Prozac- What you should know before

you use it.

Distributed under Creative Commons license

• Prozac, or Fluxoteine hydrochloride, has been

widely prescribed since 1986-87 as a popular antidepressant.

• By increasing availability of serotonin neurotransmitter in the brain, Prozac brings out a *FEEL GOOD* reaction from the brain.

• Experiments also show growth of new neurons in about a month.

How it acts -

Indications

• Depression

• Started in doses of 10-20 mgs and slowly increased up to 60-80mgs.

• improvement in mood, reduced irritability and anxiety, decrease in severity of symptoms of depression usually take 3 to 4 weeks to appear.

• For long term benefits, it has to be used for at least 6 to 12 months.

Indications- contd.

• OCD (Obsessive compulsive disorder), Bulimia and Panic disorders.

• Prozac decreases severity of panic attacks as well as relieves anxiety.

• PreMenstrual Syndrome- It relieves physical symptoms (like body ache) as well as mood related problems (like depression and irritability) which are associated with premenstrual syndrome in women (PMS).

Use in Children

• Avoided in children.

Chance of increased impulsivity and suicide attempts.

• Used only in serious cases of Major depression

and Obsessive compulsive Disorder, when no other drug works.

Precautions -

You can not be taking Prozac if-• History of an allergic reaction while using

Prozac.

This allergic reaction can manifest as rash, itching, swelling over face and puffiness of eyes, difficulty in breathing and sometimes may cause death.

Precautions – contd.

• Avoid using Prozac in combination with other mood altering drugs or Antipsychotic.

Prozac, when used along with other such medications which act on the brain, can cause many drug interactions. In such cases, Prozac has to be used under strict medical supervision.

Special precautions

• It’s a Category C drug in the U.S in pregnancy, meaning there is insufficient data about its effects on the Fetus.

So if you are planning a pregnancy while using Prozac, contact your doctor. The doctor would slowly taper the dose of Prozac before finally withdrawing it completely. It is also secreted in the breast milk, so it is recommended you refrain from breast feeding if you are using Prozac.

Use with Caution

• Patients with severe Liver or renal disease are generally not prescribed Prozac. These organs are involved in the metabolism and excretion of Prozac. Use small doses and constant monitoring in such cases.

• Prozac is also avoided in Diabetics, especially those who use oral medications to control their blood sugar levels. Prozac is known to cause hypoglycemic attacks.

Points to note when you are taking Prozac –

• DON’T STOP ABRUPTLY – Abrupt withdrawal causes rebound Depression

which might be more difficult to treat. Withdraw by slowly decreasing the dose and finally tapering it off completely over a few weeks.

• Prozac may cause aggressiveness and violent behavior in some people. It also leads to impulsive behavior. These changes happen usually while starting Prozac or when increasing the dose.

Points to note when you are taking Prozac -

• May cause symptoms like nausea, vomiting, restlessness, Tremors, abdominal pain, diarrhea, confusion, increased activity and hyperpyrexia (fever) due to the increased serotonin levels

• May cause decrease in libido and impotence.

• Take it in the morning, preferably with food. Prozac may cause drowsiness.

Points to note when you are taking Prozac -

• If you miss any dose, DON’T DOUBLEDOSE the next day. Just carry on with the normal daily dose even after any skipped doses.

• Be Patient- Beneficial effects take up to 3 to 4 weeks to appear. For sustainable, relapse free improvement in depression, it needs to be taken usually for at least 6 to 12 months.

Dr. Neelesh Bhandari MBBS(A.F.M.C), MD (Path.)

PGP Human Rights.