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Brand name: Prozac
Generic name: Fluoxetine
Prozac is prescribed for the treatment
of depression, that is, a continuing depression that interferes
with daily functioning. The symptoms of major depression often include
changes in appetite, sleep habits, and mind/body coordination; decreased
sex drive; increased fatigue; feelings of guilt or worthlessness;
difficulty concentrating; slowed thinking; and suicidal thoughts.
Prozac is also prescribed to treat
obsessive-compulsive disorder. An obsession is a thought that won't
go away; a compulsion is an action done over and over to relieve
anxiety. The drug is also used in the treatment of bulimia (binge-eating
followed by deliberate vomiting). It has also been used to treat
other eating disorders and obesity.
In addition, Prozac is used to treat
panic disorder, including panic associated with agoraphobia (a severe
fear of being in crowds or public places). People with panic disorder
usually suffer from panic attacks--feelings of intense fear that
develop suddenly, often for no reason. Various symptoms occur during
the attacks, including a rapid or pounding heartbeat, chest pain,
sweating, trembling, and shortness of breath.
In children and adolescents, Prozac
is used to treat major depression and obsessive-compulsive disorder.
Prozac is a member of the family of drugs called "selective
serotonin re-uptake inhibitors." Serotonin is one of the chemical
messengers believed to govern moods. Ordinarily, it is quickly reabsorbed
after its release at the junctures between nerves. Re-uptake inhibitors
such as Prozac slow this process, thereby boosting the levels of
serotonin available in the brain.


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Most important fact about Prozac
Serious, sometimes fatal, reactions
have been known to occur when Prozac is used in combination with
other antidepressant drugs known as MAO inhibitors, including Nardil
and Parnate; and when Prozac is discontinued and an MAO inhibitor
is started. Never take Prozac with one of these drugs or within
at least 14 days of discontinuing therapy with one of them; and
allow 5 weeks or more between stopping Prozac and starting an MAO
inhibitor. Be especially cautious if you have been taking Prozac
in high doses or for a long time.
If you are taking any prescription
or non prescription drugs, notify your doctor before taking Prozac.
How should you take Prozac?
Prozac should be taken exactly as prescribed
by your doctor.
Prozac usually is taken once or twice
a day. To be effective, it should be taken regularly. Make a habit
of taking it at the same time you do some other daily activity.
It may be 4 weeks before you feel any
relief from your depression, but the drug's effects should last
about 9 months after a 3-month treatment regimen. For obsessive-compulsive
disorder, the full effect may take 5 weeks to appear.
If you miss a dose of Prozac
Take the forgotten dose as soon as
you remember. If several hours have passed, skip the dose. Never
try to "catch up" by doubling the dose.
Storage instructions for Prozac
Store at room temperature.
What side effects may occur
when taking Prozac ?
Side effects cannot be anticipated.
If any develop or change in intensity, inform your doctor as soon
as possible. Only your doctor can determine if it is safe for you
to continue taking Prozac.
More common side effects of
Prozac may include:
Abnormal dreams, abnormal ejaculation, abnormal vision, anxiety,
diminished sex drive, dizziness, dry mouth, flu-like symptoms, flushing,
gas, headache, impotence, insomnia, itching, loss of appetite, nausea,
nervousness, rash, sinusitis, sleepiness, sore throat, sweating,
tremors, upset stomach, vomiting, weakness, yawning
Less common side effects of
Prozac may include:
Abnormal taste, agitation, bleeding problems, chills, confusion,
ear pain, emotional instability, fever, frequent urination, high
blood pressure, increased appetite, loss of memory, palpitations,
ringing in the ears, sleep disorders, weight gain
In children and adolescents, less common side
effects may also include:
Agitation, excessive menstrual bleeding, frequent urination, hyperactivity,
mania or hypomania (inappropriate feelings of elation and/or rapid
thoughts), nosebleeds, personality changes, and thirst
A wide variety of other very rare reactions have been reported during
Prozac therapy. If you develop any new or unexplained symptoms,
tell your doctor without delay.
Why should Prozac not be prescribed?
If you are sensitive to or have ever
had an allergic reaction to Prozac or similar drugs such as Paxil
and Zoloft, you should not take this medication. Make sure that
your doctor is aware of any drug reactions that you have experienced.
Do not take Prozac while using an MAO
inhibitor. (See "Most important fact about this drug.")
You should also not use Prozac if you are taking Mellaril (thioridazine).
Likewise, do not start taking Mellaril within 5 weeks of stopping
Prozac.
Special warnings about Prozac
Unless you are directed to do so by
your doctor, do not take this medication if you are recovering from
a heart attack or if you have liver disease or diabetes.
Prozac may cause you to become drowsy
or less alert and may affect your judgment. Therefore, driving or
operating dangerous machinery or participating in any hazardous
activity that requires full mental alertness is not recommended.
While taking Prozac, you may feel dizzy
or light-headed or actually faint when getting up from a lying or
sitting position. If getting up slowly doesn't help or if this problem
continues, notify your doctor.
If you develop a skin rash or hives
while taking Prozac, discontinue use of the medication and notify
your doctor immediately.
Prozac should be used with caution
if you have a history of seizures. You should discuss all of your
medical conditions with your doctor before taking this medication.
Prozac can occasionally cause decreased
appetite and weight loss, especially in depressed people who are
already underweight and in those with bulimia. If you notice changes
in your weight or appetite, tell your doctor.
Possible food and drug interactions
when taking Prozac
Combining Prozac with MAO inhibitors
or Mellaril (thioridazine) is dangerous.
Do not drink alcohol while taking this
medication.
If Prozac is taken with certain other
drugs, the effects of either could be increased, decreased, or altered.
It is especially important to check with your doctor before combining
Prozac with the following:
Alprazolam (Xanax)
Carbamazepine (Tegretol)
Clozapine (Clozaril)
Diazepam (Valium)
Digitoxin (Crystodigin)
Drugs that impair brain function, such as sleep aids and narcotic
painkillers
Flecainide (Tambocor)
Haloperidol (Haldol)
Lithium (Eskalith)
Other antidepressants (Elavil)
Phenytoin (Dilantin)
Pimozide (Orap)
Tryptophan
Vinblastine (Velban)
Warfarin (Coumadin)
Special information if you
are pregnant or breastfeeding
The effects of Prozac during pregnancy
have not been adequately studied. If you are pregnant or plan to
become pregnant, inform your doctor immediately. This medication
appears in breast milk, and breastfeeding is not recommended while
you are taking Prozac.
Recommended Prozac dosages
ADULTS
The usual starting dose is 20 milligrams per day,
taken in the morning. Your doctor may increase your dose after several
weeks if no improvement is observed. People with kidney or liver
disease, the elderly, and those taking other drugs may have their
dosages adjusted by their doctor.
Dosages above 20 milligrams daily should be taken once a day in
the morning or in 2 smaller doses taken in the morning and at noon.
The usual daily dose for depression
ranges from 20 to 60 milligrams. For obsessive-compulsive disorder
the customary range is 20 to 60 milligrams per day, though a maximum
of 80 milligrams is sometimes prescribed. For bulimia nervosa, the
usual dose is 60 milligrams, taken in the morning. Your doctor may
have you start with less and build up to this dosage. The usual
dose for premenstrual dysphoric disorder is 20 milligrams a day.
For depression, it may take up to 4
weeks before the full effects of the medication are seen. For obsessive-compulsive
disorder, treatment can take 5 weeks or more to be effective.
If you are taking a 20-milligram daily
dose of Prozac for depression, the doctor may switch you to a delayed-release
formulation called Prozac Weekly. To make the change, you'll be
asked to skip your daily dose for 7 days, then take your first weekly
capsule.
CHILDREN
The usual starting dose for depression
is 10 or 20 milligrams a day. After 1 week at 10 milligrams a day,
the doctor may increase the dose to 20 milligrams. It may take up
to 4 weeks before the full effects of the medication are seen.
For obsessive-compulsive disorder, the usual starting dose is 10
milligrams a day. After 2 weeks, the doctor may increase the dose
to 20 milligrams. If no improvement is seen after several weeks,
the dosage may be increased as needed, up to a maximum of 60 milligrams
a day. Treatment may take 5 weeks or more to be effective.
Children who are underweight, have
kidney or liver problems, or are taking multiple medications may
need their dosages adjusted by their doctor.
Overdosage of Prozac
Any medication taken in excess can
have serious consequences. An overdose of Prozac can be fatal. In
addition, combining Prozac with certain other drugs can cause symptoms
of overdose. If you suspect an overdose, seek medical attention
immediately.
Common symptoms of Prozac overdose
include:
Nausea, rapid heartbeat, seizures, sleepiness, vomiting
Other symptoms of Prozac overdose include:
Coma, delirium, fainting, high fever, irregular heartbeat, low blood
pressure, mania, rigid muscles, sweating, stupor.
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