Prozac (Fluoxetine)

prozac pills

Prozac® is a medication that belongs to the class of drugs known as SSRIs (selective serotonin reuptake inhibitors). The generic name for Prozac is fluoxetine. The first of its kind, Prozac was introduced to the public in 1986 for the treatment of major depression. Since that time, Prozac has been approved for the treatment of several other disorders as well.

Prozac quickly became a very popular for those struggling with depression. This was largely due to two reasons. First, it was effective in reducing the symptoms of depression for many who took it. Second, most patients found it easier to tolerate than tricyclic antidepressants and MAO inhibitors – the two most common types of medications used to treat depression before SSRIs became available. The side effects were relatively minimal.

Prozac had one particular side effect that also helped boost its popularity: weight loss. Many doctors began prescribing it “off label” for individuals who wanted some additional help to lose weight. It wasn’t a “magic pill” for weight loss, but many studies showed that it could be beneficial. This side effect also made it popular for those battling depression, as older antidepressants were notorious for causing weight gain and depression sometimes causes an increase in appetite as well.

What Prozac is Used to Treat

Prozac has been used for nearly 3 decades to treat major depressive disorder. In addition to being FDA-approved for treating major depression in adults, it is also approved for the treatment of obsessive-compulsive disorder (OCD), panic disorder, and the eating disorder bulimia nervosa. The FDA has also approved Prozac for the treatment of OCD in children and adolescents between the ages of 7 and 17 years, and major depression in children and adolescents between 8 and 18 years of age.

Doctors may prescribe Prozac “off label” to treat other disorders and conditions. It may also be used in combination with other medications to treat other mental health conditions not listed above.

How Prozac Works

The exact mechanism by which Prozac works is not fully understood. Most experts believe that Prozac works primarily by targeting serotonin, a brain chemical known as a neurotransmitter. Serotonin is believed to play a major role in regulating mood. When your serotonin levels are out of balance, SSRIs like Prozac may help to bring them back into balance and reduce symptoms of depression and anxiety.

In recent years, some scientists have suggested that the original serotonin theory behind the effectiveness of Prozac is incorrect. They propose that rather than boosting serotonin levels, the medication actually helps heal damaged neurons in the brain. As the neurons begin to flourish and grow once again, mood symptoms start to subside.

How it’s Administered

Prozac is available in tablets, capsules (including a delayed-release capsule), and an oral solution. Unlike many medications, you can take it with or without food. It is typically prescribed to be taken once or twice a day, in the morning or morning and noontime. The delayed-release capsules are typically taken only once a week.

As with all medications, it’s crucial to take Prozac only as your doctor prescribes. Your doctor will likely start you on a low dose and gradually increase it. The full benefits of Prozac and other SSRIs are usually not felt for a few weeks. Don’t stop taking it abruptly, as this could result in unpleasant side effects. Talk to your doctor and follow his or her instructions for gradually tapering your dose.

Potential Side Effects

One of the most serious and controversial potential side effects of Prozac is suicidality, particularly in children, teens, and young adults (under 25 years of age). Research has shown that a small percentage of these individuals may be at increased risk for the development or worsening of suicidal thoughts and behaviors when taking Prozac and other SSRIs. This is why close monitoring by parents and treatment providers is especially crucial for this age group when Prozac is prescribed.

Other common side effects may include (but aren’t limited to):

  • Dry mouth
  • Sweating
  • Low libido
  • Flu-like symptoms
  • Sleepiness
  • Runny nose
  • Dizziness
  • Upset stomach or nausea
  • Throat irritation
  • Appetite loss
  • Nervousness or anxiety
  • Weakness
  • Insomnia

Some serious, but less frequent or rare side effects may include (but aren’t limited to):

  • Worsening of depressive symptoms
  • Mood changes
  • Trouble breathing
  • Extreme allergic reaction
  • Abnormal heart beat
  • Erectile problems
  • Chest tightness or pain
  • Neuroleptic malignant syndrome
  • Serotonin syndrome*
  • Seizures
  • Mania

*The symptoms of serotonin syndrome are most likely to appear within hours of starting a new medication, such as Prozac, or increasing the dose of your current medication. In severe cases, this rare side effect can be fatal.

As with all medications, side effects should be discussed with your doctor. Contact your doctor immediately if you experience any serious or life-threatening side effects.


Before taking Prozac, be sure to inform your doctor of any current and past medical conditions, including whether or not you are pregnant or nursing, or thinking about becoming pregnant. Any history of seizures, glaucoma, heart attack, diabetes, or other serious illnesses such as heart disease or liver disease should be discussed before taking Prozac.

If you have a family history of bipolar disorder, have been diagnosed with bipolar disorder, or have a history of manic or hypomanic symptoms, be sure to discuss this with your doctor. Prozac, like other antidepressants, may trigger a manic episode in individuals who have or are at risk for bipolar disorder.

Tell your doctor about any other medications or supplements you are taking, particularly other antidepressants, St. John’s wort, or supplements that contain tryptophan.

If you are undergoing ECT (electroshock therapy), discuss this with your doctor before taking Prozac.

Since sleepiness is one of the side effects of Prozac, don’t drive or operate machinery until you know you can do so safely while taking it. Also, be aware that alcohol can make the drowsiness caused by Prozac even worse.

Additional Considerations

The most effective treatment for depression, anxiety disorders, panic attacks, and eating disorders is psychotherapy, particularly cognitive behavioral therapy. While Prozac can be very beneficial in terms of reducing or alleviating symptoms while taking it, they often return once the medication is stopped. This is because medication rarely, if ever, treats the underlying cause of these disorders.

Working with a skilled therapist can help you understand the underlying reasons for your symptoms. It can also help you learn how to manage, control, and change the thoughts and behaviors that cause and / or exacerbate them. While some people may need to take medications like Prozac for a long period of time, others can learn to manage or overcome their symptoms so that they no longer require medication


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