Best time to take prozac

How and when to take fluoxetine

Dosage

The usual dose of fluoxetine for adults is 20mg a day. However, you may start at a lower dose and gradually be increased to a maximum dose of 60mg a day.

Some people might need to take a lower dose of fluoxetine. This includes people with liver problems, and older people.

The usual dose of fluoxetine for children is 10mg a day but this may be increased to 20mg a day.

How to take it

You’ll usually take fluoxetine once a day, with or without food.

You can take fluoxetine at any time, but it’s best to stick to the same time every day.

If you have trouble sleeping, try taking it in the morning.

How long to take it for

Once you're feeling better it's likely that you will continue to take fluoxetine for several more months.

Most doctors recommend that you take antidepressants for 6 months to a year after you no longer feel depressed. Stopping before that time can make depression come back.

If you forget to take it

If you occasionally forget to take a dose, just take your next dose the next day at the usual time. Never take 2 doses at the same time to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

Stopping fluoxetine

If you stop taking fluoxetine suddenly, you may get withdrawal symptoms such as:

feeling dizzy
feeling sick
numbness or tingling in the hands or feet
trouble sleeping
feeling agitated or anxious
headaches
shaking

Talk to your doctor if you want to stop. They will reduce your dose gradually to help you with any side effects.

If you take too much

The amount of fluoxetine that can lead to an overdose varies from person to person.

Taking too much can cause symptoms such as:

being sick (vomiting)
shaking
feeling sleepy
feeling agitated
feeling dizzy
racing heart
fits or seizures

Urgent advice: Contact 111 for advice now if:

you take more than your prescribed dose of fluoxetine

Go to 111.nhs.uk or call 111.

If you need to go to A&E, do not drive yourself. Get someone else to drive you or call for an ambulance.

Take the fluoxetine packet, or the leaflet inside it, plus any remaining medicine with you.

Page last reviewed: 10 February 2022
Next review due: 10 February 2025

Prozac: Dosage, Side Effects, Uses, and More

If you have certain mental health conditions, your medical professional may recommend that you take a prescription drug called Prozac.

Prozac is used to treat the following conditions:

panic disorder with or without agoraphobia in adults
obsessive-compulsive disorder (OCD) in adults and some children
major depressive disorder (MDD) in adults and some children
bulimia in adults
episodes of depression caused by bipolar I disorder* in adults and some children
treatment-resistant depression* in adults

We’ll explain more about these conditions and how Prozac helps treat them in the “What do you take Prozac for?” section below.

* Prozac is prescribed in combination with olanzapine (Zyprexa) for this condition.

Prozac details

Prozac is a type of antidepressant drug called a selective serotonin reuptake inhibitor (SSRI). It contains the active drug fluoxetine.

Prozac comes as capsules that you swallow.

Prozac generic

Prozac is a brand-name medication. It’s also available as a generic drug called fluoxetine.

Most medications, including Prozac, may cause side effects that can be serious or mild. To give you an idea of what might occur with Prozac, we’ve listed some of the medication’s more common side effects below. Not all of the potential side effects are included here.

Your medical professional or pharmacist can provide more information on possible side effects of Prozac. They’ll also be able to recommend tips on how to help prevent and ease side effects.

Note: Certain factors may affect a medication’s side effects. These factors can include other health conditions you may have, other drugs you may be taking, and your age.

Mild side effects

Some of the mild side effects that Prozac may cause are listed below. For information about other mild side effects of the drug, we suggest that you talk with your medical professional or pharmacist. And it may also be helpful to refer to the medication guide.

Mild side effects of Prozac that have been reported in studies include the following:

decreased appetite, which may lead to weight loss*
tiredness*
sexual side effects,† such as:
- problems ejaculating
- erectile dysfunction (inability to get or maintain an erection)
- low sex drive
headache
unusual dreams
mild insomnia (trouble sleeping)
diarrhea
dry mouth
dilated (enlarged) pupils
nausea
sinus infection
sore throat
tremor (shaking that you can’t control)

Mild side effects of Prozac tend to ease or go away within a few days or weeks. But if you find that the side effects bother you, we encourage you to talk with your medical professional or pharmacist.

* For details on this side effect, you can see “Side effects: A closer look” below.
† You can see “Side effects specific to women and men” just below for details about possible sexual side effects of Prozac.

Serious side effects

Prozac may cause serious side effects, but this isn’t common. If you do develop serious side effects while taking Prozac, call your medical professional immediately. If you feel as if you’re having a medical emergency, call 911 or your local emergency number right away.

Serious side effects of Prozac that have been reported in studies include the following:

serious mood and behavior changes, such as:
- severe insomnia (trouble sleeping)
- anxiety
- nervousness
abnormal heart rhythm
low level of sodium in your blood
mania or hypomania (episodes of extremely high energy and excitement)
problems with thinking, coordination, or judgment
seizures
serotonin syndrome (high level of a chemical called serotonin, which is produced by your nerve cells)
unusual bleeding, such as bleeding from your nose or in your digestive tract
withdrawal symptoms if the drug is suddenly stopped
boxed warning: suicidal thoughts and behaviors*
allergic reaction*

* For details on this side effect, you can see “Side effects: A closer look” below.

Side effects specific to women and men

The side effects of Prozac are generally expected to be the same for females* and males* who take the drug. (For more information, see the “Mild side effects” and “Serious side effects” lists above.)

However, females and males may experience different types of sexual side effects with Prozac.

For example, females taking Prozac have reported problems with reaching orgasm. Males taking Prozac have reported:

problems ejaculating
erectile dysfunction (inability to get or maintain an erection)
low sex drive

Other side effects of Prozac that are specific to females are related to using Prozac during pregnancy or while breastfeeding. For details, you can see the “What should you know before taking Prozac?” section below.

If you have questions about your risk for certain side effects from Prozac, a medical professional will be able to offer advice.

* Throughout this article, we refer to someone’s sex assigned at birth by using the terms “male” and “female. ” To learn about the difference between sex and gender, you can refer to this article.

Prozac side effects in children and teens

Prozac is used to treat the following conditions in children and teenagers, in certain situations:

obsessive-compulsive disorder (OCD)
major depressive disorder (MDD)
episodes of depression caused by bipolar I disorder

Most side effects of Prozac in children and teenagers are expected to be the same as the side effects seen in adults. (For more information, you can see the “Mild side effects” and “Serious side effects” lists above.)

However, Prozac has a boxed warning for suicidal thoughts and behaviors, especially in children, teenagers, and adults age 24 and younger. A boxed warning is a serious warning from the Food and Drug Administration (FDA). For details, you can see the “Side effects: A closer look” section just below.

Also, certain side effects of Prozac may be more common in children and teenagers than in adults. These include:

abnormal or excessive movements
agitation
heavy or irregular menstrual periods
increased thirst
nosebleeds
personality disorders, such as paranoid personality disorder or antisocial personality disorder
urinating more often than usual

Side effects: A closer look

This section provides a close-up look at key side effects of Prozac.

Weight loss

Weight loss may occur with Prozac use. This side effect was common in studies of the drug.

Prozac can cause decreased appetite, which may lead to weight loss.

Changes in weight are a common symptom of depression and bulimia (a type of eating disorder). And Prozac is used to treat these conditions.

So if you have weight loss with Prozac, we recommend telling your medical professional right away. They’ll help determine if your weight loss is caused by the condition you’re using Prozac to treat, or if Prozac itself may be causing the weight loss.

Tips for managing

If you’re concerned about weight loss with Prozac, a medical professional may be able to answer any questions you have. They may monitor your weight while you’re taking the drug. They can also suggest ways for you to maintain a weight that’s healthy for you.

Tiredness

Taking Prozac can cause tiredness. This was a common side effect in studies of the drug.

However, Prozac can affect people differently. Both tiredness and insomnia (trouble sleeping) are possible side effects of the drug. So it’s possible that Prozac could either make you sleepy or keep you awake.

Tips for managing

Tiredness with Prozac can lead to problems with thinking, coordination, or judgment. For this reason, it’s recommended that you avoid driving until you know how Prozac affects you. You’ll likely know how Prozac will affect you after taking several doses of the drug.

If you’re concerned about tiredness while you’re taking Prozac, we encourage you to talk with your medical professional.

For some conditions Prozac is used to treat, it’s recommended to take the drug in the morning. But if taking Prozac makes you tired, it may be best to take your dose at bedtime. Your medical professional can recommend when it’s best for you to take Prozac.

Allergic reaction

Many drugs, including Prozac, can cause an allergic reaction.

Symptoms that can occur with a mild allergic reaction may include:

itchiness
skin rash
flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction may also occur, but this is rare. Symptoms of a severe allergic reaction may include swelling of your mouth, tongue, or throat, which may cause trouble breathing. You may also experience swelling under your skin, often in your lips, eyelids, hands, or feet.

Tips for managing

If you have symptoms of an allergic reaction to Prozac, call your medical professional immediately. If you feel as if you’re having a medical emergency, call 911 or your local emergency number right away.

Boxed warning

Prozac has a boxed warning from the Food and Drug Administration (FDA). The boxed warning appears on the drug’s label and alerts you to possible serious risks.

Suicidal thoughts and behaviors. Antidepressants, such as Prozac, can raise the risk of suicidal thoughts and behaviors. This risk may be highest for children, teenagers, and adults who are age 24 or younger.*

And regardless of your age, your risk may also be higher if your Prozac dosage has been changed recently, or if you started taking the drug recently (within a few months ago).

While you’re taking Prozac, watch for the following symptoms:

aggressive behavior
anxiety
mania or hypomania (episodes of extremely high energy and excitement)
feelings of agitation, irritability, or restlessness
insomnia (trouble sleeping)
thoughts about harming yourself

* Prozac is only approved to treat certain types of depression in children and teenagers, in some situations. For details, you can see the “What do you take Prozac for?” section below.

Tips for managing

If you have unusual changes in your thoughts, moods, behaviors, or feelings while taking Prozac, tell your medical professional right away. They may change your treatment plan or prescribe a drug for you other than Prozac. And if you have thoughts about harming yourself, it’s important to get help right away.

Suicide prevention

If you or someone you know is considering suicide, you’re not alone. Help is available right now:

Call the National Suicide Prevention Lifeline 24 hours a day at 800-273-8255.
Text “HOME” to the Crisis Text Line at 741741.
The Trevor Project provides crisis support for LGBTQIA+ individuals. Call their hotline at 866-488-7386 or text “START” to 678-678.
Contact the teen-to-teen peer hotline, Teen Line, at 800-852-8336 or text TEEN to 839863.

Not in the U. S.? Find a helpline in your country with Befrienders Worldwide.

Your medical professional can advise you on how much Prozac to take and how often. Commonly used dosages are mentioned below, but always take the dosage your medical professional recommends.

Your medical professional may prescribe a different dosage depending on certain factors, such as:

your age
other health conditions you have
other medications you take

Form and strengths (10 mg, 20 mg, 40 mg)

Prozac comes as capsules that you swallow.

The drug is available in the following strengths: 10 milligrams (mg), 20 mg, and 40 mg.

Recommended dosages

Below are the recommended dosages of Prozac for each condition the drug is used to treat. Your medical professional will monitor the effects of Prozac week by week to determine if your dosage needs to be adjusted.

Dosage for panic disorder with or without agoraphobia: The typical starting dosage of Prozac for panic disorder (a type of anxiety) is 10 mg each day. The usual maximum dose of Prozac for panic disorder is 60 mg per day.
Dosage for OCD: The typical starting dosage of Prozac for obsessive-compulsive disorder (OCD) is 20 mg each morning. The usual maximum dose of Prozac for OCD is 60 mg per day.
Dosage for depression: The usual starting dosage of Prozac for major depressive disorder (MDD), which is also called depression, is 20 mg each morning. The maximum dose of Prozac for depression is 80 mg per day.
Dosage for bulimia: The usual starting dosage of Prozac for bulimia is 60 mg each morning, which is also the maximum dose of Prozac for this use.
Dosage for episodes of depression caused by bipolar I disorder: For episodes of depression with bipolar I disorder, Prozac is used in combination with olanzapine (Zyprexa).* The typical starting dosage of Prozac for this purpose is 20 mg each evening. The usual maximum dose of Prozac for depression episodes caused by bipolar I disorder is 50 mg per day.
Dosage for treatment-resistant depression: For treatment-resistant depression, Prozac is used in combination with olanzapine (Zyprexa).* The usual starting dosage of Prozac for this purpose is 20 mg each evening. The typical maximum dose of Prozac for treatment-resistant depression is 50 mg per day.

* Fluoxetine (the active drug in Prozac) is available in combination with olanzapine as the brand-name drug Symbyax. Your medical professional or pharmacist can advise whether Symbyax is right for you.

Here are the answers to some commonly asked questions about Prozac.

Is Prozac used to treat anxiety?

One of the conditions Prozac is approved to treat is panic disorder, which is a specific type of anxiety. But Prozac may also be prescribed off-label to treat other types of anxiety. (Off-label means using a drug for a condition it hasn’t been approved to treat.)

Specifically, Prozac is sometimes used off-label to treat:

generalized anxiety disorder
social anxiety disorder

Your medical professional or pharmacist can provide more information about using Prozac to treat these conditions or other types of anxiety.

Does Prozac cause weight gain?

No, weight gain wasn’t reported as a side effect in studies of Prozac.

Prozac is used to treat depression and bulimia (a type of eating disorder). And weight changes are known to happen with these conditions.

If you have weight gain while taking Prozac, your medical professional can help determine if the weight gain is caused by Prozac or by the condition you’re using Prozac to treat. They can also help you with managing a weight that’s healthy for you.

Does the half-life of Prozac affect how long it stays in your system?

Yes. The amount of time you’ve been taking Prozac can also affect how long the drug stays in your system.

Half-life refers to the time it takes for your body to get rid of half of a drug’s dose. The half-life of Prozac is shorter for people who’ve just started taking the drug compared with people who’ve taken several doses.

When you start taking Prozac, the drug’s half-life is about 1 to 3 days. After you’ve taken several doses, Prozac’s half-life extends to 4 to 6 days.

It usually takes about five half-lives for a drug to leave your system entirely. This means Prozac will stay in your system for about 5 to 15 days after your first few doses. But after several doses, the drug will stay in your system for about 20 to 30 days.

What does Prozac feel like when it starts working?

Prozac can help improve your emotions and mood. But you may not feel the effects of it right away. It can take several weeks for you to notice the drug’s effects. Over time, you may notice that you feel more relaxed, less worried, and less tense than before you started taking Prozac.

Your medical professional or pharmacist can answer any questions you may have about what to expect with Prozac treatment.

Is Prozac a controlled substance?

No, Prozac is not a controlled substance.

Controlled substances are medications that have high potential for misuse or for being addictive. (With misuse, a drug is taken differently than how it’s prescribed. And with addiction, a drug continues to be taken even if it’s causing harm.)

These effects aren’t known to happen with Prozac. But your medical professional will help make sure you’re taking the drug safely and as prescribed.

Before taking Prozac, it’s recommended that you talk with your medical professional about:

your overall health
medical conditions you have
any other medications you take

We discuss these considerations in more detail below.

Interactions

Taking certain drugs, foods, vaccines, and other substances with a medication may affect how that medication works. These effects are known as interactions.

Before you take Prozac, it’s important to talk with your medical professional about any other drugs you take. This includes prescription and over-the-counter medication. It’s also essential to mention any herbs, supplements, and vitamins you may use.

Your medical professional or pharmacist can tell you about possible interactions these substances may have with Prozac.

Interactions with drugs or supplements

Prozac can interact with several types of drugs. These include:

drugs that increase your serotonin level, such as:
- the attention deficit hyperactivity (ADHD) drug amphetamine (Adderall XR)
- a type of antidepressant drug called tricyclic antidepressants
- the pain drug fentanyl (Duragesic)
- the mood stabilizer drug lithium (Lithobid)
- the anxiety drug buspirone
- the herbal supplements tryptophan and St. John’s wort
- certain migraine drugs called triptans
drugs that affect your central nervous system, such as benzodiazepines
drugs broken down in your body by an enzyme (type of protein) called CYP2D6
drugs that increase your risk for bleeding, such as
- aspirin
- the blood thinner drug warfarin (Jantoven)
the mental health condition drugs haloperidol (Haldol) and clozapine (Clozaril)
the seizure drugs phenytoin (Dilantin) and carbamazepine (Tegretol)
a type of antidepressant drug called monoamine oxidase inhibitors (MAOIs)*
the schizophrenia drug thioridazine*
the Tourette syndrome drug pimozide*

We haven’t listed all types of drugs that may interact with Prozac. Your medical professional or pharmacist can provide more details as well as information on other possible interactions.

* Because of this interaction, you should not take Prozac if you’re taking these medications.

FDA boxed warning

Prozac has a boxed warning from the Food and Drug Administration (FDA) about suicidal thoughts and behaviors. The boxed warning appears on the drug’s label and alerts you to possible serious risks.

This risk is highest for children, teenagers, and young adults who take an antidepressant, such as Prozac.

For details, see “Side effects: A closer look” in the “Does Prozac have side effects?” section above.

Other warnings

If you have certain medical conditions or other factors that affect your health, Prozac may not be the right choice for you. Before you take Prozac, it’s important to discuss your health history with your medical professional. The list below includes some factors to consider.

Diabetes. Prozac can make it hard to manage blood sugar levels. If you have diabetes, your medical professional may watch your blood sugar levels more closely than usual if you take Prozac.
Heart problems. If you have heart problems, Prozac may cause an abnormal heart rhythm. Your risk for this side effect may be higher, and your medical professional may monitor your heart closely during treatment.
Liver problems. If you have liver problems, such as cirrhosis, your body may have trouble removing Prozac from your system. This could cause the drug to build up in your body, which increases your risk for side effects from Prozac. Let your medical professional know about any liver problems you have.
Allergic reaction. If you’ve had an allergic reaction to Prozac or any of its ingredients, you should not take Prozac. Your medical professional can recommend other treatments that might be better choices for you.

Prozac and alcohol

It’s recommended to avoid drinking alcohol during treatment with Prozac. Drinking alcohol while taking the drug can worsen certain side effects of the drug, such as tiredness.

If you drink alcohol, talk with your medical professional about whether it’s safe to drink while you’re taking Prozac.

Prozac use while pregnant or breastfeeding

It may not be safe to take Prozac during pregnancy. Taking the drug during pregnancy can increase the risk of heart problems in the fetus.

If you take Prozac during pregnancy, consider enrolling in a pregnancy registry. Pregnancy registries collect details about the effects of a drug used during pregnancy. This information can help researchers understand the risks of using the drug during pregnancy.

To enroll in the National Pregnancy Registry for Antidepressants and report side effects of Prozac if used during pregnancy, visit the registry’s site. Or call 844-405-6185. It’s important to talk with your medical professional about the risks and benefits of taking Prozac while you’re pregnant.

Additionally, Prozac can pass into breast milk. If you’re breastfeeding while taking Prozac, it’s recommended that you watch your child for these side effects:

irritability or agitation (acting fussy, restless, or cranky)
poor feeding
trouble gaining weight

Your medical professional can advise you about taking Prozac while you’re breastfeeding.

While researching Prozac, you may wonder how the drug compares with alternatives such as sertraline (Zoloft). You may wonder about other drugs as well, such as paroxetine (Paxil) and bupropion (Wellbutrin).

Prozac, Zoloft, and Paxil belong to a group of antidepressant drugs called selective serotonin reuptake inhibitors (SSRIs). Wellbutrin belongs to a group of drugs called norepinephrine and dopamine reuptake inhibitors (NDRIs). All of these drugs are used to treat forms of depression and anxiety.

To learn about the similarities and differences between Prozac and Zoloft, you can refer to this comparison article. You can also ask your medical professional or pharmacist whether any of these drugs are right for you.

Both Prozac and escitalopram (Lexapro) belong to a group of antidepressant drugs called selective serotonin reuptake inhibitors (SSRIs). And both drugs can be used to treat forms of anxiety and depression.

To learn how Prozac and Lexapro are alike and different, you can refer to this comparison article. Your medical professional or pharmacist can answer any additional questions you may have.

Suddenly stopping Prozac can cause withdrawal symptoms. This can happen within days of stopping Prozac treatment. And they may last for several weeks after your last dose.

However, Prozac is less likely to cause withdrawal symptoms than other antidepressant drugs. This is because Prozac can stay in your body for many days after you take it.*

Possible symptoms of withdrawal from Prozac can include:

confusion
dizziness
headache
mood changes, such as agitation, anxiety, and irritability
paresthesia (temporary numbness, burning, or prickling sensation in your legs, feet, hands, or arms)

Don’t stop taking Prozac unless your medical professional says it’s safe to do so. When it’s time for you to stop taking the drug, your medical professional will explain how to wean off Prozac. This will help lower your risk for withdrawal symptoms.*

Your medical professional can answer any questions you may have about the withdrawal timeline for Prozac.

* For details, you can see “Does the half-life of Prozac affect how long it stays in your system?” in the “What are some common questions about Prozac?” section above.

If you have certain mental health conditions, your medical professional may recommend that you take Prozac. Below, we describe the conditions that Prozac may be prescribed to treat.

Prozac for panic disorder

Prozac can be used in adults to treat panic disorder with or without agoraphobia. Panic disorder is a type of anxiety. You may have sudden, strong symptoms of anxiety that seem to happen without a known cause. Agoraphobia is an intense fear of being in public.

Symptoms of panic disorder can include:

chest tightness
chills or sweating
nausea
fast heart rate
shaking or trembling
shortness of breath

Prozac for OCD

Prozac can be used to treat obsessive-compulsive disorder (OCD) in adults and in children ages 7 years and older. With OCD, you experience obsessions (repeated, unwanted thoughts) in combination with compulsions (overwhelming urges to do certain actions).

These obsessions can lead to stress and anxiety, and compulsions can offer some relief for this stress and anxiety.

Prozac for depression

Prozac can be used to treat major depressive disorder in adults and in children ages 8 years and older. With this condition, you have depression symptoms almost every day for at least 2 weeks.

Symptoms of depression can include:

changes in mood
inability to concentrate
loss of appetite
loss of interest in activities that you used to enjoy
trouble sleeping
weight changes

Prozac for bulimia

Prozac is used in adults to treat bulimia nervosa. With this eating disorder, you may be focused on food, body image, and weight. And this can lead you to binge and purge.

Bingeing describes eating a large amount of food in a very short period of time. And purging refers to getting rid of the food in some way, such as forcing yourself to vomit.

Prozac for episodes of depression caused by bipolar I disorder

Bipolar disorder is a condition that causes sudden, extreme changes in mood. It generally involves episodes of depression as well as episodes of mania (extremely high energy and excitement).

Bipolar I disorder means someone has had at least one episode of mania. Prozac is used to treat the episodes of depression that also happen with this condition.

Prozac can be used to treat episodes of depression in adults and in children ages 10 years and older. For this purpose, Prozac is taken in combination with olanzapine (Zyprexa).*

Prozac for treatment-resistant depression

Prozac can be used for treatment-resistant depression in adults. With this condition, you have depression symptoms that haven’t improved after trying at least two other antidepressant drugs.

For this purpose, Prozac is used in combination with olanzapine (Zyprexa).

How Prozac works

Prozac belongs to a group of antidepressant drugs called selective serotonin reuptake inhibitors (SSRIs).

The drug works by increasing the level of a chemical in your brain called serotonin. Higher levels of serotonin can help improve your emotions and mood.

Prozac for children

Prozac is used to treat the following conditions in some children:

obsessive-compulsive disorder (OCD) in children ages 7 years and older
major depressive disorder (MDD) in children ages 8 years and older
episodes of depression in bipolar I disorder in children ages 10 years and older

How Prozac works

Prozac belongs to a group of antidepressant drugs called selective serotonin reuptake inhibitors (SSRIs).

The drug works by increasing the level of a chemical in your brain called serotonin. Higher levels of serotonin can help improve your emotions and mood.

Prozac for children

Prozac is used to treat the following conditions in some children:

obsessive-compulsive disorder (OCD) in children ages 7 years and older
major depressive disorder (MDD) in children ages 8 years and older
episodes of depression in bipolar I disorder in children ages 10 years and older, when used in combination with olanzapine (Zyprexa)

See the rest of this section above for details about these conditions.

It’s important that you do not take more Prozac than your medical professional recommends. Taking more than the recommended dosage can lead to severe side effects.

Symptoms of overdose

Symptoms caused by an overdose can include:

increased heart rate
seizures
tiredness
nausea and vomiting

What to do in case you take too much Prozac

If you believe you’ve taken too much Prozac, call your medical professional right away. You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use its online resource. But if your symptoms are severe, immediately call 911 (or your local emergency number) or go to the closest emergency room.

Your medical professional can help explain how to take Prozac. It’s important to follow the instructions they provide.

Below are a few suggestions for how to take Prozac.

Tips for taking Prozac

Prozac comes as capsules that you swallow whole. You’ll likely take the capsules once a day.

Depending on the condition you’re taking the drug to treat, you may take Prozac in the morning or in the evening. But regardless of when you take it, try to take your doses around the same time each day. This helps keep a steady level of the drug in your system, which can help prevent withdrawal symptoms.

Until you know how Prozac affects you, it’s recommended that you avoid driving or doing tasks that require you to think clearly. The drug can cause tiredness, which can be dangerous while you’re driving. After taking several doses, you’ll likely know whether Prozac will cause these effects for you.

Your medical professional can answer any questions you may have about how to take Prozac.

Taking Prozac with other drugs

Your medical professional may prescribe Prozac along with other drugs to treat your condition.

But before starting Prozac, it’s important to tell your medical professional about any other drugs you take. This is because certain drugs may affect how Prozac works or they may raise your risk for side effects from Prozac.

For example, taking Prozac with amphetamine (Adderall XR) can raise your risk for serotonin syndrome. This condition is caused by a high level of a chemical in your brain called serotonin. This condition can be dangerous.

For more information about possible interactions with Prozac, you can see the “What should you know before taking Prozac?” section above.

How long it takes for Prozac to work

After you start taking Prozac, it may take up to several weeks for your symptoms to improve. We encourage you to talk with your medical professional about when you can expect to notice that Prozac is working for you.

Frequently asked questions about taking Prozac

We’ve provided the answers below to some frequently asked questions about using Prozac:

What’s the best time to take Prozac? Depending on the condition you’re using the drug to treat, you may take Prozac in the morning or in the evening. But regardless of when you take it, try to take your dose at about the same time each day. This helps keep a steady level of the drug in your system, which can help prevent withdrawal symptoms.
What should I do if I miss a dose of Prozac? If you miss a dose of Prozac, take your missed dose as soon as you remember. But if it’s almost time for your next dose, just skip your missed dose. Then take your next dose at the regular time. Do not take two doses of Prozac to make up for a missed dose. Doing so can increase your risk for side effects from the drug. If you aren’t sure whether to take a dose or skip it, ask your medical professional or pharmacist.
Is Prozac meant for long-term use? Your medical professional may prescribe Prozac for long-term use. If the drug is working for you and isn’t causing bothersome side effects, you’ll likely take it long term.
Can you chew, split, or crush Prozac? It may not be safe to chew, split, or crush Prozac. Your medical professional or pharmacist can offer advice if you’re unable to swallow the capsules whole.
Should you take Prozac with food? You can take Prozac with food or without it.

What should you ask your medical professional?
It’s common to have questions about your treatment plan for Prozac. Your medical professional will work with you to help address any concerns you have.
To help guide your discussion, here are some suggestions:
Try writing down questions you have before your visit. For example, “How will taking Prozac affect my mood, body, and lifestyle?”
Think about asking a loved one or friend to come with you to your appointment. Having in-person support may help you feel more at ease.
If your medical professional says something that’s unclear, you can always ask them to explain it.
Working with your healthcare team may help you stay on track with your treatment. The team wants you to get the best care possible.

Prozac is a prescription drug. The costs of prescription medications may depend on several factors, such as your insurance coverage and the pharmacy you use.

Prozac is available as a generic drug called fluoxetine. A generic is a copy of the active drug in a brand-name medication. The generic may cost less than the brand-name form. Your medical professional can help determine if the generic form of Prozac may be an option for your treatment.

If you’re wondering how to pay for Prozac, discuss this with your medical professional or pharmacist. You may also want to visit the website of the Prozac manufacturer to see if support options are available.

Studies of Prozac haven’t shown a high risk of misuse. (Misuse means taking a drug differently than how it’s prescribed.)

But it is possible that Prozac may be misused. To lower your risk of misuse, it’s important to take Prozac exactly as your medical professional has prescribed.

If you still have questions about Prozac after reading this article, we recommend talking with your medical professional. Together you can decide if Prozac might be a good choice for you.

You can also discuss other treatments, forms of support, and resources that may benefit you. We’ve listed some helpful suggestions below.

Additional treatment options

While you take Prozac, additional treatments or remedies may help you manage your condition better. These can include:

psychotherapy
nutritional counseling and therapy
deep brain stimulation
breathing techniques

Finding support

Whether you’re looking for a therapist, support group, or information on how to afford therapy, these resources may help:

how to find a therapist
online counseling search through BetterHelp
online support groups
how to afford therapy

Other resources

To receive weekly information on mental health, you may want to sign up for the Psych Central newsletter. You’ll find stories directly from other people on their mental health journey as well as the latest information on treatments.

Will the symptoms of my condition come back after I stop taking Prozac?

Anonymous patient

It’s possible that symptoms of your condition may come back after you stop taking Prozac. After you stop your treatment, a medical professional will continue to monitor you for symptoms.

If you have any changes in your mood or behavior after stopping Prozac, including suicidal thoughts, it’s important to call your medical professional immediately.

It’s also important to talk with a medical professional before you stop taking Prozac. The two of you can decide whether stopping it is right for you. And your medical professional can recommend how to stop taking the medication safely.

Neal Patel, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Disclaimer: Psych Central has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

What you should know about antidepressants

Ekaterina Kushnir

treats anxiety disorder

I have generalized anxiety disorder.

For a long time I coped without pills and other help, but one day I got tired of constant anxiety and began to interfere with my normal life. As a result, I turned to a private psychiatrist.

The doctor prescribed an antidepressant from the SSRI group - these are selective serotonin reuptake inhibitors. Such drugs are the first thing prescribed in the treatment of depression and a number of other conditions, including my disease.

The doctor immediately warned me about some peculiarities associated with taking the drug. Some of them I then felt on myself. I think everyone who plans to be treated with antidepressants should know about them.

At the same time, it should be taken into account that most of the negative effects of therapy are temporary and not dangerous, and if they do not go away, one medicine can be replaced with another. Antidepressants help many people with mental disorders and other illnesses get rid of their symptoms and return to a full life, so you definitely should not be afraid of them. The main thing is to take such drugs when they are really needed: as prescribed by a competent doctor and under his control.

See a doctor

Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don't write prescriptions, we make recommendations. Relying on our point of view or not is up to you.

Fact No. 1

Antidepressants may make symptoms worse at first

Antidepressants can increase anxiety in anxiety disorders, as well as cause irritability and agitation - this is the name for causeless motor arousal, the inability to sit still. It's not dangerous, but rather unpleasant. This condition is sometimes referred to as initial anxiety, that is, the anxiety of starting therapy. Up to 65% of people face it.

Antidepressant-induced anxiety syndrome - a systematic review in the British Journal of Psychiatry

There is also evidence that some classes of antidepressants, including SSRIs, may increase suicidal ideation in depression in young people aged 18 to 24 years. These data are not very reliable, and in older people, the risk of suicide no longer increases and even decreases.

Without treatment, depression is more likely to lead to suicidal thoughts, and in case of anxiety, you just need to prepare for such an effect, then it will be easier to survive the attacks.

The doctor told me that in the first two or three weeks there may be an increase in anxiety, but I did not take it too seriously.

Everything was fine for the first week. After about seven days, I became nervous and irritable. And then I woke up at night and after a while I felt an incomprehensible fear. My heartbeat increased, my head was spinning, my throat was constricted. Because of this, I felt a real panic - I spent the rest of the night fighting terrible thoughts, in the morning I got up completely broken.

/list/antidepressant-myths/

8 myths about antidepressants

I have never had such panic attacks before medication - my anxiety was background, general. I got scared and wrote to the doctor, who reassured me and said that it was not dangerous and would pass soon.

After that, I already expected these panic attacks, immediately tried to relax, calm down, remember that this was just a temporary effect of the drugs. And they ended faster, and then they completely disappeared.

My letter to a psychiatrist. I was scared: I expected an increase in background anxiety, but not panic attacks. I even thought about giving up the medicine

Fact No. 2

The effect of antidepressant treatment will not be immediate

Increase the dose of antidepressants gradually to reduce side effects. They usually start with the minimum, and then bring it up to the working one. For example, for SSRIs with the active ingredient "sertraline", the working dose is from 100 mg per day. I started taking such a drug with 25 mg, and then gradually, in several steps, under the supervision of a doctor, raised the dose to 100 mg.

SSRI dosage - NHS

What doses of antidepressants will be optimal - an article in The Lancet

The process of reaching a working dose can take from two weeks to a month or more. It depends on the drug and its tolerance. I turned out to be sensitive to the medicine, it was hard for me to survive every increase in dosage: anxiety increased again, there were other side effects that then stopped. However, this is not the case for everyone, sometimes the process goes faster.

The full therapeutic effect, that is, the disappearance or a strong improvement in the symptoms of the disease, occurs some time after reaching the working dosage. As a rule, this is a week or two, although some positive changes may be earlier. For some people, this process stretches for a longer period: 6-12 weeks. Minimum initial doses of drugs usually do not work.

It is better to prepare for the fact that the symptoms of the disease will not disappear in the first weeks of treatment. And remember - this does not always mean that the drug needs to be changed, sometimes you just need to wait or further increase the dosage under the supervision of a doctor.

Fact No. 3

Antidepressants are usually taken in combination with other drugs

Another way to mitigate the side effects of antidepressants is to prescribe an additional drug along with them: for example, from the group of tranquilizers. Such drugs may have their own side effects, they should not be taken for a long time. Unlike antidepressants, some of them can be addictive. They are usually appointed for a month, but this period may be shorter or longer.

Antidepressants together with benzodiazepines work better for depression - BMJ magazine

My doctor prescribed a rather mild drug for me. However, he did not suit me. At first, it caused increased drowsiness: during the period of increased anxiety, it went away for a while, but then returned - even with half a pill I turned off and could sleep all day. And if I drank at night, I woke up with difficulty in the morning. The psychiatrist prescribed another medicine, but I could not buy it: the drug was not available in any pharmacy nearby.

As a result, I simply endured all the side effects of therapy - they were unpleasant, but tolerable. When discussing with the doctor, she called this option acceptable if the side effects of the second medicine only worsen the situation.

My prescriptions for drugs. I never used one, because there was no such medicine in pharmacies

Fact No. 4

Side effects are not always, but they are

Modern antidepressants, including SSRIs, are mild and have almost no side effects. Older drugs - tricyclic antidepressants and monoamine oxidase inhibitors - cause more side effects. Doctors usually use them when milder first-line drugs don't work or when they can't be prescribed.

Side effects of antidepressants - the National Health Service of the UK

Side effects of various antidepressants - Uptodate

Side effects of antidepressants and their impact on the treatment of a large depressive disorder - the journal NATURE

STOCE OF RIGHT OF STROTOLNIA 9000 - UPTODATE 9000 effects of antidepressants - advice from the Mayo Clinic staff

Choosing an SSRI drug does not guarantee the absence of side effects - many people tolerate treatment easily, but sometimes a change in drug may be necessary.

The first couple of weeks of taking there is a risk that the state of health will be so-so - it's worth thinking about. It may be worth scheduling the start of therapy on vacation.

I work remotely, and it was easier for me: the first pill was taken on Saturday, I slept through the weekend. Then she continued to work, but refused any additional loads: housework, part-time jobs, training and everything else.

It was hard work: I wanted to sleep, then I began to worry and get distracted. I also had diarrhea, nausea, headaches, tremors, i.e. hand trembling, hot flashes, sweating, palpitations. At night, panic attacks began, in the morning I had difficulty getting up because I was in pain and dizzy.

There are mixed data on how common the side effects of antidepressants are. If we summarize them, then the numbers look something like this:

nausea - about 25% feel it;
diarrhea - it happens in 15% of people, and 5%, on the contrary, will have constipation;
sweating and a feeling of heat occur in about 20% of people;
sexual dysfunction, decreased libido may occur in 80% of cases;
insomnia - in 11% of cases;
headache and dizziness - in about 10-11% of cases;
weight gain - not all drugs give this effect. Some, on the contrary, can reduce weight. On my medicine, I lost 2 kilograms in the first month, despite the fact that I quit training due to poor health. True, then they returned back.

It can be seen that most side effects occur in less than half of the cases. In addition, in most cases they pass in the first weeks and are not dangerous.

Side effects not listed above are very rare. I was "lucky", and I faced one such - a decrease in visual acuity. Once in the morning I noticed that I see worse without glasses. A little later, I realized that something was wrong with the glasses.

I wrote to the doctor, she replied that this happens, as a rule, is not dangerous and passes, but it is better to visit an ophthalmologist. I went to the ophthalmologist, everything was fine with my eyes, there was nothing terrible, but my vision really worsened - it was not a subjective feeling. On the right eye, it was -0.5 diopters, it became -0.75, and on the left eye it was -1. 5, and it became -3.5.

I was offered to try changing the drug, but I decided to wait. Vision was then restored. I have not yet gone to the doctor to have it measured, but according to subjective feelings, it is at the same level as before: I am comfortable again in my glasses.

Side effects should not be tolerated - if something greatly worries, scares or interferes with life, it is better to tell the doctor right away. The psychiatrist will be able to determine whether the side effect of the drug is dangerous and whether it is worth continuing to take it. There are several antidepressants of the SSRI group, in addition, there are groups of drugs with a slightly different mechanism of action. As a rule, doctors manage to find a medicine that gives a good effect without side effects.

If there is no danger, the doctor can adjust the dose or increase it more gradually - this often helps to cope with unpleasant effects.

I wrote to the doctor again when my visual acuity decreased

Fact No. 5

Antidepressants need to be taken long term

Antidepressants are not drugs that you can stop drinking as soon as you get better. They are taken for a long time: usually from several months, less often several years.

Anxiety Therapy - UpToDate

For example, for generalized anxiety disorder, the duration of treatment is at least a year. Moreover, the date is not counted from the very beginning, but from the moment when a lasting effect appeared from the pills. In fact, they will have to be drunk for about 1.5 years - it depends on how long it takes to reach the working dosage of the medicine.

The cost of a package of the most famous antidepressant "Zoloft" is about 700 R, enough for about a month. That is, a course of therapy will cost about 10,000 R - maybe more or less, depending on which drug is selected.

Psychotherapy review - UpToDate

Another drug of the same group already costs more than 2000 R per pack. Source: rigla.ru

The cost of an appointment with a good psychiatrist in Moscow is 3000-5000 R. At first, you will need to visit him about once every 1-1.5 months, then less often.

You can apply to the psycho-neurological dispensary at the place of residence under compulsory medical insurance - it's free. At the same time, they will not put you on psychiatric registration: it was canceled in 1993. People with disorders that do not threaten their lives or those around them are on consultative and diagnostic care. If you stop going to the doctor, he will not find out what happened: a person seeks help at will.

Psychotherapy, usually cognitive-behavioral, is also commonly prescribed to enhance and sustain the effects of antidepressants. In many cases, it improves the effectiveness of drugs, including depression and generalized anxiety disorder. An appointment with a psychotherapist in Moscow costs an average of 5000 R. For treatment, you will need about 10 sessions or more.

/psychotherapy/

How psychotherapy works

Fact No. 6

Antidepressants should not be stopped abruptly

Antidepressants do not develop dependence. However, if you abruptly stop drinking them, there will be a withdrawal syndrome. This is felt as electric current discharges while moving or turning the head, headaches, dizziness, insomnia. Many people experience symptoms similar to the flu or an intestinal virus: low fever, diarrhea, general malaise, chills. Often there is anxiety, there are intrusive images.

Withdrawal symptoms after taking serotonin reuptake inhibitors - Journal of Clinical Psychiatry

How difficult it is to stop taking antidepressants - American Psychological Association

Stopping antidepressants in adults - UpToDate

treatment, they should be canceled only under the supervision of a doctor.

Antidepressant withdrawal occurs as gradually as the start of treatment. The dosage is slowly reduced, usually at this time again a cover-up drug is prescribed to alleviate side effects. As a rule, this is the same medicine that was at the beginning of the intake.

Withdrawal is usually harmless and resolves within the first weeks of stopping the drug. Sometimes even within a few days - it still depends on which medicine was prescribed. If severely disturbing symptoms appear during the withdrawal period, you should consult a doctor.

Fact No. 7

If you need to change the drug, everything will start over

It is far from always possible to immediately find the right antidepressant - sometimes the side effects do not go away and you need to take a new one.

Changing antidepressants in adults - UpToDate

Serotonin syndrome - MSD

Most often, it is started again with a small dosage, this delays the process of obtaining the effect of treatment. The new drug may also have side effects - the same or different. We will have to wait again until they pass.

You won't be able to change the drug on your own, since all antidepressants are sold only by prescription - and that's good. Switching from one drug to another can be dangerous if you do not know the characteristics of different groups of drugs.

For example, taking SSRIs is possible only some time after the withdrawal of antidepressants from the group of monoamine oxidase inhibitors - due to the risk of developing serotonin syndrome. This is a potentially fatal condition, accompanied by a change in mental state, high fever, increased muscle tone and other symptoms.

If the drug is changed correctly, there will be no dangerous negative effects, so consultation with a doctor is required.

/psychotherapy-search/

How to choose a psychotherapist

Fact No. 8

Among antidepressants there are original drugs and generics

Preparations may be original or generic. Originals are medicines first released by some pharmaceutical company that have passed all clinical trials and checks. Generics are drugs with the same active ingredient from another pharmaceutical company, that is, copied from the original drug.

Theoretically, the action of generics should not differ from the action of original drugs. However, this is possible, since generics may contain other additional substances or the manufacturer may use other raw materials.

Due to my anxiety, I did not read anything in detail about specific drugs before I bought my first antidepressant in a pharmacy so as not to be scared and not think about taking it. I also didn’t think to ask the doctor about this question.

/list/covid-depression/

Psychoneurological complications after covid: memory problems and depression

As a result, I first bought a generic because it was in stock. Then it turned out that, after all, according to the experience of my psychiatrist, the original drug often gives fewer side effects and is better tolerated. As a result, I changed the generic to the original drug - and, indeed, the side effects softened.

In my subjective opinion, which is supported by some data, in the case of antidepressants and other psychotropic drugs, you should always choose the original medicine. Moreover, the cost of originals and generics is not always very different.

Originals and generics of some SSRIs

Active ingredient	Original	Original cost	Generics	Cost of generics
Sertraline	Zoloft	About 700 R, 100 mg tablets	Serenata, Sirlift	500-600 R 100mg tablets
Escitalopram	Cipralex	3000 R, tablets 10 mg	"Selektra", "Elycea"	500-1300 R 10 mg tablets
Fluoxetine	Prozac	About 350 R, 20 mg tablets	Profluzak, Fluoxetine	100-200 R, tablets 20 mg

CERTRALIN

Original

Zoloft

Original cost of the original

about 700 r, tablets 100 mg

generics

"Serenata", "Cerelift"

The cost of generies

9000 500-600 r.

, tablets 100 mg

Escitalopram

Original

Cipralex

Original price

3000 r, tablets 10 mg

generics

“Selectra”, “Elice”

The cost of generics

500-1300 r, tablets 10 mg

Fluoxetine

“Przak”

Cost Kene original

About 350 R, tablets 20 mg

Generics

Profluzak, Fluoxetine

Cost of generics

100—200 R, tablets 20 mg

one remained unclaimed

Fact No. 9

Do not take alcohol along with antidepressants

Drinking alcohol while taking antidepressants may exacerbate unpleasant side effects. Also, alcohol is a depressant, that is, it has the opposite effect, and its intake can adversely affect the results of treatment.

Why you shouldn't mix antidepressants and alcohol - Mayo Clinic

Alcohol is strictly forbidden to drink with some groups of antidepressants, for example, tricyclic antidepressants and monoamine oxidase inhibitors: combination with the latter, for example, can lead to an uncontrolled increase in pressure. MAO inhibitors in general require a special diet - it is unlikely that a doctor will prescribe such drugs as the first antidepressants, but if necessary, he will issue a list of what is allowed and prohibited.

With other antidepressants, moderate use may not be dangerous and may even pass without consequences, but doctors still recommend abstaining so as not to increase side effects and improve treatment outcome.

The main thing is not to temporarily stop taking the drug in order to drink. This can lead to the development of a withdrawal syndrome.

/trevoga/

How I Treated Generalized Anxiety Disorder under CHI

Fact No. 10

Antidepressants are incompatible with certain drugs and have contraindications

It is important to tell your doctor what medications you are taking and what chronic illnesses you have. For example, SSRIs may not be suitable for epilepsy and bleeding disorders, and tricyclic antidepressants are usually not prescribed for those who have recently had a heart attack, suffer from glaucoma, or porphyria.

Antidepressant Warnings - NHS

Drug Compatibility Test - Drugs.com

It is also important to be careful if you are about to take any over-the-counter medicine. For example, ibuprofen, which people often take on their own to relieve pain and reduce fever. It should not be taken with SSRIs as it increases the risk of gastrointestinal side effects.

If it is not possible to consult a doctor before taking any medication, carefully read the instructions for it and your antidepressant. It is also worth informing all doctors who prescribe something to you during the therapy period about taking antidepressants.

How Prozac Made the World Love Depression — Bird In Flight

At the end of the 20th century, Prozac helped humanity cope with one of the most difficult diseases of our time - depression. But at the same time, he created a cult out of the disease. Bird in Flight tells the story of the rise and fall of the happiness pill.

The diagnosis of "clinical depression" began a century and a half ago, today it is already the second most common in the world. This disorder affects about 300 million people. One in six people with severe depression is at risk of committing suicide. Despite the complexity of the disease, it is now not considered incurable, and for this we should be grateful to Prozac, a drug that has changed the idea of depression.

An incurable disease

For a long time, medicine did not know how to help people with depression: in the Middle Ages, it was treated with prayers, in the Renaissance, with vegetarianism. Only in the 19th century did doctors realize that the main cause of depression was a malfunction in the nervous system. Patients were prescribed stimulant psychoactive substances such as alcohol, opium, cocaine, and eventually sedative barbiturates. They did not cure the disease, but only temporarily relieved the symptoms, while causing addiction.

Accidental discovery

A breakthrough in the fight against depression occurred in the early 1950s, when a drug for tuberculosis, iprovizid, was being studied in the United States. The medicine coped with its task poorly, but it was found to have an unusual side effect: after taking it, appetite returned to tuberculosis patients, their mood improved. As the doctors recalled, "the patients danced despite the holes in their lungs." Psychiatrists who undertook to study iprovisid confirmed its psychoactive properties. Thus, a new class of drugs appeared - antidepressants.

The first such drugs were very toxic and had many side effects. Patients taking them suffered from heart problems, excess weight and slow reflexes. However, the medications did not help everyone.

The first antidepressants had many side effects. Patients taking them suffered from heart problems, excess weight and slow reflexes.

In the early 1970s, a number of pharmaceutical companies began to develop a new generation of depression medication that would not have these unpleasant side effects. Its discoverer was David T. Wong, a researcher at the American pharmaceutical company Eli Lilly. For a long time, Wong studied the mechanisms of reuptake of serotonin, a neurotransmitter responsible, among other things, for the emotional background of a person. The researcher's task was to find a substance that would prevent the absorption of serotonin by brain neurons. It was opened at 1972, the substance was named fluoxetine.

Unlike the older antidepressants, which, like weapons of mass destruction, acted on all neurotransmitters at once, fluoxetine worked selectively. Patients could no longer be afraid of lethargy; the problem of side effects seemed to be solved.

"Prozac: wash away your blues!" Source: Tumblr / Adbusters

Killer marketing

Another advantage of the new drug was that, in addition to reuptake, it also blocked the uptake of norepinephrine, that is, it acted as a stimulant on the nervous system. So Eli Lilly made the right decision to sell fluoxetine not as an antidepressant but as a mood booster. The company wanted customers not to think about taking the medicine. Fluoxetine was supposed to be associated with energy and vivacity, so the first step in its promotion was a name change. This task was entrusted to Interbrand, whose clients included Sony, Microsoft and Nintendo. Thanks to her, fluoxetine became Prozac.

Eli Lilly introduced the drug to the US Food and Drug Administration in the late 1970s. Consideration of the application stretched for ten years. Department officials were embarrassed that Prozac had a stimulant rather than a sedative property. Despite this, it was still approved, and in December 1987 the drug entered the market.

Cult of Sorrow and Joy

In its first year, Prozac sold $350 million in the US and $2.6 billion worldwide. The drug finally convinced humanity that depression is not a sentence, as previously thought, and happiness is not an abstract concept, but a state that can be achieved with the help of pills.

"Prozac" finally convinced humanity that depression is not a sentence, as previously thought, and happiness can be achieved with the help of pills.

The popularity of the medicine was also supported by media attention. So, on December 18, 1989, New York Magazine came out with Prozac pills on the cover. The headline was "Buy-Buy Blues." After that, almost all the major magazines of that time wrote about the pills.

Eli Lilly's marketing idea worked. The Americans perceived the drug as an energy drink, after drinking which one could become more productive. It seemed that the whole country fell in love with the medicine, including doctors. At 19In 1993, psychiatrist Peter Kramer published Listening to Prozac, which became a New York Times bestseller. In it, the author suggested that the drug not only allows you to cope with depression, but also can make a mediocre person more bright, a shy person more open and sociable, and an ambitious employee can help climb the career ladder. After the publication of the book, sales of the pills increased another 15%.

Shot from the movie Prozac Nation (2001) / Miramax / Album

Prozac's popularity peaked in the 1990s when comedians and writers started talking about the drug. “When do the holidays start in New York? When drug dealers start selling more Prozac than crack" - this joke was made on the evening show with David Letterman in 1994. In the same year, writer Elisabeth Wurzel published Prozac Nation, a book about her experience of dealing with clinical depression. Wurzel's work is considered one of the examples of the romanticization of the image not only of Prozac, but of antidepressants in general.

Prozac has made its way into music as well. In 1996, the rock group Mr. T Experience released the song That Prozac Moment, in which the effect of taking the drug was compared to a moment of fleeting happiness, when you can forget about everything. Also, the drug is mentioned in the compositions of Aerosmith, Pixies, Red Hot Chili Peppers, Neil Diamond, Nick Cave and other artists.

Love no matter what

When INXS lead singer Michael Hutchence took his own life in 1997, the media wrote that Prozac killed the star. The musician's case was one of several dozen suicide cases that swept across the United States, all of which were associated with the use of fluoxetine. Eli Lilly started getting lawsuits. Later it turned out that the company knew that the drug could increase the risk of suicide even at the stage of clinical trials. It was especially dangerous for teenagers.

How could a pill designed to treat depression cause people to commit suicide? It was assumed that suicidal thoughts were in patients who committed suicide even before the start of the drug, but due to depression they lacked the strength to realize their plans. Prozac just became a source of energy. Defenders of the drug argued that it was not the drug that was responsible for the deaths, but the disease. However, according to The Guardian, the drug can cause suicidal thoughts in people who do not suffer from depression.

The fact that the drug can increase the risk of suicide, the company knew even at the stage of clinical trials.

When Eli Lilly's patent for Prozac expired in 2001, fluoxetine-based competitor products flooded the market. The side effects of the new generation of antidepressants were even less. However, even today, Prozac, along with them, remains one of the most effective means to combat depression.

The drug scandals have made the medical community and the media more critical of antidepressants—they are no longer considered a panacea. In 2008, a study was published proving that drugs for depression are effective in severe manifestations of the disease, but in the lungs they are barely noticeable than placebo. The approaches of pharmaceutical companies to the promotion of antidepressants on the market were also subject to revision. The Guardian believes that manufacturers often do not publish the results of their research or, even worse, influence them. Often, companies use advertising to change the idea of the disease, convincing the public that even minor sleep disturbances and mood swings are a cause for concern.

Learn more