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Overview
Prozac was the first of a new generation of antidepressants to come on the market. It works by enhancing the action of a brain chemical called serotonin.
In a few short years this drug has become so popular that, in addition to becoming the most prescribed antidepressant on the physicians' hit parade of drugs, it has become a household name.
Prozac has been featured on the covers of newsmagazines and has even been the subject of a best-selling book (Listening to Prozac).
This success comes largely because Prozac is less likely to cause typical side effects associated with older medications.
Tricyclic antidepressants like Elavil, Tofranil, Sinequan and Pamelor can produce dry mouth, constipation, dizziness, weight gain, and a sluggish or lethargic feeling. Prozac does not.
If anything, it has a slight stimulant action.
Prozac is used in the treatment of depression; it is also approved for treating obsessive compulsive disorder.
Psychiatrists continue to experiment with the use of this medication for eating disorders and other problems.
Side Effects and Interactions
Side effects associated with Prozac include headache, nervousness, agitation, insomnia, tremor, fatigue, rash, lightheadedness, drowsiness, dizziness, depersonalization, nausea, upset stomach, diarrhea, loss of appetite, stomach pain, sweating and dry mouth.
Somewhat less common adverse reactions include impaired concentration and memory, weird dreams, lowered libido, loss or delay of orgasm, abnormal ejaculation, dry skin, constipation, hair loss and itching. Report any symptoms to your physician promptly.
Uncommon but very serious side effects to be alert for are rash with flulike symptoms such as chills, fever or sore throat, anemia, breathing problems, severe allergy, or seizures.
Prozac interacts with a number of other medications. Anyone taking other antidepressants, especially drugs such as Nardil, Marplan or Parnate should stop such a medicine at least two weeks before starting on Prozac.
If Prozac was taken first, five weeks should elapse before starting on one of these other medicines, because Prozac can last in the body a long time.
Tricyclic antidepressants like Elavil or Tofranil and even Anafranil for obsessive-compulsive disorder may have stronger actions and more pronounced toxicity when they are combined with Prozac.
If such a combination is prescribed, the physician should monitor blood levels of the medications.
The same is true of the antipsychotic drug Haldol.
If the amino acid tryptophan ever becomes available in this country again, it should not be taken with Prozac, as it may increase the potential for adverse reactions.
Other compounds that could cause complications in combination with Prozac include lithium, Coumadin, Lanoxin and Valium (or similar medications such as Dalmane, Halcion or Klonopin).
Interactions between the herb St. John's wort and Prozac are possible. Switching between antidepressants and herbal treatment calls for medical guidance (physicians can find a suggested protocol for gradual substitution of St. John's wort in Hyla Cass's book, St. John's Wort: Nature's Blues Buster).
Check with your pharmacist and physician before taking any other medicines or herbs.
Special Precautions
Some people may need very close monitoring if the doctor prescribes Prozac.
Because this drug may cause anxiety, nervousness and insomnia in a substantial number of people, those with a predisposition to such conditions need to alert their physicians if such symptoms are aggravated by Prozac.
Patients with kidney disease, diabetes, liver problems or a history of seizures also require careful monitoring while they are taking Prozac.
People with a history of suicide attempts must also be extremely vigilant. There have been reports that some people may develop a preoccupation with suicide or violence while taking Prozac.
It is still not certain whether this is caused by the underlying mental condition or is in some way related to the drug.
Family members must help monitor people on Prozac for suicidal thoughts or self-destructive behaviors. The doctor must be notified immediately in such cases.
Taking the Medicine
According to the manufacturer, you can take Prozac with or without food.
If it upsets your stomach you may find that swallowing Prozac with meals may be helpful.
I have been taking fluoxetine at 40mg/day for 4 months now, and I can't believe the difference I have seen in myself and others have seen in me. It really has given me back my life, and I would strongly recommend this drug to anyone suffering from severe depression. I only experienced a few side effects. The worst one that I have experienced, sadly, is loss of orgasm. It's frustrating and it sucks, but I have a wonderful husband who completely understands (and who also takes an anti-depressant), and the benefits of the drug still outweigh the side effects for me. However, I am also on a strong narcotic, and this also contributes to not being able to reach orgasm. So I am double whammied. Anyone else experience the same thing on Fluoxetine?
My 16 year old son took his life after taking fluoxetine 20mg (by TEva) for 43 days. A friend of his later told me that my son had confided in him & told him the medication (the only medication he was on) made him feel like a different person who didn't care about anything anymore, not even living. We were never told of the Black Box Warning on SSRI's (for people under the age of 24yrs) Not the Dr. nor the Pharmacy said a thing.. after contacting the F.D.A., I learned about the high suicide rates for teens on fluoxetine, more than all the other SSRI's combined. My son had no previous suicide attempts or ideations.. Beware of this drug if you are within this age group!
My dr prescirbed this med to me knowing about the migraine meds and elavil that I also take for chronic pain--when I picked up the rx the pharmacist told me not to take it cause taking with zomig-maxalt-etc.. can cause fatal heartbeats--make sure to tell your dr all meds and have the cross reference before they write the rx .
I have been taking Prozac since 1990 and have had excellent results. My insurance company INSISTED I change to the generic of Prozac. After about 3-4 weeks my family started to notice a difference in my behavior and asked if I had stopped taking my medicine. I had noticed I was feeling "down" more often and it was a fight to bring myself back "up" and get everyday things accomplished. I also found I began to have serious thoughts of just "ending it all". Something I hadn't had for years.
I thought it was just a tough period I was going through for some reason. I never thought my body was not responding to the generic drug. I spoke with my doctor and she suggested I try the brand name Prozac for a few weeks to a month and see how I felt. After about 2 weeks I noticed a remarkable difference in my outlook and my family said they noticed that I was more like my "normal" self again.
Since this time, my insurance has made errors and my doctor's office has concurred with their requests to change my medicine to the generic -- 3 times. I now have my file marked in YELLOW AND ORANGE HIGHLIGHTS that there is to be NO SUBSTITUTIONS. MUST HAVE THE BRAND NAME. Although I have heard from many people that generics are exactly the same as the brand name drugs -- in this case for me the generic was like taking nothing at all. I DO take generics whenever possible, but this is one medication I refuse to ever change again. Life with chronic depression is no fun, and life-threatening for me.
I have taken Prozac for almost 10 years and just lately realized I do not care about anything anymore. I don't answer my phone, do not care how I look or how much weight I gain....I think it all goes back to my taking Prozac for so long. I am afraid to stop taking it because I am afraid to care about things now.
I have been on Prozac since 1999, now that there is a generic I have been taking that one. I have noticed a dramatic change in the way I feel...I have a heavy head and have a hard time concentrating and keeping my train of thought, I forget things and feel like I am functioning in a out of focus world. Unfortunately my insurance doesn't cover the nongeneric brand. Is it possible that taking generics is different than the name brand?
The generic form of Prozac (called fluoxetine hydrochloride) does NOT WORK NEARLY AS WELL AS THE ORIGINAL! And it tastes like melted plastic as soon as it hits your saliva...it's awful. God forbid it starts to dissolve in your esophagus and back up into your throat. It is a terrible feeling and I had to race home at high speeds in my car to drink some milk to wash down the medicine. Almost did me in. Spend the extra money and get the real thing folks!
I have been taking generic fluoxetine for 6 months now and have noticed a HUGE difference between generics. The fluoxetine made by Barr pharmaceuticals is awful! It tastes like rotton eggs and is about as effective as taking a placebo. My depression was back, I couldn't think straight, and my anger problems were back too.
But the other generics I've taken of fluoxetine worked fine. I think the Barr version of fluoxetine is inferior to all fluoxtetines made, which is weird, because they were the first to manufacture generic Prozac. You think they would have gotten it right by now, or maybe they have just recently gotten careless with their manufacturing processes.
Sometimes when I take my Prozac I get incredible stomach upset. Have you ever tasted the powder inside the capsule? It feels like it's burning a hole through your tongue. No wonder my stomach is upset.
Generic SSRI's do not work. Prozac, Paxil, Zoloft, ect. I have not used them in my psychiatric practice for 4 years.
H. Wagemaker, MD
i have been taking fluoxetine for 3 weeks now and have been finding it very difficult to climax, something that has never been a problem before! i am gutted! its reassuring to hear i am not the only one!
Is there a way to find out which generic company makes the closest equivalent to the original FLUOXETINE HYDROCHLORIDE? The generics I have been getting DO NOT WORK and I don't have insurance so I'm hoping to find a generic that will work as well as the original did. I have found the FDA Orange Book but am unsure as to what to look for there. Thank you for any help you can give.