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Doctors' Answers to "Frequently Asked Questions" - Prozac
These comments are made for the purpose of discussion and should NOT be used as
recommendations for or against therapies or other treatments. An individual patient is
always advised to consult their own physician.
Question: I am concerned about a friend who has been on prozac on and off for the past few years. He also drinks heavily and drives a delivery truck during the day. He says the prozac makes him tired and he pulls over for naps when he has to. How does the alcohol interact with the prozac and how does the prozac effect the time that the alcohol remains in his system? Is it safe for him to drive during the day after drinking at night and taking prozac?
Answer: Alcohol decreased the depth of sleep as does prozac. So, patients taking both are often tired. Hard to know which of the drugs is the culprit. Also, he may have sleep apnea-unrelated to the alcohol. But, alcohol would make it a lot worse. He needs to get his thyroid functions checked, decrease/stop the alcohol and be considered for a sleep study. The prozac is not a contraindication to professional driving. The sleep spells may be. So, he needs to find the cause and correct it.
Question: I have been diagnosed with mild depression. My doctor has started me taking Prozac at 20/mg. I have been on this drug for almost two weeks now. I have noticed that I am very tired, throughout the day, and night. I am sluggish and sleepy even after sleeping 12+ hours. I also have felt nausia, which this, the doctor warned me of. I also seem to have NO appitite, and my appitite was very poor BEFORE I started on the drug. The doctor said I might have more energy being on the drug, but the opposite has occured. Also, while I think it has helped my anxiety somewhat, it seems to have had only a mild effect on my depression. Is a new drug on order or should I wait this one out??
Answer: It usually takes about 3 weeks before you know how you'll feel. However, the fatigue generally lasts. This can often be blunted with ritalin 5mg for a couple of weeks concurrently with the prozac.
Question: I have taking Prozac for a couple years. Are there any other drugs that offer the same help but don't have the side effects?
Answer: Celexa, Serzone, Wellbutrin, Effexor in about that order.
Question: I am breastfeeding a 3 month old and am severely depressed. My doctor
started me on prozac last week. Is this the safest medicine for my
baby? Where can I find some documentation about breastfeeding and anti-depressants?
Answer: It would be recommended to stop breast feeding while on the Prozac. There is information in the PDR about Prozac, or information can be found from the company Lilly 800-545-5979.
Question: Just wondering if there is a problem taking Metabolite which includes Ma Huang with Prozac.
Answer: Not that I am aware of.
Question: I am taking both Prozac and Ritalin. Are either of these MAO inhibitors? I am considering taking Thermoslim and that is the only deterring factors - whether or not they are inhibitors.
Answer: Neither are MAO inhibitors. Prozac is a SSRI antidepressant and Ritalin is an amphetamine type drug.
Question: Is it possiible thatt the prozak dooesn''t work anymore becaus of the interaction of lorcet. I'm still very much depres?sed
Answer: Narcotics are an antidepressant, as is alcohol. The prozac is working but, being opposed by the narcotics.
Question: Prozac has been a great boon to my life. I'm currently taking 25 mg at bedtime, and 25 more in the morning. The week before my period starts, I take 50 mg in the morning, as I otherwise get VERY irritable. My husband and I have overcome the sexual side effects, so that is not my problem. I have always fought to keep my bodyfat percentage somewhere near normal. Since turning 40, it has gone way up. I have gained about 40 pounds, perhaps more than 40 pounds of fat! I am somewhat active, and have recently started working out on a stepper for 30 mins, 5 times a week. I think I have lost about 3 pounds in 3 weeks. I work at Wal-Mart, and walk all over a 200,000 square foot store 40 hours a week. I know that it is partly my age, but I can't believe my metabolism has quit on me this bad. I lost weight when I started on Prozac in '93, but needless to say, that has been regained, plus bonus pounds. I'm 5'6" and weigh 180 lbs. I have a muscular build, so I will never be skinny looking. If the Prozac is part of the problem, what could I take instead? I don't smoke, have never used alcohol, and only take vitamins and herbals such as garlic, fish oil, ginkgo, E, C, Calcium, multi-vitamins w/ iron and ginseng.
WellButrin made me irritable, as did St John's Wort. I have started taking ginseng every other day, and it makes me feel more energized. Will taking more of it help my metablism, as long as I don't take too much? I tried one pill of a product called Xenadrine, which is supposed to boost your metabolism, and was as irritable as my worst pre-Prozac PMS day. I appreciate any advice you feel is pertinent. If you can respond before April 20th, I can share your info with my doctor. Thanks so much.
Answer: This is a chronic problem with the whole class of drugs, although Prozac tends to be less severe than some. There doen't appear to be a great solution currently concerning ways to block this problem.
Question: I need to know if I have been harming myselft by taking 20mg Prozac and one or two Metabolife pills a day.
PLEASE, let me know ASAP. Thank you very much.
Answer: Probably not.
Question: Your site is wonderful!
Jim had bypass 9 years ago and since has been on a variety of cholesterol medicines. The last was zocor until he asked to be changed to lipitor in sept. He was also on Paxil for mild depression until sept. when he changed to prozac.
Recently, he is experiencing greater fatique( drowziness )
and some nausea. We are trying to figure out which is the culprit? What would you think.
Secondly. we figure it makes sense to try stopping the prozac but wonder if we can do so cold turkey or should we back off slowly and how slowly? Thanks
Answer: The lipitor would be the easiest to stop for a short period to see if the nausea goes away. Stopping the prozac cold is probably ok. I do have patients who have some sort of withdrawal syndrome. But, this is only about 5% of patients, consequently, I'd probably cut it back in a gradual fashion-1/2 for a few days then 1/4 for a few days etc.
Question: I've been deeply depressed and had insomnia so my doctor put me on 20mg Prozac approx. 4 weeks ago and 0.5mg Klonopin at night and half a tablet in the morning. The Klonopin helped my insomnia and outbreaks of crying but after 3 weeks on these meds I seemed to become even more depressed. Last week my doctor upped the Prozac to mg and changed the Klonopin to 50mg Trazodone. Since taking the Trazodone my insomnia is back so she doubled the dosage and this still is not helping, plus my crying outbreaks seem to be starting again. I am very depressed and so tired but can not get more than 3-4 hours of sleep at night. I was on Prozac years ago and it worked great, but now after 4 weeks on the drug I don't see a change in my depression. Any suggestions would be greatly appreciated!
Answer: I'd increase the Prozac, mg isn't a very high dosage. If he/she is not comfortable with this, see a psychiatrist. Also, small doses of Ritalin are often very helpful in treating depression.
Question: I am taking St. Johns Wort and would like to start Prozac. Do I need to wait, or can I take them together?
Answer: Stop the St. John's for a week and then start the Prozac. In reality, there should be little interaction and the two can be taken together. However, they are different classes of anti-depressants chemically and doctors rarely do this to avoid the occasional severe reaction seen in occasional individuals. If there is no emergent reason, let one wash out.
Prozac [posted 1/7/99]
Question: I have a friend who is afraid of Prozac. I try to tell her that prozac,
or any antidepressant, is like any other medication adjusting the chemical imbalances in
people that effect the needed changes. Can you tell me in detail how prozac works? I
assume it effects the serotonin, but how? Compare it to say, insulin or coumadin, or some
Answer: Well, we don't know. It appears to affect the reuptake of
serotonin into nerve endings. That is, the nerve first releases serotonin and takes it
back apparently to conserve the drug. The drug blocks reuptake, which seems to have the
effect of increasing the levels. As to the exact mechanism, we don't know sufficiently at
Prozac and Pregnancy [posted
Question: I am currently taking 20 mg of Prozac and I am 9 months pregnant. I
wanted to know of any dangers that would occur to my baby. Also if there is any affects on
the baby when breastfeeding?
Answer: No studies done, but early risks look low. No studies have
been done on children's neurological development, however. Risks are unpredictable
Prozac and Pregnancy [posted
Question: I want to know of any side effect of Prozac on pregnant women or their
baby. Is there any information on breastfeeding and prozac?
Answer: Prozac is a Class C drug for use during pregnancy. Studies in
pregnant women have not/and will not be done. Long term studies of children born to women
on Prozac have not been done, but the drug does pass through the placenta. Prozac also
passes into milk and is not recommended.
More Concerns About
Prozac & Pregnancy [posted 12/10/98]
Question: I have been on Prozac for the last 4 years. Whenever I try to get off
Prozac, I feel fine for a month or two but then the depressive symptoms again come back
and I start on Prozac again. Are these the withdrawl symptoms or is it depression. I want
to become pregnant, that's the reason I am trying to get off Prozac. Is it safe during
pregnancy or are there any other safe alternatives.
Answer: Depression. It seems pretty safe with pregnancy as far as we
can tell. Long term studies on children have not been done.
Male on Prozac & the Unborn
Child [posted 12/08/98]
Question: My wife and are anxious to start a family and
considering the Prozac warnings for women, are there any risks associated with taking
Prozac for 10 years by the male. I am particulary concerned with problems with conception
and potential harm to the unborn child.
Prozac & Urinary Frequency
Question: I have been on Prozac for at least 6 months and I am finding myself
with constant urinary frequency. (I go on an average of 14-20 times a day.) I have been
tested for infections and other things, but everything is fine. Thinking back, I believe
that this started when I started the Prozac. Is this a known side effect of Prozac? I am
thinking of working with my doctor to get off Prozac, but I really like what it does for
my bipolar and anxiety situation. (Plus, it is helping me lose the weight I gained with
Effexor.) Is there anything close to Prozac out there that I can try? The only reason I am
even considering getting off the Prozac is because the urinary frequency is interfering
with work and school. Any help is most appreciated.
Answer: Well, you would find out pretty fast if you stopped it. Prozac
can affect bladder sphincter tone and give difficulty starting urine stream in some. But,
if it goes away off the Prozac, clearly the cause.
Stopping Prozac [posted
Question: What is the safest way to stop taking prozac? I go to a university
a doctor hasn't returned my calls. Prozac is causing me several terrible side effects.
Answer: Well, most think you can stop it without a taper. But, some patients on
large doses for long periods seem to have symptoms on stopping. For these, we recommend
1/2 for 1-2 weeks, possibly 1/4 then stop. Most can stop immediately without problems.
Prozac & Loss of Sex Drive [posted
Question: I'm on Prozac (40 mg) for depression. My sex drive has suffered as a
result. My doctor has prescribed 75 mg of Wellbutrin to counteract this effect. I haven't
been able to find any info on this subject. Is this a common use of Wellbutrin?
Answer: No. Try Serzone instead of mixing them. Usually once the prozac has this
effect (common by the way) it won't change with other medications.
Prozac Effectiveness [posted
Question: When does prozac lose its effectiveness
Answer: Not usually at all.
Combining Alcohol & Prozac [posted
Question: My mother has a terrible problem. She is on prozac and she has been
drinking alcohol everday until she is totally enebriated I am very worried about her. She
is 70 yrs old and I would like to know what the effects of prozac combined with alcohol
will do to her if she continues this long term behavior.
Answer: Alcohol is a depressant so, doesn't make a lot of sense to treat
depression with one drug and cause it with another. However, moderate intake has no
Can Loss of Orgasm Be a Prozac Side
Effect [posted 10/28/98]
Question:I am a bi-polar female who was put on Neurontin in June after being
hospitalized for a major depression. I had discovered that my husband had had two affairs.
We are in marriage counseling and our marriage is back on track. I had difficulty reaching
an orgasm while in the hospital and can not reach one at all now. I am on prozac but have
found my libido increased rather than decreased. I am frustrated since I can't have an
orgasm. Has anyone else experience this? My doctor thinks I may have to "live with
this" since this medication seems to control my mood swings. What do you think?
Answer: Prozac is notorious for decreasing or stopping female orgasm. I am not
aware of Neurontin having this effect. Different antidepressants(Serzone, Wellbutrin, St.
John's Wort) may need to be tried to find one that works without eliminating your orgasm.
Prozac & Tiredness [posted
Question: I have been on prozac for about two weeks now and i am feeling very
tired. I have been told that this is a side effect of the drug. Will that subside after I
am on prozac for a while? Will I always be tired? Should I take the drug at night rather
than in the morning? Thank you for your help.
Answer: Usually persists. But, I would take the drug at bedtime and see if that
helps. Sometimes taking it wiht a sleeper helps. It tends to decrease depth and length of
sleeping in some.
Prozac [posted 10/21/98]
Question: I am a 58 year old female. I have been taking 20mg of Prozac per day for
approximately 3 years. Prior to that my doctor had tried me on serzone, effexor and all
the available SRI's available. Prozac has been the only I could tolerate and help me with
depression and make me feel well. Recently (about a month) I have been experiencing very
tight muscles in my jaw, shoulders, and arms, and pain in my lower back. I tried taking
Advil but it only helps temporarily. Could Prozac suddenly be causing these symptoms?
Answer: Probably not.
Prozac's Common Side Effects [posted
Question: What are Prozac's known side effects and does it cause sun sensitivity?
Answer: Decreased sex drive, occasional sleep disturbance, occasional
constipation. Rare/no sun sensitivity.
Prozac and Loss of Libido [posted
Question: I have had migraines almost daily for 3 years. Prozac seems to reduce the
number of headaches and associated symptoms but also, of course, reduces the libido. I
have seen a number of other drugs suggested to combat this problem: Yohimbine, Urecholine,
Pericatin, dopamine, adding Wellbutrin and amphetamine. Because the other non-SSRI types
of anti-depressants have not been shown to be effective on migraine it is unlikely that I
can switch. However, would Wellbutrin if added daily help the libido and if so, how much?
Answer: Usually doesn't help. Small doses of amphetamines seem to be the
best-taken the day one desires to have sex. Have you tried other preventatives like beta
blockers, calcium channel blockers, aspirin, etc?
Prozac and Alcohol [posted
Question: Prozac is frequently prescribed as an antidepressant, as it was for me
several months ago, that is to be taken in the morning and NOT at night, because it
interferes with sleep. I had been using Wellbutrin for two years, which was very helpful,
but the constipation that it caused became intolerable. For three weeks I took the Prozac
in the morning as prescribed and found myself unable to functioan due to fatigue and
drowsiness, and then had difficulty sleeping once I went to bed at night.
I was virtually "out of it" all day, and uable to sleep when I really needed to.
My psychiatrist suggested I continue with the drug, hoping this was a side effect that
would wear off. No such luck, and a change of medications was imminent. Then, I decided to
just TRY taking it before bed instead of in the morning. WOW, what a dramatic change!!!
That first night, I slept like I had not slept in years....straight through. And, the next
day, I felt better than I had felt in over a year: awake, alert, functional. I continue to
take Prozac ONLY at night, and its benefits are a Godsend. After reading a number of
entries under DEPRESSION, and noticing stories from patients who experienced fatigue and
drowsiness from SRI's, I wanted to share my experience in the hope that a simple
alteration in dosing time might help others find a solution with medication they believed
did not work for them. With that in mind, although there is no question here, I hope you
will print this.
Answer: Sure, glad to.
Prozac and Alcohol [posted
Question: I am trying to find out some information about the known affects of
drinking alcohol while taking Prozac. I have a family member who is doing this and I am
trying to present them with some hard facts about why it is a bad idea.
Answer: It is listed as a contraindication, but there is little data. Alcohol is
a depressant and this can have an interaction. I am not aware of direct drug interactions
and in fact prozac is amazingly safe relative to side effects. I tell my patients not to
over indulge and to limit themselves to one or two per day - due mainly to the depressant
effects. However, I am not aware of direct interactions or contraindications.
Children and Prozac [posted
Question: My six year old has been prescribed 10 mg of Prozac. I wonder what the
effects will be and how long would you keep a child on such medicine? I would really
appreciate any feedback on this subject.
Answer: There is no research done on children on any drugs due to ethical
considerations. The side effects long term do not appear to differ from short term side
Prozac Side Effects [posted
Question: I have been on prozac and had side affects with this drug, including loss
of memory and poor judgment calls in everyday actions. Are these normal and are there any
other reports made about this?
Answer: This is not usual, but occasional patients have this type of reaction.
It will clear with cessation of the drug.
Prozac [posted 7/21/98]
Question: How safe is Prozac?
Answer: So far incredibly safe, few drug interactions, no physical dependence.
You will find patients that feel they do experience a withdrawal syndrome, but clearly not
a usual dependence. Described as headache, disorientation, etc.
Question: My daughter is on 20 mg a day of Prozac and all the other questions have
been asking why this drug makes people tired and have no energy. My daughters doctor
is giving her this drug to give her more energy I thought, as she was very depressed. She
states that she now has so much energy. Should this be true?
Answer: This drug (and other SRI antidepressants) can be a lifesaver for the
right patient. They feel just wonderful and see/feel things that have been blunted for
years. This is a very heady experience. It is also wonderful as a physician to see this
effect, which about 20% of patients experience.
Prozac and twitches
Question: My 54-year-old sister, who has had Alzheimer's symptoms (and
"probable" diagnosis) for 5 years, has been on 20 mg. Prozac for probably 2-3
years. She has severe depression (cries constantly - she recognizes that she is losing her
faculties). In the last several weeks she has developed sudden body, head, or hand and arm
twitches or jerks - something like a startle reflex. Could the Prozac be causing this?
Other drugs are indomethecin and Vitamin E. She tried Aricept for a while but got no
benefit. Years ago she tried Cognex. She is at the stage of Alzheimer's where she needs
help with everything, cannot understand or follow directions, but recognizes loved ones
and the fact of her demise. (She was diagnosed here at the Univ. of Iowa but lives in a
small town in southern Illinois, with her 54-year-old husband as her caregiver, and a long
time family doctor, an internist, as her primary physician.
Answer: These would be uncommon in Alzheimers. I'd see her neurologist
Question: I have been on Prozac several times. It has helped me very much with my
depression and other problems related to Lupus E. I feel better. I have less muscular and
joint pains, less anxiety, but there is a great problem for me. My sexual life is gone,
and I think if I do not do something about it my relation with my husband will be ending
soon. I have to decide if I want to go back to feeling physically and mentally bad or
keeping my sexual drive and my husband. I have tried Yohimbe. I am also going through my
pre-menopause, and I am under Premarin. My doctor prescribed male hormone, and also I had
a hysterectomy 8 years ago but kept my ovaries. This has been for me the best
antidepressant ever, but I think I will have to ask my doctor to change it and perhaps
have the awful side/effects that I had with other previous antidepressants.
Answer: Two possibilities 1) Try serzone, wellbutrin or Effexor in that order.
They tend to work nearly as well as the SRI antidepressants and serzone especially helps
the sex drive. 2) There are reports of small amounts of amphetamines used on an occasional
basis to give a patient an appropriate sex drive. These are taken 24 hours or so before
you desire to have sex. It removes some of the spontaneity but restores your sexual drive
while you are on the amphetamines. I have tried both and prefer the serzone if it works,
but the amphetamines do help. Taking large doses long term is not good, but small doses
used occasionally to save a marriage seem appropriate.
Prozac Side Effects
Question: Has cramping and pain of legs been associated with the use of prozac?
Answer: There is about 1-2% who report back pain, but not muscle spasms per se.
Prozac for stress and anxiety
Question: I am presently under tremendous pressure and I am having severe anxiety
attacks. My friend, who is a doctor, has recommended Prozac as a solution. I am a 50 year
old male and am in need of relief. Your input would be appreciated.
Answer: All the SRI drugs have been used for the last several years to treat
different types of anxiety and panic disorders. I'd try them. You might need to add drugs
like valium, xanax, etc., but they often are very effective.
Question: I have been on Prozac since 1993; starting at 10mg/day, then 30, and in
the last 6 months to 30mg/day. It has been effective in treating my depression. Suddenly,
I have become incapacitated: extreme dizziness, bad headaches, urinary hesitancy, no
appetite. It's back into deep depression, but is it the Prozac shutting down? Or possibly
a disconnected malady? A switch to Effexor is suggested. Any ideas?
Answer: I'm not sure this is all depression. The urinary hesitancy and headaches
are common side effects of Prozac-- especially in larger doses. Vertigo would occasionally
occur as a side effect. The lack of appetite could be depression. Do you feel like the
"old depression"? Many of these sound like side effects to the drug. If this is
so, a switch to a different class might be helpful, and Effexor or Wellbutrin is what most
physicians would pick.
Prozac and Drowsiness
Question: I experience drowsiness and increased sleep desire from Prozac. This drug
is very effective for me aside from this. Any suggestions?
Answer: Try Serzone-- usually less sleep disturbance.
Prozac and Striae
Question: Can prozac cause striae? My child has been on it for 4 months and is in a
growth spurt and I have noted red stretch marks. Is this an indication to stop the drug?
Answer: I haven't used this drug in children, but I don't see this as reported
in the PDR. On the other hand, there is no research done in children for ethical reasons.
I'd have your physician query the company concerning this effect.
Prozac and Tylenol
Question: I have just started taking prozac and was wondering if it was still all
right to take tylenol for headaches? If not, what should I be taking?
Answer: The answer to your question is yes, you can take tylenol as needed for
headaches while being on prozac. However, if these headaches are occurring often, or are
associated with other symptoms! they should be brought to the attention of your health
care provider. In addition, both tylenol and prozac are metabolized by the body in the
liver. This usually only becomes a significant issue if you start taking more than the
daily recommended dosing of tylenol. If indeed you do need that much tylenol, then a visit
to your health care provider is in order. In general, however, simple occasional headaches
can be treated with tylenol as needed.
Cold medication and Prozac
Question: My friend is taking Prozac for depression. She has a cold that started
with a headache and sore throat and low grade fever a week ago. Now she doesnt have
the headache or fever, but she still has an itchy throat and bad dry cough. No runny nose
nor stuffy nose. She usually takes Alka-Seltzer Plus for her colds and it works very well
for her. The alka -seltzer plus usually clears up her cold in one to two days. She read on
the package of Alka Seltzer that it is not to be taken with MAOI medication for
depression. What will happen if she takes Alka-seltzer plus for her cold? What kind of
over the counter medication can she take?
Answer: Prozac is not a MAO inhibitor. Taking aspirin, etc... is not a problem.
Prozac and Infertility
Question: My wife has been taking Prozac for depression. We have also been trying
to have a baby. Her doctor has been telling her that the drug does not cause any kind of
infertility (or sexual dysfunction). Yet reports that we have both read about it indicate
that it does. Currently she is taking Clomid with it. Which is true about Prozac?
Answer: Prozac causes an inability to reach orgasm and decreases the sexual
drive. This is true for all the SRI drugs. It does not inhibit the fertility of a man or a
woman, but their desire for intercourse and the satisfaction from intercourse is
Prozac and dehydration
Question: I am currently taking 20 mg of prozac daily. I am curious if this drug
has any effect on appearance of the skin. My reason worrying about this is because I'm on
Prozac to treat intrusive obsessive/worrying thoughts. I try to drink the required amounts
of water, but was just wondering if the drug causes dry mouth, constipation, or a
dehydrated look to one's skin.
Answer: The dryness of the mouth has nothing to do with fluid balance, but with
the subjective sensation of dryness. It will not affect your skin.
Question: Are there any drugs which are harmful when combined with prozac?
Answer: It is not recommended to take other antidepressants (MAO inhibitors
especially), alcohol. Trytophan, lithium, dilantin, and CNS active drugs should be watched
Prozac and awareness
Question: My father is 86 and has recently been treated for Lymphoma. This was
treated successfully with Chlorambucil. However, since the treatment he has felt very
depressed. As a result of this he has gone on to Prozac, which have made him feel better,
but in the last few days he has complained of feeling disconnected and not really in touch
with reality. He has been on the Prozac now for some three months and I would say is
generally much better because of it. He also takes Allopurinol for Gout, Quinine Sulfate
for night cramps, Aspirin, and Enalapril for blood pressure regulation His doctor is
mystified. Do you have any suggestions?
Answer: Common sense usually is the best advice. Try stopping the drug for 7-10
days and see what happens. St. John's Wort (hypericum) can be used occasionally to treat
depression with usually less side effects than Prozac.
Question: I have been on Prozac 20 mg for about a year now. It was given to me for
chronic pain in my lower back and left leg. I was given Oravail 200 mg at the same time. I
really never noticed a significant change in the pain management. I have lost weight which
I give Prozac credit for. That has helped. I've been taking melatonin at night to help me
sleep, but is there any adverse side effects from taking this also? What are your
Answer: Currently, we are not aware of any major problems with taking either
Prozac or Mellatonin for long periods of time. However, if it is not helping, why take it?
Prozac vs. Zoloft
Question: Recently I was switched from Prozac to Zoloft. I was taking 10 mg per day
Prozac, then a three day rest before starting 25 mg per day Zoloft for one week, then
increased to 50 mg per day. My current symptoms are extreme tiredness as I can barely stay
awake. Another problem I have been having since switching drugs is a "buzzing"
when I bend my head down towards my chest. This is causing a mild tingling down my legs
and arms. What is going on? Also, how long does it take your system to clear of either of
Answer: These drugs take about a week to completely clear your system. You fail
to mention why Prozac was stopped? If for side effects, the side effects of Prozac and
Zoloft are very similar. If the problem you are experiencing is the drug, I'd discuss it
with your physician and allow the drug to clear your system. Possibly a smaller dose might
work. Also, Wellbutrin and Serzone are newer anti-depressants which have different side
effects than Prozac and Zoloft.
Question: I have been on Paxil (20 mg) for a year now and seems like it has not
been doing much good lately. I mentioned this to my doctor and he switched me to Prozac
(20 mg). He said I could just stop the Paxil immediately and take the Prozac. He also said
the Prozac would not start working well until about 4 weeks into my system. Whenever I
have run out of Paxil or forgotten to take one, I seemed to become very unpleasant (mean
and angry). This gets even worse in the period of getting the Prozac into my system. Does
this sound right? Could I take a Paxil and a Prozac during this time to help my mood
change for the better?
Answer: Both of these drugs are similar and I doubt that one would be markedly
superior. However, you are really taking very small doses. Most patients need to be on 40
to 60 mg and even doses of 80 or 100 are not uncommon. Sometimes small doses of
amphetamines will markedly improve the performance of this class of drugs.
Prozac and Hair Loss
Question: I am a 50 year old woman not doing HRT. I took Redux for six months, lost
20 pounds, and to my surprise, found it to eliminate all my menopause systems (terrible
hot flashes and mini panic attacks). My Doctor suggested we stop Redux and try 10 mg of
Prozac a day. It seems to work almost as good as Redux on the hot flashes and my
temperament seems to be more even and stable. However, it seems to me that after three
weeks of taking Prozac I seem to be noticing increased hair loss. Could this be a side
effect of the Prozac?
Answer: Hair loss will usually take a minimum of three weeks. That is because
the hair needs to grow out and have a "weak spot" at the base. If your hair loss
is before 3 weeks I doubt if it is the Prozac, and possibly the weight loss since that
lowers available protein and will create this weak area. I haven't had many complaints of
hair loss with any of the SRI drugs.
Question: I stopped taking Amitryptilene at the end of September (150-200 mg/day)
and began taking Prozac (10 mg/day) at the beginning of October. I continued taking 10
mg/day until March when my dosage was increased to 20 mg/day. I am trying to learn whether
or not there is any information on Prozac having an effect on a person's cholesterol
level. The past many years, my cholesterol level is usually somewhere between 160 and 200
-- and my "ratio" is generally quite good. In the middle of last year I was not
eating as healthy as I should have, but in October my cholesterol was still around 200.
The last couple of months I ate "better" and even lost about five pounds (and
I'm one who can easily gain 5 pounds during the holidays -- but didn't). At the end of
December, I started working out more regularly again (and still eating pretty good).
However, early in March my cholesterol was 245. My husband and I talked about this and
could not think of anything any different aside from my beginning to take Prozac.
Answer: I'm not aware of any interaction. You might call the company and see if
there have been any drug reports (Dista, a division of Eli Lilly: 800-645-5979). Another
way is to stop it for 10 to 14 days and see if your cholesterol falls. If not, and I
suspect there won't be a change, you need an evaluation for the cause. Several things can
cause sudden rise, but this needs a complete physical. Common causes for a sudden rise are
hypothyroidism, diabetes mellitus, hepatitis, etc.
Suicide and Prozac
Question: Is it true that Prozac patients have committed suicide while on
Answer: Zoloft (sertaline hydrochloride) is an antidepressant usually included
in the class of drugs called serotonin inhibitors. This class of drugs initially received
a great deal of publicity concerning the increased risk of suicide. This publicity was
mainly focused on Prozac (fluoxetine hydrochloride). Further evaluation has not
demonstrated that there is any special risk for suicide. However, studies are still
ongoing. Depression in general clearly increases the risk for suicide; consequently, would
be expected to be higher in the group of patients taking this class of drug.
Question: What are the consequences of stopping Prozac? I feel the drug is making
me gain weight.
Answer: Prozac is not especially noted for weight gain. One of the potential
risks of the drug is actual weight loss. Weight loss may be a symptom of depression;
consequently, treatment of your depression may cause weight gain. I would discuss this
with your physician and absolutely do not decrease or stop the drug without seeing your
Question: I have a patient who is taking Prozac and is experiencing severe urinary
hesitancy. Is this a side effect of this drug?
Answer: Prozac, like many other antidepressants, has some anti-cholinergic
activity. The parasympathetic nervous system is consequently affected and can cause
urinary symptoms as well as constipation and a dry mouth. These will clear with
discontinuation of the drug.
Question: I have been using Prozac for about 3 months - the suggested trial time -
and am having some side effects that I need information on. My sleep pattern has
shortened. If I don't take Klonopin before I sleep, I wake up clutching myself or the
pillow. I feel that my muscles are continually tight. Sometimes, the back of my head feels
very tight which often can be relieved by relaxing my jaw - which always seems to be
tight. I am taking 20mg a day. I would GREATLY appreciate any suggestions. And where do I
look to find what ever your answers are? Please e-mail me back.
Answer: One of the most common complaints of patients on prozac and other drugs
has to do with the lack of diminution of sleep. Other than other sedatives-like
klonopin-there doesn't appear to be much to be done other than stop the drug. There are
newer more selective drugs in this class which are advertized by the drug companies as
having less effect on sleep and sexual libido-the other major complaint. I have used these
drugs and find some improvement. Serzone is the first of these drugs-others are on the
Prozac and Wellbutrin
Question: I have been taking Prozac for 7 years. During the last year, I became
more and more depressed until it became intolerable. The psychiatrist I am seeing put me
on Wellbutrin in ADDITION to the Prozac. I am taking 20mg of Prozac in the morning and
75mg of Wellbutrin in the morning and 75mg more at noon. Is this a normal procedure to use
both drugs together? I called my old doctor and he said it was unusual but not unheard of.
I have had an aching pain under my rib cage on the right for the past few weeks and I am
concerned about liver function being affected. My doctor does not seem to want to answer
all my questions. I am very nervous about this and I don't know where to turn so I
searched the Internet for information. Please help. I am feeling much much better after
taking the Wellbutrin for 2 weeks now. It's like a new beginning. But is it the
combination or just the Wellbutrin? THANK YOU!
Answer: Prozac(fluoxetine hydrochloride) is an anti-depressant from the family
of drugs called serotonin uptake inhibitors and is used in treating depression,
obsessive-compulsive disorders, and panic disorders. Wellbutrin(bubropion hydrochloride)
is an antidepressant almost in a class by itself. Currently, the mode of action is not
clear. It can be used with other antidepressants except the class called Monoamine Oxidase
Inhibititors(MAO). This is a fairly common combination when one drug does not appear to be
treating the depression effectively. You will need to be checked occasionally for liver
function, but these drugs are usually fairly non-toxic in conventional doses.
Prozac and Alcohol
Question: I would like to know the effects combining alcohol and Prozac are. I
understand that it can cause greater sedative effect, but I would like to know how it
affects the central nervous system and anything else. Does drinking reduce the effect
Prozac has, or impair its function in the brain? Also, I have heard that one drink while
on an anti-depressant has the effect of two. Is this true?
Answer: Prozac(fluoxetine hydrochloride)belongs to a group of anti-depressant
drugs called Serotonin Reuptake Inhibitors(SRI). Any drug which works primarily in the
central nervous system can impair ones judgement or cognitive skills. Ethanol works also
as a depressant and an inhibitor of motor skills, judgement and cognitive ability. The
interaction of these two drugs has not been well studied; however, common sense dictates
extreme care in mixing drugs-yet, alone two that work in the same part of the body.
Unable to have Orgasm
Question: I am a 45 year old male. I take 40 mg of prozac daily for clinical
depression. I am able to achieve an erection and have intercourse but I am unable to reach
an orgasm or to ejaculate. This has only occured since I have taken this medicine. I
previously tried zoloft and serzone but they caused gastrointestinal discomfort. Could a
doctor familiar with this condition and medication please recommend any other medications
etc. That would allow orgasm and still help with the depression?
Answer: The biggest side effect and complaint of my patients using SRI class of
drugs is a lack of sex drive and erections. Women will complain about lack of drive also.
Serzone can get around this problem. Sometimes Effexor will work or a complete different
class of anti-depressant.
Question: My pharmacology class would like to know about prozac. What happens if
you stop taking it abruptly? Do you have any statistical or research information?
Answer:There does not appear to be any specific problems with discontinuing
Prozac(or any drug of this class, the SRI antidepressants) abruptly. There is no addiction
or dependence. I do have patients who feel psychologically dependent because they benefit
so markedly. However, stopping it abruptly is without problem.
Prozac vs. Effexor
Question: My doctor recently changed my prescription from 40 mg. Prozac per day to
37.5 mg. Effexor twice a day. What is the difference in the two medicines? I have also had
trouble sleeping since the change. Could this be related to the Effexor?
Answer:Prozac is a drug that belongs to a class of drugs called Serotonin
Reuptake Inhibitors. These drugs work (we think) at the nerve to nerve interface by
blocking the reuptake of serotonin back into the sending nerve after a nerve transmission.
Effexox is belongs to a different class of drugs which effects dopamine as well as
serotonin reuptake. Therefore, they act in a different manner on similar chemicals in the
brain. Some patients are much better on one drug or the other-presumably because of their
different action. Both drugs can affect sleep; but, it sounds like Effexor is having more
of an affect.
Time Frame in System
Question: How long does it take for prozac to completely exit your system?
Answer: Chemically out in about 24-36 hours. Cellular effects seem to last 4-5
days in some patients.
Question:Is it harmful for pregnant women to take Prozac? What kind of effects does
it have on the fetus?
Answer:Currently there is no indication of any harm to the fetus by Prozac.
Studies done in mice and bacteria show no potential for genetic mutations or changes.
There also appears to be little or no effect on fertility.
Prozac & Cough Suppresant
Question:I am currently taking Prozac and have a slight cough and sore throat. Is
there something I can take that will not have a harmful effect? Is there a regular cough
suppressant without all the other symptom.
Answer: Dextromethorphan is usually a good agent for cough relief and only has
minor constipation. It is available over the counter and shouldn't cause problems with
Switch From Prozac
Question:How do you switch over from prozac to an alternative medication such as,
St. John's Wort? Do you recommend it for mild cases of depression?
Answer: There hasn't been enough research done yet to tell the doses and effects
in spite of what 20-20 would have you believe. If you decide to try it, let the Prozac
wash out of your system for a week or so. Doses are currently somewhat of a guess.
Prozac & The Military
Question:My son was on prozac for a few months while in residential treatment for
an identity disorder a few years ago. Now he is applying for military service. When he
told the army recruiter he had been on prozac the recruiter called him back several weeks
later and told him he could not apply to the army until he had been off prozac for 5
years. What is the big scare with prozac? I have read there is hardly any half life. The
prozac had no effect on my son and that is the reason we took him off of it. Can you give
me some feedback on the military and prozac? Can you refer me to any place where I could
read up more on this decision of enlistment for anyone who has taken prozac? Is it
possible to have the word "prozac" removed from his medical records as it was a
med he did not really need, or stay on long?
Answer: It doesn't have anything to do with the drug; but, with the situation
requiring him to take it. The military is very conservative and also a risk avoider. They
will avoid situations where they have difficulty predicting behavior. A report from his
physician might help. Also, try a different service and "forget" about the
Prozac & The Elderly
Question:What are the side effects of prozac for the elderly?
Answer: No major difference than for other patients. The major difference is
that the elderly tend to have less response. They will experience constipation, dry mouth
and occasional problems with urination. This can occasionally be a problem with elderly
men with large prostates.
Life Long Use
Question: My mother (51 yrs/in otherwise good health) was told by her doctor that
he thought that she should just plan to use prozac for the rest of her life. What are the
long term and short term side effects of the drug?
Answer: Long term really isn't known, but doesn't appear to differ from short
term side effects. Short term side effects include dry mouth, constipation, sleep
disorders, occasional headache
Question: Thanks for the information I found through your web page. I am currently
taking 20 mg Prozac daily and found that I have to take it around 7:00pm, otherwise I am
in a drugged state most of the day. The pill actually made me feel tired and depressed if
I took it in the morning. My depression and what I called sad thoughts are gone, but I
thought that this was an upper so to speak, but actually find that I am tired
most of the time, gaining weight because I have no desire to do anything more than watch
TV. Fortunately I am still active and interested in my work, but my home life has
suffered. What do you recommend for my lethargic being?
Answer: The situation you are describing is not an uncommon one found in
patients on anti-depressant medication. Ultimately the question is, are the fatigue and
lethargy related to the medication, or are they due to the depression, with insufficient
medication control of the depressive symptoms? Perhaps there is, or are, issues in your
life that have not been addressed or resolved, or have occurred recently, and are
contributing to some depressio I
mptoms. A visit to your health care provider or
prescribing physician would be of benefit. He or she has seen your energy level before,
and knows what your depressive symptom presentation was prior to starting the Prozac. They
would have the best chance of determining whether your lethargy is medication related, is
the result of the your depression recurring, or is the result of another problem
altogether. He or she can then determine the best course of action to take.
Question: I am on PROZAC 250 mg. I am taking 3 doses per day. Is it dangerous?
Answer: I hope you mean 25 mg and not 250 mg. 250 three times a day would be a
very large dosage indeed. Assuming you are taking 25 mg three times a day this is an
average to small dosage and shouldn't cause any particular problems other than the usual
dry mouth, constipation and occasional headache.
Question: How long can you stay on Prozac? I have been on it for two years, and it
really seems to help.
Answer: Doesn't seem to be any current limit. Many patients have been on this
drug for over 7 years. No current known long term side effects.
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