Form, Strengths, How to Take, and More

If you have certain mental health conditions, your doctor might suggest Prozac as a treatment option for you. It’s a prescription drug used to treat the following conditions in adults:

• panic disorder
• obsessive-compulsive disorder (OCD)
• depression
• depression related to bipolar I disorder*
• treatment-resistant depression*
• bulimia nervosa (an eating disorder)

Prozac is also approved to treat the following conditions in some children:

• OCD
• depression
• depression related to bipolar I disorder*

The active ingredient in Prozac is fluoxetine. An active ingredient is what makes a drug work. Fluoxetine belongs to the group of drugs called selective serotonin reuptake inhibitors (SSRIs).

Prozac comes as a capsule that you swallow. It’s also available as the generic drug fluoxetine.

This article describes the dosages of Prozac, as well as its strengths and how to take it. To learn more about Prozac, see this in-depth article.

Note: This article covers Prozac’s usual dosages, which are provided by the drugmaker. But when using Prozac, always take the dosage that your doctor prescribes.

* For this condition, Prozac is used together with olanzapine (Zyprexa).

This section covers standard dosage information for Prozac. Before prescribing this medication, your doctor will talk with you about the dosage instructions specific to your condition.

Note: This chart highlights the basics of Prozac’s dosages for adults. (For details about children’s dosages, see the “What’s the dosage of Prozac for children?” section below.) Prozac’s strengths are in milligrams (mg). Be sure to read on for more detail.

* For this condition, Prozac is used together with olanzapine (Zyprexa).
† For this condition, doctors may prescribe a lower dose to start. Then they’ll increase it over several days to the recommended dose of 60 mg.

What is the form of Prozac?

Prozac comes as a capsule that you swallow.

What strengths does Prozac come in?

Prozac capsules come in the following strengths:

• 10 mg
• 20 mg
• 40 mg

What are the usual dosages of Prozac?

Your doctor will likely start by prescribing a low dosage of Prozac. They may adjust it over time to reach the right therapeutic dose for you. (A therapeutic dose is a dose that treats your condition and manages your symptoms.) They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The information below describes dosages that are commonly recommended for adults. But be sure to take the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs.

Dosage for panic disorder

For panic disorder (a kind of anxiety disorder), your doctor may initially prescribe a low dose of Prozac. The starting dosage is 10 mg per day.

After 1 week, your doctor may increase your dosage to 20 mg per day. This is the recommended dosage for panic disorder. They may increase it further to reach the dose that’s right for you.

The usual daily dose ranges from 10 mg to 60 mg. The maximum recommended dosage for panic disorder is 60 mg.

Dosage for OCD

For OCD in adults, the recommended starting dosage is 20 mg per day. Your doctor may gradually increase your dosage to reach the dose that’s right for you.

The usual daily dose ranges from 20 mg to 60 mg. The maximum recommended dosage for OCD is 80 mg per day.

Dosage for depression related to bipolar I disorder

For depression related to bipolar I disorder, Prozac’s recommended starting dosage in adults is 20 mg per day. Your doctor may gradually increase or adjust your dosage to reach the dose that’s right for you.

Prozac’s usual daily dose ranges from 20 mg to 50 mg. The maximum recommended dosage is 50 mg.

For this use, Prozac is prescribed together with olanzapine (Zyprexa). Your doctor will recommend the dosage of olanzapine that’s right for you.

Dosage for depression

For depression in adults, the typical dosage of Prozac is 20 mg per day. You’ll likely take this dosage for the first several weeks or longer. Then your doctor may increase or adjust your dosage over time to reach the dose that’s right for you.

The usual daily dose ranges from 20 mg to 80 mg. The maximum recommended dosage is 80 mg per day.

Dosage for treatment-resistant depression

For treatment-resistant depression in adults, the usual starting dosage is 20 mg per day. You’ll likely take this dosage for the first several weeks or longer. Then your doctor may increase or adjust your dosage over time to reach the dose that’s right for you.

The usual daily dose ranges from 20 mg to 50 mg. The maximum recommended dosage is 50 mg per day.

For this use, Prozac is prescribed together with olanzapine (Zyprexa). Your doctor will recommend the dosage of olanzapine that’s right for you.

Dosage for bulimia nervosa

For bulimia nervosa, the usual dosage of Prozac is 60 mg per day. Doctors sometimes prescribe a lower dose to start. Then they’ll increase it over several days until they reach the recommended dose.

For this use, 60 mg per day is the recommended dosage and the maximum dosage of Prozac.

What’s the dosage of Prozac for children?

Prozac is approved to treat:

• depression in children ages 8 years and older
• OCD in children ages 7 years and older
• depression related to bipolar I disorder in children ages 10 years and older

The chart below summarizes the usual recommended dosages of Prozac for children. Prozac’s strengths are in milligrams (mg).

* For this condition, Prozac is used together with olanzapine (Zyprexa).

Dosage for depression

For depression in children, Prozac’s usual starting dosage is 10 mg per day to 20 mg per day. Your child’s doctor may start by prescribing 10 mg per day and increase it to 20 mg per day after 1 week.

Your child’s dosage may need to be adjusted based on their body weight. Their doctor will determine the dosage that’s right for your child. For details, see the “Dosage adjustments” section below.

Dosage for OCD

For OCD in children, the usual starting dosage is 10 mg per day. After 2 weeks, your child’s doctor will likely increase their dosage to 20 mg per day. They may raise the dosage over time until they reach the dose that’s right for your child.

The recommended daily dose ranges from 20 mg to 60 mg.

Dosage for depression related to bipolar I disorder

For depression related to bipolar I disorder, Prozac’s recommended starting dosage is 20 mg per day. Your child’s doctor may gradually increase their dosage over time until they reach the dose that’s right for your child.

The maximum dosage of Prozac for this use in children is 50 mg per day.

For depression related to bipolar I disorder, Prozac is prescribed together with olanzapine (Zyprexa). Your child’s doctor will recommend the dosage of olanzapine that’s right for your child.

Is Prozac used long term?

Yes, Prozac is usually taken as a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you’ll likely take it long term.

Dosage adjustments

Your doctor may decrease your Prozac dosage if you have liver problems or you’re age 65 years or older.

The dosage of Prozac may also need to be adjusted for children with a low body weight. For example, if your child weighs less than usual for their age, their doctor may prescribe a lower dosage.

Below are answers to some commonly asked questions about Prozac’s dosage.

What is the maximum dose of Prozac I can take?

The recommended maximum dose of Prozac varies by age and the condition being treated. For details, see the “What factors can affect my dosage?” section below.

For example, the recommended maximum dosage for depression and obsessive-compulsive disorder (OCD) is 80 mg per day. But for bulimia nervosa (an eating disorder) and panic disorder, it is 60 mg per day. To learn more, see the “What is Prozac’s dosage?” section above.

Keep in mind that the response to a medication differs between people. This is why it’s important to take Prozac exactly as your doctor prescribes. For example, the maximum dose for you may be a lethal dose for someone else. Your doctor will recommend the right dosage for you.

Do not take more medication than your doctor prescribes. Doing so can increase your risk of serious side effects. (For details about Prozac’s side effects, you can read this article.)

If you have questions about the maximum dose of Prozac that you can take, talk with your doctor or pharmacist.

Can I avoid side effects such as weight loss if I take a low dose of Prozac?

It depends. Prozac side effects, which may include weight loss, can occur with any dose. The risk increases at higher doses. So the risk of side effects, such as weight loss, may decrease with a lower dosage of Prozac.

Always take the dosage of Prozac your doctor prescribes. They’ll prescribe the lowest dose of Prozac that relieves your symptoms and treats your condition. (For details about Prozac’s side effects, you can read this article.)

If you’re concerned about weight loss with Prozac, talk with your doctor. They may monitor your (or your child’s) weight during treatment with Prozac.

If my Prozac dose increases from 10 mg to 20 mg, will I have a higher risk of side effects?

It’s possible. Prozac side effects can happen with any dose. But a dose increase may raise the risk or severity of side effects.

It’s important to note that Prozac has a boxed warning for the risk of suicidal thoughts and behaviors in young adults and children. This is a serious warning from the Food and Drug Administration (FDA). The risk is higher after any dosage changes and during your first few months of treatment. For more details about Prozac’s boxed warning, see the “Boxed warning: Risk of suicidal thoughts and behaviors” section at the top of the article.

Be sure to always take Prozac exactly as your doctor prescribes. Do not change your dosage without your doctor’s recommendation. To review Prozac’s usual recommended dosages, see the “What is Prozac’s dosage?” section above.

If you have more questions about dosage changes and side effects, talk with your doctor. You can also read about Prozac’s side effects in this article.)

What’s the dosage of Prozac when it’s taken with olanzapine?

Olanzapine (Zyprexa) is prescribed together with Prozac for certain conditions. These include treatment-resistant depression in adults and depression associated with bipolar I disorder in adults and some children. For both conditions, the usual daily dose of Prozac in adults ranges from 20 mg to 50 mg. But always take the dosage that your doctor prescribes.

Olanzapine and fluoxetine (the active ingredient in Prozac) are also the active ingredients in the brand-name drug Symbyax. This drug is available as a generic version. Your doctor may prescribe you Symbyax instead of Prozac and olanzapine together. If your doctor prescribes Symbyax, they’ll recommend the right dosage for you.

If you miss a dose of Prozac, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Do not take two doses together to make up for a missed dose.

If you need help remembering to take your dose of Prozac on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.

The dosage of Prozac you’re prescribed may depend on several factors. These include:

• the type and severity of the condition you’re taking the drug to treat
• your age
• body weight for children
• other conditions you may have (see the “Dosage adjustments” section above)

Prozac is usually taken once per day in the morning. In some cases, your doctor may recommend that you take Prozac twice a day. For example, if your dosage is 40 milligrams (mg) per day, your doctor may recommend taking 20 mg in the morning and 20 mg at noon.

If you take Prozac with olanzapine (Zyprexa), your doctor will likely recommend taking both drugs at night. (Prozac and olanzapine are prescribed together for depression related to bipolar I disorder and treatment-resistant depression. For details, see the “What is Prozac’s dosage?” section above.)

You can take Prozac with or without food.

For information on the expiration, storage, and disposal of Prozac, see this article.

Accessible drug containers and labels

If you find it hard to read the prescription label on your medication, tell your doctor or pharmacist. Some pharmacies provide medication labels that:

• have large print or use braille
• feature a code you can scan with a smartphone to change the text to audio

Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.

If you have trouble opening medication bottles, let your pharmacist know. They may be able to supply Prozac in an easy-open container. They may also have tips to help make it simpler to open the drug’s container.

Prozac doesn’t have a high risk of misuse. Drug misuse means taking a drug in a way other than how a doctor prescribes it.

If you have questions about drug misuse and Prozac, talk with your doctor.

Do not take more Prozac than your doctor prescribes, as this can lead to serious side effects.

Symptoms of overdose

Symptoms caused by a Prozac overdose can include:

• dizziness
• increased blood pressure
• fainting
• slow, fast, or irregular heartbeat or heart rate
• hallucinations (seeing or hearing things that aren’t really there)
• confusion
• tremors (shakiness or shaky limbs)
• seizure
• coma

What to do in case you take too much Prozac

Call your doctor right away if you think you’ve taken too much Prozac. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

You may have withdrawal symptoms if you stop taking Prozac suddenly. Withdrawal symptoms are side effects that can occur when you stop taking a drug that your body has become dependent on.

Prozac withdrawal symptoms can include:

• dizziness
• irritability
• agitation
• anxiety
• feeling of indifference or discontent
• electric shock sensations
• headache
• insomnia
• mood changes

If you and your doctor decide that you should stop taking Prozac, they’ll gradually decrease your dosage. This may help decrease the risk of withdrawal symptoms or their severity.

It’s important to follow your doctor’s instructions for stopping Prozac treatment. Your doctor will recommend a schedule that slowly reduces your dosage over time.

Tell your doctor if you have bothersome withdrawal symptoms while stopping Prozac treatment. They may have you temporarily go back to your previous dose or decrease your dosage slower.

Note that Prozac takes a while to get out of your system after your last dose. So if withdrawal symptoms occur, they may not start right away.

If you have questions about stopping your Prozac treatment or what side effects to expect, talk with your doctor.

The sections above describe the usual dosages provided by the drugmaker. If your doctor recommends Prozac for you, they’ll prescribe the dosage that’s right for you. To review Prozac’s usual recommended dosages, see the “What is Prozac’s dosage?” section above.

Remember, you should not change your dosage of Prozac without your doctor’s recommendation. Only take Prozac exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Here are some examples of questions you may want to ask your doctor:

• How long will I need to wait before any dose changes?
• Does my dosage of Prozac need to change if I’m taking other drugs along with it?
• Will you lower my dosage if I have side effects from Prozac?
• Will my dosage of Prozac need to change if I have kidney problems?

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline 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 another 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.

Form, Strengths, How to Take, and More

If you have certain mental health conditions, your doctor might suggest Prozac as a treatment option for you. It’s a prescription drug used to treat the following conditions in adults:

• panic disorder
• obsessive-compulsive disorder (OCD)
• depression
• depression related to bipolar I disorder*
• treatment-resistant depression*
• bulimia nervosa (an eating disorder)

Prozac is also approved to treat the following conditions in some children:

• OCD
• depression
• depression related to bipolar I disorder*

The active ingredient in Prozac is fluoxetine. An active ingredient is what makes a drug work. Fluoxetine belongs to the group of drugs called selective serotonin reuptake inhibitors (SSRIs).

Prozac comes as a capsule that you swallow. It’s also available as the generic drug fluoxetine.

This article describes the dosages of Prozac, as well as its strengths and how to take it. To learn more about Prozac, see this in-depth article.

Note: This article covers Prozac’s usual dosages, which are provided by the drugmaker. But when using Prozac, always take the dosage that your doctor prescribes.

* For this condition, Prozac is used together with olanzapine (Zyprexa).

This section covers standard dosage information for Prozac. Before prescribing this medication, your doctor will talk with you about the dosage instructions specific to your condition.

Note: This chart highlights the basics of Prozac’s dosages for adults. (For details about children’s dosages, see the “What’s the dosage of Prozac for children?” section below.) Prozac’s strengths are in milligrams (mg). Be sure to read on for more detail.

* For this condition, Prozac is used together with olanzapine (Zyprexa).
† For this condition, doctors may prescribe a lower dose to start. Then they’ll increase it over several days to the recommended dose of 60 mg.

What is the form of Prozac?

Prozac comes as a capsule that you swallow.

What strengths does Prozac come in?

Prozac capsules come in the following strengths:

• 10 mg
• 20 mg
• 40 mg

What are the usual dosages of Prozac?

Your doctor will likely start by prescribing a low dosage of Prozac. They may adjust it over time to reach the right therapeutic dose for you. (A therapeutic dose is a dose that treats your condition and manages your symptoms.) They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The information below describes dosages that are commonly recommended for adults. But be sure to take the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs.

Dosage for panic disorder

For panic disorder (a kind of anxiety disorder), your doctor may initially prescribe a low dose of Prozac. The starting dosage is 10 mg per day.

After 1 week, your doctor may increase your dosage to 20 mg per day. This is the recommended dosage for panic disorder. They may increase it further to reach the dose that’s right for you.

The usual daily dose ranges from 10 mg to 60 mg. The maximum recommended dosage for panic disorder is 60 mg.

Dosage for OCD

For OCD in adults, the recommended starting dosage is 20 mg per day. Your doctor may gradually increase your dosage to reach the dose that’s right for you.

The usual daily dose ranges from 20 mg to 60 mg. The maximum recommended dosage for OCD is 80 mg per day.

Dosage for depression related to bipolar I disorder

For depression related to bipolar I disorder, Prozac’s recommended starting dosage in adults is 20 mg per day. Your doctor may gradually increase or adjust your dosage to reach the dose that’s right for you.

Prozac’s usual daily dose ranges from 20 mg to 50 mg. The maximum recommended dosage is 50 mg.

For this use, Prozac is prescribed together with olanzapine (Zyprexa). Your doctor will recommend the dosage of olanzapine that’s right for you.

Dosage for depression

For depression in adults, the typical dosage of Prozac is 20 mg per day. You’ll likely take this dosage for the first several weeks or longer. Then your doctor may increase or adjust your dosage over time to reach the dose that’s right for you.

The usual daily dose ranges from 20 mg to 80 mg. The maximum recommended dosage is 80 mg per day.

Dosage for treatment-resistant depression

For treatment-resistant depression in adults, the usual starting dosage is 20 mg per day. You’ll likely take this dosage for the first several weeks or longer. Then your doctor may increase or adjust your dosage over time to reach the dose that’s right for you.

The usual daily dose ranges from 20 mg to 50 mg. The maximum recommended dosage is 50 mg per day.

For this use, Prozac is prescribed together with olanzapine (Zyprexa). Your doctor will recommend the dosage of olanzapine that’s right for you.

Dosage for bulimia nervosa

For bulimia nervosa, the usual dosage of Prozac is 60 mg per day. Doctors sometimes prescribe a lower dose to start. Then they’ll increase it over several days until they reach the recommended dose.

For this use, 60 mg per day is the recommended dosage and the maximum dosage of Prozac.

What’s the dosage of Prozac for children?

Prozac is approved to treat:

• depression in children ages 8 years and older
• OCD in children ages 7 years and older
• depression related to bipolar I disorder in children ages 10 years and older

The chart below summarizes the usual recommended dosages of Prozac for children. Prozac’s strengths are in milligrams (mg).

* For this condition, Prozac is used together with olanzapine (Zyprexa).

Dosage for depression

For depression in children, Prozac’s usual starting dosage is 10 mg per day to 20 mg per day. Your child’s doctor may start by prescribing 10 mg per day and increase it to 20 mg per day after 1 week.

Your child’s dosage may need to be adjusted based on their body weight. Their doctor will determine the dosage that’s right for your child. For details, see the “Dosage adjustments” section below.

Dosage for OCD

For OCD in children, the usual starting dosage is 10 mg per day. After 2 weeks, your child’s doctor will likely increase their dosage to 20 mg per day. They may raise the dosage over time until they reach the dose that’s right for your child.

The recommended daily dose ranges from 20 mg to 60 mg.

Dosage for depression related to bipolar I disorder

For depression related to bipolar I disorder, Prozac’s recommended starting dosage is 20 mg per day. Your child’s doctor may gradually increase their dosage over time until they reach the dose that’s right for your child.

The maximum dosage of Prozac for this use in children is 50 mg per day.

For depression related to bipolar I disorder, Prozac is prescribed together with olanzapine (Zyprexa). Your child’s doctor will recommend the dosage of olanzapine that’s right for your child.

Is Prozac used long term?

Yes, Prozac is usually taken as a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you’ll likely take it long term.

Dosage adjustments

Your doctor may decrease your Prozac dosage if you have liver problems or you’re age 65 years or older.

The dosage of Prozac may also need to be adjusted for children with a low body weight. For example, if your child weighs less than usual for their age, their doctor may prescribe a lower dosage.

Below are answers to some commonly asked questions about Prozac’s dosage.

What is the maximum dose of Prozac I can take?

The recommended maximum dose of Prozac varies by age and the condition being treated. For details, see the “What factors can affect my dosage?” section below.

For example, the recommended maximum dosage for depression and obsessive-compulsive disorder (OCD) is 80 mg per day. But for bulimia nervosa (an eating disorder) and panic disorder, it is 60 mg per day. To learn more, see the “What is Prozac’s dosage?” section above.

Keep in mind that the response to a medication differs between people. This is why it’s important to take Prozac exactly as your doctor prescribes. For example, the maximum dose for you may be a lethal dose for someone else. Your doctor will recommend the right dosage for you.

Do not take more medication than your doctor prescribes. Doing so can increase your risk of serious side effects. (For details about Prozac’s side effects, you can read this article.)

If you have questions about the maximum dose of Prozac that you can take, talk with your doctor or pharmacist.

Can I avoid side effects such as weight loss if I take a low dose of Prozac?

It depends. Prozac side effects, which may include weight loss, can occur with any dose. The risk increases at higher doses. So the risk of side effects, such as weight loss, may decrease with a lower dosage of Prozac.

Always take the dosage of Prozac your doctor prescribes. They’ll prescribe the lowest dose of Prozac that relieves your symptoms and treats your condition. (For details about Prozac’s side effects, you can read this article.)

If you’re concerned about weight loss with Prozac, talk with your doctor. They may monitor your (or your child’s) weight during treatment with Prozac.

If my Prozac dose increases from 10 mg to 20 mg, will I have a higher risk of side effects?

It’s possible. Prozac side effects can happen with any dose. But a dose increase may raise the risk or severity of side effects.

It’s important to note that Prozac has a boxed warning for the risk of suicidal thoughts and behaviors in young adults and children. This is a serious warning from the Food and Drug Administration (FDA). The risk is higher after any dosage changes and during your first few months of treatment. For more details about Prozac’s boxed warning, see the “Boxed warning: Risk of suicidal thoughts and behaviors” section at the top of the article.

Be sure to always take Prozac exactly as your doctor prescribes. Do not change your dosage without your doctor’s recommendation. To review Prozac’s usual recommended dosages, see the “What is Prozac’s dosage?” section above.

If you have more questions about dosage changes and side effects, talk with your doctor. You can also read about Prozac’s side effects in this article.)

What’s the dosage of Prozac when it’s taken with olanzapine?

Olanzapine (Zyprexa) is prescribed together with Prozac for certain conditions. These include treatment-resistant depression in adults and depression associated with bipolar I disorder in adults and some children. For both conditions, the usual daily dose of Prozac in adults ranges from 20 mg to 50 mg. But always take the dosage that your doctor prescribes.

Olanzapine and fluoxetine (the active ingredient in Prozac) are also the active ingredients in the brand-name drug Symbyax. This drug is available as a generic version. Your doctor may prescribe you Symbyax instead of Prozac and olanzapine together. If your doctor prescribes Symbyax, they’ll recommend the right dosage for you.

If you miss a dose of Prozac, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Do not take two doses together to make up for a missed dose.

If you need help remembering to take your dose of Prozac on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.

The dosage of Prozac you’re prescribed may depend on several factors. These include:

• the type and severity of the condition you’re taking the drug to treat
• your age
• body weight for children
• other conditions you may have (see the “Dosage adjustments” section above)

Prozac is usually taken once per day in the morning. In some cases, your doctor may recommend that you take Prozac twice a day. For example, if your dosage is 40 milligrams (mg) per day, your doctor may recommend taking 20 mg in the morning and 20 mg at noon.

If you take Prozac with olanzapine (Zyprexa), your doctor will likely recommend taking both drugs at night. (Prozac and olanzapine are prescribed together for depression related to bipolar I disorder and treatment-resistant depression. For details, see the “What is Prozac’s dosage?” section above.)

You can take Prozac with or without food.

For information on the expiration, storage, and disposal of Prozac, see this article.

Accessible drug containers and labels

If you find it hard to read the prescription label on your medication, tell your doctor or pharmacist. Some pharmacies provide medication labels that:

• have large print or use braille
• feature a code you can scan with a smartphone to change the text to audio

Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.

If you have trouble opening medication bottles, let your pharmacist know. They may be able to supply Prozac in an easy-open container. They may also have tips to help make it simpler to open the drug’s container.

Prozac doesn’t have a high risk of misuse. Drug misuse means taking a drug in a way other than how a doctor prescribes it.

If you have questions about drug misuse and Prozac, talk with your doctor.

Do not take more Prozac than your doctor prescribes, as this can lead to serious side effects.

Symptoms of overdose

Symptoms caused by a Prozac overdose can include:

• dizziness
• increased blood pressure
• fainting
• slow, fast, or irregular heartbeat or heart rate
• hallucinations (seeing or hearing things that aren’t really there)
• confusion
• tremors (shakiness or shaky limbs)
• seizure
• coma

What to do in case you take too much Prozac

Call your doctor right away if you think you’ve taken too much Prozac. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

You may have withdrawal symptoms if you stop taking Prozac suddenly. Withdrawal symptoms are side effects that can occur when you stop taking a drug that your body has become dependent on.

Prozac withdrawal symptoms can include:

• dizziness
• irritability
• agitation
• anxiety
• feeling of indifference or discontent
• electric shock sensations
• headache
• insomnia
• mood changes

If you and your doctor decide that you should stop taking Prozac, they’ll gradually decrease your dosage. This may help decrease the risk of withdrawal symptoms or their severity.

It’s important to follow your doctor’s instructions for stopping Prozac treatment. Your doctor will recommend a schedule that slowly reduces your dosage over time.

Tell your doctor if you have bothersome withdrawal symptoms while stopping Prozac treatment. They may have you temporarily go back to your previous dose or decrease your dosage slower.

Note that Prozac takes a while to get out of your system after your last dose. So if withdrawal symptoms occur, they may not start right away.

If you have questions about stopping your Prozac treatment or what side effects to expect, talk with your doctor.

The sections above describe the usual dosages provided by the drugmaker. If your doctor recommends Prozac for you, they’ll prescribe the dosage that’s right for you. To review Prozac’s usual recommended dosages, see the “What is Prozac’s dosage?” section above.

Remember, you should not change your dosage of Prozac without your doctor’s recommendation. Only take Prozac exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Here are some examples of questions you may want to ask your doctor:

• How long will I need to wait before any dose changes?
• Does my dosage of Prozac need to change if I’m taking other drugs along with it?
• Will you lower my dosage if I have side effects from Prozac?
• Will my dosage of Prozac need to change if I have kidney problems?

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline 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 another 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.

How Prozac Made the World Love Depression — Bird In Flight

At the end of the 20th century, Prozac helped humanity cope with one of the most difficult diseases of our time – depression. But at the same time, he created a cult out of the disease. Bird in Flight tells the story of the rise and fall of the happiness pill.

The diagnosis of “clinical depression” began a century and a half ago, today it is already the second most common in the world. This disorder affects about 300 million people. One in six people with severe depression is at risk of committing suicide. Despite the complexity of the disease, it is now not considered incurable, and for this we should be grateful to Prozac, a drug that has changed the idea of ​​​​depression.

An incurable disease

For a long time, medicine did not know how to help people with depression: in the Middle Ages, it was treated with prayers, in the Renaissance, with vegetarianism. Only in the 19th century did doctors realize that the main cause of depression was a malfunction in the nervous system. Patients were prescribed stimulant psychoactive substances such as alcohol, opium, cocaine, and eventually sedative barbiturates. They did not cure the disease, but only temporarily relieved the symptoms, while causing addiction.

Accidental discovery

A breakthrough in the fight against depression occurred in the early 1950s, when a drug for tuberculosis, iprovizid, was being studied in the United States. The medicine coped with its task poorly, but it was found to have an unusual side effect: after taking it, appetite returned to tuberculosis patients, their mood improved. As the doctors recalled, “the patients danced despite the holes in their lungs.” Psychiatrists who undertook to study iprovisid confirmed its psychoactive properties. Thus, a new class of drugs appeared – antidepressants.

The first such drugs were very toxic and had many side effects. Patients taking them suffered from heart problems, excess weight and slow reflexes. However, the medications did not help everyone.

The first antidepressants had many side effects. Patients taking them suffered from heart problems, excess weight and slow reflexes.

In the early 1970s, a number of pharmaceutical companies began to develop a new generation of depression drugs that would not have these unpleasant side effects. Its discoverer was David T. Wong, a researcher at the American pharmaceutical company Eli Lilly. For a long time, Wong studied the mechanisms of reuptake of serotonin, a neurotransmitter responsible, among other things, for the emotional background of a person. The researcher’s task was to find a substance that would prevent the absorption of serotonin by brain neurons. It was opened at 1972, the substance was named fluoxetine.

Unlike the older antidepressants, which, like weapons of mass destruction, acted on all neurotransmitters at once, fluoxetine worked selectively. Patients could no longer be afraid of lethargy; the problem of side effects seemed to be solved.

“Prozac: wash away your blues!” Source: Tumblr / Adbusters

Killer marketing

Another advantage of the new drug was that, in addition to reuptake, it also blocked the uptake of norepinephrine, that is, it acted as a stimulant on the nervous system. So Eli Lilly made the right decision to sell fluoxetine not as an antidepressant but as a mood booster. The company wanted customers not to think about taking the medicine. Fluoxetine was supposed to be associated with energy and vivacity, so the first step in its promotion was a name change. This task was entrusted to Interbrand, whose clients included Sony, Microsoft and Nintendo. Thanks to her, fluoxetine became Prozac.

Eli Lilly introduced the drug to the US Food and Drug Administration in the late 1970s. Consideration of the application stretched for ten years. Department officials were embarrassed that Prozac had a stimulant rather than a sedative property. Despite this, it was still approved, and in December 1987 the drug entered the market.

Cult of Sorrow and Joy

In its first year, Prozac sold $350 million in the US and $2.6 billion worldwide. The drug finally convinced humanity that depression is not a sentence, as previously thought, and happiness is not an abstract concept, but a state that can be achieved with the help of pills.

“Prozac” finally convinced humanity that depression is not a sentence, as previously thought, and happiness can be achieved with the help of pills.

The popularity of the medicine was also supported by media attention. So, on December 18, 1989, New York Magazine came out with Prozac pills on the cover. The headline was “Buy-Buy Blues.” After that, almost all the major magazines of that time wrote about the pills.

Eli Lilly’s marketing idea worked. The Americans perceived the drug as an energy drink, after drinking which one could become more productive. It seemed that the whole country fell in love with the medicine, including doctors. At 19In 1993, psychiatrist Peter Kramer published Listening to Prozac, which became a New York Times bestseller. In it, the author suggested that the drug not only allows you to cope with depression, but also can make a mediocre person more bright, a shy person more open and sociable, and an ambitious employee can help climb the career ladder. After the publication of the book, sales of the pills increased another 15%.

Shot from the movie Prozac Nation (2001) / Miramax / Album

The peak of Prozac’s popularity came in the 90s – comedians and writers started talking about the drug. “When do the holidays start in New York? When drug dealers start selling more Prozac than crack” – this joke was made on the evening show with David Letterman in 1994. In the same year, writer Elisabeth Wurzel published Prozac Nation, a book about her experience of dealing with clinical depression. Wurzel’s work is considered one of the examples of the romanticization of the image not only of Prozac, but of antidepressants in general.

Prozac has made its way into music as well. In 1996, the rock group Mr. T Experience released the song That Prozac Moment, in which the effect of taking the drug was compared to a moment of fleeting happiness, when you can forget about everything. Also, the drug is mentioned in the compositions of Aerosmith, Pixies, Red Hot Chili Peppers, Neil Diamond, Nick Cave and other artists.

Love no matter what

When INXS lead singer Michael Hutchence took his own life in 1997, the media wrote that Prozac killed the star. The musician’s case was one of several dozen suicide cases that swept across the United States, all of which were associated with the use of fluoxetine. Eli Lilly started getting lawsuits. Later it turned out that the company knew that the drug could increase the risk of suicide even at the stage of clinical trials. It was especially dangerous for teenagers.

How could a pill designed to treat depression cause people to commit suicide? It was assumed that suicidal thoughts were in patients who committed suicide even before the start of the drug, but due to depression they lacked the strength to realize their plans. Prozac just became a source of energy. Defenders of the drug argued that it was not the drug that was responsible for the deaths, but the disease. However, according to The Guardian, the drug can cause suicidal thoughts in people who do not suffer from depression.

The fact that the drug can increase the risk of suicide, the company knew even at the stage of clinical trials.

When Eli Lilly’s patent for Prozac expired in 2001, fluoxetine-based competitor products filled the market. The side effects of the new generation of antidepressants were even less. However, even today, Prozac, along with them, remains one of the most effective means to combat depression.

The drug scandals have made the medical community and the media more critical of antidepressants—they are no longer considered a panacea. In 2008, a study was published proving that drugs for depression are effective in severe manifestations of the disease, but in the lungs they are barely noticeable than placebo. The approaches of pharmaceutical companies to the promotion of antidepressants on the market were also subject to revision. The Guardian believes that manufacturers often do not publish the results of their research or, even worse, influence them. Often, companies use advertising to change the idea of ​​the disease, convincing the public that even minor sleep disturbances and mood swings are a cause for concern.

However, the global antidepressant market is expected to surpass $18 billion by the end of 2024, with fluoxetine accounting for a significant portion of the profits. What makes these drugs so popular?

As Vladislav Dorofeev writes in his book “Great Medicines”, this is a person’s desire to get a simple and universal remedy for anxiety and loneliness. Modern people do not have time to delve into themselves.

Photo: Stephen Chernin / Getty Images North America / Getty Images via AFP

official instructions for use, analogues, price, availability in pharmacies

Chemical rational name : (±)N-methyl-3-phenyl-3[(α,α,α-trifluoro-p-tolyl) hydroxy] propylamine hydrochloride

Composition

Each capsule contains:
Active ingredient: fluoxetine hydrochloride equivalent to 20 mg fluoxetine;
Excipients:

contents of the capsule: starch, dimethicone;
capsule shell composition: dye patent blue V, iron oxide yellow dye, titanium dioxide, gelatin, food ink (for identification printing).

Description

Capsules: opaque green/cream, hard gelatin (size 3), imprinted with the LILLY logo and identification code 3105.
Capsule contents: white powder.

Pharmacological properties

Pharmacodynamics

Prozac ^® is an antidepressant, selective serotonin reuptake inhibitor, which determines its mechanism of action. Fluoxetine has little to no affinity for other receptors, such as αl-, α2- and β-adrenergic, serotonergic, dopaminergic, histaminergic1, muscarinic and GABA receptors.
Pharmacokinetics

Absorption and distribution. Fluoxetine is well absorbed when taken orally. Peak plasma concentration is reached after 6-8 hours. Fluoxetine is highly protein bound and has a high volume of distribution (20-40 L/kg). The Cmax value is 15-55 ng/ml. Equilibrium plasma concentrations are achieved after taking the drug for several weeks. Equilibrium concentrations after prolonged use of the drug are similar to the concentrations observed at 4-5 weeks of taking the drug.
Metabolism and excretion. Fluoxetine is extensively metabolized in the liver to norfluoxetine and a number of other unidentified metabolites, which are excreted in the urine. The half-life of fluoxetine is 4 to 6 days and its active metabolite is 4 to 16 days.

development of insomnia.
Severe psychomotor agitation (eg, agitation, akathisia, panic) has also been a risk factor during treatment with fluoxetine. The presence or occurrence of these conditions before or during therapy is the basis for strengthening clinical monitoring or adjusting the treatment.
Skin rash: Skin rash, anaphylactic reactions and progressive systemic disorders, sometimes serious involving the skin, kidneys, liver and lungs, have been reported in patients treated with fluoxetine. If a skin rash or other possible allergic reactions appear, the etiology of which cannot be determined, fluoxetine should be discontinued.
Seizures: As with other antidepressants, fluoxetine should be used with caution in patients with a history of epileptic seizures.
Hyponatremia: there have been cases of hyponatremia (in some cases, the concentration of sodium in the blood serum was less than 110 mmol / l). Basically, such cases were observed in elderly patients and in patients receiving diuretics due to a decrease in the volume of circulating blood.
Glycemic control: in patients with diabetes mellitus, hypoglycemia was noted during treatment with fluoxetine, and hyperglycemia developed after discontinuation of the drug. At the beginning or after the end of treatment with fluoxetine, it may be necessary to adjust the doses of insulin and / or hypoglycemic drugs for oral administration.
Hepatic/Renal Insufficiency: Fluoxetine is extensively metabolized by the liver and excreted by the kidneys. In patients with severe hepatic impairment, it is recommended to prescribe lower doses of fluoxetine, or to prescribe the drug every other day. When taking fluoxetine at a dose of 20 mg / day for two months in patients with severely impaired renal function (CC <10 ml / min) in need of hemodialysis, there were no differences in the concentration of fluoxetine and norfluoxetine in blood plasma from healthy individuals with normal function kidneys.

Use during pregnancy and breastfeeding

Pregnancy: There were 2072 known pregnancies while taking fluoxetine in the first trimester. Available data indicate no adverse effects on the course of pregnancy or on the development of the fetus or newborn. However, caution should be exercised, especially in late pregnancy, since there are rare reports of the development of a withdrawal syndrome in the newborn (short-term restlessness, feeding difficulties, rapid breathing and irritability) if the mother took the drug shortly before delivery.
Fluoxetine may be used during pregnancy provided the expected benefit outweighs the potential risk.
Breastfeeding: fluoxetine is excreted in breast milk, therefore, caution should be exercised when prescribing fluoxetine to nursing mothers.
Childbirth: the effect of fluoxetine on the process of childbirth in humans is not known.

Dosage and administration

Depression. The initial recommended dose is 20 mg per day.
Bulimia. The recommended dose is 60 mg per day.
Obsessive-compulsive disorders. The recommended dose is 20-60 mg per day.
Premenstrual dysphoric disorders. The recommended dose is 20 mg per day.
All indications. The recommended dose may be reduced or increased. Doses greater than 80 mg/day have not been systematically studied.
Age. There are no data on the need to change doses depending only on age.
Reception write. Fluoxetine can be taken at any time with or without food.
Concomitant diseases and/or concomitant treatment. In patients with impaired liver function, concomitant diseases or taking other drugs, doses should be reduced and the frequency of administration should be reduced.

Side effect

As in the case of the use of other drugs of the group of selective serotonin reuptake inhibitors, the following adverse events are observed during the use of fluoxetine.
Cardiovascular system:

Often (≥1% – <10%) : atrial flutter, hot flashes (“flashes” of heat).
Uncommon (≥0.1% – <1%): hypotension.
Rare (<0.1%): Vasculitis, vasodilation.
Digestive system:

Very common (≥10%): diarrhea, nausea.
Common (≥1% – <10%): dry mouth, dyspepsia, vomiting, anorexia (including weight loss).
Uncommon (≥0.1% – <1%): dysphagia, taste perversion.
Rare (<0.1%): pain along the esophagus.
General effect on the body:

Very common (≥10%): weakness (including asthenia).
Often (≥1% – <10%): chills, anxiety attacks, restlessness, yawning.
Rarely (≥0.1% – <1%): sensation of heat, sensation of cold, malaise, discomfort.
Immune system:

Very rare (<0.1%): anaphylactic reactions, serum sickness.
Metabolic and nutritional disorders:

Common (≥1% – <10%): anorexia (including weight loss).
Musculoskeletal system:

Uncommon (≥0.1% – <1%): muscle twitching.
Nervous system:

Very common (≥10%): headache.
Often (≥1% – <10%): impaired attention, dizziness, lethargy, drowsiness (including hyper drowsiness, sedation), tremor.
Uncommon (≥0.1% – <1%): psychomotor hyperactivity, ataxia, incoordination, bruxism, dyskinesia, myoclonus.
Rare (<0.1%): bucco-glossal syndrome, convulsions.
Mental disorders:

Very common (≥10%): insomnia (including early morning awakening, initial and moderate insomnia).
Often (≥1% – <10%): unusual dreams (including nightmares), nervousness, tension, decreased libido (including lack of libido), euphoria, sleep disturbance.
Infrequently (≥0.1% – <1%): depersonalization, hyperthymia, orgasm disturbance (including anorgasmia), impaired thinking.
Rare (<0.1%): mania, hypomania.
Leather:

Common (≥1% – <10%): hyperhidrosis, pruritus, rash (including exfoliative, hyperthermic, erythematous, follicular, generalized, macular, maculopapular, morbilliform, papular, pruritic, vesicular, erythema with umbilicus in the center; erythema), urticaria.
Uncommon (≥0.1% – <1%): ecchymosis, bruising tendency, alopecia, cold sweat.
Rare (<0.1%): angioedema, photosensitivity reactions.
Sense organs:

Often (≥1% – <10%): blurred vision.
Uncommon (≥0.1% – <1%): mydriasis.
Genitourinary system:

Often (≥1% – <10%): frequent urination (including pollakiuria), ejaculation disorders (including lack of ejaculation, dysfunctional ejaculation, early ejaculation, delayed ejaculation, retrograde ejaculation), erectile dysfunction, gynecological bleeding (in including cervical bleeding, dysfunctional uterine bleeding, genital tract bleeding, menometrorrhagia, menorrhagia, metrorrhagia, polymenorrhea, post-menopausal bleeding, uterine bleeding, vaginal bleeding).
Uncommon (≥0.1% – <1%): dysuria.
Rare (<0.1%): sexual dysfunction.
Spontaneous (post-marketing) communications

Endocrine system:

Insufficient secretion of antidiuretic hormone.
Hepatobiliary system:

Rare (<0.1%): Idiosyncratic hepatitis.
Nervous system:

Serotonin syndrome.
Genitourinary system: priapism.

Overdose

There are 633 known cases of fluoxetine overdose in adult patients, of which 378 have fully recovered; 15 had symptoms of accommodation disorders, gait, confusion, inaccessibility to contact, nervousness, respiratory system dysfunction, vertigo, tremor, increased blood pressure, male potency disorders, movement disorders and hypomania; 34 had a fatal outcome; details of the remaining 206 patients are not known. The maximum known dose of fluoxetine that has been taken orally by humans is 8 g; this case of overdose ended in complete recovery. The lowest known dose of fluoxetine that has been fatal, but without a clearly established causal relationship, is 520 mg.
The main manifestations of overdose included convulsions, drowsiness, nausea, tachycardia and vomiting.
Other serious events reported with fluoxetine overdose (both alone and in combination with other drugs) included coma, delirium, QT interval prolongation, and ventricular tachyarrhythmia, including ventricular fibrillation-flutter and cardiac arrest, hypotension , syncope, mania, pyrexia, stupor, and a condition similar to neuroleptic malignant syndrome.
Treatment. It is recommended to monitor the general condition and cardiac activity, along with general symptomatic and supportive measures / No specific antidote is known. Increased diuresis, dialysis, hemoperfusion, and cross-transfusion are unlikely to be of benefit. In the treatment of overdose, the possibility of using several drugs should be considered.

Interaction with other drugs

Fluoxetine and its main metabolite norfluoxetine have long half-lives, which must be considered when fluoxetine is combined with other drugs, as well as when it is replaced by another antidepressant.
Phenytoin. Changes in the concentration of phenytoin in the blood were revealed when combined with fluoxetine. In some cases, manifestations of intoxication were noted. Increasing the dose of phenytoin or fluoxetine with their simultaneous appointment should be carried out with caution and under the control of the clinical dynamics of the condition.
Serotonergic drugs. Simultaneous use of serotonergic drugs (for example, tramadol and triptans) increases the likelihood of developing serotonin syndrome. Simultaneous administration of triptans also increases the likelihood of developing coronary vasoconstriction and arterial hypertension.
Benzodiazepines. With the simultaneous use of fluoxetine and benzodiazepines, an increase in the half-life of the latter is possible. When taking alprazolam and fluoxetine together, an increase in the concentration of alprazolam in the blood and an increase in its sedative effect were observed.
Lithium and tryptophan. There are known cases of the development of serotonin syndrome while taking SSRIs and lithium or tryptophan, and therefore the simultaneous administration of fluoxetine with these drugs should be carried out with caution. With the simultaneous administration of fluoxetine and lithium, more frequent and careful monitoring of the clinical condition is necessary.
Drugs metabolized with the participation of the CYP2D6 isoenzyme (propafenone, carbamazepine, triglyceric antidepressants). It should be borne in mind that the metabolism of fluoxetine (as well as tricyclic antidepressants, as well as selective serotonergic antidepressants) is carried out with the participation of the CYP2D6 isoenzyme of the liver cytochrome system. Simultaneous administration of drugs, the main route of biotransformation of which is metabolism with the participation of the CYP2D6 isoenzyme, and having a small interval of therapeutic doses (such as propafenone, carbamazepine, tricyclic antidepressants), should be carried out using the minimum therapeutic doses. The above also applies if less than 5 weeks have passed since fluoxetine was discontinued.
Oral anticoagulants and other drugs that affect the blood coagulation system (NSAIDs, acetylsalicylic acid). It is known about the change in anticoagulant action (by laboratory parameters and / or clinical manifestations) without any general characteristic trend, but with the likelihood of increased bleeding while taking fluoxetine and oral anticoagulants. The functional state of the blood coagulation system in patients receiving warfarin should be carefully monitored when prescribing and canceling fluoxetine.
Electroconvulsive therapy (ECT). There are rare reports of an increase in the duration of seizures in patients taking fluoxetine and receiving ECT, and therefore caution is advised.
Alcohol. In experimental studies, fluoxetine did not increase the concentration of alcohol in the blood, as well as enhance the effects of alcohol. However, concomitant use of SSRIs and alcohol is not recommended.
Products based on the plant Hypericum perforatum. As with other SSRIs, a pharmacodynamic interaction between fluoxetine and agents based on the plant Hypericum perforatum may develop, which may lead to increased undesirable effects.