Prozac making me sleepy

🥇 Does Prozac Make You Tired and Sleepy- The Truth About Fluoxetine

The name of the drug, Prozac, sounds both scientific and clinical. But does it really? To many people, the drug sounds like a miracle cure for Anxiety and depression. With its therapeutic effects and the best time of the day to take fluoxetine is 20 mg, in mind, does Prozac make you tired and sleepy?

One of the side effects of SSRIs such as fluoxetine is it gives you fatigue and sleepiness, especially during the early weeks of treatment with an antidepressant. The reason why these medications cause sleepiness is that they inhibit the natural production of serotonin in your brain. Many people experience fatigue and sleepiness when they take Prozac. And while this side effect isn’t common, it is possible for your body to react negatively to Prozac.

You should never stop taking Prozac without consulting a doctor first who can recommend changing the best time to take Prozac a=or help you taper off the medication. If you do, there is a risk that you will experience withdrawal symptoms like dizziness, anxiety, and agitation.

If you find that you or someone in your family is experiencing these side effects from Prozac, consult with your physician as soon as possible so they can help decide if the side effects can be managed or if it would be best to stop the medication altogether.

Although the harmful effects of taking too much Prozac are not common, there are some side effects of the medication that many people don’t know about.

Contents

1 Does Prozac Make You Tired and Sleepy?
- 1.1 Does Prozac make you sleepy?
- 1.2 Is fatigue a side effect of Prozac?
- 1.3 Stopping Prozac fatigue
  - 1.3.1 SSRI fatigue: The period till they dissipate
  - 1.3.2 Does Prozac tiredness wear off?
- 1.4 Does Prozac give you energy or make you tired?
- 1.5 Antidepressants that make you sleepy
- 1.6 Other Side Effects of Prozac
2 What is Prozac?
- 2. 1 Is Prozac Effective?
3 Does Prozac cause brain fog?
4 Tme of day to take Prozac
- 4.1 Best time of day to take fluoxetine 20 mg (Prozac 20mg)
  - 4.1.1 Morning is the Best Time to Take Prozac 20mg
    - 4.1.1.1 Why is morning the best time for fluoxetine 20 mg?
  - 4.1.2 Evening Can Be Better for Some People
  - 4.1.3 Later Can Be Better for Certain Conditions
  - 4.1.4 Morning is Best for Concentration and Work Outcomes
  - 4.1.5 Morning is Best for Anxiety Relief
  - 4.1.6 Morning is Best for Fighting Depression
  - 4.1.7 Evening Is Best for Sleep Quality
5 Summary
6 FAQs
- 6.1 But what is Prozac fatigue?
- 6.2 Why does my antidepressant make me tired?
- 6.3 Which antidepressant is best for fatigue?
- 6.4 What is the most energizing antidepressant?
- 6.5 Can you take a sleep aid with Prozac?

Does Prozac Make You Tired and Sleepy?

Yes, one of the side effects of SSRIs such as fluoxetine is it gives you fatigue and sleepiness, especially during the early weeks of treatment with an antidepressant. The reason why these medications cause sleepiness is that they inhibit the natural production of serotonin in your brain. It may also give you dry mouth, headaches, and sexual problems.

The Truth About Prozac: Does it Make You Tired and Sleepy?

Many people don’t want to admit that they can get tired or sleepy while they are on antidepressants. But it is a well-known side effect of medications like fluoxetine. Fluoxetine is the generic name for the medication in the brand names of Prozac and Sarafem.

Other antidepressants, such as Paxil and Zoloft, have this side effect as well. When you take fluoxetine or another SSRI medication, it prevents serotonin from being released into your system which makes you feel drowsy throughout the day.

Does Prozac make you sleepy?

When you take Prozac (fluoxetine) and other serotonin reuptake inhibitors (SSRIs) such escitalopram (Lexapro), citalopram (Celexa), and paroxetine (Paxil) for depression or anxiety it can make you feel sleepy. This is because they affect the reabsorption of serotonin in the brain causing an increase in the available serotonin in the brain.

Sleepiness is mainly a side effect in the first few weeks of starting the dosage with Prozac and normally should get resolved once the body gets used to the medication.

Is fatigue a side effect of Prozac?

Fatigue is a side effect of Prozac, especially in the first weeks of treatment. You can get fatigued/ tiredness, insomnia, headaches, and nausea as the common side effects. The first weeks of treatment are when the Prozac starts to take effect. Your body might not be used to the drug and it could cause sleep problems, headaches, and/or nausea. These side effects go away after a few weeks or once your body gets used to the medication.

One of the most common side effects that people taking Prozac experience is fatigue or tiredness. This should be expected in the first few weeks of treatment with Prozac because the drug takes time to take effect. The other possible side effects may include confusion, diarrhea, and depression.

Some people also experience drowsiness from Prozac because it can affect serotonin levels in your brain which can lead to sleepiness.

Another thing that might make you tired from Prozac is that it changes your emotions! This means that sometimes people might feel more depressed or sadder than normal, which can make them tired too.

Lastly, some people might experience fatigue because they aren’t sleeping well during the day with their new schedule. It’s important to try to get on a good sleep schedule so you don’t feel as tired all day long!

Prozac is an antidepressant medication that was first FDA-approved in 1987. It’s meant to be taken daily and can help with depression, anxiety, obsessive-compulsive disorder, bulimia nervosa, panic disorders, and post-traumatic stress disorder.

Stopping Prozac fatigue

Even though the harmful effects of taking too much Prozac are not common, there are some side effects of the medication that many people don’t know about. One of these side effects is a condition called fluoxetine fatigue, also called Prozac fatigue.

Fluoxetine fatigue is when you feel excessively tired and sleepy after taking Prozac. This can happen when your body builds up a tolerance to the drug over time. The solution? There are a few ways to stop Prozac fatigue.

You might try getting a short nap or doing some light physical activity (like walking around your office or home). If you plan on driving or operating machinery, avoid it for a while or talk to your doctor about adjusting your dose.

SSRI fatigue: The period till they dissipate

SSRI fatigue is a very common side effect of taking Prozac. This type of fatigue typically disappears as the body adjusts to its use. For most people, it only lasts a few days or weeks and then goes away for good.

It has been reported that up to half of SSRI patients will experience fatigue as one of the side effects, but it usually goes away fairly quickly.

This type of fatigue is not dangerous in any way, and it’s not harmful to take more than prescribed if you find that your SSRI medication is making you tired and sleepy. As always, it is important to talk with your doctor before taking any medication related to depression, particularly an SSRI medication like Prozac.

Prozac and similar drugs work by manipulating serotonin levels, a neurotransmitter that affects your mood. When you first start taking an SSRI drug, it might leave you feeling tired and sleepy. For example, if you’re usually a morning person but now can’t get out of bed before 11 am, this could be an effect of the drug.

However, most people adjust to the medication after a few days and their sleep patterns return to normal. SSRI-induced fatigue is not permanent; it often goes away within days or weeks as your body adjusts to the medication.

Does Prozac tiredness wear off?

Prozac tiredness wears off as the body adjusts to the medication since the body is able to tolerate the increased serotonin levels in the brain. For most people, Prozac’s tiredness only lasts a few days or weeks and then goes away for good. It has been reported that up to half of fluoxetine patients will experience this effect, but it usually goes away fairly quickly.

However, it may persist in a few patients or become intolerable. In these cases, we recommend talking to the doctor to either reduce the dosage, change the medication, or help you manage fatigue.

Does Prozac give you energy or make you tired?

The side effects of taking Prozac are not as negative as some other SSRIs, but they can still be significant. For example, the drug can cause intense drowsiness or sleepiness. This is one of the most common side effects that people experience when they take the medication. In fact, this is one of the most common complaints from those who have taken SSRIs in general.

The problem with taking too much Prozac is that it could make you sleepy and drowsy throughout the day. And if you have trouble sleeping at night, then this can really be a problem for you. In some cases, insomnia has been reported as a side effect of taking Prozac.

There are many different effects that Prozac has on people. Some people have a positive experience with the drug and say it’s made their lives better. Other people have a negative experience with the drug and say it’s made their lives worse. This is the case with all drugs, of course. But what about this one? Does Prozac give you energy or make you tired? It depends on how much you take.

Fluoxetine, which is the generic name for Prozac, can cause either effect depending on how much you take. Too little, and you might feel more energized than usual because it blocks your brain’s reuptake of serotonin, which is a mood-boosting neurotransmitter.

Too much fluoxetine, and you might start feeling sluggish because the drug blocks your brain from producing serotonin altogether. SSRI drugs like Prozac work by blocking neurotransmitters that contribute to depression but they also block other neurotransmitters that regulate things like sleep and appetite. This means that taking too much Prozac could leave you feeling tired or sleepy as well as depressed!

Antidepressants that make you sleepy

Tricyclics like amitriptyline (Elavil, Vanatrip), doxepin (Silenor, Sinequan), imipramine (Tofranil, Tofranil PM), trimipramine (Surmontil), and SSRIs like Prozac (fluoxetine), citalopram (Celexa, Cipralex), escitalopram (Lexapro, Esertia) will normally have sleepiness as one of the common side effects.

It’s a common side effect for antidepressants to make people sleepy. When taking fluoxetine as prescribed by your doctor, there’s the possibility that you’ll feel less energetic or even develop sleep problems like insomnia or hypersomnia. The dose of Prozac can affect how sleepy you will feel.

For example, if you’re at a low dose of 20mg per day then the chances of feeling sleepy are low. But if you take 40mg per day then your chances of feeling drowsy are higher.

The type of antidepressant that is prescribed also affects how sleepy you will become. Antidepressants like SSRIs or tricyclics are more likely to cause sleep disturbances than non-tricyclic antidepressants such as moclobemide (Manerix). It all depends on why your doctor prescribes an antidepressant to you and what they think would be best for your specific needs.

Other Side Effects of Prozac

Yes, Nausea, drowsiness, tiredness, insomnia, dizziness, anxiety, loss of appetite, sweating, or yawning are all side effects that you can experience when taking Prozac. The most common side effect of the drug is feeling sleepy. Even though this might be a good thing for those who have been suffering from insomnia, it is not a good thing when you are taking the medication to cure your depression.

If you have trouble sleeping and feel drowsy after being on the pill for a while, there’s a chance you will develop a tolerance to the drug which means you may need more of it in order to get rid of the symptoms. This also means we’ll need to start looking into other treatments for depression.

One of the other common side effects of Prozac is drowsiness. It’s an effect that many people experience, and it’s one that often leads to decreased productivity at work or school. In addition to this, insomnia is also a common side effect for those taking Prozac. Insomnia can be difficult for some people because it means they have trouble sleeping at night and worry about not being able to sleep.

This can lead to anxiety and depression as well, which only make insomnia worse. Drowsiness and insomnia are two of the most prevalent, but there are other side effects such as nausea, dizziness, anxiety, trouble sleeping, loss of appetite, tiredness, sweating, or yawning that might occur with the use of Prozac.

What is Prozac?

Prozac is a brand name for an anti-depressant that falls in the SSRI family of drugs. Prozak is one of the most popular anti-depressants prescribed by doctors today. What does Prozac do?

Prozac inhibits the reabsorption of serotonin, which improves mood. This specific drug is not just for depression, but it treats many other mental disorders as well such as obsessive-compulsive disorder and panic disorder.

It may seem like a miracle cure to those who don’t know about the harmful effects of taking too much Prozac or have never experienced them before. Unfortunately, these side effects can be quite dangerous and they’re not common either.

Nevertheless, there are still some benefits of taking fluoxetine. For example, Prozac may help increase your appetite. Despite the well-known side effects of Prozac such as fatigue and sleepiness, many people have found that the drug has been a life-changing treatment for them.

Is Prozac Effective?

Yes, Prozac is the first-line treatment drug for people with some types of anxiety disorders including OCD and panic disorder since it helps improve mood, increase quality sleep, regulate emotions, and boost appetite. There is further scientific evidence to suggest that Prozac is also very effective for people who suffer from depression.

People will often take Prozac to improve their mood, regulate emotions, increase quality sleep, and boost appetite for people with anxiety and depression. But there are some side effects of the medication that many people don’t know about.

For many people, antidepressants, like Prozac, seem to be a miracle cure for depression. This is because the medication can help improve mood, regulate emotions, and increase quality sleep. Plus, it boosts appetite.

However, there are some side effects of the medication that many people don’t know about. For example, the drug can make you tired and sleepy. As a result of these side effects, your body might feel like it needs more sleep or food than usual.

If you take excessive amounts of Prozac for an extended time period or stop taking the drug abruptly without tapering off first, then this could cause withdrawal symptoms like dizziness and headache as well as other symptoms such as fever and sore throat.

Does Prozac cause brain fog?

A small percentage of people who take Prozac report experiencing brain fog, or a general feeling of confusion and difficulty focusing. This is a relatively rare side effect, but it can occur in less than 1 in 100 people, no matter what medication they’re taking.

Prozac is known to cause this type of side effect because it affects serotonin levels in the brain, which are responsible for controlling our moods and how we process information. When you’re on Prozac, your serotonin levels are slightly lower than they would be if you weren’t taking the medication. The problem with low serotonin levels? They can lead to brain fog and other problems with memory and cognition such as not thinking clearly or forgetting things easily.

One way around these problems is by taking a supplement that contains sodium (such as salt) to replace what you may be lacking when on Prozac.

Tme of day to take Prozac

Many people take Prozac in the morning. Most people find that taking the medication in the morning is easiest because it helps them stay alert throughout the day. But what’s the best time of day for taking Prozac?

Anytime, but doctors recommend taking the drug in the morning! It might be a good idea to stick to the same time every day, however. If you take your medication at different times each day, it can be challenging for your body to adjust and then maintain its balance.

If you are working on a new schedule, give yourself around two weeks before changing your regimen. This way, you’ll have enough time to adjust before your next dose is due.

Prozac is a brand name for the drug fluoxetine hydrochloride. It is a type of antidepressant called a selective serotonin reuptake inhibitor, or SSRI. SSRIs are frequently used as first-line treatments for depression because they have been found to be effective in reducing depressive symptoms in many patients.

Losing sleep over stressors? Stressed about school? Problems with parents? Any routine stressor can lead to feeling depressed, but it’s not always apparent why this happens. That’s why you need to take Prozac at the right time! Other treatment options include psychotherapy, exercise, and light therapy; however, some people experience persistent depression that doesn’t respond well to these interventions. In these cases, it makes sense to try an SSRI like Prozac.

Best time of day to take fluoxetine 20 mg (Prozac 20mg)

Morning is the Best Time to Take Prozac 20mg

The morning is statistically the best time to take Prozac. In fact, it’s the only time of day you should be taking the drug. In the morning, your cortisol levels are at their lowest point. This will help you maintain a stable mood throughout the day.

By taking Prozac in the morning, you’ll have an increased efficacy since your serotonin levels will be relatively high at this time of day. If you take it in the evening, it can interfere with sleep.

And if you take it late in the day, it can cause feelings of anxiety and agitation because your body’s natural production of serotonin is high at that time of day.

Why is morning the best time for fluoxetine 20 mg?

Some of the most common adverse effects of Prozac are insomnia, anxiety, and weight gain. Most of these side effects can be mitigated by taking it in the morning.

If you take it at night, you will have a higher risk of developing insomnia, which may lead to worsening depression. In addition, if you take Prozac in the morning, it will help with your appetite and weight control because serotonin levels spike during the day.

So, why is morning best for Prozac? It’s all about balance. You want to take your medications when they can be most effective while minimizing risks and side effects. Taking Prozac in the morning gives you a good balance between therapeutic benefits and potential drawbacks.

Evening Can Be Better for Some People

Some people find that taking Prozac in the evening offers them better therapeutic benefits. Studies have shown that SSRIs are more effective at this time of day. One study found that those who were given a dose of fluoxetine in the morning had more disruptive effects on personal sleep than those given a dose at night.

Moreover, for people suffering from side effects of the drug, it is better to take it in the evening to ensure by morning time the dosage has reduced in the morning thus giving you a better day.

However, this may be preferable to feel less depressed during the day and having insomnia. Some people find they sleep better when they take their dose at night and experience fewer daytime symptoms as well.

Later Can Be Better for Certain Conditions

The best time to take fluoxetine 20 mg for certain conditions depends on the therapeutic benefits you’re looking for and your personal schedule. For example, if you have a depressive disorder, taking Prozac in the morning is generally recommended so that it can start working as soon as possible.

But if you have obsessive-compulsive disorder (OCD), taking it at bedtime will offer therapeutic benefits while you sleep.

If you’re an early riser who wants to work out in the morning, but need antidepressant medication to do so, speak with your doctor about whether or not it’s better to take Prozac right before your workout or earlier in the day.

Morning is Best for Concentration and Work Outcomes

Most doctors recommend taking Prozac in the morning. For example, our clinic recommends that you take your SSRI at around 9 AM. The reason for this is that it’s easier to maintain concentration throughout the day if you take your SSRI early in the morning.

If you need to concentrate because of work, your mood will be more consistent throughout the day. If you take your SSRI late in the evening, it may have a tendency to interfere with sleep. This is because it increases activity in regions of the brain associated with wakefulness and arousal.

You’ll feel more energized after taking your medication, which may make falling asleep difficult. Not only will this affect sleep but also affect mood tomorrow when you wake up.

Morning is Best for Anxiety Relief

If you’re taking fluoxetine 20 mg for anxiety and depression, your morning dose will have the most therapeutic benefits. For those who are struggling with depression, a morning dose can help to provide therapeutic relief while you’re in active thought mode.

The antidepressant effects of Prozac will wear off after 12 hours, so it’s important to take your second dose at lunchtime or in the evening. For those who are struggling with anxiety, the serotonin-boosting power of Prozac can be most effective if taken in the morning.

This is because much of our anxiety is related to our thoughts and feelings of impending danger. Morning anxiety relief allows this heightened sense of fear to gradually decrease as we go about our day. If you want to feel less agitated throughout your day, talk to your doctor about taking an evening dosage instead.

Morning is Best for Fighting Depression

The best time to take Prozac is in the morning, preferably on an empty stomach. The benefits of taking Prozac in the morning are:

You can sleep better at night
It will be most effective for helping with depression during the day
You have more energy.

How does taking Prozac 20mg in the morning help people with depression? Some studies suggest that serotonin levels naturally rise in the morning and fall as the day progresses. This means that taking your Prozac early in the day will result in increased serotonin levels for a longer period of time.

It also may help people feel less tired and more energized throughout their days. Serotonin levels typically drop when it’s dark outside, so it’s important to take your SSRI before 5pm, if possible. Taking a dose before bedtime might lead to insomnia, which is not good if you are already battling depression.

Evening Is Best for Sleep Quality

The best time to take Prozac is evening if you are looking for better sleep. This is because the therapeutic effects of Prozac will wear off at night. If you are taking it in the morning, the benefits may wear off before bedtime.

If you have difficulty sleeping and need to take Prozac at night, this is okay. It’s best to start taking it early in the evening, around six o’clock. You should gradually work your way up to taking it before bedtime.

Summary

Prozac is a drug that’s used to treat depression, obsessive-compulsive disorder, bulimia nervosa, panic disorder, and other mental conditions. It does this by changing the levels of serotonin in your brain.

The drug is known for its calming effects as well as the reduction of depressive symptoms. However, many people don’t know that there are some side effects associated with Prozac use. Some of the side effects include feeling tired and drowsy and having problems sleeping. These side effects are not uncommon but they can be very annoying for those who are trying to take care of themselves mentally.

FAQs

But what is Prozac fatigue?

The term refers to the sedating effect this drug has on some people. Some people experience a feeling of fatigue as a side effect of taking Prozac. This can lead to sleepiness during the day or difficulty concentrating on tasks. On occasion, you may see your doctor adjust your dose or recommend that you start taking it at night instead of during the day for others who are susceptible to this type of side effect

Why does my antidepressant make me tired?

You may be taking an antidepressant and have noticed that it makes you feel tired, this is because they affect neurotransmitters. This can be a common side effect of anti-depressants like Prozac.
A neurotransmitter is a chemical in your brain that helps send signals from one nerve cell to another. Brain chemicals like serotonin help control mood and sleep cycles. Antidepressants are designed to regulate serotonin levels, which in turn regulate the brain’s other neurotransmitters, making you feel better about yourself.

Which antidepressant is best for fatigue?

Many people who take Prozac report feeling tired. Some people even say they sleep 12 hours a day. But what is the best antidepressant for fatigue?
Tricyclics, Amitriptyline (Elavil), Desipramine (Norpramin), and Nortriptyline (Pamelor) may be the best option for those experiencing fatigue. This group of antidepressants tends to be less effective in treating depression but more effective in treating fatigue and pain. According to most studies, these medications are only minimally sedating. The selective serotonin reuptake inhibitors, Citalopram (Celexa), Escitalopram (Lexapro), Fluoxetine (Prozac), Paroxetine (Paxil), and Sertraline (Zoloft) are also an option for those with fatigue because these antidepressants are not too sedating.

What is the most energizing antidepressant?

The most energizing antidepressant is Wellbutrin and Prozac which have less sedating effects than most SSRIs especially when the body adjusts to its usage. Wellbutrin is also more effective for people who are anxious or suffer from sexual dysfunction. The use of Wellbutrin is contraindicated in people with epilepsy and any form of mania. Paxil (paroxetine) and Celexa (citalopram) are more sedating.

Can you take a sleep aid with Prozac?

No, it may accentuate the effects of a sleeping aid such as doxylamine or melatonin including dizziness, drowsiness, confusion, difficulty concentrating, impairment in thinking, judgment, and motor coordination. One of the side effects of taking too much Prozac is that it can make you feel really tired. For instance, if you were to take a sleep aid with Prozac, it may accentuate the effects of the sleep aid. This is especially true if you were to take a sleeping aid like doxylamine or melatonin. If you took these medications and then took Prozac, it would make you feel very sleepy.
But this isn’t the only way that Prozac causes people to feel tired; it also does so by increasing your serotonin levels. A higher serotonin level means that your body would feel more relaxed and therefore more tired.

Fluoxetine | SSRI Uses, Warnings & Side Effects

About fluoxetine

Please note

Thinking about trying medication? Read our guide

How fluoxetine works

Fluoxetine is a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI).

Research suggests that depression or low mood is more likely to occur when the brain doesn’t have enough serotonin.

Serotonin (also called '5HT') is a naturally-occurring chemical messenger (or “neurotransmitter”) that has an important role in areas of the brain that control mood and thinking.

Selective serotonin reuptake inhibitors (SSRIs) - like fluoxetine - are thought to work by increasing levels of serotonin in the brain. They do this by blocking the recycling of released serotonin back into the nerve endings.

Fluoxetine is often prescribed alongside a talking therapy.

Find out more about depression

Fluoxetine and everyday life

Frequently asked questions

Antidepressants like fluoxetine can start to work on depression within the first two weeks of treatment, with the improvements continuing over the following weeks,

For anxiety, antidepressants like fluoxetine can take slightly longer to work. For some people, anxiety briefly increases at the start of treatment, but the anxiety does decrease with continued treatment.

Your weight can be affected by fluoxetine.

A side effect of fluoxetine can be not feeling as hungry as normal, which might lead to weight loss.

It is very difficult to know how this will affect each person who takes it.

Talk to your doctor about this if it worries you.

You may want to let your family and friends know you are taking fluoxetine effects.

For guidance on this, check out our page on getting support with your medication.

You can feel drowsy in the first few days of taking fluoxetine. However, it should get better after the first week or two. You may become more anxious, or it may make you irritable. This should settle after a couple of weeks.

If you feel very sleepy, and you’ve been taking it for more than a month, you should go back to the doctor and see what else you could do.

Alcohol

You can continue to drink some alcohol while taking fluoxetine, but it is best to do so in moderation. Fluoxetine can sometimes cause drowsiness as a side effect, so it is possible that alcohol might make you feel more drowsy than usual.

Drinking alcohol every day, however, can make the symptoms of depression worse and you will not feel the benefit of your medicine.

Side effects might make you sleepy or you might lose your focus when you first start taking fluoxetine.

This could be dangerous if you drive or use machines or do anything that needs a lot of focus.

During the first few days, it might be best to stop drinking alcohol until you see how the medicine affects you, or until the effects pass.

Street drugs

Be careful if you are also using street drugs.

Cannabis can have unpredictable effects when taken with fluoxetine, so great care is needed.

Cannabis and other drugs may have their own side effects on your mental health, like anxiety or psychosis. For more information, have a look at our drugs and alcohol page.

Methadone and fluoxetine together can seriously affect your heart so these should only be combined under doctor supervision.

Fluoxetine has been shown to dampen down the 'high' of cocaine.

Taking fluoxetine with cocaine, ecstasy or amfetamines could bring on serotonin syndrome. You could get a high temperature/fever, agitation, confusion, trembling or weird muscle movements. You need to go to hospital if this happens. Tell the doctor everything that you have taken.

Fluoxetine can produce a false positive test for amfetamines and LSD on a urine drug screen. Talk to your doctor about this if it is a problem for you.

Fluoxetine does not mix well with some other medicines and drugs.

Do not take fluoxetine if you take an antidepressant medicine called a monoamine oxidase inhibitor (MAOI), or if you have taken one in the last two weeks. MAOIs include moclobemide, isocarboxazid, phenelzine and tranylcypromine.

Tell your doctor or pharmacist before you take fluoxetine if you are prescribed any other medication, to check that the combination is safe.

Before you start taking fluoxetine, tell your doctor if you are taking any other medications, including things you have bought over the counter for common illnesses like colds and flu or topical applications that you put on your skin.

Let your pharmacist know if you have any food allergies or intolerances, and always check with them if you’re concerned about any of the ingredients in your medication.

Do not drive or ride a bike just after you start taking fluoxetine.

Taking fluoxetine may affect your ability to do things like drive a car, ride a bike, use machines, or anything else that needs a lot of focus.

It might be best to stop doing these things for the first few days, until you know how it affects you, or until the effects pass.

Do not worry - most people drive as normal while taking fluoxetine.

Pregnancy

If you become pregnant while you are on fluoxetine, you should carry on taking the medicine and go back to your doctor as soon as possible, to see if you should change or stop your medicine.

There is a slightly higher risk of problems in the developing baby if you take fluoxetine it in the early stages of pregnancy. However, fluoxetine and related antidepressants (known as SSRIs) are thought to be better choices if you need antidepressant medicine.

Remember that you need to stay well through your pregnancy, and you may need a medicine to help you to do that.

Fluoxetine may cause heart problems in the developing baby, and other symptoms in new-born babies.

If you and your doctor agree that you will continue taking fluoxetine during your pregnancy, then you should tell your midwife that you are taking it before you give birth.

Post-natal

If fluoxetine is taken in the last five months of a pregnancy, it can cause a serious condition called persistent pulmonary hypertension of the new-born (PPHN). This can make the baby breathe faster and look a bit blue in colour. PPHN affects around three in 1,000 babies born to mums who take SSRIs. This compares with a rate of two in 1,000 among babies born to mums who do not take SSRIs.

PPHN appears in the first 24 hours after birth. You will need help from the midwife and doctors, so it is better if they are looking out for symptoms.

The newborn baby may also develop withdrawal effects, which might not appear straight away but might develop over the first few days of life. These could include:

being irritable and crying a lot
having difficulty sleeping or sucking
poor weight gain

Breastfeeding

Fluoxetine is passed to the baby in breast milk, and side effects have been seen in breastfed babies. The main one is likely to be colic.

The amount of fluoxetine in breast milk is usually around 7% of the mum’s dose, but it can build up over time. This is because fluoxetine is hard for your baby to get rid of. This does not mean breastfeeding will be a problem, but do look out for side effects.

If your baby was premature or has health problems, then you may be better off not breastfeeding as your baby will likely struggle even more to get rid of the fluoxetine.

Talk to your doctor or midwife about your feeding options.

Sex

Fluoxetine can have side effects that might affect your sex life. These include:

painful erections that last for a long time (this is rare but serious - visit a hospital or see your doctor straight away if you experience this side effect), or problems getting an erection (getting hard) and ejaculating (coming)
bleeding from the vagina
difficulty reaching orgasm the same way as before
some growth of the breasts and some milk flow, regardless of gender
you may have a lower sex drive

Fluoxetine has been known to slow growth and delay sexual development (puberty) in a small number of children and young people. Your doctor should check your growth while you are taking it. If this worries you, talk to your doctor or pharmacist about it.

These effects should pass after the first couple of weeks. If they do not, and this is a problem for you, go back to the doctor and see what else you could try.

The good effects of fluoxetine may, after a while, have a positive impact on your sex life as your mood lifts and you become interested in life and relationships again.

Fertility

Fluoxetine does not seem to affect human fertility.

Talk to your doctor about your fluoxetine if you are trying to get pregnant.

Fluoxetine is not a banned substance in sport.

Taking fluoxetine may affect your ability to do things like riding a bike, competitive gymnastics, or anything else that needs a lot of focus.

It might be best to stop such sports for the first few days, until you know how it affects you or the effects get better.

Do not worry - most people play sports as normal while taking fluoxetine.

Try not to take fluoxetine for the first time just before your exams.

Taking fluoxetine may affect your ability to do things that need a lot of focus, like exams.

You should talk to your doctor about any future exams if you are starting fluoxetine.

You might decide together to delay starting it until you have done them. If they are more than a month away, however, you might find that it is better to start fluoxetine to lift your mood and improve your motivation to study.

Do not worry - most people do exams as normal while taking fluoxetine.

Uses, warnings, safety and side effects of fluoxetine

Taking fluoxetine

How long will I need to take fluoxetine for?

Most people take fluoxetine for at least six to 12 months after they start to feel better.

If you have suffered from depression in the past, you should keep taking this medication for at least two years after you start to feel better.

You and your doctor should talk about how long you need to take fluoxetine before you begin your treatment.

If you stop taking the fluoxetine too soon, the chance that your mental health symptoms will come back increases.

You should only take fluoxetine as agreed with your doctor

You will get the best effect from fluoxetine if you take it every day at the dose prescribed by your doctor.

Your doctor might start you on a low dose and then increase it to your full dose slowly over two to four weeks.

Make sure that you know your dose. If it's not written on the label, check with your pharmacist or doctor.

Young people aged eight to 18 may start taking fluoxetine at a lower dose using the liquid, and then move on to the capsules if the dose increases.

It is usually best to take fluoxetine in the morning. This is to reduce the chance of it causing insomnia (difficulty sleeping). However, it is important to choose a time each day that you can always remember. This could be when you wake up, a mealtime, or when you brush your teeth.

Fluoxetine is best taken after food.

Swallow the capsule with a drink of water - if you chew it, it tastes bitter.

What should I do if I miss a dose of fluoxetine?

If you remember later during the day, take it as soon as possible.

You may find it difficult to sleep if you take it towards bedtime.

If you forget to take it by the time of your next dose, just take the next dose.

Do not take a double dose.

What will happen if I forget to take my fluoxetine?

If you forget to take it for a few days, you may start getting withdrawal symptoms and should talk to your doctor about it.

Stopping the use of fluoxetine

Stopping fluoxetine suddenly can sometimes cause side effects, which are usually mild, but for a few people can be severe. Also, if you stop taking fluoxetine too soon, the chance that your mental health symptoms will come back increases.

Once you start taking an SSRI, the brain adjusts to having a new level of serotonin around. If you stop taking the SSRI suddenly, the balance starts to change again. You could get some symptoms from the change.

Fluoxetine is less likely to cause withdrawal effects upon stopping than other antidepressant medicines. This is because your body takes longer to get rid of it.

You can stop taking fluoxetine safely with your doctor’s help. Many people who take 20mg or less of fluoxetine can stop taking it without problems. For people on higher doses of fluoxetine, the dose may be stepped down over a few weeks to reduce the chance of withdrawal effects.

Fluoxetine and other antidepressants are not addictive. Although there can be withdrawal effects when they are stopped, you will not have cravings for or get ‘hooked’ on an antidepressant.

Some of the withdrawal effects you might get when fluoxetine is stopped include:

flu-like symptoms such as chills, muscle aches, excessive sweating, headache, and feeling or being sick
feeling unusually tired or weak
sleep disturbances such as difficulty sleeping or vivid dreams
electric shock-like sensations - especially down the spine (back)
dizziness, especially when moving
feeling anxious, restless, irritable, or agitated
difficulty remembering things or concentrating on things

These symptoms should stop after two weeks for most people, but some people can get them for a few months.

Warnings and safety

Safety headlines

If you have taken more fluoxetine than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately – even if you do not feel any different.

While taking fluoxetine, some people may think about hurting themselves or taking their own lives. You must go straight to hospital with your medicine if you have any of these thoughts.

Fluoxetine can also cause rare but serious side effects: allergic reactions (difficulty breathing, swelling of your face or throat, itching skin lumps), rashes or blotches on your skin, and a rare condition called serotonin syndrome (see 'Side Effects'). Go to a hospital with your medicine if you get any of these symptoms.

Do not take fluoxetine if you have taken a monoamine oxidase inhibitor antidepressant (MAOI) like moclobemide, phenelzine, isocarboxazid or tranylcypromine in the last 14 days.

Stopping fluoxetine suddenly can sometimes cause withdrawal effects, which are usually mild, but for a few people can be severe. Also, if you stop taking fluoxetine too soon, the chance that your mental health symptoms will come back increases. See your doctor if you want to stop fluoxetine or have withdrawal effects after stopping it.

You might not be able to concentrate very well, and may feel sleepy, in the first few days after taking fluoxetine. Do not drive a car, ride a bike or operate machines until you see how this affects you.

If you are pregnant, or thinking of becoming pregnant, please read the pregnancy section (see ‘Side Effects') because fluoxetine may affect the developing baby.

When to go to the hospital

If you have taken more fluoxetine than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately – even if you do not feel any different.

Go to A&E. Take your medicine with you to show to the doctors. Tell them how much you have taken. Get a friend or family member to go with you, if you can, just in case you feel ill on the way.

You might get any of the following signs:

feeling sick or being sick
having seizures (fits)
an irregular heartbeat or a heart attack
breathing difficulties
a change in the way you feel, ranging from agitation to falling into a coma

You are also at risk of getting ‘serotonin syndrome’ (symptoms include a high fever, agitation, confusion, trembling, shivering and excessive sweating or weird movements of your muscles). This is rare, but you should watch out for it.

If you have any thoughts of taking your own life or of other ways of hurting yourself, go straight to a hospital with your medicine. This may be a side effect and is more common at the start of treatment. Thoughts of suicide are more likely to occur if you are under 25 years old. Fluoxetine is safer than other antidepressants for people under the age of 18.

You must stop taking Fluoxetine and go straight to hospital if you have any of the following symptoms:

tiredness, confusion, headache, irritability, feeling or being sick (nausea and vomiting), and muscle twitching. These can be symptoms of a low blood level of sodium, but some of these are also symptoms of serotonin syndrome
rashes; blotches; itching; blistering; redness; peeling; or ulcers on your skin, in your mouth, or in your genital area. These can be symptoms of a rare but serious skin reaction
difficulty breathing, swelling of your face or throat, and itching skin lumps. These may be symptoms of an allergic reaction
having seizures (fits)
feeling very excited or ‘high’

Go to a doctor or hospital straight away but do not stop taking your fluoxetine if you get the following symptoms:

your behaviour changes because you feel irritated or agitated
you get an erection that is painful and lasts for a long time (priapism)

Side effects of fluoxetine

Please do not be worried by the side effects listed on this page. Many people take fluoxetine without any side effects or only a few mild side effects. Starting with a lower dose can sometimes help if side effects do occur.

Side effects that do appear should disappear or get better after a few days. If they do not, you should go back to your doctor.

Do not stop taking the fluoxetine until you talk to your doctor, or you may get withdrawal symptoms as well.

Very common side effects when taking fluoxetine (affecting more than one in ten people) include:

insomnia (sleep problems)
headache and feeling tired
diarrhoea (loose poo)
nausea (feeling sick)

Common side effects of taking fluoxetine (affecting up to one in ten people) include:

not feeling hungry
weight loss
nervousness, anxiety, restlessness, poor concentration, feeling tense
decreased sex drive or sexual problems, including difficulty maintaining an erection (staying hard)
sleep problems, unusual dreams, tiredness or sleepiness
dizziness
change in taste, or dry mouth
uncontrollable shaking movements
blurred vision
heartbeat feels quick and uneven
flushing, sweating more, feeling shaky or chills
yawning
indigestion, being sick
rash, itching lumps (hives, urticaria), other skin itching
joint pain
needing to wee more often
unexplained vaginal bleeding

There are other side effects that you can get when taking this medicine – we have only included the most common ones here.

Please look at the leaflet inside your medicine box, or ask a doctor or pharmacist, if you want to know whether you are getting a side effect from your medicine.

If you do get a side effect, please think about reporting it via the Yellow Card Scheme.

Taking fluoxetine

How long will I need to take fluoxetine for?

Most people take fluoxetine for at least six to 12 months after they start to feel better.

If you have suffered from depression in the past, you should keep taking this medication for at least two years after you start to feel better.

You and your doctor should talk about how long you need to take fluoxetine before you begin your treatment.

If you stop taking the fluoxetine too soon, the chance that your mental health symptoms will come back increases.

You should only take fluoxetine as agreed with your doctor

You will get the best effect from fluoxetine if you take it every day at the dose prescribed by your doctor.

Your doctor might start you on a low dose and then increase it to your full dose slowly over two to four weeks.

Make sure that you know your dose. If it's not written on the label, check with your pharmacist or doctor.

Young people aged eight to 18 may start taking fluoxetine at a lower dose using the liquid, and then move on to the capsules if the dose increases.

Fluoxetine is best taken after food.

Swallow the capsule with a drink of water - if you chew it, it tastes bitter.

What should I do if I miss a dose of fluoxetine?

If you remember later during the day, take it as soon as possible.

You may find it difficult to sleep if you take it towards bedtime.

If you forget to take it by the time of your next dose, just take the next dose.

Do not take a double dose.

What will happen if I forget to take my fluoxetine?

If you forget to take it for a few days, you may start getting withdrawal symptoms and should talk to your doctor about it.

Stopping the use of fluoxetine

Fluoxetine is less likely to cause withdrawal effects upon stopping than other antidepressant medicines. This is because your body takes longer to get rid of it.

Fluoxetine and other antidepressants are not addictive. Although there can be withdrawal effects when they are stopped, you will not have cravings for or get ‘hooked’ on an antidepressant.

Some of the withdrawal effects you might get when fluoxetine is stopped include:

flu-like symptoms such as chills, muscle aches, excessive sweating, headache, and feeling or being sick
feeling unusually tired or weak
sleep disturbances such as difficulty sleeping or vivid dreams
electric shock-like sensations - especially down the spine (back)
dizziness, especially when moving
feeling anxious, restless, irritable, or agitated
difficulty remembering things or concentrating on things

These symptoms should stop after two weeks for most people, but some people can get them for a few months.

Warnings and safety

Safety headlines

If you have taken more fluoxetine than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately – even if you do not feel any different.

While taking fluoxetine, some people may think about hurting themselves or taking their own lives. You must go straight to hospital with your medicine if you have any of these thoughts.

Do not take fluoxetine if you have taken a monoamine oxidase inhibitor antidepressant (MAOI) like moclobemide, phenelzine, isocarboxazid or tranylcypromine in the last 14 days.

If you are pregnant, or thinking of becoming pregnant, please read the pregnancy section (see ‘Side Effects') because fluoxetine may affect the developing baby.

When to go to the hospital

If you have taken more fluoxetine than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately – even if you do not feel any different.

Go to A&E. Take your medicine with you to show to the doctors. Tell them how much you have taken. Get a friend or family member to go with you, if you can, just in case you feel ill on the way.

You might get any of the following signs:

feeling sick or being sick
having seizures (fits)
an irregular heartbeat or a heart attack
breathing difficulties
a change in the way you feel, ranging from agitation to falling into a coma

You must stop taking Fluoxetine and go straight to hospital if you have any of the following symptoms:

tiredness, confusion, headache, irritability, feeling or being sick (nausea and vomiting), and muscle twitching. These can be symptoms of a low blood level of sodium, but some of these are also symptoms of serotonin syndrome
rashes; blotches; itching; blistering; redness; peeling; or ulcers on your skin, in your mouth, or in your genital area. These can be symptoms of a rare but serious skin reaction
difficulty breathing, swelling of your face or throat, and itching skin lumps. These may be symptoms of an allergic reaction
having seizures (fits)
feeling very excited or ‘high’

Go to a doctor or hospital straight away but do not stop taking your fluoxetine if you get the following symptoms:

your behaviour changes because you feel irritated or agitated
you get an erection that is painful and lasts for a long time (priapism)

Side effects of fluoxetine

Side effects that do appear should disappear or get better after a few days. If they do not, you should go back to your doctor.

Do not stop taking the fluoxetine until you talk to your doctor, or you may get withdrawal symptoms as well.

Very common side effects when taking fluoxetine (affecting more than one in ten people) include:

insomnia (sleep problems)
headache and feeling tired
diarrhoea (loose poo)
nausea (feeling sick)

Common side effects of taking fluoxetine (affecting up to one in ten people) include:

not feeling hungry
weight loss
nervousness, anxiety, restlessness, poor concentration, feeling tense
decreased sex drive or sexual problems, including difficulty maintaining an erection (staying hard)
sleep problems, unusual dreams, tiredness or sleepiness
dizziness
change in taste, or dry mouth
uncontrollable shaking movements
blurred vision
heartbeat feels quick and uneven
flushing, sweating more, feeling shaky or chills
yawning
indigestion, being sick
rash, itching lumps (hives, urticaria), other skin itching
joint pain
needing to wee more often
unexplained vaginal bleeding

There are other side effects that you can get when taking this medicine – we have only included the most common ones here.

Please look at the leaflet inside your medicine box, or ask a doctor or pharmacist, if you want to know whether you are getting a side effect from your medicine.

If you do get a side effect, please think about reporting it via the Yellow Card Scheme.

The information on this page was reviewed by the College of Mental Health Pharmacy in March 2020.

Visit the CMHP website

CMHP. College of Mental Health Pharmacy

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.

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).

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).

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.

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.

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.

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).

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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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.

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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.

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.

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.

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.

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.

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.

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

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Author: Ekaterina Mishchenko

Tags #How we are treated

SIDE EFFECTS OF ANTIDEPRESSANTS (SSRIs) | Clinical Center "Psychiatry - Narcology"

Currently, the most commonly prescribed antidepressants are drugs from the group of selective serotonin reuptake inhibitors (SSRIs). For most, these medicines are safe and effective, but like all medicines, they can cause side effects. According to statistics, about 40% of patients taking antidepressants also experience side effects, in about 25% of cases they are quite unpleasant. Two of the most common side effects (sexual dysfunction and weight gain) are often the reason people stop taking these medications.

The following are the 7 most common side effects of antidepressants that patients should be aware of:

1. SOMATIC SYMPTOMS.

When medications for depression are first prescribed, the most common physical symptoms are headache, nausea, joint and muscle pain, rash, and diarrhea. These symptoms are usually mild and temporary. The results of clinical studies have shown that nausea and headache are the most common. As a rule, these symptoms are adaptive in nature, as a rule, they pass on their own, without requiring discontinuation of the drug.

2. SLEEP DISTURBANCE.

Many patients, when first prescribed antidepressants, report problems with sleep: difficulty falling asleep or light sleep with frequent awakenings. Also, against the background of taking SSRIs, nightmares and sleepwalking can be observed. Studies have shown that about 22% of people taking antidepressants experience sleep problems.

3. DAY SLEEPNESS .

Sleepiness during the day may be the result of a poor night's sleep, or the direct sedative effect of the antidepressant. In the case when it is a sedative effect, the problem can be solved by transferring the drug to the evening.

4. MIGRAINES

Due to the fact that people who are prone to depression also often suffer from migraines, you need to be careful when taking medications in combination. Medicines; used to treat migraines, triptans, like SSRIs, increase serotonin levels in the brain. If these drugs are used together, it can lead to the development of serotonin syndrome, which manifests itself in the form of headache, heart palpitations, hot flashes. Be sure to discuss with your doctor how to avoid the development of serotonin syndrome if you are prescribed medications of both groups.

5. WEIGHT SET.

Weight gain is one of the late side effects of antidepressants and is one of the most common reasons for refusing to continue taking or switching medications. A good prevention of this side effect is moderate physical activity (for example, a 30-minute workout every other day). The likelihood of weight gain also depends on the drug that is prescribed. According to clinical trials, while taking paroxetine, about 25% of patients gain 7% of their weight.

6. SUICIDE .

The risk of suicide while taking antidepressants is currently under extensive investigation. According to most studies, compared with placebo, taking SSRIs or other antidepressants doubles the likelihood of suicidal thoughts. The overall risk of this side effect when taking antidepressants in adolescents and adults is 2 to 4 percent. One of the reasons for suicide while taking antidepressants is that medications increase activity, giving energy for the implementation of a suicidal plan. Regular follow-up by a doctor can reduce the risk of this side effect.

7. SEXUAL DYSFUNCTION.

Sexual dysfunction is one of the most common long-term side effects of SSRIs.

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