Prozac Review – side effects, weight loss, safety
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What is Prozac?
Prozac is the leading brand name for the drug fluoxetine.
Other brand names for fluoxetine include:
First of all, in this article, the terms ‘Prozac’ and ‘fluoxetine’ are interchangeable.
What is Prozac used for?
The answer to the question – Why is Prozac prescribed? – is that Prozac, (or fluoxetine), primarily treats depression.
The main type of depression Prozac treats is what psychiatrists call major depressive disorder or clinical depression. (Briefly, a mood disorder where you persistently feel sad and/or lack interest in life).
Additionally, doctors also prescribe Prozac for:
- bulimia nervosa,
- obsessive-compulsive disorder (OCD),
- panic disorder
- premenstrual dysphoric disorder (PMDD, extremely bad PMS).
Fluoxetine (Prozac) may also be prescribed for bipolar disorder (manic depression), in which case it’s sometimes prescribed along with olanzapine (brand name Zyprexa).
As a result, the Federal Drug Administration (FDA) in the USA has issued official license to Prozac (fluoxine) for treatment of these are the conditions.
However, the FDA has licensed only brand name Sarafem for PMDD, but not Prozac or generic Prozac. (Yet Sarefem is the exact same thing: fluoxetine!)
Other uses of Prozac
Prozac may be prescribed for other conditions too, at a doctor’s discretion. This is referred to as “off-label” uses because they are not uses for which Prozac has been officially approved.
Other uses of Prozac include:
- ADHD (attention-deficit disorder),
- bipolar disorder,
- hot flashes,
- PMDD, PMS,
- PTSD (posttraumatic stress disorder),
- Raynaud’s syndrome,
- weight loss
- Tourette’s syndrome,
- premature ejaculation
As mentioned above, fluoxetine is officially approved to treat depression, OCD, PMDD (severe PMS) and bulimia.
Furthermore, research is currently under-way examining the usefulness of Prozac for the treatment of autism spectrum disorders.
However, many of these uses are quite specific to the individual. For example, one Prozac side effect is insomnia, though for some people it does make them drowsy.
Prozac side effects and mood disorders
Another side effect of Prozac is anxiety. As a result social anxiety sufferers are often prescribed Prozac.
Additionally, the medical profession prescribes fluoxetine to help people deal with anger issues. This is because fluoxetine can have a calming effect that helps people deal with difficult emotions.
However, a possible side effects of fluoxetine is aggression, hostility and anger.
As a short-term treatment for obesity, fluoxetine (Prozac) can be useful. Prozac treats obesity caused be eating more than needed – not for obesity caused by hormonal imbalance.
As for weight loss more generally, in some people it acts as an appetite suppressant and lead to weight loss. In other people it can cause weight gain.
The results are inconclusive for bipolar disorder.
Some people have found success in using Prozac as a short-term treatment for severe depressive episodes.
However, it can cause manic reactions in some people. Therefore in these cases combinations of Prozac and a mood stabilizer drug is employed.
Also, those with bipolar disorder have a greater risk of developing suicidal thoughts.
Prozac as a pain reliever
For pain, it’s found that some antidepressants may disrupt pain signals being transmitted to the brain. It may help with some kinds of chronic pain, including tension headaches and pain associated with fibromyalgia.
However, SSRIs like fluoxetine don’t work so well this way, though they’re good for helping depression associated with chronic pain.
Tricyclic antidepressants are more effective for pain relief. More on that here: mayoclinic.org/pain-medications
For Raynaud’s syndrome, initial research indicates effectiveness. More studies will to confirm this either way.
How does Prozac (fluoxetine) work?
Prozac is a selective serotonin reuptake inhibitor (SSRI). Serotonin is a neurotransmitter, a chemical which transmits signals between nerves.
How does Prozac affect the brain and the nervous system?
It works like this: an electrical signal travels along a nerve and when it reaches the end, triggers the release of serotonin from the end of the nerve cell into a gap (synapse) between nerves.
Serotonin then stimulates receptors on the next nerve cell. That initiates an electrical signal to travel along that nerve. The first nerve then reabsorbs (re-uptakes) any excess serotonin that’s lying around.
So a selective serotonin reuptake inhibitor is a chemical preventing re-absorbtion of serotonin into the nerves once released.
Therefore more serotonin remains in the nerve synapses (the area between nerves), and consequentially the nerve cells in the brain are activated to respond to serotonin.
Effectively, an SSRI increases serotonin levels, which generally boosts mood, though it’s not clear exactly how it improves depression or even what causes depression.
How effective is Prozac – does it really work?
For mild depression, there’s mixed evidence as to whether Prozac really helps, however studies do show it to be more effective than a placebo for severe depression.
The placebo effect is a psychological boost you can get from thinking you are taking a medicine and believing it’s working.
Consequentially, this can actually affect physical processes in your brain and body to fulfil those expectations. A placebo effect can affect your health, not just your perceptions.
You should also note that while Prozac may help alleviate symptoms of depression, it doesn’t treat the causes.
So if you’re feeling bad enough to be taking Prozac, then it’s a good idea to be having some kind of counselling or psychotherapy as well in order to try to deal with the underlying roots of your emotional distress or discomfort.
There’s a good UK NHS (National Health Service) article about antidepressants here: nhs.uk/conditions/Antidepressant-drugs
Who invented, developed Prozac / fluoxetine?
Eli Lilly and Company discovered Fluoxetine in 1972 and released Prozac for medical use until 1986.
Who manufactures Prozac and makes generic Prozac available?
Eli Lilly and Company manufactures brand name Prozac. However, their patent has now expired. Generic versions of Prozac are currently widely available.
Safety concerns when using Prozac
Is Prozac safe for you? Who shouldn’t take Prozac.
There are various health conditions which mean taking Prozac may not be safe for you.
Check with a doctor about any other health conditions you have, in case they make Prozac inadvisable, and particularly if you have or have had any of the following:
- cirrhosis of the liver
- kidney disease
- narrow-angle glaucoma
- seizures or epilepsy
- bipolar disorder (manic depression)
- a history of drug abuse or suicidal thoughts; or …
- if you are being treated with electro-convulsive therapy (ECT).
There are various drugs – and even herbs – which interact with fluoxetine and if you’re taking those, you shouldn’t take fluoxetine.
See below for details on what not to take Prozac with.
Obviously, if you know you’re allergic to fluoxetine (Prozac), don’t take it.
If you’re allergic to any foods or medicines or other substances, then tell a doctor in case you turn out to be allergic to fluoxetine also.
Some of the side effects of Prozac can be severe. See directly below for details.
The link between Prozac and increased depression, self-harm and suicide.
One of the major side effects, which the makers of Prozac (Eli Lilly and Company) did not publicize or admit to initially, is that it causes some people to feel more depressed and even think about suicide or self harm.
Young people under about the age of 25 are more prone to this side effect.
This means that as well as going to your doctor or psychiatrist for regular check-ups, you should get close friends or family members to look out for you as well.
It’s often easier for others to spot psychological changes in you than it is for you to notice them yourself, especially if they come on gradually.
So look out for, and have others look out for, changes in your mood or behaviour. Changes to watch out for include becoming (more) anxious, nervous, depressed, panicky, impulsive, irritable, agitated, aggressive or hostile, restless or hyperactive, insomnia, suicidal or self-harm thoughts.
These changes are reported to be more likely when you first start taking fluoxetine (Prozac) or if your dose is altered, though they could happen any time. These side effects are also more likely if you have a history or family history of mental illness, including depression.
Since Prozac is most commonly prescribed for depression, this is not reassuring!
US government Medline website says : No matter your age, before you take an antidepressant, you, your parent, or your caregiver should talk to your doctor about the risks and benefits of treating your condition with an antidepressant or with other treatments.
You should also talk about the risks and benefits of not treating your condition. You should know that having depression or another mental illness greatly increases the risk that you will become suicidal.
This risk is higher if you or anyone in your family has or has ever had bipolar disorder (mood that changes from depressed to abnormally excited) or mania (frenzied, abnormally excited mood) or has thought about or attempted suicide.”
What are the other Prozac side effects?
A common side effect is that taking fluoxetine can make you feel dizzy or maybe drowsy and affect your ability to think and react quickly and clearly. So, obviously, don’t drive or operate machinery or do anything else requiring full alertness until you are sure that Prozac is not having that effect on you.
The most common side effects are insomnia, tiredness, headaches, nausea (feeling sick) and diarrhoea.
Other common side effects include: strange dreams, vision changes, tremors or shaking, weakness, pain, fatigue, upset stomach, vomiting, dry mouth, sweating or hot flashes (flushes), stuffy nose, pain in sinuses, sore throat, flu-like symptoms. You can also have changes in your appetite and your weight.
Some common side effects are sexual – lower libido, difficulty having an orgasm, vaginal dryness for women and impotence for men.
You might think those sound quite unpleasant but some people experience more serious side effects, so you must consult a doctor immediately if any of these occur to you:
- joint pain,
- swelling of the eyes, hands, feet, ankles, or lower legs,
- difficulty breathing or swallowing,
- fast or irregular heartbeat,
- severe muscle stiffness,
- seeing things or hearing voices that do not exist (hallucinating),
As with all drugs, there’s a small risk of having an allergic reaction to it so get medical help urgently if you start to develop any signs of allergic reaction, like a skin rash or hives, swelling of your face, lips, tongue, or throat, and/or trouble breathing.
There may be other serious side effects not mentioned here.
A more comprehensive and easy-to-read list of side effects can be found here: drugs.com/prozac-side-effects
Also, if you take too much fluoxetine, or if you take it in combination with some other drugs, it can increase your serotonin levels too much, resulting in serotonin syndrome with symptoms like
- fast heart rate,
- muscle tremor or rigidity,
- nausea, vomiting,
- worst – you might go into a coma!
Are Prozac side effects permanent?
I can’t find information on this specifically, although Prozac does persist for a long time in your body (several weeks), which means that once you reduce your dose or stop taking it, it could still take a while for side effects to decrease.
Why does Prozac cause weight gain, weight loss, make you tired, make you sleepy?
These are just some of the possible side effects of taking Prozac. However, Prozac is less likely to cause you to gain weight than some other antidepressants, and may cause you to lose weight. It’s also less likely to cause you to feel sleepy or sedated than some other antidepressants and may actually keep you up with insomnia.
Does Prozac change personality?
Well, maybe. Taking Prozac alters the chemistry of your brain. It can make you feel better – more positive and bright, although for some it has very negative side effects including making you more anxious, aggressive and even suicidal. Some people find they feel their emotions are dulled or dampened when taking it. Others find their emotions which have been dulled by their depression become more vibrant again.
Do any of these changes constitute a change in personality? I suppose that depends on how you view personality. Proponents of antidepressants would argue that by alleviating some of the negative effects of depression, they’re revealing your personality, which was otherwise dampened or hidden by your depression.
Is Prozac addictive?
Prozac is not considered to be addictive in the same way that some other medications are, like Valium (diazepam), whereby you can quickly become physically dependent on it, and eventually psychologically dependent on it. However, once you’ve been taking Prozac for a while, your brain does get used to it. This means that if you stop taking it suddenly you can get withdrawal symptoms like headaches, nausea, dizziness, or flu-like symptoms. So it’s important to stop taking Prozac by gradually decreasing your dose.
Is Prozac safe when pregnant or breastfeeding?
Not unless you really have to. Taking Prozac, or any SSRI antidepressant, when you’re pregnant could cause lung or cardiac problems or other complications in your unborn baby. It can also pass into breast milk and could harm your child. If you get pregnant while taking Prozac, or want to, talk to your doctor about it. Same for breastfeeding.
What not to take Prozac with?
You shouldn’t take Prozac with herbs like St John’s Wort, supplements containing tryptophan, and various medications. For details on each of these, see the next two questions below.
Is Prozac safe to take with alcohol, coffee, food, St John’s Wort?
It’s not a great idea to take Prozac with alcohol. The booze can increase the risk and severity of some of Prozac’s side effects. It’s not as risky as it is with some other antidepressants though.
You don’t need to talk Prozac with food but it is okay if you do.
Don’t take Prozac with St John’s Wort. It puts you at risk of serotonin syndrome and may interfere with Prozac’s effectiveness.
Drinking coffee while taking Prozac is okay but be aware that it can produce some similar side effects to Prozac. It might increase your risk of feeling nervous and agitated – especially if you drink a lot of coffee.
Is Prozac safe to take with other medications?
It depends. Fluoxetine is known to interact, sometimes dangerously, with some other medications so – if you’re on any meds at all, or even taking herbs or supplements – this is something you need to check with a doctor or pharmacist.
Prozac and MAO inhibitors
One of the most dangerous Prozac interactions is with MAO (monoamine oxidase) inhibitors, such as
This is not a complete list.
If you’ve taken an MAO inhibitor medicine in the last two weeks, you shouldn’t take Prozac as it can lead to serotonin syndrome (discussed under Prozac dosage) which can be very serious.
Anti-psychotic drugs like pimozide and thioridazine are also risky combinations with Prozac. You should not take them together. In fact, it must be at least five weeks since you took Prozac before you can take thioridazine.
You should also avoid Prozac if you are having methylene blue injection.
Prozac and NSAIDs
Other medicines which interact with Prozac are non-steroid anti-inflammatory drugs (NSAIDs).
These are medicines usually taken for pain, arthritis, fever, swelling, and include aspirin, and taking these with Prozac can mean you bruise and/or bleed easily.
They include common over-the-counter medications such as:
- ibuprofen (Advil, Motrin, Nurofen),
- naproxen (Aleve),
- celecoxib (Celebrex),
- also many others.
Check with a doctor before you take Prozac if you’re taking any of these (or vice versa).
Also, since Prozac may make you sleepy, any medications which can make you sleepy can make this worse. This includes medicines for anxiety, depression, and seizures, as well as narcotic pain relievers and muscle relaxants, and of course, sleeping pills. Check with a doctor before mixing these meds.
Prozac and other antidepressants
Also, don’t take Prozac with other antidepressants as this can be very dangerous.
This includes but is not limited to
- other SSRIs like Lexapro,
- SNRIs like Cymbalta and Effexor,
- NDRIs like Wellbutrin
- Tri or Tetracylic antidepressants like Trazodone.
Other medications which interact with Prozac include:
Again, check with your doctor before mixing these medications.
These are just some of the medicines which can interact with Prozac.
This Prozac review is the result of extensive research and cross comparisons.
A sample list of our references and sources is listed below,