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What is the maximum dosage of prozac


Fluoxetine Dosage Guide + Max Dose, Adjustments

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Medically reviewed by Drugs.com. Last updated on Nov 9, 2021.

Applies to the following strengths: 90 mg; 10 mg; 20 mg; 40 mg; 60 mg; 20 mg/5 mL; 15 mg

Usual Adult Dose for:

  • Bulimia
  • Depression
  • Obsessive Compulsive Disorder
  • Panic Disorder
  • Premenstrual Dysphoric Disorder

Usual Pediatric Dose for:

  • Depression
  • Obsessive Compulsive Disorder
Additional dosage information:
  • Renal Dose Adjustments
  • Liver Dose Adjustments
  • Dose Adjustments
  • Precautions
  • Dialysis
  • Other Comments

Usual Adult Dose for Bulimia

Immediate-release oral formulations: 60 mg orally once a day in the morning

Comments:

  • Some patients may need to be started at a lower dose and titrated up over several days to the recommended dose.
  • Daily doses greater than 60 mg have not been systematically studied for the treatment of bulimia.

Use: Acute and maintenance treatment of binge-eating and vomiting behaviors in moderate to severe bulimia nervosa

Usual Adult Dose for Depression

Immediate-release oral formulations:
Initial dose: 20 mg orally once a day in the morning, increased after several weeks if sufficient clinical improvement is not observed
Maintenance dose: 20 to 60 mg orally per day
Maximum dose: 80 mg orally per day

Delayed release oral capsules:
Initial dose: 90 mg orally once a week, commenced 7 days after the last daily dose of immediate-release fluoxetine 20 mg formulations.

Comments:

  • Doses above 20 mg per day may be given in divided doses, in the morning and at noon.
  • The full effect may be delayed until after at least 4 weeks of treatment.
  • If a satisfactory response with the once weekly oral fluoxetine is not maintained, a change back to daily fluoxetine dosing using the immediate-release oral formulations should be considered.
  • Acute episodes of Major Depressive Disorder (MDD) require several months or longer of sustained pharmacologic therapy.
  • Whether the dose needed to induce remission is the same as the dose needed to maintain and/or sustain euthymia is unknown.

Use: Acute and maintenance treatment of MDD

Usual Adult Dose for Obsessive Compulsive Disorder

Immediate-release oral formulations:

  • Initial dose: 20 mg orally once a day in the morning, increased after several weeks if sufficient clinical improvement is not observed.
  • Maintenance dose: 20 to 60 mg orally per day
  • Maximum dose: 80 mg orally per day

Comments:

  • Doses above 20 mg per day may be given in divided doses, in the morning and at noon.
  • The full effect may be delayed until after at least 5 weeks of treatment.

Use: Acute and maintenance treatment of obsessions and compulsions in patients with Obsessive Compulsive Disorder (OCD)

Usual Adult Dose for Panic Disorder

Immediate-release oral formulations:

  • Initial dose: 10 mg orally once a day, increased after one week to 20 mg orally once a day
  • Maintenance dose: 20 to 60 mg orally per day
  • Maximum dose: 60 mg orally per day

Comments:

  • Doses above 20 mg per day may be given in divided doses, in the morning and at noon.
  • A dose increase may be considered after several weeks if clinical improvement is not observed.
  • Doses greater than 60 mg per day have not been systematically studied for the treatment of panic disorder.

Use: Acute treatment of panic disorder with/without agoraphobia

Usual Adult Dose for Premenstrual Dysphoric Disorder

Immediate-release oral formulations:
Initial dose:

  • Continuous regimen: 20 mg orally once a day on every day of the menstrual cycle
  • Cyclic regimen: 20 mg orally once a day starting 14 days prior to the anticipated start of menstruation through to the first full day of menses, and repeated with each new cycle

Maintenance dose: 20 to 60 mg per day for either the continuous or intermittent regimens
Maximum dose: 80 mg orally per day

Comments:

  • A daily dose of 60 mg has not been shown to be significantly more effective than 20 mg daily.
  • Daily doses above 60 mg have not been systematically studied in patients with this condition.
  • The 20 mg daily dosage has been shown to be effective for up to 6 months of treatment.

Use: Treatment of premenstrual dysphoric disorder (PMDD)

Usual Pediatric Dose for Depression

Immediate-release oral formulations:
8 to 18 years:
Initial dose: 10 to 20 mg orally once a day; the 10 mg daily dose may be increased after one week to 20 mg orally once a day

Lower weight children:

  • Initial dose: 10 mg orally once a day, increased to 20 mg orally once a day after several weeks if sufficient clinical improvement is not observed
  • Maintenance dose: 10 to 20 mg orally once a day

Comments:

  • The full effect may be delayed until after at least 4 weeks of treatment.
  • The potential risks versus clinical need should be assessed prior to using this drug in children and adolescents.

Use: Acute and maintenance treatment of MDD

Usual Pediatric Dose for Obsessive Compulsive Disorder

Immediate-release oral formulations:
7 to 17 years:
Adolescents and higher weight children:

  • Initial dose: 10 mg orally once a day, increased to 20 mg orally once a day after 2 weeks
  • Maintenance dose: 20 to 60 mg orally per day
  • Maximum dose: 60 mg orally per day

Lower weight children:

  • Initial dose: 10 mg orally once a day, increased after several weeks if sufficient clinical improvement is not observed
  • Maintenance dose: 20 to 30 mg orally once a day
  • Maximum dose: 60 mg orally per day

Comments:

  • Additional dose increases may be considered after several more weeks if clinical improvement is insufficient.
  • Doses above 20 mg per day may be given in divided doses, in the morning and at noon.
  • In lower weight children, there is minimal experience with doses greater than 20 mg per day, and none with doses greater than 60 mg per day.
  • The full effect may be delayed until after at least 5 weeks of treatment.
  • The potential risks versus clinical need should be assessed prior to using this drug in children and adolescents.

Use: Acute and maintenance treatment of obsessions and compulsions in patients with
OCD

Renal Dose Adjustments

No adjustment recommended

Liver Dose Adjustments

Liver dysfunction (including cirrhosis):

  • Immediate-release oral formulations: Lower or less frequent dosing may be appropriate in these patients
  • Delayed-release oral capsules: Data not available

Dose Adjustments

A lower or less frequent dose should be considered in elderly patients, and/or those on multiple concomitant medications or with concurrent disease.

Switching from:

  • MAOI therapy to this drug: At least 14 days should elapse
  • This drug to MAOI therapy: At least 5 weeks should elapse
  • This drug to tricyclic antidepressant (TCA) therapy: The dose of the TCA may need to be reduced and plasma levels temporarily monitored

Treatment withdrawal:

  • A gradual dose reduction is recommended instead of abrupt cessation where possible.
  • If intolerable symptoms occur, it is recommended to consider resuming the previously prescribed dose and to decrease the dose at a more gradual rate.

Precautions

US BOXED WARNINGS:
SUICIDAL THOUGHTS AND BEHAVIORS:

  • Antidepressants increase the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term studies. These studies did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in patients over age 24; there was a reduction in risk with antidepressant use in patients aged 65 and older.
  • In patients of all ages who are started on antidepressant therapy, monitor closely for worsening and for emergence of suicidal thoughts and behaviors. Advise families and caregivers of the need for close observation and communication with the prescriber.
  • Fluoxetine is not approved for use in children less than 7 years of age.

Safety and efficacy have not been established in pediatric patients younger than 7 years (OCD) and 8 years of age (MDD).
Safety and efficacy in the treatment of PMDD have not been established in pediatric patients.

Consult WARNINGS section for additional precautions.

Dialysis

No adjustment recommended

Other Comments

Administration advice:

  • A once a day dose should be taken in the morning; doses greater than 20 mg per day may be divided into morning and noon doses.
  • Oral dissolving tablets may be swallowed with fluid or dispersed in water just prior to administration; the tablets should not be crushed or chewed.
  • Because fluoxetine may cause insomnia, night-time dosing should be limited to those patients experiencing sedation.

Storage requirements:

  • Oral solution and some tablet formulations: Protect from light.

General:

  • The delayed release oral capsule (given weekly) contains enteric-coated pellets.
  • Oral capsules, tablets, oral solution, and delayed release oral capsules (given weekly) are bioequivalent
  • Changes in dose will not be fully reflected in plasma for several weeks due to the long elimination half-lives of fluoxetine and its major active metabolite.
  • The need for ongoing treatment should be regularly reviewed.
  • Patients should be maintained on the lowest effective dose.
  • Avoid use as monotherapy in treatment-resistant depression i.e., patients who do not respond to two antidepressants of adequate dose and duration in the current episode.

Monitoring:

  • Cardiovascular: ECG monitoring (in patients with risk factors for QT-interval prolongation)
  • Hepatic: Liver function
  • Metabolic: Electrolyte levels (especially in patients at risk of hyponatremia), weight (especially in underweight depressed or bulimic patients)
  • Nervous system: Seizure activity (especially in patients at risk of seizures), serotonin syndrome
  • Psychiatric: Emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior.

Patient advice:

  • Tell your healthcare provider about all of the medicines that you take, including prescription and non-prescription medicines.
  • This medicine may increase the risk of suicidal thoughts and behavior. Be alert for the emergence or worsening of symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts, behavior, or thoughts about self-harm. Report any behavior of concern to your healthcare provider as soon as possible.
  • Patients should be advised to speak to a healthcare provider if they are pregnant, intend to become pregnant, or are breastfeeding.
  • This medicine may cause impaired judgment, thinking, or motor skills; do not drive a car or operate dangerous machinery until you know how this drug affects you.

Frequently asked questions

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  • Prozac vs Zoloft - What are the Differences & Similarities?
  • What are some common side effects of antidepressants?
  • If I'm on fluoxetine, what can I take for a bad cough associated with a cold or strep throat?

More about fluoxetine

  • Check interactions
  • Compare alternatives
  • Pricing & coupons
  • Reviews (2,084)
  • Drug images
  • Side effects
  • Patient tips
  • During pregnancy

Patient resources

  • Drug Information
  • Fluoxetine Capsules and Tablets
  • Fluoxetine Capsules and Tablets (PMDD)
  • Fluoxetine Delayed-Release Capsules
  • Fluoxetine Solution
  • Support group
  • Breastfeeding
  • En español
Other brands

Prozac, Sarafem, Prozac Weekly, Rapiflux, Selfemra

Professional resources

  • Prescribing Information
  • Drug class: selective serotonin reuptake inhibitors

Related treatment guides

  • Anxiety and Stress
  • Binge Eating Disorder
  • Body Dysmorphic Disorder
  • Agoraphobia

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Side effects, dosage, uses, and more

  1. Fluoxetine oral capsule is available as a brand-name drug and as a generic drug. Brand name: Prozac.
  2. Fluoxetine comes in four forms: capsule, delayed-release capsule, tablet, and solution. All forms are taken by mouth.
  3. Fluoxetine oral capsule is used to treat different types of depression, obsessive-compulsive disorder, some eating disorders, and panic attacks.

Other warnings

  • Serotonin syndrome warning: This drug can cause a life-threatening condition called serotonin syndrome. This syndrome happens when medications cause too much serotonin to build up in your body. Symptoms can include agitation, hallucinations (seeing or hearing something that isn’t there), problems with coordination, and a racing heart rate. They can also include overactive reflexes, fever, nausea, vomiting, or diarrhea. Call your doctor right away if you have any signs of this condition.
  • Mania warning: This drug may cause mania or hypomania. Symptoms include greatly increased energy, extreme irritability, talking more or faster than usual, racing thoughts, or severe trouble sleeping. If you have a history of mania or bipolar disorder, talk to your doctor before using this drug.
  • Low salt levels warning: This drug may cause you to have dangerously low salt levels in your blood. Symptoms include headache, weakness, confusion, trouble concentrating, memory problems, and feeling unsteady. Call your doctor right away if you have any symptoms of this condition.

Fluoxetine is a prescription drug. It comes as a capsule, delayed-release capsule, tablet, and solution. All forms are taken by mouth. (A delayed-release capsule is released into your body more slowly.)

Fluoxetine oral capsule is available as the brand-name drug Prozac. It’s also available as a generic drug. Generic drugs usually cost less than brand-name versions. In some cases, they may not be available in every strength or form as brand-name drugs.

Fluoxetine oral capsule may be used as part of a combination therapy. This means you may need to take it with other medications. For the treatment of depressive episodes related to bipolar I disorder and treatment-resistant depression, this drug must be used with olanzapine.

Why it’s used

Fluoxetine oral capsule is used to treat the following conditions:

  • Depression. This includes major depression.
  • Obsessive-compulsive disorder. This condition causes bothersome thoughts that won’t go away (obsessions) and the need to do certain actions over and over (compulsions).
  • Bulimia nervosa. This condition is an eating disorder marked by binge eating followed by extreme behaviors to avoid gaining weight (purging, fasting, or excessive exercise).
  • Panic attacks. These are sudden episodes of extreme fear and worry even though no threat exists.

How it works

Fluoxetine oral capsule belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs). A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Fluoxetine works by increasing the amount of serotonin (a natural substance) in your brain. Serotonin helps maintain mental health balance. An increase in serotonin helps to treat symptoms of depression, obsessive-compulsive disorder, bulimia nervosa, and panic attacks.

Fluoxetine oral capsule doesn’t cause drowsiness, but it can cause other side effects.

More common side effects

The more common side effects of fluoxetine can include:

  • strange dreams
  • decreased sex drive and trouble having an orgasm
  • decreased appetite
  • anxiety and nervousness
  • weakness
  • diarrhea
  • dry mouth
  • indigestion
  • flu
  • erectile dysfunction (trouble getting or keeping an erection)
  • trouble sleeping
  • nausea
  • sore throat
  • rash
  • watery nasal discharge
  • sleepiness
  • sweating and hot flashes
  • tremors (uncontrollable rhythmic movement in one part of your body)
  • yawning
  • If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Serotonin syndrome. Symptoms can include:
    • agitation (feeling aggravated or restless)
    • hallucinations (seeing or hearing something that isn’t there)
    • problems with coordination
    • racing heart rate
    • overactive reflexes
    • fever
    • nausea
    • vomiting
    • diarrhea
  • Abnormal bleeding. Symptoms can include:
    • bruising or bleeding more easily than normal
  • Mania. Symptoms can include:
    • greatly increased energy
    • severe trouble sleeping
    • racing thoughts
    • reckless behavior
    • unusually grand ideas
    • excessive happiness or irritability
    • talking more or faster than normal
  • Seizures
  • Low salt levels in your blood. Symptoms can include:
    • headache
    • weakness
    • confusion
    • trouble concentrating
    • memory problems
    • feeling unsteady

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Fluoxetine oral capsule can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with fluoxetine are listed below.

Drugs you should not use with fluoxetine

Do not take these drugs with fluoxetine. Doing so can cause dangerous effects in your body. Examples of these drugs include:

  • Monoamine oxidase inhibitors (MAOIs), such as isocarboxazid, phenelzine, and tranylcypromine. You shouldn’t take fluoxetine if you take an MAOI or if you’ve stopped taking an MAOI within the last two weeks. Don’t take an MAOI within five weeks of stopping fluoxetine. Taking these drugs too close together could cause serious and life-threatening side effects. Symptoms include high fever, constant muscle spasms that you can’t control, and stiff muscles. They also include fast changes in your heart rate and blood pressure, confusion, and unconsciousness.
  • Thioridazine. You shouldn’t take these drugs together. Don’t take thioridazine within five weeks of stopping fluoxetine. Taking these drugs together can cause serious heart rhythm problems. These problems can cause you to die suddenly.
  • Pimozide. You shouldn’t take these drugs together. Fluoxetine can cause the levels of pimozide to increase in your body. This raises your risk for heart rhythm problems.

Interactions that increase your risk of side effects

Increased side effects: Taking fluoxetine with certain medications raises your risk of side effects. This is because fluoxetine and these other medications can cause the same side effects. These drugs include serotonergic drugs, such as:

  • selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine and sertraline
  • serotonin-norepinephrine reuptake inhibitors (SNRIs) such as duloxetine and venlafaxine
  • tricyclic antidepressants (TCAs) such as amitriptyline and clomipramine
  • the opioids fentanyl and tramadol
  • the anxiolytic buspirone
  • triptans
  • lithium
  • tryptophan
  • St. John’s wort
  • amphetamines

Taking these drugs with fluoxetine may increase your risk of serotonin syndrome, which can be fatal. If you take any of these drugs, your doctor will start you on a lowered dosage of fluoxetine and monitor you for signs of serotonin syndrome. Symptoms can include agitation, sweating, muscle twitches, and confusion.

Increased side effects from other drugs: Taking fluoxetine with certain medications raises your risk of side effects from these drugs. Examples of these drugs include:

  • Benzodiazepines, such as triazolam and midazolam. Taking these drugs together may cause more sedation and drowsiness.
  • Warfarin. Taking these drugs together may cause an increase in bleeding. Your doctor will monitor you closely.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs). Taking these drugs together may cause an increase in bleeding. Your doctor will monitor you closely.
  • Aspirin. Taking these drugs together may cause an increase in bleeding. Your doctor will monitor you closely.
  • Drugs broken down by the enzyme CYPD2D6, such as aripiprazole, dextromethorphan, and risperidone. Taking these drugs with fluoxetine may increase your risk of serotonin syndrome, heart rhythm problems, and involuntary muscle movements.
  • Lithium. Your doctor should monitor your lithium blood levels if you need to take these drugs together.
  • Phenytoin. Taking these drugs together may cause confusion, dizziness, and fever. You may also have changes in your behavior. These changes include anger, irritability, or sadness. Your doctor should monitor the level of phenytoin in your body.
  • Carbamazepine. Taking these drugs together can cause blurred vision, vertigo, or tremors. Your doctor should monitor the level of carbamazepine in your body.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

This drug comes with several warnings.

Allergy warning

This medication can cause a severe allergic reaction. Symptoms can include:

  • hives
  • rash alone or with a fever and joint pain
  • trouble breathing
  • swelling of your throat or tongue

If you develop these symptoms, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Warnings for people with certain health conditions

For people with blood clotting disorders: This drug may cause you to bleed more easily. If you take another drug to thin your blood, it could cause dangerous bleeding.

For people with diabetes: This drug may cause low blood sugar levels. Once you stop taking this drug, it may cause your blood sugar levels to increase.

For people with bipolar I disorder: You shouldn’t take this drug alone to treat depression associated with bipolar I disorder. This drug may increase your risk of a mixed or manic episode.

For people with liver disease: If you have liver problems or a history of liver disease, your body may not be able to process this drug as well. This may increase the levels of this drug in your body and cause more side effects. Your doctor may lower your dose or have you take this drug less often.

For people with closed-angle glaucoma (a sudden buildup of pressure inside your eye): Fluoxetine may cause a glaucoma attack. If you have closed-angle glaucoma, talk with your doctor before taking this drug.

For people with epilepsy or other conditions that cause seizures: This drug can increase your risk of seizures. If you’ve had seizures in the past, talk with your doctor before taking this drug. Tell them if you have increased seizures after starting the treatment.

For people with heart rhythm problems: This drug can cause your heart to beat abnormally. Sometimes, this has led to an unsafe abnormal heartbeat called torsades de pointes. You have a higher risk if you’ve ever had heart problems. Call your doctor right away if you have a fast or irregular heartbeat. Anyone who loses consciousness requires urgent medical care.

Warnings for other groups

For pregnant women: Talk to your doctor if you’re pregnant or plan to become pregnant. Research in animals has shown adverse effects to the fetus when the mother takes the drug. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus. This drug should only be used if the potential benefit justifies the potential risk.

For women who are breastfeeding: This drug may pass into breast milk and may cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For seniors: Seniors may have a higher risk of side effects from this drug. Because of this risk, your doctor may lower your dosage or have you take the medication less often.

Bulimia nervosa and panic disorder: This drug hasn’t been studied in children for these conditions. It shouldn’t be used in people younger than 18 years.

Major depressive disorder: This drug shouldn’t be used in children younger than 8 years for this condition.

Obsessive-compulsive disorder: This drug shouldn’t be used in children younger than 7 years for this condition.

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

Dosage for bulimia nervosa

Generic: Fluoxetine

  • Form: oral capsule
  • Strengths: 10 mg, 20 mg, 40 mg

Brand: Prozac

  • Form: oral capsule
  • Strengths: 10 mg, 20 mg, 40 mg

Adult dosage (ages 18 to 64 years)

Typical dosage: 60 mg per day taken in the morning.

Child dosage (ages 0 to 17 years)

This drug hasn’t been studied in children for this condition. It shouldn’t be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

Seniors may have a higher risk of side effects from this drug. Because of this risk, your doctor may lower your dosage or reduce how often you take the drug.

Dosage for major depressive disorder

Generic: Fluoxetine

  • Form: oral capsule
  • Strengths: 10 mg, 20 mg, 40 mg
  • Form: oral delayed-release capsule
  • Strength: 90 mg

Brand: Prozac

  • Form: oral capsule
  • Strengths: 10 mg, 20 mg, 40 mg

Adult dosage (ages 18 to 64 years)

  • Typical dosage: 20–80 mg per day.
  • Maximum dosage: 80 mg per day.
  • Initial dosage: 20 mg per day taken in the morning.
  • Alternative dosage: You may be a candidate for taking this drug once per week. In this case, your doctor will stop your daily dose of the immediate-release capsules and switch you over to the delayed-release capsules. You’ll take 90 mg once per week. You’ll start taking it seven days after your last daily dose of fluoxetine.

Child dosage (ages 8 to 17 years)

  • Typical dosage: 10–20 mg per day.
  • Initial dosage: After your child takes 10 mg per day for one week, your doctor may increase their dosage to 20 mg per day.

Child dosage (ages 0–7 years)

This drug shouldn’t be used in children younger than 8 years for this condition.

Senior dosage (ages 65 years and older)

Seniors may have a higher risk of side effects from this drug. Because of this risk, your doctor may lower your dose or reduce how often you take the drug.

Dosage for obsessive-compulsive disorder

Generic: Fluoxetine

  • Form: oral capsule
  • Strengths: 10 mg, 20 mg, 40 mg

Brand: Prozac

  • Form: oral capsule
  • Strengths: 10 mg, 20 mg, 40 mg

Adult dosage (ages 18 to 64 years)

  • Typical dosage: 20–60 mg per day.
  • Maximum dosage: 80 mg per day.
  • Initial dosage: 20 mg per day taken in the morning.

Child dosage (ages 13 to 17 years, and higher weight children)

  • Typical dosage: 20–60 mg per day.
  • Initial dosage: 10 mg per day. After two weeks, your doctor will likely increase your child’s dosage to 20 mg per day.

Child dosage (ages 7 to 12, and lower weight children)

  • Typical dosage: 20–30 mg per day.
  • Initial dosage: 10 mg per day.

Child dosage (ages 0 to 6 years)

This drug shouldn’t be used in children younger than 7 years for this condition.

Senior dosage (ages 65 years and older)

Seniors may have a higher risk of side effects from this drug. Because of this risk, your doctor may lower your dosage or reduce how often you take the drug.

Dosage for panic disorder

Generic: Fluoxetine

  • Form: oral capsule
  • Strengths: 10 mg, 20 mg, 40 mg

Brand: Prozac

  • Form: oral capsule
  • Strengths: 10 mg, 20 mg, 40 mg

Adult dosage (ages 18 to 64 years)

  • Typical dosage: 20–60 mg per day.
  • Initial dosage: 10 mg per day. After one week, your doctor will likely increase your dosage to 20 mg per day.

Child dosage (ages 0 to 17 years)

This drug hasn’t been studied in children for this condition. It shouldn’t be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

Seniors may have a higher risk of side effects from this drug. Because of this risk, your doctor may lower your dosage or reduce how often you take the drug.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.

Fluoxetine oral capsule is used for short- and long-term treatment of bulimia nervosa, major depression, and obsessive-compulsive disorder. It’s also used for short-term treatment of panic attacks.

This drug comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all: If you don’t take this drug, the symptoms of your condition may not improve.

Don’t stop taking this drug without talking to your doctor first. Stopping this drug too quickly may cause serious symptoms. These can include:

  • anxiety
  • irritability
  • mood swings
  • restlessness
  • changes in your sleep habits
  • headache
  • sweating
  • nausea
  • dizziness

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • tiredness
  • vomiting
  • fast heart rate
  • nausea
  • dizziness
  • agitation
  • tremors

If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: The symptoms of your condition should improve. However, you might not feel better right when you start taking this drug. It can take 1–4 weeks to start working.

Keep these considerations in mind if your doctor prescribes fluoxetine for you.

General

  • You can take this drug with or without food.
  • Take this drug at the time(s) recommended by your doctor.
  • Don’t open the oral capsules or oral delayed-release capsules.

Storage

  • Store this drug at room temperature. Keep it between 59°F and 86°F (15°C and 30°C).
  • Keep this drug away from light.
  • Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t harm your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

You and your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These health issues include:

  • Mental health and behavioral problems. You and your doctor should watch for any unusual changes in your behavior and mood. This drug can cause new mental health and behavior problems. It may also worsen problems you already have.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

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

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

💊 Ingredients of Prozac ®

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

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

Update date: 2020.06.09

Marketing authorization holder:

ELI LILLY VOSTOK, S.A. (Switzerland)

Made:


PATHEON FRANCE, S.A.S. (France)

ATX code: N06AB03 (Fluoxetine)

Active substance: fluoxetine (fluoxetine)

Rec.INN WHO registered

Dosage form


Prozac ®

Caps. 20 mg: 14 or 28 pcs.

reg. No.: P N014206/01 dated 17.03.08 - Indefinitely

Release form, packaging and composition Prozac

®

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

Excipients : starch, dimethicone.

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

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

Clinical and pharmacological group: Antidepressant

Pharmacotherapeutic group: Antidepressant

Pharmacological action

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

Pharmacokinetics

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

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

Indications of the active substances of the drug Prozac

®

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

Open list of ICD-10 codes

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

Dosage regimen

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

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

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

Side effects

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

From the digestive system: possible diarrhea, nausea.

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

From the reproductive system: decreased libido.

Allergic reactions: possible skin rash, itching.

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

Contraindications for use

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

Use in pregnancy and lactation

Contraindicated in pregnancy and lactation.

Use in hepatic impairment

Use with extreme caution in patients with hepatic impairment.

Use in impaired renal function

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

Use in children

The safety of fluoxetine in children has not been established.

Use in elderly patients

Elderly patients require dosage adjustment.

Special instructions

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

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

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

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

Elderly patients require dosage adjustment.

The safety of fluoxetine in children has not been established.

Do not drink alcohol during treatment.

Influence on the ability to drive vehicles and mechanisms

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

Drug Interactions

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

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

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

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

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

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

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

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

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

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

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


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How we are treated: 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 understand medicines 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

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

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

The lists (not) included

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

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

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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.

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

The most popular subject of fluoxetine reviews was fighting depression. But the authors of most of them note the lack of data (for example, in this 2013 review). In a 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 drug always outweighs its benefits, but such dishonest behavior of manufacturers does not allow us to assess the risks more accurately. Given the difficulty with the selection of an individual dose and the slow effect, adjusting the dosage is really not easy.

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.

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