Does prozac help depression

How to use Prozac for Anxiety and Depression

*This article does not replace the advice of a medical professional and is only intended for informational and educational purposes.

What do you know about how Prozac can help depression and anxiety?

Anxiety disorders and depressive disorders are the most common mental disorders in the United States, but thankfully, they are manageable with professional treatment.

An effective form of treatment for anxiety and depression is medication, specifically antidepressants. If you’ve talked to a psychiatric provider about your mental health, they may recommend one of these medications to help with your symptoms.

One of the most commonly prescribed medications for depressive disorders and anxiety is Prozac or fluoxetine. It’s normal to be a bit hesitant about taking it with the stigma and misconceptions out there about antidepressants.

Let’s clear the air and talk about how to safely use Prozac for your anxiety and depression, and how Prozac and other antidepressants can help improve your mental health.

Want to speak 1:1 with an expert about your anxiety & depression?

Start with a free assessment

How do antidepressants work?

Common antidepressant medications include SSRIs, or selective serotonin reuptake inhibitors. Serotonin is an important neurotransmitter that helps regulate sleep, appetite, and mood. In anxiety and depression, it is common to see lower levels of serotonin, often resulting in symptoms of fatigue, reduced appetite, lack of pleasure, and more.

An SSRI works by blocking the reabsorption of serotonin into the brain’s neurotransmitter receptors, which then allows the chemical to be more abundant. This can help balance the serotonin levels in individuals with anxiety or depression.

Prozac can help anxiety and depression because it is an SSRI, alongside other common antidepressants like Zoloft (sertraline) or Lexapro (escitalopram).

There is another class of antidepressants called SNRIs—serotonin and norepinephrine reuptake inhibitors. Similar to SSRIs, SNRIs work to block the reabsorption of serotonin, as well as norepinephrine, which is another neurotransmitter heavily involved in mood and feelings of energy and alertness.

A third common class of antidepressants are known as NDRIs, or norepinephrine-dopamine reuptake inhibitors. Norepinephrine is thought to play a role in the body’s stress response, while dopamine is thought to affect motivation and the ability to experience pleasure. One commonly prescribed SNRI is Cymbalta (duloxetine).

NDRIs work in a similar way as SSRIs, they just block the reabsorption of the above two neurotransmitters instead of blocking serotonin. More often than not, NDRIs are prescribed to people who do not respond well to SSRIs or cannot tolerate their side effects. A commonly prescribed NDRI is Wellbutrin or bupropion.

How and when to take Prozac

While there are general recommendations for taking Prozac, you should follow the specific instructions your provider gives you when they prescribe the medication.

Everyone is different, especially when it comes to your unique symptoms and mental health, and your provider can work with you to find a good starting dose, as well as make adjustments until you find the right dosage.

How long does it take for Prozac to start working?

As with all antidepressants, it can take some time to start noticing results. For Prozac, it can take anywhere from four to six weeks to start working. Keep in mind that everyone’s bodies are different, and Prozac may not work for you even after that time frame.

It’s worth noting that Prozac stands out from other antidepressants because its half-life is substantially longer when compared to other SSRIs. A medication’s half-life is the amount of time it takes for 50% of its concentration to be reduced in the body. The half-life of most antidepressants is one day, but for Prozac, it’s anywhere from two to four, which can make it easier to taper or discontinue the medication when appropriate.

Does Prozac calm you?

This is a somewhat complex question. Prozac works for anxiety largely by helping manage symptoms. It’s a daily maintenance medication, and Prozac is not designed to be highly effective at stopping a panic attack that’s in progress.

As an SSRI, Prozac helps anxiety by keeping serotonin in your system, helping your mood, energy levels, and more. So while Prozac may, technically calm you, it is more of a long-term medication than one that provides immediate relief.

Where to get Prozac

Antidepressants are medications that require a prescription from a licensed psychiatric provider. This means you will need to see a medical provider to get Prozac for your anxiety or depression.

A therapist may recommend that you start taking antidepressant medication, but they can’t actually prescribe Prozac for your anxiety or depression. What they can do is relay information to your psychiatric provider to help them better assess which course of action is best.

Potential side effects of Prozac

One of the reasons that medical providers often choose Prozac for depression and anxiety is because the list of side effects is relatively small compared to many other antidepressant medications. The most common side effects are nausea, headaches, and trouble sleeping. However, they are usually mild and go away after just a few weeks.

Similar to many other antidepressants, you may also experience gastrointestinal problems such as bloating. This is because there are actually serotonin receptors in your digestive tract, which can be temporarily impacted. These symptoms typically resolve in 2 to 3 weeks.

Potential withdrawal symptoms

First and foremost, you should never discontinue taking antidepressant medication without approval from a psychiatric provider. Antidepressants alter your neurochemicals and biology, and stopping them without proper guidance can lead to an antidepressant withdrawal called discontinuation syndrome.

When you stop taking Prozac for anxiety or depression, you may experience mood swings or feel abnormally irritable, or you may have difficulty sleeping. Physical withdrawal symptoms may include nausea, dizziness, or even excessive sweating.

However, if you and your provider decide it is time to stop taking your antidepressant medication, they can help you do so safely in a way that may minimize or prevent these symptoms from occurring. By gradually decreasing, or tapering, your dose over time.

Prozac alternatives

It’s possible that treating anxiety or depression with Prozac might not work for you, or you may experience adverse side effects. Everyone’s body is different, so don’t lose hope. There are plenty of other options your provider might suggest until you find the perfect fit.

Zoloft and Lexapro are two common SSRIs that may be prescribed instead of Prozac for your anxiety or depression. These work in very similar ways as far as blocking the absorption of serotonin, but your body may react to them more positively.

Your psychiatric provider may also prescribe you an NDRI like Wellbutrin. Wellbutrin usually requires more dosage per day and often requires long-term use even after you feel better. Not to mention, it typically comes with more side effects. However, some people respond much better to NDRIs, so you and your psychiatric provider can decide if it’s right for you.

In summary

Prozac is good for anxiety and depression because it is an SSRI antidepressant medication that works by blocking the reabsorption of serotonin by your brain’s neurotransmitter receptors. Serotonin is a chemical in your brain responsible for sleep, appetite, and mood regulation.

It’s commonly prescribed for depression and anxiety because it has a long half-life and comes with fewer side effects compared to many other SSRIs.

If your psychiatric provider feels that you no longer need to use Prozac for anxiety or depression, they will guide you on safely tapering off your current dose.

The most important thing to remember about taking Prozac to help with depression and anxiety is that it won’t change who you are, it will just reduce the impact of some of the things weighing you down.

If you’re ready to take a big step towards alleviating your depression or anxiety, Brightside can help.

You’ll be matched with a licensed psychiatric provider who can prescribe medication to be sent directly to your door. And if Prozac isn’t right for you, your personalized treatment plan can be adjusted accordingly.

Getting help can feel scary, but it doesn’t have to be. We’re here for you every step of the way.

Sources:

Selective serotonin reuptake inhibitors (SSRIs) | Mayo Clinic

What causes depression | Harvard Health

Fluoxetine (Prozac): an antidepressant | NHS.

Bupropion | MedlinePlus

Going Off Antidepressants | Harvard Health

Prozac may be the best treatment for young people with depression – but more research is needed

This is a plain English summary of an original research article

Children and adolescents with moderate-to-severe depression are being prescribed treatments that are not backed by reliable evidence. There is insufficient data on whether treatments work and if they are safe. Unlike for adults, the best way to treat symptoms of depression in these age groups is unknown.

A review of 71 separate trials found that fluoxetine (Prozac) seems to be the best choice, either alone or combined with cognitive behavioural therapy (CBT). CBT is a talking therapy that can help people change the way they think or behave, in order to better manage problems. But most of the studies were rated as low quality, so this conclusion is uncertain.

Psychiatrists will need to continue to use their judgement and treat young people on a case-by-case basis, the study authors conclude. Treatment decisions take into account drugs’ effectiveness, and whether individual patients are likely to take them as prescribed. The possible risk of extreme side effects such as increasing suicide attempts must be considered.

Better collaboration between academia, industry and researchers is needed to produce research that analyses individual patient data.

What’s the issue?

Depressive disorders are common in children and adolescents and they increase with age. About one in 330 (0.3%) of 5-10 year olds is affected and the numbers rise to almost one in 20 (4.8%) of 17-19 year olds.

The symptoms of depression include sadness, irritability, a lack of motivation and extreme tiredness. Depression can have a more serious impact on young people’s social life and educational achievements than adults experience. It can increase risks of smoking, substance abuse, obesity and suicide.

Antidepressant drugs, talking therapies (psychotherapies) and a combination of the two are routinely used. There is little evidence to indicate which of the possible interventions is the best choice. Some clinical guidelines recommend that anti-depressants are reserved for the most serious childhood cases, or after psychotherapy has failed. But, again, evidence to support this strategy is limited.

What’s new?

Researchers reviewed the available evidence. They included 71 trials, which included a total of 9510 participants. Together, the trials assessed 16 antidepressants, seven psychotherapies and five combination therapies.

The results showed that:

most of the studies were rated “low” to “very low” quality
fluoxetine was the most effective option, either alone or combined with CBT
fewer patients stopped taking fluoxetine and nefazodone than several other drugs (sertraline, imipramine and desipramine) suggesting they are more acceptable
interpersonal therapy, which focuses on relationships with others, was the only type of talking therapy more effective than a dummy intervention such as being added to a waiting list
antidepressants alone were not more effective than psychotherapies alone
the drug venlafaxine was associated with an increased risk of suicidal thoughts or attempts.

Why is this important?

Current NICE guidelines recommend psychotherapies alone (such as CBT within a group) for children and adolescents with mild depression. For those with moderate to severe depression (such as the young people in this study), NICE recommends more intense psychological therapies (such as individual CBT) as initial treatment. However, the guidelines state that combined therapy (fluoxetine and psychological therapy) is an alternative.

The results of this study broadly support that approach. The research found that fluoxetine (with or without CBT) gave the best results. But the report also noted that evidence is based on relatively poor-quality studies.

What’s next?

The findings suggest that fluoxetine (alone or in combination with CBT) might be the best option for treating children and adolescents with severe depression.

This is the most comprehensive review to date. But it is important to interpret the findings with caution. Results could vary from individual to individual. Patients, carers and clinicians should continue to carefully balance the potential benefits of treatments with how acceptable they are, and the risk of suicide.

Few new studies into the use of these treatments in children and adolescents are being carried out. This means that new data which could test this conclusion, is lacking.

You may be interested to read

The full paper: Zhou X, and others. Comparative efficacy and acceptability of antidepressants, psychotherapies, and their combination for acute treatment of children and adolescents with depressive disorder: a systematic review and network meta-analysis. Lancet Psychiatry 2020; 7: 581-601

A review of evidence on antidepressants: Cipriani A, and others. Comparative efficacy and tolerability of antidepressants for major depressive disorder in children and adolescents: a network meta-analysis. Lancet 2016; 388: 881-890

A review of evidence on psychotherapies: Zhou X, and others. Comparative efficacy and acceptability of psychotherapies for depression in children and adolescents: A systematic review and network meta-analysis. World Psychiatry 2015; 14: 207-222

Funding: This research was supported by the NIHR Oxford Cognitive Health Clinical Research Facility, by an NIHR Research Professorship, by the NIHR Applied Research Collaboration Oxford and Thames Valley, and by the NIHR Oxford Health Biomedical Research Centre.

Conflicts of Interest: Study authors report fees and grants from various pharmaceutical companies, outside of this research.

Disclaimer: NIHR Alerts are not a substitute for professional medical advice. They provide information about research which is funded or supported by the NIHR. Please note that views expressed in NIHR Alerts are those of the author(s) and reviewer(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

What they treat us with: Prozac. From depression to bulimia

Medicine

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”.

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. nine0003

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). nine0003

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). nine0003

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. nine0003

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. nine0003

You can learn how to deal with medications on your own in the author's online course "How we are treated" by the editor of Indicator.Ru Ekaterina Mishchenko: https://clck.ru/Pnmtk

Such "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. nine0003

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). nine0003

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. nine0003

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. nine0003

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. nine0003

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. nine0003

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. nine0003

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. nine0003

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. nine0003

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 “happiness hormone” (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 brain regions 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. nine0003

The lists (not) included

But all these are just 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. nine0003

Double-blind, randomized, placebo-controlled method is a method of clinical drug research in which the 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. nine0003

Indicator.Ru

Help

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. nine0003

Indicator.Ru

Help

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. nine0003

The authors of a 2008 review reviewed the benefits of serotonin reuptake inhibitors (including fluoxetine) in obsessive-compulsive disorder and concluded that they help better than placebo, and the associated side effects are much more significant, among which nausea is 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 the fight against depression. But the authors of most of them note the lack of data (for example, in this 2013 review). In a broad inclusion criteria review of 1177 randomized controlled trials of fluoxetine for depression in adults, 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. nine0003

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. nine0003

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 medicine always outweighs its benefit, 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. nine0003

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. nine0003

All this suggests that the drug should be used under the supervision of a doctor (most likely, it will not be sold without a prescription), and that its action alone may not be enough for a complete recovery. And don't forget that serotonin is involved in many other processes in the body. Therefore, you should not use the drug in violation of the functions of the liver and kidneys, an increased risk of thrombosis, and not only during pregnancy and lactation. With manic states and suicidal moods, it is also better to abandon the drug. If you notice allergic reactions or nausea and headache, you need to see a doctor and ask if you should stop taking the medicine. nine0003

Our advice cannot be compared to a doctor's prescription. Before you start taking this or that drug, be sure to consult a specialist.

Subscribe to Indicator.Ru on social networks: Facebook, VKontakte, Twitter, Telegram, Odnoklassniki.

Author: Ekaterina Mishchenko

Tags #Treatment

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. nine0003

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. nine0003

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. nine0003

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. nine0003

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. nine0003

"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 drug 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

The peak of Prozac's popularity came in the 90s - 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. nine0003

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. nine0003

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. nine0003

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 filled 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.

Learn more