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.

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  1. Sargrith
    UK
    Reply

    Hi. I am 87 and have had several bad anxiety bouts from age 25 to having one currently. I have always struggled with them and often felt desperate leading to panic attacks The physical symptoms have mostly varied although palpitations have always been a factor to a varying degree. Constipation usually a physical symptom.

    I had banging and snapping in my earliest attack at 25 years of age at night in my head. The attacks have varied as a problem from several months to 2 years duration and then only subsided due to medication of Tofranil after the first attack in which I received no help from the doctors at all but did get blank stares. This was in 1950. At that time the average doctor hadn’t a clue how to react and medication for most was nil. However, most of my life for the main has been good. Bouts would only start at times of feeling trapped in a given predicament and could see no easy way out. I inherited it from my father who committed suicide at 44. Wish I’d had more of my mother’s genes! But what I did have has pulled me through life. Thankfully. Anxiety attacks are hell. Depression is a lot more than just feeling fed up as some who know no better think!!

  2. kal
    florida
    Reply

    I was prescribed 20 mg of Prozac in early august, went back in to see my dr in late/early September because my anxiety was horrible and he upped my dosage to 40 mg and put me on 2mg Ativan and atenolol. Its been going well so far, I’m lost 23 lbs since my first appointment with this dr. I have energy, my social anxiety is almost gone.

    I don’t get all shaky and red faced when I’m in a room full of strangers. However, I’m still having major panic attacks so I’m going to see about going with Xanax instead of Ativan, I have ptsd and severe anxiety. The Prozac gives me a ton of energy, I’m always hyped up and I sweat a lot more and barely have an appetite but its giving me motivation to keep working out. If I don’t don’t take Ativan or Xanax with the Prozac I get bad insomnia. Other than that I’ve had a good experience with it.

  3. dk
    Reply

    I had problems with this brand. I was hearing voices, and suicidal thoughts….. I too am looking for a generic that works like the real thing. One is 350.00 month, the other 6.00 month.

  4. Sam
    Reply

    Hi ppl. I recently started taking Prozac 40 mg r/t anxiety. Before that I had taken Effexor 75 xr roughly ten years ago for the same thing and it went away and I would take the Effexor off and on when I felt my anxiety start up. My dr that prescribed the Effexor years ago was the same one who changed me to Prozac. I saw him a week after starting it and I really felt no different. It’s been 7 weeks now and still feel anxiety throughout the day but I feel like I can concentrate more than previous at times. I’m a nurse, father.

  5. Dav
    Reply

    I have been taking prozac for little over four years, It helped me soooooo much. I don‘t know where I would be without it.

  6. Deb
    Reply

    I have been on and off Prozac for the last 20 years. Currently I am taking 60mg of Sandoz fluxotine and have noticed very little positive effect. It has been 4 weeks now and I am wondering about the manufacturer and how much time before the drug will work for my depression. I barely can make it to work, house is a mess, and I have suicidal thoughts occasionally. Prozac has always worked for me in the past but now I just feel lethargic and sad and disinterested in just about everything. If anyone knows specifically about the manufacturer Sandoz fluxotine please email me.

  7. E.
    Reply

    Wow, lots of different experiences. Prozac was the first antidepressant I ever took, back in 1992 before it was dispensed like candy. I was in college, barely functioning, not eating, and praying for death to take me. I flew home for Thanksgiving break and my father had a psychiatrist ready to see me. She gave me Prozac and in about two days I felt a 180 degree turn. My brain chemistry was clearly a mess, and I feel it saved my life… back then I felt it was worth saving, Now, again, this was 1992, when ppl who REALLY needed it got it. Not every random person who had a bad day, I took it for some years. Orgasms damn near impossible (female). Basically it just stopped working and for 22 years or so I’ve been on various cocktails of drugs. It’s frustrating. Nothing ever gave me suicidal thoughts, because I already had them and still do sometimes.
    But, like I said, looking back I would say Prozac saved my life. I was seeking ways to end it. Unfortunately, in a half-assed fashion, I still do. And no drug is going to change that. But at least I can function.

  8. Sono
    Reply

    Hello All,
    I was prescribed Fluoxetine August of 2012. At That point I had been on crutches for 8 1/2 months. (Torn ligament diagnosed as a sprain at first)But because I was injured so long, I had to move out of my nice apt and in w/ my folks till I could get back on my feet (pun intended!). My Dr. suggested trying 20 mg of Fluoxetine because I seamed depressed.(Go figure)
    I was very happy with the results. I did not notice any of the side effects (well..except the no climax thing) and it really did help with all that was going on at the time. (like squeezing an established life into my old bdrm…on crutches)
    So, back to the wrongly diagnosed foot problem. Because I had an injury that went untreated for so long I ended up W/ nerve damage in the foot. This apparently called for Gabapentin 400 mg to make it possible to walk after physical rehab did not do the trick.
    Whether it was Gabapentin alone or in combo w/ the Fluoxetine, I am having *such* brain fog. I forget words, go to get something I’m holding, shave the same leg twice, say hello all over again to someone I just greeted 3 min’s ago. This is not working for me. Sure I can walk, but I’m used to being clear minded.
    I also ‘lose time’. I’ll be washing dishes and will not be sure how much time has passed. I’ll realize that there is someone in front of me and that I may have been talking to them…but now, I’m just standing there staring at them. YES! I was talking to them… but about what… never mind, they just walked away.
    Based on this something has got to go. Since the 20th I have been taking the Fluoxetine every other day and now intend to take it every 3 days for about 2 weeks to bow out safely. Since I have been on it for quite awhile, I feel confident that it is time to get off of the prescription anyhow. I did let my Dr know about my ‘flight plan’ last month. She says the side effects I am feeling are normal. But I can not function like this.
    So far so good getting off the prescription. If I would benefit from a anti-depressant in the future, I would absolutely go back on Fluoxetine.

  9. Mona
    Reply

    Does anyone else experience abnormal/weird dreams with fluoxetine??? I am being to wonder if my abnormal dreams are the cause of this pill. I am not complaining because for me they help A LOT!!! I can tell when I don’t take them. I feel the difference. I worry to though, will I be dependent on them forever now??? Guess I will cross that bridge when I get there right?!

  10. VN
    Reply

    Nt don’t stop cold turkey! One every other day for a week, then 3 days. I had a horrible reaction stopping years ago and feel blessed I lived through it.

  11. nt
    Reply

    Does any one know how long the side effect would wear off I was on 20 mg and I cut cold turkey.

  12. Melissa
    Reply

    The same thing just happened to me when I took my dose. I had some indigestion and burped and powder actually came out that looked like smoke. My throat hurts so much right now that is why I came on here to read blogs! It works well for my mental state but I do notice a major delay in orgasm and the fact that it burns my stomach and now my throat isn’t the greatest.

  13. aaa
    Reply

    Hi SO,
    yes I have experienced delay of orgasm on 20-60mg of fluoxetine a day.
    It has improved over the years if I am highly aroused, it has taken a while though but it should come back even if delayed.
    I never want to come off this medication as I have my happiness back and can laugh again now (been on it 12 years)
    Good luck

  14. Mel
    Reply

    I am taking 40mg of Lily Fluoxitine in the morning – the worst side effect has been extreme fatigue! I can sleep all day – it’s debilitating!

  15. AJ
    Reply

    Hello all. I’m writing about possible discontinuation side effects of Prozac. After going from brand to generic to brand, I had what I can only describe as symptoms of “excess serotonin” (I know this from internet research and a previous experience bumping up the dose on my own.) I went off and felt immediately better.
    For 6 weeks I was off the 20 mg I had been taking. It was the longest I had been off of an SSRI for 15 years. I had some brain zaps, but that was about it. During that time, I took something called, “Ashwagandha”– an herb that is an adaptogen. I stopped that after a month when I doubled the dose (I had only been taking half the recommended dose at that time) and felt “weird”.
    A few days later, I tried to go back on the Prozac– 10mg/day for three days. I had what felt like a minor allergic reaction. So I stopped that was two weeks ago. So in total, 8 weeks have elapsed since I stopped the Prozac.)
    5 days ago, I got a nasty bout of diarrhea. I NEVER get diarrhea. Never. I’ve had digestion problems, but never with that. I thought it was something I ate. But 5 days later, I have gas, bloating, fullness and loose stools. I’ve had searing stomach pain.
    At this point, I’m not sure if it’s a flu bug, or discontinuation symptoms from the Prozac.
    Any ideas/thoughts/suggestions are appreciated.
    AJ

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