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Fluoxetine

 

Fluoxetine (generic Prozac) Review

brand names: Prozac Weekly, Sarafem, Prozac
generic names: Fluoxetine hydrochloride, Fluoxetine or capsules, Fluoxetine

Why is Prozac prescribed?

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 Weekly is approved for treating major depression.

Under the brand name Sarafem, the active ingredient in 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 belongs to the class of drugs called selective serotonin re-uptake inhibitors (SSRIs). 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.

How should I take this medicine?

Take fluoxetine tablets or capsules by mouth. Follow the directions on the prescription label. Swallow with a drink of water. You can take fluoxetine with or without food. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not stop taking except on your prescriber's advice.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed. While this drug may be prescribed for children as young as 7 years for selected conditions, precautions do apply. A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Why should Prozac (Fluoxetine) not be prescribed?

If you are sensitive to or have ever had an allergic reaction to Prozac (Fluoxetine) 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 this drug 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 (Fluoxetine).

Warning!

• Consult your doctor if you develop a skin rash or other unexplained allergic reaction while taking this medicine.
  
  
• If you experience seizures (convulsions or fits) while taking this medicine, consult your doctor immediately, as you will need to stop treatment with this medicine. This also applies if you suffer from epilepsy and experience more seizures than normal after starting this medicine.
  
  
• You should avoid suddenly stopping this medicine, as suddenly stopping SSRIs can cause symptoms such as pins and needles, nausea, headache, dizziness and anxiety. Withdrawal symptoms are temporary and are not due to addiction or dependence on the medicine. They are rare with fluoxetine, because it remains in your blood for a few weeks after you stop taking it, and its blood level naturally decreases slowly over time. However, you should follow the instructions given by your doctor or pharmacist when it is time to stop treatment.
  
  
• Antidepressants may cause the amount of sodium in the blood to drop - a condition called hyponatraemia. This can cause symptoms such as confusion, drowsiness, muscle twitching or convulsions. Elderly people may be particularly susceptible to this effect. You should consult your doctor if you develop any of these symptoms while taking this medicine, so that your blood sodium level can be checked if necessary.
  
  
• SSRI antidepressants have been associated with the development of unpleasant or distressing restlessness and the need to move, often accompanied by an inability to sit or stand still. This is most likely to occur within the first few weeks of treatment. If you experience these symptoms you should consult your doctor.
  
  
• It is recommended that you avoid drinking alcohol while taking this medicine.
  
  
• This medicine may reduce your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won't affect your performance.
  
  
• There is only limited evidence available concerning the long-term safety of fluoxetine in children and adolescents, in terms of its effect on growth (height and weight) and sexual, cognitive, emotional and behavioural development. Your doctor should carefully discuss the risks and benefits of the medicine with you and your child before treatment is started. The child's growth and development should be monitored during and after treatment. If there is no obvious benefit on the child's depression after nine weeks of treatment, use of the medicine should be reconsidered.
  
  
• In children, fluoxetine is not licensed or recommended for uses other than moderate to severe depression. Children and adolescents may be more susceptible to hostility and suicidal thoughts or behaviour when starting treatment with antidepressants. They should be carefully monitored and encouraged to report any distressing feelings, thoughts about suicide or self-harm, irritability, mood changes or other unusual change in behaviour that they may experience while taking the medicine. If you are worried about your child at any point it is important to talk to your doctor immediately.
  
  
• Depression and other psychiatric illnesses are associated with an increased risk of suicidal thoughts, self-harm, and suicide. You should be aware that this medicine may not start to make you feel better for at least two to four weeks. However, it is important that you keep taking it in order for it to work properly and for you to feel better. If you feel your depression or anxiety has got worse, or if you have any distressing thoughts, or feelings about suicide or harming yourself in these first few weeks, or indeed at any point during treatment or after stopping treatment, then it is very important to talk to your doctor.
  
  

Most important fact about Prozac (Fluoxetine)

Serious, sometimes fatal, reactions have been known to occur when Prozac (Fluoxetine) 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 (Fluoxetine) 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 (Fluoxetine) in high doses or for a long time.

In addition, Prozac should never be combined with thioridazine (Mellaril) due to the risk of life-threatening drug interactions; and a minimum of 5 weeks should be allowed between stopping Prozac (Fluoxetine) and starting Mellaril.

If you are taking any prescription or nonprescription drugs, notify your doctor before taking Prozac (Fluoxetine).

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
•diabetes
•heart disease
•kidney disease
•liver disease
•receiving electroconvulsive therapy
•seizures (convulsions)
•suicidal thoughts
•an unusual or allergic reaction to fluoxetine, other medicines, foods, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding