Side effects and how to manage them

Prozac (fluoxetine) is a brand-name prescription medication. The Food and Drug Administration (FDA) has approved it to treat the following conditions in adults:

• major depressive disorder (MDD)
• obsessive compulsive disorder (OCD)
• bulimia nervosa
• panic disorder with or without agoraphobia

In addition, Prozac can also be used in combination with olanzapine (Zyprexa) to treat the following conditions in adults:

• depression related to bipolar disorder
• depression if other medications aren’t working for you

Prozac can also be used in certain children with MDD, OCD, or in combination with olanzapine for depression related to bipolar disorder.

Here are some fast facts about Prozac:

• Active ingredient: fluoxetine
• Drug class: selective serotonin reuptake inhibitor (SSRI)
• Drug form: oral capsule

In most cases, if Prozac works for you, your doctor will recommend taking it long-term. However, in some cases, your doctor may recommend short-term treatment. Before you start Prozac, your doctor will discuss your treatment plan with you.

As with other drugs, Prozac can cause side effects. Read on to learn about potential common, mild, and serious side effects. For a general overview of Prozac, including details about its uses, see this article.

Prozac can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took Prozac in clinical trials:

• abnormal dreams
• anxiety
• diarrhea
• dry mouth
• weakness
• sexual side effects, such as decreased libido*

* For more information about this side effect, see “Side effect specifics” below.

Mild side effects can occur with Prozac use. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Prozac’s prescribing information.

Mild side effects that have been reported with Prozac include:

• anxiety
• diarrhea
• dry mouth
• weakness
• heartburn
• flu-like symptoms
• insomnia
• nervousness
• rash
• sleepiness
• dizziness
• sweating
• tremor
• loss of appetite, which can lead to weight loss
• sexual side effects, such as decreased libido*
• nausea*
• headache*
• hair loss*
• mild allergic reaction*

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Prozac and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see “Side effect specifics” below.

Prozac may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Prozac’s prescribing information.

If you develop serious side effects while taking Prozac, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

• Serotonin syndrome (a buildup of serotonin in your body). Symptoms can include:
  • confusion
  • fast heartbeat
  • rigid or twitching muscles
  • headache
• Bleeding. Symptoms can include:
  • bruising easier than usual
  • nosebleeds
  • black, tarry stool
  • abdominal pain
• Glaucoma. Symptoms can include:
  • headache
  • blurry vision
  • nausea or vomiting
• Seizures. Symptoms can include:
  • uncontrolled movements of the arms or legs
  • unconsciousness
  • confusion
• Low blood sodium levels. Symptoms can include:
  • nausea or vomiting
  • headache
  • seizures
• Heart rhythm changes, such as QT prolongation. Symptoms can include:
  • dizziness
  • heart palpitations
  • fainting
• Mania (episodes of unusually high energy that affects your mood and behavior). Symptoms can include:
  • agitation (feeling annoyed or restless)
  • hallucinations
  • racing thoughts
• Increased risk of suicidal thoughts and behaviors in certain people.*
• Severe allergic reaction.†

* Prozac has a boxed warning for this side effect. This is a serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effect specifics” section below.
†An allergic reaction is possible after using Prozac. However, it’s not clear whether this side effect occurred in clinical trials. To learn more, see the “Side effect specifics” section below.

Prozac is approved to treat certain children and adults. However, the drug has a boxed warning for the risk of for the risk of suicidal thoughts and behaviors in certain people. Boxed warnings are the most serious warnings recommended by the FDA. The purpose of a boxed warning is to make patients and doctors aware of the risk of taking a medication.

Specifically, Prozac may increase the risk of suicidal thoughts and behaviors in children or young adults taking the drug. For more information on this warning, see the “Side effects specifics” section below.

Prozac is approved to treat the following conditions in children:

• ages 8 and older with major depressive disorder (MDD)
• ages 7 and older with obsessive-compulsive disorder (OCD)
• ages 10 and older with depression related to bipolar disorder

In most cases, children taking Prozac reported the same side effects that adults taking the drug experienced. Prozac side effects in teens were also usually the same as the side effects in adults. However, children taking Prozac may experience other side effects, such as feeling thirsty, muscle spasms, or urinary frequency.

In addition, it’s not known if the drug may have long-term effects on the growth or development of children. So, doctors may monitor your child’s height and weight to be sure that they’re growing as they should be while taking Prozac.

If you have concerns about side effects that your child may experience from taking Prozac, talk with their doctor.

You shouldn’t experience weight gain from taking Prozac. Weight gain wasn’t reported in clinical trials of people taking this drug.

In fact, weight loss was actually a side effect of this medication in clinical trials. This may be because Prozac can cause a decrease in appetite, which may lead to weight loss.

However, it’s possible for depression to cause weight gain to occur. Prozac can be used to treat depression.

So, if you notice weight gain during your treatment with Prozac, talk with your doctor. They can help you determine what may be causing the weight gain to occur. In addition, they may be able to recommend ways to help manage your weight.

Often, females* and males* taking Prozac will experience similar side effects. However, it’s possible for sexual side effects to occur from taking Prozac. Sexual side effects may differ between females and males.

For example, in males, Prozac may cause a decreased libido, erectile dysfunction, or a delay or trouble ejaculating. However, in females, this drug may decrease libido or cause a delay in orgasm.

For more information on sexual side effects that Prozac may cause, see the “Side effect details” section below.

* Sex and gender exist on spectrums. Use of the terms “female” and “male” in this article refers to sex assigned at birth.

Prozac may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

Does stopping Prozac treatment cause withdrawal symptoms?

Yes, it’s possible that stopping treatment with Prozac may cause withdrawal symptoms to occur. Withdrawal symptoms are symptoms that can happen when your body is used to taking a medication that you suddenly stop taking.

Some examples of withdrawal symptoms that may occur from stopping Prozac include:

• mood changes, such as irritability or agitation
• dizziness
• tingling of the arms or legs
• confusion
• headache
• insomnia

Because of these side effects, be sure to talk with your doctor before stopping treatment with Prozac. They’ll likely recommend slowly decreasing your dose of Prozac so that your body can adjust to the change.

If you’re interested in stopping treatment with Prozac, talk with your doctor about the safest way to do so.

What are the long-term side effects of Prozac?

Although uncommon, it’s possible for Prozac to cause long-term side effects to occur. Examples of long-term side effects that Prozac may cause include glaucoma, seizures, or hair loss.

If you’re concerned about long-term side effects from Prozac, talk with your doctor or pharmacist. They can discuss the risk of side effects with you and ways to help prevent side effects from occurring.

Are there side effects with a low dose of Prozac?

Yes, it’s possible to experience side effects if you take a low dose of Prozac. This drug is available in 10 milligram (mg), 20 mg, or 40 mg capsules. Taking even a low dose of Prozac may cause side effects to occur.

The lowest dose of Prozac that your doctor may prescribe for you is 10 mg. And, although higher doses of Prozac may have a higher risk of side effects, you still may experience side effects from lower doses.

If you’re concerned about side effects that you may experience from Prozac, talk with your doctor or pharmacist. They may be able to help recommend ways to reduce side effects that you experience. For example, if you’re concerned about Prozac 20 mg side effects, your doctor or pharmacist may be able to recommend ways to reduce side effects from occurring.

Prozac doesn’t have a high risk for misuse. Misuse of a drug means using it in a way that’s different than how the drug was prescribed to you. Misusing a drug may increase your risk of serious side effects and overdose.

However, even though Prozac isn’t commonly misused, stopping the drug suddenly may cause withdrawal symptoms. Withdrawal symptoms can happen if your body is used to a medication that you suddenly stop taking.

To learn more about withdrawal symptoms that may occur from Prozac, see the “FAQs about the side effects of Prozac” section above.

Learn more about some of the side effects that Prozac may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Prozac.

Increased risk of suicidal thoughts and behaviors

It’s possible for Prozac to increase the risk of suicidal thoughts and behaviors in certain people. In fact, Prozac has a boxed warning for this risk. A boxed warning is the most serious warning recommended by the FDA. The purpose of a boxed warning is to alert doctors and patients about the risks of taking a medication.

Antidepressants, including Prozac, have a boxed warning for the risk of suicidal thoughts and behaviors. This risk was seen in children and young adults ages 24 and younger taking the drug. The risk of this side effect is highest when you first start taking Prozac or when your dose of medication is increased.

It’s important to note that this risk was seen in people taking Prozac short-term. So, it’s not known if taking this drug long-term may still have this risk.

What you can do

Because of the risk of suicidal thoughts and behaviors, your doctor will likely recommend monitoring you throughout your treatment with Prozac. They may monitor you for increasing symptoms of depression, changes in behavior, or suicidal thoughts or behaviors. If you develop these symptoms, your doctor may recommend stopping Prozac and trying a different medication.

In addition, be sure to report any changes in mood to your doctor right away. Your doctor may also recommend that your family or loved ones watch for changes in behavior that may indicate worsening depression or suicidal thoughts or behaviors.

Sexual side effects

It’s possible for selective serotonin reuptake inhibitors (SSRIs), including Prozac, to cause sexual side effects. In fact, sexual side effects from Prozac were commonly reported in clinical trials of people taking the drug.

Examples of sexual side effects can include:

• decreased libido
• delayed or trouble with orgasm or ejaculation
• erectile dysfunction

What you can do

If you notice sexual side effects during your treatment with Prozac, talk with your doctor. They may be able to recommend ways to manage sexual side effects that you experience. For example, your doctor may recommend Viagra (sildenafil) to treat erectile dysfunction that you experience from Prozac treatment.

Headache

You may experience headaches from taking Prozac. Although headaches weren’t one of the most common side effects in clinical trials of Prozac, they may occur.

What you can do

Tell your doctor if you’re experiencing headaches during your treatment with Prozac. Although rare, it’s possible for headaches to be due to other side effects of Prozac, including low blood sodium levels or serotonin syndrome. Your doctor will be able to help you determine what’s causing your headaches to occur.

In some cases, your doctor may recommend taking an over-the-counter medication, such as Tylenol (acetaminophen) to treat your headaches. If you’re experiencing headaches during your treatment with Prozac, talk with your doctor.

Nausea

You may experience nausea from taking Prozac. In fact, nausea was one of the most common side effects reported in clinical trials of Prozac.

What you can do

If you experience nausea from taking Prozac, talk with your doctor or pharmacist. They may be able to recommend ways to decrease this side effect from occurring. For example, in some cases, taking a medication with food may decrease nausea that you experience.

Hair loss

It’s possible to have hair loss from taking Prozac. Although hair loss wasn’t a common side effect reported in clinical trials, it can occur.

What you can do

If you notice hair loss during your treatment with Prozac, talk with your doctor or pharmacist. They may be able to recommend ways to reduce this side effect from occurring. For example, they may recommend using an over-the-counter medication, such as Rogaine (minoxidil) to manage hair loss.

Allergic reaction

As with most drugs, Prozac can cause an allergic reaction in some people. However, it’s not clear whether this side effect occurred in clinical trials.

Symptoms can be mild or serious and can include:

• skin rash
• itching
• flushing
• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking Prozac. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

• Ask the tough question: “Are you considering suicide?”
• Listen to the person without judgment.
• Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
• Stay with the person until professional help arrives.
• Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Click here for more links and local resources.

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Before you start treatment with Prozac, be sure to tell your doctor about any medical conditions that you have. They can help determine if Prozac is safe for you.

Boxed warning: Increased risk of suicidal thoughts and behaviors

This drug has a boxed warning for increased risk of suicidal thoughts and behaviors. This is a serious warning from the Food and Drug Administration (FDA). For details, see the “Side effect specifics” section above.

Other precautions

Be sure to talk with your doctor about your health history before you take Prozac. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. These are considered drug-condition or drug-factor interactions. The conditions and factors to consider include:

Mood conditions. If you have any mood problems, such as bipolar disorder, tell your doctor before taking Prozac. In some cases, it’s possible for Prozac to increase the risk of manic episodes occurring in people with certain mood conditions. If you have a mood condition, your doctor can help determine whether Prozac is safe for you.

Seizures. If you have seizures, tell your doctor before taking Prozac. It’s possible for Prozac to increase your risk of seizures occurring. And, if you already have a seizure disorder, taking Prozac may raise your risk of having a seizure. If you have a seizure condition, your doctor can advise you on whether it’s safe for you to take Prozac.

Glaucoma. It’s possible for Prozac to increase the pressure in your eye, which can make glaucoma worse. So, if you have glaucoma, talk with your doctor to see whether Prozac is safe for you.

Heart conditions. If you have any heart problems, such as an arrhythmia, tell your doctor before taking Prozac. This medication can increase your risk of heart rhythm changes occurring. And, if you already have a heart condition, taking Prozac may make your condition worse. In this case, your doctor can help determine whether Prozac may be safe for you.

Bleeding conditions. Prozac may increase your risk of bleeding. If you have a bleeding condition, taking Prozac may make it even easier for you to bleed. Tell your doctor about any bleeding conditions that you have before taking Prozac.

Allergic reaction. If you’ve had an allergic reaction to Prozac or any of its ingredients, your doctor will likely not prescribe Prozac. Ask your doctor what other medications may be better options for you.

Liver problems. Prozac is removed from your body by your liver. If your liver isn’t functioning properly, it’s possible for Prozac to build up in your body. This can increase your risk of side effects from the drug. Talk with your doctor if you have liver problems before starting treatment. They may recommend a lower dose of Prozac for you.

Low electrolyte levels. Prozac may decrease sodium (salt) levels in your blood. If you have an electrolyte condition such as low blood sodium levels, taking Prozac may increase your risk of side effects. In addition, Prozac may increase your risk of developing a heart side effect such as increased heart rate if you have an electrolyte condition.

If you have low electrolyte levels talk with your doctor before starting treatment with Prozac. They’ll likely recommend managing your electrolyte levels before starting Prozac.

Older adults. It’s possible that older adults (age 65 years or older) taking Prozac may be at an increased risk of side effects, such as low blood sodium levels. If you’re an older adult, your doctor may monitor you more often for side effects while you’re taking Prozac.

Electroconvulsive therapy. It’s possible that if you receive electroconvulsive therapy (ECT) for treatment-resistant depression, you may be at an increased risk of seizures from taking Prozac. So, if you receive ECT, talk with your doctor to see whether it’s safe for you to take Prozac.

Diabetes. If you have diabetes, taking Prozac can cause changes in your blood sugar to occur. This may make your diabetes worse and can increase your risk of developing low blood sugar. Due to this risk, if you have diabetes, your doctor may recommend more frequent monitoring of your blood sugar while you’re taking Prozac.

Alcohol with Prozac

There aren’t any known interactions between Prozac and alcohol.

However, drinking alcohol while you’re taking Prozac may increase your risk of side effects from the drug. For example, both Prozac and alcohol may cause:

• nausea
• headache
• dizziness
• sleepiness

Talk with your doctor to see if it’s safe for you to drink alcohol while taking Prozac.

Pregnancy and breastfeeding while taking Prozac

It may not be safe to take Prozac during pregnancy or while breastfeeding.

Selective serotonin reuptake inhibitors (SSRIs), including Prozac, may increase the risk of certain developmental problems. These can include difficulty breathing, trouble feeding, or irritability. In addition, the drug may increase the risk of pulmonary hypertension (high pressure in the lungs) in a newborn.

At this time, it’s not known if Prozac may increase the risk of congenital anomalies (commonly known as birth defects). There’s currently a pregnancy registry for antidepressant drugs, such as Prozac. The purpose of a pregnancy registry is to collect information on the risks of taking a drug during pregnancy. You can sign up for the registry online or by calling 844-405-6185.

In addition, it’s important to note that untreated depression may also have effects on a developing fetus. So, if you’re pregnant or planning to become pregnant, talk with your doctor before taking Prozac. They can help determine what the best treatment plan is for you.

Prozac can pass into breast milk, so a breastfeeding baby can be exposed to the drug. Babies exposed to Prozac may experience side effects such as agitation, irritability, and trouble feeding.

If you’d like to breastfeed while taking Prozac, talk with your doctor. They can help determine if breastfeeding may be safe for your baby.

Side effects with Prozac may occur, but they’re usually mild. However, it’s also possible for this drug to cause serious side effects.

If you’d like to learn more about Prozac, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from taking the drug.

Besides talking with your doctor, you can do some research on your own. These articles might help:

• More information about Prozac. For details about other aspects of Prozac, refer to this article.
• Drug comparison. Learn how Prozac compares with Zoloft and Lexapro.
• A look at your condition. For details about your condition, see our mental health hub.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or 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.

Side effects and how to manage them

Prozac (fluoxetine) is a brand-name prescription medication. The Food and Drug Administration (FDA) has approved it to treat the following conditions in adults:

• major depressive disorder (MDD)
• obsessive compulsive disorder (OCD)
• bulimia nervosa
• panic disorder with or without agoraphobia

In addition, Prozac can also be used in combination with olanzapine (Zyprexa) to treat the following conditions in adults:

• depression related to bipolar disorder
• depression if other medications aren’t working for you

Prozac can also be used in certain children with MDD, OCD, or in combination with olanzapine for depression related to bipolar disorder.

Here are some fast facts about Prozac:

• Active ingredient: fluoxetine
• Drug class: selective serotonin reuptake inhibitor (SSRI)
• Drug form: oral capsule

In most cases, if Prozac works for you, your doctor will recommend taking it long-term. However, in some cases, your doctor may recommend short-term treatment. Before you start Prozac, your doctor will discuss your treatment plan with you.

As with other drugs, Prozac can cause side effects. Read on to learn about potential common, mild, and serious side effects. For a general overview of Prozac, including details about its uses, see this article.

Prozac can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took Prozac in clinical trials:

• abnormal dreams
• anxiety
• diarrhea
• dry mouth
• weakness
• sexual side effects, such as decreased libido*

* For more information about this side effect, see “Side effect specifics” below.

Mild side effects can occur with Prozac use. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Prozac’s prescribing information.

Mild side effects that have been reported with Prozac include:

• anxiety
• diarrhea
• dry mouth
• weakness
• heartburn
• flu-like symptoms
• insomnia
• nervousness
• rash
• sleepiness
• dizziness
• sweating
• tremor
• loss of appetite, which can lead to weight loss
• sexual side effects, such as decreased libido*
• nausea*
• headache*
• hair loss*
• mild allergic reaction*

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Prozac and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see “Side effect specifics” below.

Prozac may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Prozac’s prescribing information.

If you develop serious side effects while taking Prozac, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

• Serotonin syndrome (a buildup of serotonin in your body). Symptoms can include:
  • confusion
  • fast heartbeat
  • rigid or twitching muscles
  • headache
• Bleeding. Symptoms can include:
  • bruising easier than usual
  • nosebleeds
  • black, tarry stool
  • abdominal pain
• Glaucoma. Symptoms can include:
  • headache
  • blurry vision
  • nausea or vomiting
• Seizures. Symptoms can include:
  • uncontrolled movements of the arms or legs
  • unconsciousness
  • confusion
• Low blood sodium levels. Symptoms can include:
  • nausea or vomiting
  • headache
  • seizures
• Heart rhythm changes, such as QT prolongation. Symptoms can include:
  • dizziness
  • heart palpitations
  • fainting
• Mania (episodes of unusually high energy that affects your mood and behavior). Symptoms can include:
  • agitation (feeling annoyed or restless)
  • hallucinations
  • racing thoughts
• Increased risk of suicidal thoughts and behaviors in certain people.*
• Severe allergic reaction.†

* Prozac has a boxed warning for this side effect. This is a serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effect specifics” section below.
†An allergic reaction is possible after using Prozac. However, it’s not clear whether this side effect occurred in clinical trials. To learn more, see the “Side effect specifics” section below.

Prozac is approved to treat certain children and adults. However, the drug has a boxed warning for the risk of for the risk of suicidal thoughts and behaviors in certain people. Boxed warnings are the most serious warnings recommended by the FDA. The purpose of a boxed warning is to make patients and doctors aware of the risk of taking a medication.

Specifically, Prozac may increase the risk of suicidal thoughts and behaviors in children or young adults taking the drug. For more information on this warning, see the “Side effects specifics” section below.

Prozac is approved to treat the following conditions in children:

• ages 8 and older with major depressive disorder (MDD)
• ages 7 and older with obsessive-compulsive disorder (OCD)
• ages 10 and older with depression related to bipolar disorder

In most cases, children taking Prozac reported the same side effects that adults taking the drug experienced. Prozac side effects in teens were also usually the same as the side effects in adults. However, children taking Prozac may experience other side effects, such as feeling thirsty, muscle spasms, or urinary frequency.

In addition, it’s not known if the drug may have long-term effects on the growth or development of children. So, doctors may monitor your child’s height and weight to be sure that they’re growing as they should be while taking Prozac.

If you have concerns about side effects that your child may experience from taking Prozac, talk with their doctor.

You shouldn’t experience weight gain from taking Prozac. Weight gain wasn’t reported in clinical trials of people taking this drug.

In fact, weight loss was actually a side effect of this medication in clinical trials. This may be because Prozac can cause a decrease in appetite, which may lead to weight loss.

However, it’s possible for depression to cause weight gain to occur. Prozac can be used to treat depression.

So, if you notice weight gain during your treatment with Prozac, talk with your doctor. They can help you determine what may be causing the weight gain to occur. In addition, they may be able to recommend ways to help manage your weight.

Often, females* and males* taking Prozac will experience similar side effects. However, it’s possible for sexual side effects to occur from taking Prozac. Sexual side effects may differ between females and males.

For example, in males, Prozac may cause a decreased libido, erectile dysfunction, or a delay or trouble ejaculating. However, in females, this drug may decrease libido or cause a delay in orgasm.

For more information on sexual side effects that Prozac may cause, see the “Side effect details” section below.

* Sex and gender exist on spectrums. Use of the terms “female” and “male” in this article refers to sex assigned at birth.

Prozac may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

Does stopping Prozac treatment cause withdrawal symptoms?

Yes, it’s possible that stopping treatment with Prozac may cause withdrawal symptoms to occur. Withdrawal symptoms are symptoms that can happen when your body is used to taking a medication that you suddenly stop taking.

Some examples of withdrawal symptoms that may occur from stopping Prozac include:

• mood changes, such as irritability or agitation
• dizziness
• tingling of the arms or legs
• confusion
• headache
• insomnia

Because of these side effects, be sure to talk with your doctor before stopping treatment with Prozac. They’ll likely recommend slowly decreasing your dose of Prozac so that your body can adjust to the change.

If you’re interested in stopping treatment with Prozac, talk with your doctor about the safest way to do so.

What are the long-term side effects of Prozac?

Although uncommon, it’s possible for Prozac to cause long-term side effects to occur. Examples of long-term side effects that Prozac may cause include glaucoma, seizures, or hair loss.

If you’re concerned about long-term side effects from Prozac, talk with your doctor or pharmacist. They can discuss the risk of side effects with you and ways to help prevent side effects from occurring.

Are there side effects with a low dose of Prozac?

Yes, it’s possible to experience side effects if you take a low dose of Prozac. This drug is available in 10 milligram (mg), 20 mg, or 40 mg capsules. Taking even a low dose of Prozac may cause side effects to occur.

The lowest dose of Prozac that your doctor may prescribe for you is 10 mg. And, although higher doses of Prozac may have a higher risk of side effects, you still may experience side effects from lower doses.

If you’re concerned about side effects that you may experience from Prozac, talk with your doctor or pharmacist. They may be able to help recommend ways to reduce side effects that you experience. For example, if you’re concerned about Prozac 20 mg side effects, your doctor or pharmacist may be able to recommend ways to reduce side effects from occurring.

Prozac doesn’t have a high risk for misuse. Misuse of a drug means using it in a way that’s different than how the drug was prescribed to you. Misusing a drug may increase your risk of serious side effects and overdose.

However, even though Prozac isn’t commonly misused, stopping the drug suddenly may cause withdrawal symptoms. Withdrawal symptoms can happen if your body is used to a medication that you suddenly stop taking.

To learn more about withdrawal symptoms that may occur from Prozac, see the “FAQs about the side effects of Prozac” section above.

Learn more about some of the side effects that Prozac may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Prozac.

Increased risk of suicidal thoughts and behaviors

It’s possible for Prozac to increase the risk of suicidal thoughts and behaviors in certain people. In fact, Prozac has a boxed warning for this risk. A boxed warning is the most serious warning recommended by the FDA. The purpose of a boxed warning is to alert doctors and patients about the risks of taking a medication.

Antidepressants, including Prozac, have a boxed warning for the risk of suicidal thoughts and behaviors. This risk was seen in children and young adults ages 24 and younger taking the drug. The risk of this side effect is highest when you first start taking Prozac or when your dose of medication is increased.

It’s important to note that this risk was seen in people taking Prozac short-term. So, it’s not known if taking this drug long-term may still have this risk.

What you can do

Because of the risk of suicidal thoughts and behaviors, your doctor will likely recommend monitoring you throughout your treatment with Prozac. They may monitor you for increasing symptoms of depression, changes in behavior, or suicidal thoughts or behaviors. If you develop these symptoms, your doctor may recommend stopping Prozac and trying a different medication.

In addition, be sure to report any changes in mood to your doctor right away. Your doctor may also recommend that your family or loved ones watch for changes in behavior that may indicate worsening depression or suicidal thoughts or behaviors.

Sexual side effects

It’s possible for selective serotonin reuptake inhibitors (SSRIs), including Prozac, to cause sexual side effects. In fact, sexual side effects from Prozac were commonly reported in clinical trials of people taking the drug.

Examples of sexual side effects can include:

• decreased libido
• delayed or trouble with orgasm or ejaculation
• erectile dysfunction

What you can do

If you notice sexual side effects during your treatment with Prozac, talk with your doctor. They may be able to recommend ways to manage sexual side effects that you experience. For example, your doctor may recommend Viagra (sildenafil) to treat erectile dysfunction that you experience from Prozac treatment.

Headache

You may experience headaches from taking Prozac. Although headaches weren’t one of the most common side effects in clinical trials of Prozac, they may occur.

What you can do

Tell your doctor if you’re experiencing headaches during your treatment with Prozac. Although rare, it’s possible for headaches to be due to other side effects of Prozac, including low blood sodium levels or serotonin syndrome. Your doctor will be able to help you determine what’s causing your headaches to occur.

In some cases, your doctor may recommend taking an over-the-counter medication, such as Tylenol (acetaminophen) to treat your headaches. If you’re experiencing headaches during your treatment with Prozac, talk with your doctor.

Nausea

You may experience nausea from taking Prozac. In fact, nausea was one of the most common side effects reported in clinical trials of Prozac.

What you can do

If you experience nausea from taking Prozac, talk with your doctor or pharmacist. They may be able to recommend ways to decrease this side effect from occurring. For example, in some cases, taking a medication with food may decrease nausea that you experience.

Hair loss

It’s possible to have hair loss from taking Prozac. Although hair loss wasn’t a common side effect reported in clinical trials, it can occur.

What you can do

If you notice hair loss during your treatment with Prozac, talk with your doctor or pharmacist. They may be able to recommend ways to reduce this side effect from occurring. For example, they may recommend using an over-the-counter medication, such as Rogaine (minoxidil) to manage hair loss.

Allergic reaction

As with most drugs, Prozac can cause an allergic reaction in some people. However, it’s not clear whether this side effect occurred in clinical trials.

Symptoms can be mild or serious and can include:

• skin rash
• itching
• flushing
• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking Prozac. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

• Ask the tough question: “Are you considering suicide?”
• Listen to the person without judgment.
• Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
• Stay with the person until professional help arrives.
• Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Click here for more links and local resources.

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Before you start treatment with Prozac, be sure to tell your doctor about any medical conditions that you have. They can help determine if Prozac is safe for you.

Boxed warning: Increased risk of suicidal thoughts and behaviors

This drug has a boxed warning for increased risk of suicidal thoughts and behaviors. This is a serious warning from the Food and Drug Administration (FDA). For details, see the “Side effect specifics” section above.

Other precautions

Be sure to talk with your doctor about your health history before you take Prozac. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. These are considered drug-condition or drug-factor interactions. The conditions and factors to consider include:

Mood conditions. If you have any mood problems, such as bipolar disorder, tell your doctor before taking Prozac. In some cases, it’s possible for Prozac to increase the risk of manic episodes occurring in people with certain mood conditions. If you have a mood condition, your doctor can help determine whether Prozac is safe for you.

Seizures. If you have seizures, tell your doctor before taking Prozac. It’s possible for Prozac to increase your risk of seizures occurring. And, if you already have a seizure disorder, taking Prozac may raise your risk of having a seizure. If you have a seizure condition, your doctor can advise you on whether it’s safe for you to take Prozac.

Glaucoma. It’s possible for Prozac to increase the pressure in your eye, which can make glaucoma worse. So, if you have glaucoma, talk with your doctor to see whether Prozac is safe for you.

Heart conditions. If you have any heart problems, such as an arrhythmia, tell your doctor before taking Prozac. This medication can increase your risk of heart rhythm changes occurring. And, if you already have a heart condition, taking Prozac may make your condition worse. In this case, your doctor can help determine whether Prozac may be safe for you.

Bleeding conditions. Prozac may increase your risk of bleeding. If you have a bleeding condition, taking Prozac may make it even easier for you to bleed. Tell your doctor about any bleeding conditions that you have before taking Prozac.

Allergic reaction. If you’ve had an allergic reaction to Prozac or any of its ingredients, your doctor will likely not prescribe Prozac. Ask your doctor what other medications may be better options for you.

Liver problems. Prozac is removed from your body by your liver. If your liver isn’t functioning properly, it’s possible for Prozac to build up in your body. This can increase your risk of side effects from the drug. Talk with your doctor if you have liver problems before starting treatment. They may recommend a lower dose of Prozac for you.

Low electrolyte levels. Prozac may decrease sodium (salt) levels in your blood. If you have an electrolyte condition such as low blood sodium levels, taking Prozac may increase your risk of side effects. In addition, Prozac may increase your risk of developing a heart side effect such as increased heart rate if you have an electrolyte condition.

If you have low electrolyte levels talk with your doctor before starting treatment with Prozac. They’ll likely recommend managing your electrolyte levels before starting Prozac.

Older adults. It’s possible that older adults (age 65 years or older) taking Prozac may be at an increased risk of side effects, such as low blood sodium levels. If you’re an older adult, your doctor may monitor you more often for side effects while you’re taking Prozac.

Electroconvulsive therapy. It’s possible that if you receive electroconvulsive therapy (ECT) for treatment-resistant depression, you may be at an increased risk of seizures from taking Prozac. So, if you receive ECT, talk with your doctor to see whether it’s safe for you to take Prozac.

Diabetes. If you have diabetes, taking Prozac can cause changes in your blood sugar to occur. This may make your diabetes worse and can increase your risk of developing low blood sugar. Due to this risk, if you have diabetes, your doctor may recommend more frequent monitoring of your blood sugar while you’re taking Prozac.

Alcohol with Prozac

There aren’t any known interactions between Prozac and alcohol.

However, drinking alcohol while you’re taking Prozac may increase your risk of side effects from the drug. For example, both Prozac and alcohol may cause:

• nausea
• headache
• dizziness
• sleepiness

Talk with your doctor to see if it’s safe for you to drink alcohol while taking Prozac.

Pregnancy and breastfeeding while taking Prozac

It may not be safe to take Prozac during pregnancy or while breastfeeding.

Selective serotonin reuptake inhibitors (SSRIs), including Prozac, may increase the risk of certain developmental problems. These can include difficulty breathing, trouble feeding, or irritability. In addition, the drug may increase the risk of pulmonary hypertension (high pressure in the lungs) in a newborn.

At this time, it’s not known if Prozac may increase the risk of congenital anomalies (commonly known as birth defects). There’s currently a pregnancy registry for antidepressant drugs, such as Prozac. The purpose of a pregnancy registry is to collect information on the risks of taking a drug during pregnancy. You can sign up for the registry online or by calling 844-405-6185.

In addition, it’s important to note that untreated depression may also have effects on a developing fetus. So, if you’re pregnant or planning to become pregnant, talk with your doctor before taking Prozac. They can help determine what the best treatment plan is for you.

Prozac can pass into breast milk, so a breastfeeding baby can be exposed to the drug. Babies exposed to Prozac may experience side effects such as agitation, irritability, and trouble feeding.

If you’d like to breastfeed while taking Prozac, talk with your doctor. They can help determine if breastfeeding may be safe for your baby.

Side effects with Prozac may occur, but they’re usually mild. However, it’s also possible for this drug to cause serious side effects.

If you’d like to learn more about Prozac, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from taking the drug.

Besides talking with your doctor, you can do some research on your own. These articles might help:

• More information about Prozac. For details about other aspects of Prozac, refer to this article.
• Drug comparison. Learn how Prozac compares with Zoloft and Lexapro.
• A look at your condition. For details about your condition, see our mental health hub.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or 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.

Comparative study of the effectiveness of combinations of SSRI antidepressants and antipsychotics in the treatment of recurrent depressive disorder

The relevance of the problem of treating depressive disorders, despite the growing number of antidepressants, remains to this day, since their diversity does not remove the question of the presence of therapeutic resistance in some cases [4 ]. Thus, according to the literature [6, 9, 10, 21], the number of therapeutically resistant cases is 30.0%. Incomplete exit from depression is associated with an increase in the risk of relapses, suicides, a decrease in social functioning, the appearance of comorbid somatic disorders, and, finally, with chronic depression. In this regard, in recent years, a combination of new antidepressants with atypical neuroleptics, which in some cases themselves have antidepressant properties, has been increasingly used.

In a number of studies [1, 7, 11, 14, 16, 20, 24, 25, 27, 28] the combination of fluoxetine and olanzapine has been successfully used in the treatment of depression. The combination of sertraline and amisulpride has also been successfully used [8]. It was found [19] that with combined therapy

antidepressants and antipsychotics quickly come positive changes, recorded on the following points of the Hamilton Depression Scale (HAM-D-17): anxiety, depressed mood, guilt, decreased performance and activity.

However, according to some researchers [18], the addition of atypical neuroleptics to antidepressants increases the risk of adverse events. Thus, the combined use of fluoxetine and olanzapine can lead to the risk of weight gain, increased levels of prolactin and cholesterol [9], as well as to the development of metabolic syndrome, drowsiness, dry mouth, increased appetite, and headache [12]. Other authors [13] draw attention to the “bad” combination of sertraline and amisulpride in a patient with severe depression against the background of organic brain damage: the patient had an intensified cognitive deficit and developed severe hypotension. But in some cases, the simultaneous use of selective serotonin reuptake inhibitors (SSRIs) and atypical neuroleptics alleviates the adverse effects of drugs [22]. It was also pointed out [23] to the “unique effect” of weight loss when combined with SSRIs and atypical antipsychotics.

A number of researchers [17, 26] draw attention to the fact that the long-term effects of combination therapy with new generation antidepressants and atypical antipsychotics have not yet been sufficiently studied.

The purpose of this study is to conduct a comparative evaluation of the effectiveness of two options for combining SSRI antidepressants with atypical neuroleptics: Prozac-Zyprexa and Stimlaton-Solyan in the treatment of depression developing in the structure of recurrent depressive disorder.

Material and methods

We examined 63 patients aged 18 to 40 years (mean – 34.0±0.42 years) with recurrent depressive disorders (mean disease duration – 4.1±1.35 years).

All patients were divided into 2 groups: the 1st was treated with Prozac (40 mg per day) and Zyprexa (10-15 mg per day) – 30 people; 2nd group – stimulatone (100-150 mg per day) and Solian (50-150 mg per day) – 33 patients.

Patients with organic lesion of the central nervous system, severe somatic diseases, abusing alcohol and other psychoactive substances, pregnant and lactating women were excluded from the study. Patients were selected who did not receive treatment for the depressive disorder studied.

Clinical examination of patients was supplemented by the study of medical documents relating to previous periods of the disease.

Severe depressive episodes without psychotic symptoms occurred in 32 patients, moderate ones with somatic symptoms – in 31. Their structural characteristics were represented by simple melancholic (34 people – 53.97%), polymorphic (21 – 33.33%), depersonalization ( 8 – 12.7%) depressions. The dominant affect in all was melancholy, which periodically for a short time could be replaced by anxiety (29patients – 46.03%), at the height of which 11 (17.46%) patients developed rudiments of panic attacks without the formation of agoraphobia. The rudiments of panic attacks included 2-3 (out of 13) symptoms and were characterized by palpitations, dizziness with a feeling of weakness, a feeling of lack of air, a lump in the throat. Polymorphic depressive disorders included, in addition to the main and additional symptoms, obsessions, phobias, sensory hypochondria, depersonalization (in the form of an unusual perception of one’s own “I” or a sense of unreality in the perception of the surrounding world). The depersonalization variant is represented mainly by pronounced hypopathic depersonalization (a feeling of experienced insensitivity, a hypopathic variant of derealization and alienation of vital feelings). In each analyzed group, the distribution of patients depending on the structure of depression was approximately the same. Depth of depression was somewhat greater with Prozac and Zyprexa.

Clinical diagnosis of depression was supplemented by an assessment on the HAM-D scale (17 points). A side effect scale was also used. The scales were completed before the start of treatment, on the 10th, 20th and 40th days of active treatment. By the 40th day, the HAM-D result was assessed as “very good” (0-5 points), “good” (6-10 points), “satisfactory” (over 10 points, but a decrease in the number of points compared to baseline by 50% or more), “unsatisfactory” (over 10 points, but a decrease in the number of points compared to the original by less than 50%). The side effects scale contained 19symptoms, assessed on a 5-point system (0-4) depending on severity. They were: dry mouth, constipation, dizziness, tremor, disturbance of accommodation, anxiety, drowsiness, insomnia, nausea, dyspepsia, headache, hypotension, including orthostatic, urinary disorders, tachycardia, sweating, fainting, skin itching, rash, muscle pain.

The results of the assessment on the HAM-D scale before treatment, on the 10th, 20th and 40th days of therapy were subjected to statistical processing according to the Student’s method, in addition, standard statistical indicators were used: mean value, standard error.

Results and discussion

When using the combination of Prozac and Zyprexa, out of 30 patients, 3 (10.0%) dropped out due to the appearance of adverse events. One patient (hypopathic depression, second episode) refused to take drugs due to the appearance of severe weakness, drowsiness, dizziness, and a decrease in blood pressure to 100/70 mm Hg, which was not characteristic of him before taking the drugs. This happened on the 6th day of therapy, with a dose of Prozac 40 mg, Zyprexa – 10 mg. In 2 other patients (3-4 points) there was an increase in anxiety, internal agitation, the appearance of early and moderate insomnia, moderate psychomotor agitation (on the 5th and 6th days of therapy at a dose of 40 mg of Prozac and 10 mg of Zyprexa). Both patients had polymorphic depression, the second and third episodes.

In general, side effects that did not require discontinuation of drugs were detected in 17 (56.7%) patients taking Prozac and Zyprexa. They were not pronounced and persistent (1-2 points), were determined mainly during targeted questioning, passed independently and were characterized in 5 (16.7%) patients by a slight increase in anxiety and internal tension, which in 3 (10.0%) patients was combined with headache; in 4 (13.3%) patients – increased sleep disturbances, in 7 (23.3%) – headache with nausea, in 1 (3.33%) – nausea and dyspepsia.

When using a combination of stimulaton and solian, out of 33 patients who received this combination, 3 (9. 09%) also dropped out due to adverse events. Cancellation of drugs, in contrast to taking Prozac and Zyprexa, was made not on the 1st week of therapy, but on the 20th, 34th and 36th days of admission. The reason for the cancellation was breast engorgement with galactorrhea, headache (4 points). All three women had severe melancholic depression, two with a disease duration of more than 10 years (5th and 6th episodes), the third had a disease duration of 5 years (episode 3). Side effects that did not require discontinuation occurred at 9(27.27%) cases (1-2 points). Basically, they were: unexpressed galactorrhea (4 patients – 12.12%), increased drowsiness and weakness during the day (2 – 6.06%), subfebrile condition (2 – 6.06%), weight gain (1 – 3.03 %). Galactorrhea appeared on the 10th (2 patients) or after the 20th day of taking the combination of drugs and continued until the end of the study, did not increase and did not disturb the patients. Increased drowsiness and weakness occurred in one patient by the 10th day and disappeared by the end of the 1st month, in the second patient – by the end of the observation (on the 35th day of therapy). Subfebrile condition without any particular fluctuations during the day (37.1-37.3 °C) was determined in 2 women, not accompanied by any other disorders, and lasted 5-7 days. In some cases, there was an increase in body weight of 5 kg by the end of the study, but this occurred without a noticeable increase in appetite.

When compared with earlier results with Prozac or stimulaton monotherapy [1, 2, 5, 15, 16], it appears that adding a second drug to both Prozac and stimulaton slightly increases ( p ≤0.05) the incidence of serious adverse events. effects (in the treatment with Prozac: monotherapy – 6.2%, bitherapy – 10.0%; in the treatment with stimulatone, respectively: 7.14% – 9.09%). The combination of an antidepressant with an antipsychotic, which does not require discontinuation, in the first case compared to Prozac monotherapy, in the second, compared to stimulaton monotherapy, also gave a slightly higher percentage ( p ≤0.05) adverse events (20.0% vs. 16. 5% and 33.3% vs. 27.7%). Therefore, the addition of antipsychotics (Zyprexa, Solian) to antidepressants of the SSRI group (Prozac, stimulatone) slightly increases the number of adverse events, both serious and not requiring withdrawal.

According to the HAM-D scale, the initial depth of depression in patients treated with Prozac and Zyprexa was 31.7 points, stimulaton and Solian – 26.09 points; on the 10th day of therapy – 22.2 and 17.19, respectivelypoints; on the 20th day – 15.8 and 12.56 points; on the 40th day – 9.8 and 7.63 points (see table, Fig. 1) .

On the 40th day of treatment (Fig. 2) with Prozac and Zyprexa, a “very good” result was detected in 33.33% of cases (10 patients), “good” – in 36.67% (11), “satisfactory” – in 16.67% (5), “unsatisfactory” – in 3.33% (1), cancellation was made in 10.0% (3 cases). Figure 2. The effect of combination therapy on the 40th day of observation. The number of responders was 86.67%. During therapy with stimulatone and soliane, by the 40th day, a “very good” result was recorded in 30. 3% of cases (10 patients), “good” – in 42.42% (14), “satisfactory” – in 12.12% ( 4), “unsatisfactory” – in 6.06% (2), cancellation was at 9.9% (3). The number of responders was 84.84%.

With both combinations of drugs, there is a fairly uniform weakening of depression. In the group of patients treated with Prozac and Zyprexa, the HAM-D score was significantly higher ( p <0.05) at baseline. This difference persisted on the 10th and 20th day of observation ( p <0.05) and disappeared only by the 40th day, which indicates a slightly better effect with the combination of Prozac and Zyprexa. By the 40th day of treatment, a “very good” result was observed with approximately equal frequency, “good” was significantly more common with the combination of stimulaton and solian, “satisfactory”, on the contrary, was less common with this combination.

When comparing the results of the study with previously obtained results [3, 5], it is clear that the combination of drugs causes a faster effect (already by the 10th day of observation) than with Prozac or Stimuton monotherapy (by the 20th day of observation). In addition, the overall effectiveness of therapy is higher.

When comparing the individual symptoms of the HAM-D scale (see table) in both groups before treatment, the following picture is revealed: patients who took the combination of Prozac and Zyprexa initially had significantly more pronounced feelings of guilt, early and moderate insomnia, speech delay and decreased ability to concentrate, somatic anxiety, hypochondria, decreased criticality. It was these symptoms that accounted for the higher baseline HAM-D scores in the Prozac and Zyprexa group.

By the 10th day of therapy (see table) , a significant decrease in the symptoms of depression in patients of both groups occurred only on 3 points: depressive mood, suicidal thoughts and slowing of thinking and speech with impaired ability to concentrate. The attenuation of the last item was more significant with the combination of Prozac and Zyprexa. In addition, this combination significantly reduced feelings of guilt, intrasomnic disorders, somatic anxiety and hypochondria. They were initially higher than in the stimulatone-solian group, and by the 10th day, the difference in performance between the groups became unreliable. Treatment with stimulatone and soliane significantly reduced early and late insomnia, gastrointestinal somatic symptoms, and weight loss, while the combination therapy with Prozac and Zyprexa did not significantly reduce these depressive symptoms. In general, in both groups, a significant decrease in severity by the 10th day of treatment was not observed for the following items: working capacity and activity, anxiety with episodes of anxiety (were mildly expressed even before treatment), a feeling of loss of energy with a feeling of heaviness in the limbs, head, genital symptoms , criticality to the disease.

By the 20th day of therapy (see table) compared with the 10th day in both groups, the severity of late insomnia and decreased performance, activity significantly weakened; in the group of patients treated with Prozac and Zyprexa – feelings of guilt, suicidal thoughts, early insomnia, impaired ability to concentrate and thought retardation, anxiety, gastrointestinal somatic disorders, weight loss; in the group of patients treated with stimulaton and solian, the actual depressive mood decreased to a greater extent.

On the 40th day of treatment in both groups, when compared with the 20th day of therapy, the lowered mood continued to significantly weaken. In the group of patients taking Prozac and Zyprexa, the feeling of guilt, suicidal thoughts, middle and late insomnia, decreased sense of efficiency and activity continued to decrease significantly. In the treatment with stimulatone and soliane, the symptom of depressed mood was significantly weakened. In general, a comparative analysis of the HAM-D scores on the 40th day between the groups did not reveal significant differences in symptoms, which ultimately resulted in the absence of a total difference in scores – 9.8 (Prozac and Zyprexa) and 7.63 (Stimulaton and Solian).

Therefore, at each of the stages of the study, a peculiar dynamics of the weakening of depressive symptoms was revealed, depending on the type of combination therapy. More evenly, with significant significance in both groups, the manifestations of depressive mood weakened. Other symptoms could weaken significantly on the 10th and 20th days in one group or another, but by the 40th day of observation, the results were almost leveled.

Thus, with both studied combinations of drugs at all stages of the study, a uniform weakening of depression occurred, which was significantly significant already by the 10th day of observation. In the treatment with Prozac and Zyprexa, a significantly higher baseline score before treatment persisted by the 10th and 20th days and leveled off by the 40th day, which could indirectly indicate a slightly higher effectiveness of this combination by the end of the study.

The addition of antipsychotics (Zyprexa, Solian) to SSRI antidepressants (Prozac, stimulatone) slightly increases the number of adverse events (both serious and not requiring withdrawal).

Fluoxetine: Pediatric Medication | Memorial Sloan Kettering Cancer Center

Pediatric Medicine

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Provided by Lexicomp ^® , this document contains all the information you need to know about this medicine, including indications, directions for use, side effects, and when your healthcare provider should be contacted.

Trade names: USA

PROzac; Sarafem [DSC]

Brand names: Canada

ACH-FLUoxetine; ACT FLUoxetine [DSC]; AG-Fluoxetine; APO-FLUoxetine; Auro-FLUoxetine; BIO-FLUoxetine; DOM-FLUoxetine; JAMP-FLUoxetine; M-FLUoxetine; MINT-FLUoxetine; NRA-Fluoxetine; Odan-FLUoxetine; PMS-FLUoxetine; PRIVA-FLUoxetine [DSC]; PRO-FLUoxetine; PROzac; RIVA-FLUoxetine; SANDOZ FLUoxetine [DSC]; TEVA-FLUoxetine; VAN-FLUoxetine [DSC]

Warning

• Drugs like this have increased the likelihood of suicidal thoughts or actions in children and young people. This risk may be higher in people who have tried or had suicidal thoughts in the past. All people taking this drug must be closely monitored. If you develop or worsen disorders such as depression, nervousness, anxiety, grouchiness, panic attacks, and changes in mood or behavior, contact your doctor immediately. Contact your doctor immediately if you have suicidal thoughts or suicide attempts.
• This drug is not approved for use in children of all ages. Check with your doctor to make sure this drug is right for your child.

What is this drug used for?

• Used to treat depression.
• It is used to treat obsessive-compulsive disorder.
• It is used to treat emotional lability in women in the premenstrual period.
• Used to treat eating disorders.
• Used to treat panic attacks.
• This drug can be given to children for other indications. Consult your doctor.

What do I need to tell the doctor BEFORE my child takes this drug?

• If your child has an allergy to this drug, any of its ingredients, other drugs, foods, or substances. Tell the doctor about the allergy and how it manifested itself in the child.
• If your child is taking any of these drugs: Linezolid, methylene blue, pimozide, or thioridazine.
• If your child has taken medications for depression or certain other illnesses in the last 14 days. These include isocarboxazid, phenelzine, and tranylcypromine. An episode of very high blood pressure may occur.
• If your child is taking any medicines that can cause a certain type of abnormal heart rhythm (QT interval prolongation). There are many drugs that can have this effect. If in doubt, consult your doctor or pharmacist.

This list of drugs and conditions that may interact with this drug is not exhaustive.

Talk to your doctor or pharmacist about all medicines your child is taking (prescription and over-the-counter, natural, and vitamins) and any health problems. You need to make sure that this drug is safe to use for your child’s illnesses and in combination with other drugs he or she is already taking. Do not start, stop taking, or change the dosage of any drug your child is taking without the doctor’s approval.

What do I need to know or do while my child is taking this drug?

• Tell all health care providers who care for your child that your child is taking this drug. These are your child’s doctors, nurses, pharmacists and dentists.
• Have your child avoid tasks or activities that require attention until you see how this drug works for your child. This includes cycling, playing sports, or using items such as scissors, lawn mowers, electric scooters, toy cars, or motorized vehicles.
• Do not stop giving this drug to your child abruptly without talking to the doctor. This can increase your child’s risk of side effects. If needed, this drug should be stopped gradually for your child as directed by the doctor.
• Alcohol can interact with this drug. Make sure your child does not drink alcohol.
• Check with your child’s doctor before using marijuana, other forms of cannabis, or prescription or over-the-counter drugs that may slow your child’s progress.
• If your child has high blood glucose (diabetes), check the child’s blood glucose regularly.
• It may take several weeks to achieve full effect.
• This drug may increase the risk of bleeding. Sometimes bleeding can be life-threatening. Consult your doctor.
• Some patients may be at increased risk of eye problems when using this drug. Your child’s doctor may order an eye examination to see if your child is at increased risk for these eye problems. Call your doctor right away if your child has eye pain, vision changes, swelling, or redness around the eye.
• This drug may cause low sodium levels. Very low sodium levels can be life-threatening, leading to convulsions, fainting, difficulty breathing, or death.
• In some cases, the drug may affect the growth rate in children and adolescents. They may need regular growth rate checks. Consult your doctor.

If your daughter is pregnant or breastfeeding:

• Consult physician if your daughter is pregnant, pregnant, or breastfeeding. The benefits and risks for your daughter and her baby will need to be discussed.
• Taking this drug during the third trimester of pregnancy may cause some health problems in the newborn. Consult your doctor.

What side effects should I report to my child’s doctor right away?

WARNING/CAUTION: Although rare, some people may have very serious and sometimes deadly side effects of this drug. Call your child’s doctor right away or get medical help if your child has any of the following signs or symptoms that could be associated with a very bad side effect:

• Signs of an allergic reaction, such as rash, hives, itching, red and swollen skin with blisters or peeling, possibly accompanied by fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue or throat.
• Signs of low sodium levels such as headache, trouble concentrating, memory impairment, confused thinking, weakness, seizures, problems with balance.
• Seizures.
• Significant weight gain or loss.
• Dizziness.
• Bradycardia.
• Any unexplained bruising or bleeding.
• Anxiety.
• Unusual thirst.
• Frequent urination.
• With problems in controlling body movements.
• Joint pain.
• Swelling of the gland.
• Painful erections or erections that last more than 4 hours.
• A severe and sometimes deadly complication called serotonin syndrome can occur. This risk may be increased if the child is also taking certain other drugs. Call your child’s healthcare provider right away if your child has agitation, balance problems, confusion, hallucinations, high fever, tachycardia or abnormal heart rhythm, flushing, muscle twitching or stiffness, seizures, tremors or tremors, excessive sweating, severe diarrhea, nausea or vomiting, a very severe headache.
• Rarely, severe and sometimes fatal reactions accompanied by a rash have been reported with this drug. Lung, kidney, or liver problems have also occurred. Call your doctor right away if your child has signs such as changes in urine output, dark urine, decreased appetite, nausea or abdominal pain, light-colored stools, vomiting, yellow skin or eyes, or shortness of breath.
• A type of abnormal heart rhythm (QT prolongation) has happened with this drug. Sometimes it caused another type of heart rhythm disturbance (polymorphic ventricular tachycardia of the “pirouette” type). Call your doctor right away if your child has tachycardia, abnormal heart rhythms, or fainting.

If your daughter has her period:

• Menstrual disorders.

If your child is or may be sexually active:

• Against the background of taking such drugs, violations of sexual function were noted. These included decreased interest in sex, problems achieving orgasm, problems ejaculating, or problems getting or maintaining an erection. If you have any questions, please consult your doctor.

What are some other side effects of this drug?

Any drug can cause side effects. However, for many people, side effects are either minor or non-existent. Contact your child’s doctor or seek medical attention if any of these or other side effects bother your child or if they persist:

• Constipation, diarrhea, nausea, vomiting, or decreased appetite.
• Dry mouth.
• Sleep disorders.
• Drowsiness.
• Strange or unusual dreams.
• Feeling tired or weak.
• Flu-like symptoms.
• Yawn.
• Tides.
• Nervous tension and agitation.
• Shiver.
• Excessive sweating.
• Headache.
• Irritation of the nose or throat.

This list of possible side effects is not exhaustive. If you have any questions about side effects, ask your child’s doctor. Talk to your child’s doctor about side effects.

You can report side effects to the National Health Board.

What is the best way to give this drug?

Give this drug to your child as directed by your doctor. Read all the information provided to you. Strictly follow all instructions.

All forms:

• Give this drug with or without food.
• Keep giving this drug as directed by your child’s doctor or other health care provider, even if your child is feeling well.

Long acting drugs:

• Ask your child to swallow whole. Ask your child not to chew, break, or crush the tablet.

Liquid (solution):

• Liquid doses should be measured with caution. Use the dispenser that comes with the medicine. If the dispenser is not provided in the package, ask the pharmacist for a dosing agent for this drug.

What if my child misses a dose of medication?

• Give the missed dose as soon as possible.
• If it is time for your child to take the next dose, do not take the missed dose and then go back to your child’s normal schedule.
• Do not give a double dose at the same time or additional doses.

How do I store and/or discard this drug?

• Store at room temperature, protected from light. Store in a dry place. Do not store in the bathroom.
• The lid must be tightly closed.
• Keep all medicines in a safe place. Keep all medicines out of the reach of children and pets.
• Dispose of unused or expired drugs. Do not empty into a toilet or sewer unless instructed to do so. If you have any questions about disposing of medicines, ask your pharmacist. Drug disposal programs may be in place in your area.

General information about medicines

• If your child’s symptoms or health problems do not improve, or worsen, contact your child’s doctor.
• Do not share your child’s medicine with others and do not give anyone else’s medicine to your child.
• Some medicines may come with other patient information leaflets. If you have questions about this drug, talk with your child’s doctor, nurse, pharmacist, or other health care professional.
• If you think you have overdosed, call a poison control center or get medical help right away. Be prepared to tell or show what drug you took, how much, and when it happened.

Consumer Use of Information and Limitation of Liability

This summary information includes a summary of the diagnosis, treatment, and/or drug product. It is not intended to be a comprehensive source of data and should be used as a tool to help the user understand and/or evaluate potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a particular patient. It should not be considered medical advice or a substitute for medical advice, diagnosis or treatment provided by a physician based on a medical examination and assessment of the patient’s specific and unique circumstances. Patients should consult with their physician for full information about their health, medical issues, and treatment options, including any risks or benefits regarding the use of medications. This information is not a guarantee that a treatment or drug is safe, effective, or approved for a particular patient. UpToDate, Inc. and its subsidiaries disclaim any warranties or liabilities related to this information or its use. The use of this information is subject to the Terms of Use found at https://www.