ADHD Medication and Treatment Reviews

Prozac

Generic Name: Fluoxetine hydrochloride

What is Prozac?

Prozac (Generic Name: fluoxetine hydrochloride) 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 for Prozac

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 Associated with Prozac

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 Associated with Prozac

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 Associated with Prozac

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

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