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Prozac (fluoxetine) was once considered a "happy pill" and taken even by he althy people, today it is a drug recommended only for patients with depression and other mental disorders. What made Prozac so popular back then? Is the use of this preparation - if it was recommended even to he althy people - completely safe and does not cause any side effects?

Prozac - what is it?

Prozac (fluoxetine)is perhaps one of the best known psychotropic drugs. This is due not only to the fact that this agent has been on the market for over 25 years and that it is used quite often, but also to the fact that there has been (and still is) a lot of controversy around Prozac.

Preparations with the active ingredient of Prozac - fluoxetine - appeared for the first time in 1986 in Belgian pharmacies. Two years later, in 1988, the drug became available in the United States. After the introduction of Prozac in the USA, the preparation gained exceptional popularity - it was even suggested that it could be a "happy pill".

It came to the fact that Prozac was used not only by patients with depressive disorders, but also by those who simply had a low mood. This position was criticized by many doctors, yet the preparation was still praised by marketing specialists.

It comes as no surprise that there were doctors who wanted to prove that using Prozac is not a recipe for happiness. In fact, a lot of research on the effectiveness of Prozac, as well as other antidepressants, has been carried out.

There were even publications whose authors concluded that the use of various antidepressants (including fluoxetine) did not improve the mental state of patients at all, and even if these drugs were to have any effect, it was only slightly greater than a placebo.

In the end, however, the majority of scientific publications proving that antidepressants - used when indicated - actually improve the mental state of patients.

It is worth noting that Prozac is the original preparation, i.e. the drug in which fluoxetine was found for the first time. Today, however, there are many other antidepressants on the market that, like Prozac, contain fluoxetine.

Prozac: action

How was italready mentioned several times, the active ingredient in Prozac is fluoxetine. This substance belongs to the antidepressants from the group of serotonin reuptake inhibitors (SSRIs). The action of fluoxetine is based on the inhibition of the serotonin transporter - this is how the drug increases the concentration of this neurotransmitter within the nervous system (and serotonin deficiency is considered one of the possible causes of depressive disorders, among others). Prozac is taken orally. If fluoxetine is taken regularly, the steady state of fluoxetine (i.e. reaching steady levels in the body) develops within a few weeks of starting therapy - this is why the effect of using Prozac appears not immediately after starting treatment, but after a week, sometimes even four weeks from its inception.

How to get Prozac?

Prozac is a prescription drug. You can get it from any doctor, but it would be best to go to a psychiatrist. A mental he alth professional will not only be the most competent person to make a proper diagnosis for the patient.

Psychiatrists deal with psychotropic drugs on a daily basis, thanks to which they can not only precisely select the optimal doses of drugs for them, but also - thanks to the knowledge of such drugs - take into account various interactions between fluoxetine and other drugs taken by patients. In the introduction to the previous paragraph, there was a certain distortion - in Poland, we probably won't get Prozac even if we have a prescription for this drug. The reason for this is that other fluoxetine-containing preparations are more widely available in our country - we are talking about generic drugs. The only difference from Prozac is … the name - the active substance of generic drugs is finally the same as in Prozac and it is fluoxetine.

Can you get addicted to Prozac?

Patients who are prescribed psychotropic drugs may often wonder - what if I become addicted to these drugs? After all, there is so much talk about benzodiazepines and the great addictive potential of these drugs …

In the case of Prozac, however, patients can be calm - this antidepressant is not addictive. It is true that - if it is possible to discontinue the use of this drug, it is discontinued slowly and gradually, but the need for such a procedure results from the fact that the treated person does not experience the side effects of abrupt discontinuation of regularly taken fluoxetine.

Prozac (Fluoxetine)indications and contraindications for taking the drug

Indications:

Prozac is a psychotropic drug used to treat a variety of mental disorders. The indications for fluoxetine treatment include:

  • depressive disorders (occurs in both adults and children);
  • obsessive-compulsive disorder;
  • mental bulimia.

Fluoxetine is less commonly used to treat other mental disorders such as post-traumatic stress disorder (PTSD), panic disorder and trichotillomania. There are sometimes attempts to use this substance in the treatment of alcoholism, in obese patients and in people suffering from autism.

Contraindications:

Prozac is generally a well-tolerated preparation, but it does not mean that it can be used by any patient. The following are the contraindications to fluoxetine treatment:

  • allergic to the active substance of Prozac or any other ingredient of the preparation,
  • simultaneous use of MAO inhibitors (monoamine oxidase),
  • drug-resistant epilepsy.

There are also certain conditions where the use of Prozac is possible, but the drug should be taken with caution. Such states include:

  • diabetes (fluoxetine therapy may lead to the need to modify the doses of antidiabetic drugs);
  • well-controlled epilepsy;
  • a history of a seizure;
  • use of drugs that reduce blood clotting (Prozac may increase the effect of such drugs);
  • various cardiovascular diseases;
  • experience of mania or hypomania in the past (Prozac can trigger an episode of high mood);
  • the use of diuretics (especially when such therapy is used by elderly people - there is an increased risk of hyponatremia, i.e. a reduced concentration of sodium ions in the blood).

Prozac drug interactions

Before a doctor recommends a patient fluoxetine, they usually ask them if they are taking any other medications. This knowledge is needed by a physician because there may be various interactions between fluoxetine and other drugs - some of them may reduce the concentration of various preparations in the body and reduce their effectiveness.

Others may, in turn, lead to an excessive increase in the concentration of other drugs in the body, increasing the possibility of side effects.

The most important interactions,sometimes requiring changes in the dosage of medications used by the patient, occur between fluoxetine and:

  • some antipsychotics (e.g. haloperidol, clozapine);
  • benzodiazepines (such as diazepam or alprazolam);
  • tricyclic antidepressants (such as imipramine);
  • carbamazepine;
  • lithium s alts;
  • certain anti-arrhythmic drugs (e.g. flecainide).

Some patients struggling with depressed mood try to improve their condition by consuming St. John's wort - for years it has been considered an antidepressant plant.

Consuming St. John's wort by people using Prozac is definitely contraindicated - this herb may increase the side effects of fluoxetine.

Prozac (fluoxetine): side effects

Prozac - like essentially any other drug - can have some side effects. In the case of this preparation, the side effects are usually most intense during the initial period of therapy (typically for about two weeks after starting Prozac) and the most common symptoms include:

  • headaches and dizziness;
  • sleep disorders (in the form of both excessive sleepiness and insomnia);
  • gastrointestinal disorders (e.g. nausea, vomiting, diarrhea or indigestion);
  • visual disturbance;
  • taste disturbance;
  • sexual dysfunction (e.g. decreased libido, problems with getting an erection in men);
  • changes in the amount of urine excreted (both increasing the frequency of voiding and decreasing);
  • feeling of weakness, fatigue, and sometimes the opposite - agitation or feeling even euphoric;
  • dermatological problems: rash, sometimes itchy skin;
  • increased sweating;
  • the appearance of unusual (sometimes even bizarre) dreams;
  • anxiety.

In the case of some antidepressants - including Prozac - doctors point out that in the initial period of therapy, patients should be under special supervision, be it their relatives or medical personnel. This is due to the fact that in people treated with antidepressants much faster than the improvement and stabilization of mood, their drive is increased.

This situation poses a certain risk, namely due to the possibility of its occurrence, attention is drawn to the fact that in the first stage of treatment, e.g. with fluoxetine, patients (especially those with very severe depressive disorders) may be in the group of increasedrisk of committing suicide.

The use of preparations from the SSRI group is associated with a low, but with the risk of the so-called serotonin syndrome. It appears in connection with the excessive level of serotonin in the central nervous system.

Serotonin syndrome can occur when overdosing on SSRIs (including Prozac), but also when using fluoxetine with other drugs that affect serotonin levels in the body, such as painkiller tramadol or antitussive dextromethorphan. The symptoms of serotonin syndrome include such problems as:

  • temperature rise;
  • hallucinations;
  • tachycardia;
  • significant increase in sweating;
  • headache;
  • psychomotor agitation;
  • muscle tremors;
  • reddening of the skin;
  • various disturbances of consciousness (usually in the form of confusion).

Prozac and driving

Generally, fluoxetine is considered a substance that does not lead to the appearance of psychomotor disorders. The use of the preparation - although rarely - can lead to problems with concentration, so people using Prozac should make sure that they are actually able to drive safely before driving a car.

Prozac and pregnancy and breastfeeding

Pregnancy is generally the period of a woman's life in which any medications are introduced to the pregnant woman only when their use does not lead to any risk to the fetus, or when the benefits of using the drug in the mother outweigh any possible risks for the child . Prozac can be used during pregnancy, but only in exceptional cases and with special caution.

Doses of this psychotropic drug may be modified in pregnant women due to different risks. An example of this is that if a pregnant woman takes Prozac regularly, her baby may develop a withdrawal syndrome after the termination of the pregnancy.

A similar situation to the above applies to the period of breastfeeding. The preparation enters the breast milk and usually patients using Prozac are advised to refrain from natural feeding of the baby.

About the authorBow. Tomasz NęckiA graduate of medicine at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

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