her own.

  2. My son tried Prozac and it made him off the wall hyper! I’ve never seen him so wound up. He was fearless, hyper, could not sit still. He was as happy as can be, but he was just always on the move. It almost wasn’t safe. It helped his mood tremendously, but we’ll never try it again.

  3. My son reacted so badly to Prozac we almost had to call the police a few times, and my son is NOT aggressive. On Prozac he had violent outbursts, was angry all the time, ended up with major suicidal ideation. When he stopped taking it after 3 weeks, he continued to have violent outbursts for nearly a month, and two episodes that seemed to be possible seizures or were at least like that.
    I’m not trying to scare you. We got through it, but barely. My son has very severe and rare reactions to anti-depressants.

  4. My daughter has ADHD and anxiety/depression and started taking Prozac a few months ago. I liked it because of the limited side effects and it stays on the system. So if she misses a day it doesn’t affect her. The initial starting of it takes a little longer but I think the long-term results were worth it.

  5. We have used Prozac to specifically reduce anxiety that already exists in my child but is heightened with the use of a stimulant medicine to treat ADHD. It has been extremely helpful for my child. My son feels a huge difference since he has been taking it We do combine behavioral therapy so that he can learn to manage his anxiety in thoughtful ways as well. Both go hand-in-hand.

  6. My 9-year-old son has been on Prozac since he was 5 years old. It has kept him from being on a roller coaster all day, and believe me I know when he has not had his medication.

  7. My 7-year-old daughter was diagnosed with both ADHD and anxiety and multiple learning disabilities last fall. After trying two other medications, she is on Focalin for the ADHD. She did pretty well for awhile and then over the past few week she began to get more and more angry, temperamental, frustrated and just irritable. She has been nearly unmanageable after school. We went to the psychiatrist and he switched her to Daytrana patch to try to prevent a drop in the stimulant that he believed we were seeing with the Focalin and adding Prozac for the anxiety. Initially, it decreased her anger, frustration and outbursts greatly; it sort of mellowed her out and she seemed more relaxed. However, she has been acting increasingly bizarre, “manic”, and beyond impulsive. According to her teachers, she has regressed and has absolutely no ability to “attend” in class since starting the new meds.

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