Can i drink on prozac

Interactions Between Prozac and Alcohol

Mixing Prozac with brain-altering substances like alcohol can be harmful. In fact, it’s recommended that you avoid drinking alcohol while you’re on this medication.

Prozac is an antidepressant. It’s the brand-name version of the generic drug fluoxetine. You take Prozac long-term to control your symptoms.

It belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs). These drugs work with neurotransmitters in the brain to help people with depression and anxiety.

Many people tolerate SSRIs like Prozac well without having many side effects. However, that doesn’t mean the drug comes without risks.

Even though Prozac is nearly 30 years old, it’s still one of the most prescribed antidepressants in the United States. It works by inhibiting the uptake of the neurotransmitter serotonin in your brain. This can help control your mood and behavior. Prozac is prescribed for the following health conditions:

  • bulimia nervosa
  • major depressive disorder (MDD)
  • obsessive compulsive disorder (OCD)
  • panic disorder
  • treatment-resistant depression

This drug is also sometimes combined with other medications to treat bipolar disorder.

Some adults like to have a drink for a special occasion. Others might drink more often to alleviate stress. Regardless of why or how much you drink, alcohol has the same basic effects on your body.

Alcohol is a depressant that impacts your brain function. Drinking slows down and even blocks messages within your brain. It can cause the following problems:

  • trouble thinking and impaired judgment
  • fatigue
  • anxiety
  • depression
  • trouble hearing and seeing
  • decreased motor skills


The ingredients in Prozac are designed to help calm your mood. One of the side effects of the drug is tiredness. Prozac can interfere with coordinated movement and alertness, like alcohol does.

Combining Prozac with alcohol can quickly lead to increased sedation. Having even one drink while you take Prozac can cause extreme drowsiness.

This effect can lead to potentially dangerous situations. These include poor decision-making, impaired driving, and an increased risk of falls and injuries.

Mixing alcohol and Prozac can also lead to other side effects. These can include:

  • dizziness
  • sudden fatigue and weakness
  • feelings of hopelessness
  • suicidal thoughts

Mixing Prozac and alcohol may cause fatigue and weakness, which may interfere with your ability to finish simple tasks. You may find yourself needing to take a break to rest.

Alcohol can also keep Prozac from working as well as it should. Taking antidepressants like Prozac doesn’t mean you’re immune to the depressive effects of alcohol. Instead, alcohol may actually keep your medication from working to its full effect.

This means you won’t get the full benefits of Prozac. This can make the symptoms of your condition even worse.

What to do

If you take Prozac, do not drink alcohol. Mixing the two can put your health at risk. If you have strong urges to drink, talk about these feelings with your doctor.

If you’re trying to control your drinking, there’s some good news. According to a review in American Family Physician, there’s a small amount of evidence that suggests that fluoxetine, the generic name of Prozac, may help alcohol-dependent people abstain from drinking alcohol.

This doesn’t mean that Prozac should be used to treat alcoholism. But it does suggest that the drug may reduce your desire to drink.

It’s important to note that the effects of combining alcohol with Prozac can happen even if you don’t drink at the same exact time you take the drug. Prozac is a long-term medication, so it stays in your body for a long time after you take it.

Waiting a few hours after you take the drug to drink won’t reduce your chance of negative effects. If your doctor stops your treatment with Prozac, ask them how long you should wait before drinking any alcohol.

How long the drug stays in your system depends on your dosage and how long you’ve been taking the medication. Some forms of the drug can affect your body for more than two weeks after you take your last dose.

Read more: The dangers of abruptly stopping antidepressants »

Alcohol is a depressant, so drinking it when you have depression can make the symptoms of your condition worse. It can even cause signs of depression in people who don’t have clinical depression. Symptoms of depression can include:

  • frequent sadness
  • feelings of worthlessness
  • loss of interest in activities you used to enjoy
  • unusual tiredness
  • suicidal thoughts

If you’re tempted to drink when you feel depressed, don’t. Drinking will only make your health worse. Instead, call your doctor. There are many safe, effective ways to treat depression.

Learn more: Everyday lifestyle changes to help fight depression »

Due to safety risks, the U.S. Food and Drug Administration recommends avoiding alcohol while you take Prozac. Remember that dangerous interactions can happen with even a small amount of alcohol. If you take Prozac, you shouldn’t drink alcohol at all.

Prozac and Alcohol Don't Mix | San Diego

It is not unusual for a depressed person to turn to alcohol to “self-medicate.” Alcohol is typically consumed to alter your mind and bring feelings of relaxation. The irony is, alcohol is classified as a depressant, and using a depressant while depressed, is simply not a good recipe. Especially when the individual is taking a prescription antidepressant, like Prozac. Prozac and alcohol do not mix and can seriously affect the recovery process of depression.

It is important for people experiencing depression to know what their options are. Antidepressants can benefit some and should be used accordingly for good results. This resource will talk about antidepressants, alcohol, and how they should never be combined. 

If you or someone you know mixes Prozac and alcohol, don’t worry, there’s help. At Healthy Life Recovery, we offer dual-diagnosis treatment so that your depression and addiction can be treated simultaneously.

What is Prozac Used For?

Depression is on the rise in the United States, with more than 16 million Americans affected each year. In fact, one out of six adults experiences depression at some point in their life. Anyone, no matter the age, race, or gender, is susceptible to encountering this mental health issue. If you have depression and seek help, an antidepressant can be prescribed to stabilize and lift your mood.

Several signs and symptoms of depression include but are not limited to:

  • Consistent sad, anxious or empty mood
  • Feeling hopeless, worthlessness, or helplessness
  • Irritability
  • Decreased energy or fatigue 
  • Suicidal thoughts, or attempts

Prozac, perhaps the most widely known anti-depression med, is the brand name for a drug called fluoxetine. Fluoxetine is a selective serotonin reuptake inhibitor (SSRI), the most commonly prescribed antidepressant. SSRI drugs regulate serotonin amounts in the brain and nervous system. They bring feelings of joy and happiness, which is obviously lacking when you have depression. Prozac is also used to treat obsessive-compulsive, eating, anxiety, and panic disorders.

Prozac Side Effects

Prozac medication doses usually range from 10mg to 80mg to the patient. Doctors will also need a detailed medical history because of potentially dangerous reactions one can have. When taken as prescribed (the proper dose and by itself), you may still experience side effects. According to the Mayo Clinic, poor metabolism increases the risks of the drug’s side effects. It is important to contact your doctor if these symptoms do not go away or become severe. 

Some Prozac side effects include: 

  • Anxiety
  • Nausea
  • Difficulty falling asleep or staying awake
  • Heartburn
  • Excessive sweating
  • Increased blood pressure

Prozac and Alcohol Effects

It sounds like common sense not to mix an antidepressant with a depressant, yet people still mix Prozac and alcohol. Depressants like alcohol, slow down and prevent certain messages and signals in the brain. Prozac affects the brain in a similar way, causing tiredness and messing with balance and motor skills.

When you choose to mix Prozac and alcohol, an increased sedative effect will occur. The results can be harmful since the two drugs amplify each other’s effects when taken together. For instance, the tiredness caused by the Prozac turns into extreme drowsiness. Some examples you can be at higher risk of experiencing include:

  • Falls and injuries
  • Poor decision-making abilities 
  • Impaired driving
  • Dizziness
  • Weakness
  • Feelings of hopelessness/suicidal thoughts

Elderly people are at higher risk for health conditions when taking Prozac and consuming alcohol. Part of this is because they need to take more medication at once, and higher doses means more risk for danger. Alcohol takes longer to be absorbed in the body as you age, and stays in the bloodstream for extended periods. This results in an increased risk for toxic chemical interaction and possible overdose. 

When Can You Consume Alcohol Again?

You might assume that consuming alcohol hours after taking Prozac is perfectly fine and will do little to no harm. This assumption could not be farther from the truth, since this drug remains as a metabolite for some time. Prozac half-life ranges from 2 to 7 days, meaning it takes 11 to 38.5 days for the body to be clear of this substance. It is recommended to wait at least a month after last taking this drug to start drinking alcohol. 

Follow Warning Signs and Seek Help

If you are taking an antidepressant and find yourself drinking, you increase the chances of developing an alcohol addiction. When an alcohol use disorder (AUD) and mental illness co-occur, a simultaneous treatment called dual-diagnosis is necessary. Depression and alcohol abuse can be treated at the same time. 

At Healthy Life Recovery, we offer individualized treatment programs to achieve long-term recovery. Located in San Diego, our addiction treatment and dual-diagnosis can help you overcome a substance use disorder (SUD) and a mental health problem. If you or someone you know is experiencing alcohol or substance abuse, give us a call today.

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Prozac instructions for use: indications, contraindications, side effects - description of Prozac Capsules (694)

💊 Ingredients of Prozac ®

✅ How to use Prozac ®


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Description of the active ingredients of the preparation Prozac ® (Prozac ® )

The scientific information provided is general and cannot be used to make decisions. decisions about the use of a particular drug. nine0008

Update date: 2020.06.09

Marketing authorization holder:

ELI LILLY VOSTOK, S.A. (Switzerland)



ATX code: N06AB03 (Fluoxetine)

Active substance: fluoxetine (fluoxetine)

Rec.INN WHO registered

Dosage form

Prozac ®

Caps. 20 mg: 14 or 28 pcs. nine0008 reg. No.: P N014206/01 dated 17.03.08 - Indefinitely

Release form, packaging and composition Prozac


Capsules hard gelatin capsules, size #3, opaque, green/cream, imprinted with the LILLY logo and the identification code "3105"; the contents of the capsules are white powder.0008

1 caps.
fluoxetine (as hydrochloride) 20 mg

Excipients : starch, dimethicone.

Composition of the capsule shell: patented blue dye (patent blue V dye), yellow iron oxide dye, titanium dioxide, gelatin, food ink (for identification printing).

14 pcs. - blisters (1) - packs of cardboard. nine0013 14 pcs. - blisters (2) - packs of cardboard.

Clinical and pharmacological group: Antidepressant

Pharmacotherapeutic group: Antidepressant

Pharmacological action

Antidepressant, propylamine derivative. The mechanism of action is associated with selective blockade of neuronal reuptake of serotonin in the CNS. Fluoxetine is a weak antagonist of cholino-, adreno- and histamine receptors. Unlike most antidepressants, fluoxetine does not appear to cause a decrease in the functional activity of postsynaptic β-adrenergic receptors. Helps improve mood, reduces feelings of fear and tension, eliminates dysphoria. Does not cause sedation. When taken in average therapeutic doses, it practically does not affect the functions of the cardiovascular and other systems. nine0008


Absorbed from the gastrointestinal tract. Weakly metabolized during the "first pass" through the liver. Eating does not affect the degree of absorption, although it may slow down its rate. C max in plasma is achieved after 6-8 hours. C ss in plasma is achieved only after continuous administration for several weeks. Protein binding 94.5%. Easily penetrates through the BBB. It is metabolized in the liver by demethylation to form the main active metabolite of norfluoxetine. nine0008

T 1/2 fluoxetine is 2-3 days, norfluoxetine is 7-9 days. Excreted by the kidneys 80% and through the intestines - about 15%.

Indications of the active substances of the drug Prozac


Depression of various origins, obsessive-compulsive disorders, bulimic neurosis.

Open list of ICD-10 codes

F31 Bipolar affective disorder
F32 Depressive episode
F33 Recurrent depressive disorder
F41. 2 Mixed anxiety and depressive disorder
F42 Obsessive-compulsive disorder
F50.2 Bulimia nervosa

Dosage regimen

The method of administration and dosing regimen of a particular drug depends on its form of release and other factors. The optimal dosage regimen is determined by the doctor. Compliance of the dosage form of a particular drug with indications for use and dosing regimen should be strictly observed. nine0058

Initial dose - 20 mg 1 time / day in the morning; if necessary, the dose can be increased after 3-4 weeks. The frequency of admission is 2-3 times / day.

The maximum daily oral dose of for adults is 80 mg.

Side effects

From the side of the central nervous system: possible anxiety, tremor, nervousness, drowsiness, headache, sleep disturbances.

From the digestive system: possible diarrhea, nausea. nine0008

From the side of metabolism: may increase sweating, hypoglycemia, hyponatremia (especially in elderly patients and with hypovolemia).

From the reproductive system: decreased libido.

Allergic reactions: possible skin rash, itching.

Other: joint and muscle pain, shortness of breath, fever.

Contraindications for use

Glaucoma, bladder atony, severe renal dysfunction, benign prostatic hyperplasia, simultaneous administration of MAO inhibitors, convulsive syndrome of various origins, epilepsy, pregnancy, lactation, hypersensitivity to fluoxetine. nine0008

Use in pregnancy and lactation

Contraindicated in pregnancy and lactation.

Use in hepatic impairment

Use with extreme caution in patients with hepatic impairment.

Use in impaired renal function

Contraindicated in severe renal impairment. Use with extreme caution in patients with moderate and mild renal impairment.

Use in children

The safety of fluoxetine in children has not been established.

Use in elderly patients

Elderly patients require dosage adjustment.

Special instructions

Use with extreme caution in patients with impaired liver and kidney function, with a history of epileptic seizures, cardiovascular diseases.

In patients with diabetes mellitus, changes in blood glucose levels are possible, which requires correction of the dosing regimen of hypoglycemic drugs. When used in debilitated patients while taking fluoxetine, the likelihood of developing epileptic seizures increases. nine0008

With the simultaneous use of fluoxetine and electroconvulsive therapy, the development of prolonged epileptic seizures is possible.

Fluoxetine can be used no earlier than 14 days after discontinuation of MAO inhibitors. The period after the abolition of fluoxetine before the start of therapy with MAO inhibitors should be at least 5 weeks.

Elderly patients require dosage adjustment.

The safety of fluoxetine in children has not been established.

Do not drink alcohol during treatment.

Influence on the ability to drive vehicles and mechanisms

During the period of treatment, one should refrain from potentially hazardous activities that require increased attention and rapid psychomotor reactions.

Drug interactions

When used simultaneously with drugs that have a depressant effect on the central nervous system, with ethanol, a significant increase in the inhibitory effect on the central nervous system, as well as an increase in the likelihood of convulsions, is possible. nine0008

With simultaneous use with MAO inhibitors, furazolidone, procarbazine, tryptophan, serotonin syndrome may develop (confusion, hypomania, restlessness, agitation, convulsions, dysarthria, hypertensive crisis, chills, tremor, nausea, vomiting, diarrhea).

With simultaneous use, fluoxetine inhibits the metabolism of tricyclic and tetracyclic antidepressants, trazodone, carbamazepine, diazepam, metoprolol, terfenadine, phenytoin, which leads to an increase in their concentration in blood serum, an increase in their therapeutic and side effects. nine0008

With simultaneous use, inhibition of the biotransformation of drugs metabolized with the participation of the CYP2D6 isoenzyme is possible.

When used simultaneously with hypoglycemic agents, their effect may be enhanced.

There have been reports of increased effects of warfarin when co-administered with fluoxetine.

When used simultaneously with haloperidol, fluphenazine, maprotiline, metoclopramide, perphenazine, periciazine, pimozide, risperidone, sulpiride, trifluoperazine, cases of extrapyramidal symptoms and dystonia have been described; with dextromethorphan - a case of the development of hallucinations is described; with digoxin - a case of increasing the concentration of digoxin in the blood plasma. nine0008

When used simultaneously with lithium salts, an increase or decrease in the concentration of lithium in the blood plasma is possible.

With simultaneous use, it is possible to increase the concentration of imipramine or desipramine in the blood plasma by 2-10 times (may persist for 3 weeks after fluoxetine is discontinued).

When used simultaneously with propofol, a case is described in which spontaneous movements were observed; with phenylpropanolamine - a case is described in which dizziness, weight loss, hyperactivity were observed. nine0008

Co-administration may enhance the effects of flecainide, mexiletine, propafenone, thioridazine, zuclopenthixol.


How we are treated: Prozac. From depression to bulimia


16:00, December 14, 2017

Analysis of one of the popular antidepressants how it is customary to treat them and whether the antidepressant Prozac works, read in the new material of the heading “How we are treated”. nine0291

Prozac is on the list of the most important, safest and most effective (including from an economic point of view) drugs according to the World Health Organization. However, as we remember after the article with the analysis of Tamiflu, this does not guarantee its effectiveness.

Prozac is prescribed for the treatment of depression, obsessive-compulsive disorders, bulimia nervosa. If you know very well what it is, you can immediately skip to the “from what, from what” part.

When life is not nice

Depression is called depression, loss of interest in what used to make the patient happy. According to the international classification of diseases ICD-10, the main criteria by which such a diagnosis can be made include depressed mood for more than two weeks, loss of strength and consistently high fatigue (more than a month) and anhedonia (the inability to enjoy what used to bring joy). Doctors consider additional criteria for depression to be pessimism, low self-esteem, thoughts of death and suicide, appetite disturbances (weight loss or overeating), sleep problems, constant fears and anxieties, feelings of worthlessness and guilt, inability to concentrate, and a constant sweet taste in the mouth. These symptoms are unlikely to occur simultaneously (for example, fatigue and apathy may predominate in some cases, while anxiety and guilt may prevail in others), therefore, in order to diagnose depression, the patient's condition must meet at least two main criteria and three additional ones. At the same time, according to the definition of the US National Institute of Mental Health, such a state should last quite a long time (more than two weeks). nine0008

Severe depression (clinical) includes a complex set of symptoms called major depressive disorder and may sometimes not be accompanied by low mood at all. However, because of her, the patient is physically unable to live and work normally, and the comments of those around him in the spirit of “he just can’t pull himself together” or “enough to turn sour that he spread snot” sound like a mockery. Such phrases stigmatize depression, blaming a person for his condition, while he himself will not be able to cope and needs treatment. To diagnose major depressive disorder, there is a whole questionnaire of major depression compiled by the World Health Organization. Also, depressive disorders include other conditions accompanied by depression, such as dysthymia (daily low mood and mild symptoms of depression for two years or more). nine0008

The causes of depression can be very different: somatic (due to diseases of the body), psychological (after strong dramatic experiences, such as the death of a relative) and iatrogenic (as a side effect of certain drugs). As strange as it would be to provide first aid to a victim of an electric shock without removing the wire from him, it is difficult to cure the symptoms of depression without eliminating its cause or changing the lifestyle that led the patient to such a state. If the patient lacks some essential substances (for example, tryptophan), it is important to make up for their lack, and not just fight the depressed mood with drugs. If he has some kind of psychological trauma, the help of a psychotherapist will be required. And for a person whose depression is provoked by hormonal disorders, neurological diseases, heart disease, diabetes, or even cancer (and this happens), it is more important to cure the disease itself, and symptomatic treatment of depression will be a secondary goal. nine0008

When you can't stop

Obsessive-compulsive disorder, or OCD (also called obsessive-compulsive disorder), consists of two mandatory components: obsessions (obsessive anxious or frightening thoughts) and compulsions (compulsive actions). A classic example is cleanliness-related OCD, where a person is afraid of contamination or contamination by microorganisms. Such thoughts and fears are called obsessions. In order to protect themselves from them, a person will worry too much about cleanliness, such as constantly washing their hands. Any contact with a non-sterile, according to the patient, object, plunges such a person into horror. And if you can’t wash your hands again, he will experience real suffering. nine0008

You can learn how to understand medicines on your own in the author's online course "How We Are Treated" by the editor of Indicator.Ru Ekaterina Mishchenko:

This "protective" behavior is called compulsion. The desire for cleanliness can be understood if a person is in conditions of complete unsanitary conditions or, on the contrary, wants to maintain sterile conditions somewhere in the operating room. But if the action loses its true meaning and becomes a mandatory ritual, it becomes a compulsion. nine0008

However, OCD can manifest itself not only as a fear of pollution, but also as excessive superstition, fear of losing a necessary object, sexual or religious obsessive thoughts and related actions. Their reasons may lie in several areas: biological and psychological. The first includes diseases and features of the nervous system, lack of neurotransmitters (biologically active substances that ensure the transmission of a nerve impulse from one neuron to another, for example, dopamine or serotonin), genetic predisposition (mutations in the hSERT gene encoding the serotonin carrier protein and located on 17 -th chromosome). nine0008

There is also an infectious theory of the development of OCD, associated with the fact that in children it sometimes occurs after infection with streptococcus. This theory is called PANDAS - an abbreviation for the English Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections, which translates as "Children's autoimmune neuropsychiatric disorders associated with streptococcal infections." The cause of this syndrome may be an attack of its own antibodies produced against streptococcus on the patient's nerve cells. However, this theory has not yet been confirmed. nine0008

Another group of explanations for the development of OCD is psychological. They go back to the theories of the beginning of the last century (from Freud to Pavlov). Mayakovsky's father died of blood poisoning after being injected with a binder, so it is believed that the poet also showed a pathological love for cleanliness. But you don't have to be a futurist poet to experience the full benefits of OCD: even dogs and cats suffer from it. Only in them this is expressed in the endless licking of wool and attempts to catch their tail. nine0008

The Yale-Brown scale is used to diagnose obsessive-compulsive disorder. In the fight against OCD, the method of psychological persuasion can be useful: patients are patiently explained that if they skip the “ritual” once, nothing terrible will happen. But drugs are also used in treatment.

When you are how you eat

Bulimia nervosa (third indication for Prozac) is a binge eating disorder. The main signs of bulimia are uncontrolled eating in large quantities, obsession with excess weight (calorie counting, attempts to induce vomiting after eating, fasting, use of laxatives), low self-esteem, low blood pressure. Other symptoms are sudden changes in body weight, kidney problems and dehydration, enlarged salivary glands, heartburn after eating, and inflammation of the esophagus. Due to provoking vomiting, hydrochloric acid from the stomach constantly enters the oral cavity of patients, which can lead to grinding of tooth enamel and ulcers on the mucous membrane. According to the DSM-5 classification of diseases, uncontrolled consumption of large amounts of food and the simultaneous use of various drastic measures for weight loss is the main criterion for diagnosing bulimia nervosa. nine0008

Video about bulimia on the educational medical resource Open Osmosis (USA)

The causes of bulimia can be either biological (incorrect levels of hormones or neurotransmitters, including serotonin) or social. The importance of the latter is highlighted, for example, in a high-profile study among teenage girls in Fiji, which showed a sharp increase in cases of intentional bowel cleansing for weight loss in just three years (from 1995 to 1998) after television appeared in the province. Perhaps the desire to be like models from the screens and covers really pushes for such behavior. nine0008

Bulimia can often be associated with other psychiatric disorders (depression, anxiety disorders, sleep disorders). According to a study by the New York State Psychiatric Institute and Columbia University, 70% of people with bulimia have ever experienced depression, compared with just over 25% in the general population.

Bulimia itself is not very common, and it can be more difficult to diagnose than the same anorexia, because changes in body weight in bulimia are less sharp and noticeable. For diagnosis, the food attitude test, developed by the Clark Institute of Psychiatry at the University of Toronto, and other tests based on it, are used. But (as with the tests for OCD and depression above), its result only indicates the likelihood that the patient has developed a disorder, but does not allow for a definitive diagnosis, especially for oneself. nine0008

From what, from what

What is a medicine that is prescribed for three types of disorders at once? The active ingredient in Prozac is fluoxetine. The patent for Prozac expired back in 2001, so many generics are available in pharmacies - cheaper copies that use the same active ingredient, but are not as well studied and may differ slightly from the original. These drugs include Fluoxetine, Prodel, Profluzak, Fluval.

Fluoxetine, discovered and marketed by Eli Lilly and Company, belongs to a group of antidepressants called selective serotonin reuptake inhibitors. This group is considered third-generation antidepressants, fairly well tolerated and without significant side effects. nine0008

Fluoxetine is readily absorbed into the blood, can bind to plasma proteins and accumulate in body tissues. It also penetrates the blood-brain barrier, which protects the nervous system and brain from many substances circulating in the blood. There, in the nervous system, it works in the synaptic cleft we have already mentioned, preventing the excess serotonin ejected from the synapse from returning to the neurotransmitter. Because of this, serotonin is longer present in the synaptic cleft and can bind to receptors. How exactly fluoxetine achieves this effect is not clear even to manufacturers, but it is known that it has little effect on the work of other neurotransmitters. However, at high doses, fluoxetine increases adrenaline and dopamine levels, as studies in rat brain tissue show. nine0008

Fluoxetine and its metabolite, norfluoxetine, can interfere with each other's actions. Because of this, according to scientists from the Institute of Research Medicine in Barcelona, ​​a constant concentration of fluoxetine in the blood is achieved only after four weeks of taking the drug. Similarly, the effects of taking the medicine do not disappear immediately. Associated with this is the difficulty in selecting the required dose for a particular patient.

Serotonin itself, which is absolutely incorrectly called the “hormone of happiness” (hormones are produced in one organ of the body, but perform their function in another, serotonin in this context simply conducts nerve impulses in the parts of the brain responsible for good mood, and is produced there well), in fact, it performs much more functions. Yes, it affects mood, sleep, and appetite, so some cases of depression, bulimia nervosa, and OCD may be caused by insufficient production of this neurotransmitter and corrected with serotonin reuptake inhibitors. But in addition, platelets can actively capture it and affect blood clotting. Serotonin is also involved in the processes of memorization and learning. At the same time, not only vertebrate animals can produce it: according to a study by Chinese and American scientists, the pain from an insect bite is largely due to the presence of serotonin in the poison, and the dysentery amoeba, according to an article in Science, can cause diarrhea by releasing serotonin in our intestines. nine0008

The lists (not) included

But all these are only mechanisms, and besides, they have not been studied to the smallest detail. To understand how this works in real people and how often it helps, let's turn to clinical trials. However, anyone who enters the combination “fluoxetine depression double blind randomized controlled” into the PubMed scientific article database and filters clinical trial (clinical trial) will see more than 558 articles, up to work comparing the effectiveness of Prozac and homeopathy. nine0008

Double-blind, randomized, placebo-controlled method is a method of clinical drug research in which subjects are not privy to important details of the study being conducted. “Double-blind” means that neither the subjects nor the experimenters know who is being treated with what, “randomized” means that the distribution into groups is random, and placebo is used to show that the effect of the drug is not based on autosuggestion and that this medicine helps better than a tablet without active substance. This method prevents subjective distortion of the results. Sometimes the control group is given another drug with already proven efficacy, rather than a placebo, to show that the drug not only treats better than nothing, but also outperforms analogues. nine0008



No living person can analyze them within an adequate period of time. And even Cochrane reviews can be found as many as 36 (that's really a lot), although not all of them consider the action of fluoxetine for its direct indications (depression, bulimia and obsessive-compulsive disorder).

The Cochrane Library is a database of the Cochrane Collaboration, an international non-profit organization involved in the development of World Health Organization guidelines. The name of the organization comes from the name of its founder, the 20th-century Scottish medical scientist Archibald Cochrane, who championed the need for evidence-based medicine and the conduct of competent clinical trials and wrote the book Efficiency and Efficiency: Random Reflections on Public Health. Medical scientists and pharmacists consider the Cochrane Database one of the most authoritative sources of such information: the publications included in it have been selected according to the standards of evidence-based medicine and report the results of randomized, double-blind, placebo-controlled clinical trials. nine0008



One of them is dedicated to antidepressants used against bulimia nervosa. Although in general the authors note that there is little data on this topic, fluoxetine (for which there were only five randomized double-blind controlled trials in 2003) is recognized as a leader in this direction. However, the authors refuse to recommend this medicine in the conclusion, arguing that not all clinical trial data have been published and are available for consideration. nine0008

A 2008 review reviewing the benefits of serotonin reuptake inhibitors (including fluoxetine) in obsessive-compulsive disorder, concluded that they worked better than placebo, and the side effects associated with them were much more significant, among which nausea was most common , insomnia and headache. According to a 2013 review, the usefulness of this same group of drugs in autism and related OCD is unclear, and the data are insufficient to conclude.

The most popular subject of fluoxetine reviews was fighting depression. But the authors of most of them note the lack of data (for example, in this 2013 review). In a review with broad inclusion criteria, where the effectiveness of fluoxetine against depression in adults was investigated in 1177 randomized controlled trials, the authors conclude that it is about as effective as other antidepressants, but less toxic. However, they warn against hasty decisions, since most of the studies were conducted on small groups of people (100 or less) and were funded by the manufacturer, which is more profitable to publish only positive results, hiding information about failures. Data on postpartum depression are also found to be insufficient and inconsistent. The same issues are highlighted by a review of articles on the effectiveness of antidepressants against dementia-related senile depression. nine0008

Indicator.Ru concludes: one of the best stimulant antidepressants is still not perfect

A large number of studies confirm the effectiveness of fluoxetine, a key component of Prozac. But part of the reviews of the Cochrane Collaboration note that not all trial data have been published by manufacturers. And this accusation is not an empty phrase: according to Eli Lilly's internal documents, manufacturers during trials often attributed suicide cases to worsening depression or overdosing on the drug. nine0008

As a result, following numerous reports of suicide by patients prescribed this drug, the US Food and Drug Administration (FDA) has issued a warning label to the drug's packaging.

This does not mean that the harm from the drug always outweighs its benefits, but such dishonest behavior of manufacturers does not allow us to assess the risks more accurately. Given the difficulty with the selection of an individual dose and the slow effect, adjusting the dosage is really not easy. nine0008

Prozac is also classified as a serotonin reuptake inhibitor, but if the cause of your condition is something else, you need to pay more attention to finding and eliminating them than fighting depression. As we wrote above, somatic diseases (for example, cirrhosis of the liver, cancer or diabetes), and even a lack of vitamins, can also cause depression. In addition, depression or another disorder may be the result of psychological trauma that will be difficult to deal with without psychotherapy.

Learn more