Should i take prozac

Prozac Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Warnings:

Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.

Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

Warnings:

Uses

Fluoxetine is used to treat depression, panic attacks, obsessive compulsive disorder, a certain eating disorder (bulimia), and a severe form of premenstrual syndrome (premenstrual dysphoric disorder).This medication may improve your mood, sleep, appetite, and energy level and may help restore your interest in daily living. It may decrease fear, anxiety, unwanted thoughts, and the number of panic attacks. It may also reduce the urge to perform repeated tasks (compulsions such as hand-washing, counting, and checking) that interfere with daily living. Fluoxetine may lessen premenstrual symptoms such as irritability, increased appetite, and depression. It may decrease binging and purging behaviors in bulimia.

How to use Prozac Capsule

Read the Medication Guide provided by your pharmacist before you start using fluoxetine and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth as directed by your doctor, usually once daily in the morning. If you are taking this medication twice a day, your doctor may direct you to take it in the morning and at noon.

If you are taking fluoxetine for premenstrual problems, your doctor may direct you to take it every day of the month or just for the 2 weeks before your period through the first full day of your period. To help you remember, mark your calendar.

If you are using the liquid form of this medication, measure the dose carefully using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.

The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.

Keep taking this medication even if you feel well. Do not stop taking this medication without first consulting your doctor. Some conditions may become worse when the drug is abruptly stopped. Your dose may need to be gradually decreased.

You should see some improvement in 1 to 2 weeks. It may take 4 to 5 weeks before you feel the full benefit.

Tell your doctor if your condition does not improve or if it worsens.

Side Effects

Precautions

Before taking fluoxetine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: personal or family history of bipolar/manic-depressive disorder, personal or family history of suicide attempts, liver problems, diabetes, low sodium in the blood (such as may occur while taking "water pills" - diuretics), severe dehydration, seizures, stomach/intestinal ulcers, personal or family history of glaucoma (angle-closure type).

This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

The liquid form of this medication contains alcohol. Caution is advised if you have diabetes, alcohol dependence, or liver disease. Some medications (such as metronidazole, disulfiram) can cause a serious reaction when combined with alcohol. Ask your doctor or pharmacist about using this product safely.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Children may be more sensitive to the side effects of this drug, especially weight loss. Monitor weight and height in children who are taking this drug.

Older adults may be more sensitive to the side effects of this drug, especially bleeding and loss of coordination. Loss of coordination can increase the risk of falling. Older adults may also be more likely to develop low sodium in the blood, especially if they are taking "water pills" (diuretics).

During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Also, babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying. If you notice any of these symptoms in your newborn, tell the doctor promptly.

Since untreated mental/mood problems (such as depression, panic attacks, obsessive compulsive disorder) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss the benefits and risks of using this medication during pregnancy with your doctor.

This medication passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Fluoxetine can stay in your body for many weeks after your last dose and may interact with many other medications. Before using any medication, tell your doctor or pharmacist if you have taken fluoxetine in the previous 5 weeks.

Some products that may interact with this drug include: other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen, "blood thinners" such as warfarin).

Taking MAO inhibitors with his medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for 2 weeks before and at least 5 weeks after treatment with this medication. Ask your doctor when to start or stop taking this medication.

This medication can slow down the removal of other medications from your body, which may affect how they work. Examples of affected drugs include pimozide, thioridazine, vinblastine, antiarrhythmics (such as propafenone, flecainide), tricyclic antidepressants (such as desipramine, imipramine), among others.

Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking it unless your doctor instructs you otherwise.

The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/"ecstasy," St. John's wort, certain antidepressants (including other SSRIs such as citalopram/paroxetine, SNRIs such as duloxetine/venlafaxine), tryptophan, among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine). Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

This medication may interfere with certain medical/laboratory tests (including brain scan for Parkinson's disease), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Does Prozac Capsule interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: fast/irregular heartbeat, severe dizziness, fainting.

Do not share this medication with others.

Keep all regular medical and psychiatric appointments.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

How and when to take fluoxetine

Dosage

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

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

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

How to take it

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

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

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

How long to take it for

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

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

If you forget to take it

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

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

Stopping fluoxetine

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

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

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

If you take too much

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

Taking too much can cause symptoms such as:

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

Urgent advice: Contact 111 for advice now if:

you take more than your prescribed dose of fluoxetine

Go to 111.nhs.uk or call 111.

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

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

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

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.

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Author: Ekaterina Mishchenko

Tags #How we are treated

Depression under repression - Money - Kommersant

4K 7 min. ... nine0159

Happiness Pill
In 1957, a psychiatric hospital in Switzerland received a new drug for schizophrenia. The patients obediently swallowed the pills, the doctors waited for the results, but there was no healing. However, doctors noticed another curious feature: after taking the new drug, sad and inhibited patients became cheerful and active for a while. Almost at the same time, another clinic was testing a new drug for the treatment of tuberculosis. It did not affect Koch's wands in any way, but for those who received it, the feeling of constant anxiety for their lives was replaced by serenity and calmness. So, thanks to an accident, noticed in time by doctors, drugs were born, later called antidepressants. nine0160 Having studied the mechanism of action of "happiness pills", scientists have understood the very cause of depression. Studies have shown that depression occurs when the metabolism of serotonin (a hormone responsible for a stable mood in a person) is disturbed in the body, and to eliminate it, it is enough to increase the content of this hormone in the human body.
However, the first antidepressants turned out to be not a panacea at all, since they had a lot of unpleasant side effects: dry mouth, constipation, sweating, weakness, insomnia, heart rhythm disturbances, decreased pressure, problems with the liver and kidneys. In addition, those wishing to get rid of depression had to follow a diet: the drugs were incompatible with many foods (cheese, smoked meats, fish, beer, red wine). nine0160 Scientists have been perfecting "happiness pills" for 30 years, until the American pharmaceutical company Eli Lilly patented the drug "Prozac" in the late 80s. It became the first drug of a new generation of antidepressants, scientifically called "serotonin reuptake inhibitors". In the process of metabolism, serotonin is produced by some cells and immediately absorbed by others. Prozac works by blocking the uptake of serotonin.
nine0160 Return of the Sad Parrot

From an ordinary bad mood, depression differs in a protracted nature. Medical reference books say that if for at least two weeks you experience a feeling of worthlessness or guilt, suddenly gaining weight or losing weight, suffer from insomnia, loss of strength or, conversely, unreasonable excitement, easily get irritated, or, God forbid, you are thinking of committing suicide - you have all the symptoms of depression. As it turned out, such sensations were familiar to a huge number of people. So when at 19In 88, the first packages of Prozac appeared in pharmacies, in the annotation to which it was claimed that it was able to relieve the symptoms of depression and give self-confidence, the new medicine was literally swept off the shelves: in the first year, sales amounted to about $ 2 million. gave in the United States - almost without exception, Americans found symptoms of depression in themselves.
And America "hooked" on Prozac - it was bought by the old and the young, "shopaholics" and gamers, victims of bulimia and anorexia. Americans enthusiastically told their friends about the miraculous medicine, and they went to psychiatrists with a request to write them a prescription for happiness. Soon, not only psychiatrists, but also therapists began to prescribe antidepressants, since, according to doctors, "depression can be disguised as various physical ailments." It even got to the point that veterinarians began prescribing a new drug for their patients, after which messages appeared in the yellow press, such as “Many parrot after a course of Prozac cheered up and covered with feathers again” or “Sad poodle became cheerful again under the influence of antidepressants.” nine0160 At the same time, with the advent of Prozac, humanity took a fresh look at depression - this disease has become fashionable. Depression was tacitly declared to be an essential attribute of the young and progressive. Depression began to talk a lot, write, shoot television stories and films. The latest creation on this topic is the film by Norwegian director Erik Skjoldberg "Prozac Nation" with Christina Ricci in the title role. The script for the film is based on the memoirs of the famous music critic Elisabeth Wurzel, the full title of which is Prozac: The Young and the Depressed in America. nine0160
Happy to death
Under the influence of advertising, consumers forgot that antidepressants are not harmless valerian at all, but a drug for the treatment of severe mental illness. Prozac and similar drugs were drunk not only to improve mood, but simply to get rid of insomnia or even lose weight. In its ten years of existence, antidepressants have been prescribed to approximately 40 million people worldwide. The popularity of Prozac led to the fact that in America it was dubbed the "drug in the law", and people who use it began to be called happy fools (happy fools). nine0160 However, the euphoria subsided when it became clear that the “happiness pills” were far from harmless. In 2001, two scandals erupted almost simultaneously in Australia and the United States - American David Snell killed his entire family of three, and Australian David Hawkins killed his wife. After that, both took their own lives. The investigation revealed that they were being treated with antidepressants. Western scientists explained this case as follows: they say, patients with depression often want to die, but do not find the strength in themselves, and after taking antidepressants they have strength, which leads to tragedy. After showing the Hawkins and Snell trials on the BBC, patients taking antidepressants and their families reported 16 suicides, 47 suicide attempts, and 92 cases of aggressive behavior.
Meanwhile, Alexander Tesler, director of the Center for Psychotherapy and Reflexology of the Russian Academy of Medical Sciences, is sure that only abrupt withdrawal of an antidepressant can lead to suicide: “The decision to prescribe and cancel antidepressants should be made only by a doctor. The dose of the drug should be reduced gradually, then there will be no withdrawal syndrome. patients leads to the fact that depression rolls again, and a person in this state is quite capable of laying hands on himself. “I have a patient,” continued Academician Tesler, “who was treated with antidepressants, but she had problems with her libido from this, and her partner forced her to give up the pills. As a result, a week later she came to me absolutely broken, in the deepest depression ". nine0160 By the way, accusations of a decrease in libido are heard against “happiness pills” regularly. However, most manufacturers of antidepressants honestly warn about this in the annotation to the drug. As well as other side effects: migraine, amnesia, hallucinations, dizziness, weight loss, nausea, diarrhea, tremor, urticaria, tachycardia, edema, bronchospasm.
Alexander Tesler: I recently had a patient with depression who said that he would live in this world for exactly a month in order to have time to finish all his affairs, after which he would consciously die. I warned him that this month would be very difficult for him, so it would be better if he took antidepressants. But he objected: "What are you? It's so bad for the liver!" After that, I calmly let him go - a person who thinks so much about his liver is unlikely to seriously intend to harm his life. nine0159

With drink around the neck
It should be noted that mankind from time immemorial has tried to find a remedy for the blues. Before the advent of antidepressants, they tried to get rid of it with the help of drugs that have a stimulating effect (coffee, ginseng, and even opium), and to reduce anxiety, they used ordinary valerian or bromine salts. In Russia, vodka is considered a traditional "antidepressant", which most of the fellow citizens use to drive away sadness and melancholy. At first, alcohol really helps to cope with emotions, but over time, on the contrary, it begins to work as a powerful depressogen. That is why almost all psychological centers treat alcohol dependence along with depression. nine0160 Meanwhile, American values—including the fashion for taking antidepressants—have long since taken root in Russia. Alexander Tesler: One day I called a friend of mine in California and heard him talking harshly to his subordinates. When I asked what happened, he replied: "I forgot to take my morning Prozac." In the United States, successful people have long understood that no matter what happens, they must be "afloat." Now the Russians have come to the same conclusion.
"A real boom in antidepressants has begun in Russia," says Svetlana Grudacheva, a leading analyst at the Pharmexpert marketing research center.million in 2001 to $26.8 million in 2003. There are 50 companies in this market, 10 of which are domestic."
According to statistics, 11.5 million Russians suffer from depression, only a third of whom receive full-fledged treatment. The rest are engaged in getting rid of depression on their own - some drugs are sold in pharmacies without a prescription. According to the principle of action, all drugs are almost the same: among the most popular are Zoloft, Paxil, Selex, Luvox, Russian pyrazidol, Azafen. Domestic antidepressants cost about $3.5 (but their market share is only 8%), the price of imported drugs is from $11 to $50 per pack (a monthly course of treatment involves taking two packs). nine0160 Alexander Tesler: Today, a wealthy Russian believes that in order to be calm and stable, he must visit a psychoanalyst. I have several perfectly healthy clients whom I meet once a week - they just need to talk to me about their problems. Once I talked for two hours with a businesswoman about her family and friends, after which she suddenly said: "Talking with you helped me make a decision - I'm buying a plant."
Experts note that depression is often “discovered” by completely normal people. After that, they begin to treat a non-existent ailment with the help of "happiness pills". However, doctors emphasize that only a psychiatrist can diagnose depression and prescribe a course of treatment - self-medication can lead to an aggravation of the disease.
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