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Prozac
Generic name: Fluoxetine Hydrochloride
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. Prozac is also used in
the treatment of bulimia (binge-eating followed by deliberate vomiting).
Prozac 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 also prescribed for the treatment of premenstrual
dysphoric disorder (PMDD), formerly known as premenstrual syndrome (PMS).
Symptoms of PMDD include mood problems such as anxiety, depression, irritability
or persistent anger, mood swings, and tension. Physical problems that
accompany PMDD include bloating, breast tenderness, headache, and joint
and muscle pain. Symptoms typically begin 1 to 2 weeks before a woman's
menstrual period and are severe enough to interfere with day-to-day activities
and relationships.
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 nonprescription 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. For Prozac
to be effective, it should be taken regularly. Make a habit of taking
Prozac at the same time you do some other daily activity.
It may be 4 weeks before you feel any relief from your
depression, but Prozac 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 of Prozac 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 Prozac at room temperature.
What side effects when taking Prozac may occur
?
Side effects with Prozac 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 when taking 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 when taking 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 when taking Prozac 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
Prozac. Make sure that your doctor is aware of any drug reactions that
you have experienced.
Do not take Prozac while using an MAO inhibitor. 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 Prozac 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 the use of Prozac 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 Prozac.
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 Prozac
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 on Prozac 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. Prozac appears in breast milk, and breastfeeding is not recommended
while you are taking Prozac.
Recommended dosages for Prozac
ADULTS
The usual starting dose of Prozac 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 Prozac 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 Prozac 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 with 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 of Prozac, 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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