Prozac medication side effects and benefit for depression by Ray Sahelian, M.D.

 

Prozac is a medication used to treat depression, obsessive-compulsive disorder, some eating disorders, and panic attacks. Prozac (brand name Sarafem) is used to relieve the symptoms of premenstrual dysphoric disorder, including mood swings, irritability, bloating, and breast tenderness. Prozac is in a class of medications called selective serotonin reuptake inhibitors (SSRIs). Prozac works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance. A worsening of symptoms soon after starting the antidepressant Prozac suggests that the drug is unlikely to have a lasting beneficial effect.

 

Prozac Side Effects
Side effects of Prozac can include nausea, headaches, anxiety, insomnia, drowsiness, and loss of appetite. Prozac has been implicated in serious skin rashes and vasculitis. Increased blood pressure can occur and should be monitored. Seizures have been reported as a serious Prozac side effect. Life-threatening interactions can occur in combination with MAO inhibitors, such as nardil and parnate. A common Prozac side effect is sexual dysfunction such as loss of libido, decrease in genital sensation, and erectile dysfunction.

 

Prozac and Drug Interactions
Do not take Prozac with MAO inhibitors or for at least a week after their discontinuation. MAO inhibitors medications should not be taken for at least three weeks after discontinuing Prozac. The same is true for Haldol and antipsychotic drugs. Most medications affecting the brain have the potential to slow reflexes or impair judgment and caution is advised. Prozac should not be taken with 5-HTP or tryptophan when the dosages are high. Low dosages of Prozac, 5HTP and tryptophan may be combined under medical supervision. See tryptophan serotonin information.

 

Prozac and Prolactin

What is the effect of Prozac treatment on hormone levels, particularly prolactin? A study found that 5% of men and 22% of women with depression developed new onset hyper-prolactinemia following Prozac treatment for a period of 12 weeks.

 

Brand names for Prozac
Other brand names for fluoxetine include Erocap, Lovan, Zactin, and Auscap.
 

Prozac emails
Q. I've been on Prozac for three years and am in the process of weaning off the medication in the hopes of switching to 5-HTP or another natural alternative with fewer side effects. I've read that the withdrawal effects of stopping Prozac can be incapacitating. In your experience, are there nutritional supplements that can mitigate the effect of withdrawal from Prozac? If so, would you have your patients begin these supplements during the weaning process, or only after the weaning is complete and the patient has stopped the medication entirely? (I know I'll have to do this under the supervision of my doctor, but I was hoping I could use your Prozac weaning philosophy as a point of comparison.)
   A. Each patient is different depending how long they have been on Prozac or other SSRIs, the Prozac dosage, how their body reacts, their current mood and disposition, their dietary habits and exercise program, their sleep patterns, etc. etc. Plus, each person responds differently to 5HTP, SAM-e, St. John's wort or other natural supplements, and the dosages and timing can make a huge difference. Each case is unique and hence we can't even give general guidelines.


Q. Last year after taking Prozac for many years I decided to add L-tyrosine to my daily supplements. I added about 900 mg. a day. Soon after that I developed what's been diagnosed as "tics". I'm wondering if the addition of L-tyrosine could have had anything to do with this?
   A. It is possible, but we can't say for sure.
Q. Is tryptophan as good as Prozac for depression?
   A. It's difficult to compare, although they both influence serotonin levels, their mechanism is different. I have not seen head to head studies involving Prozac and tryptophan to know how similar or dissimilar they would be in terms of clinical improvement in depression. 5-HTP is another option in terms of increasing serotonin levels.

Q. Can Prozac and Passion Rx be used the same day?
   A. We suggest not using Passion Rx and Prozac or an SSRI the same day due to potential side effects. If you have a mild case of depression, and your doctor feels you can do fine being off the Prozac a couple of days a week, you could Passion Rx on the off days as long as your doctor approves.

Q. Prozac and libido. Are they related?
   A. Yes. Prozac lowers libido by increasing levels of serotonin. Serotonin has an inhibitory effect on libido. Most doctors don't warn their depressed patients that a prescription of Prozac leads to libido loss.

Q. i would like to look into converting from the antideprressant Auscap 20 to recommended products but do not know how. i am finding that the antidepressant Auscap is not relieving greatly my anxiety which i find i still can get slightly reved up. i have heard of 5 htp but looking at your website there seems to be other things too
   A. There are many natural options to treating depression than Prozac, but each person is unique in which of the natural supplements or herbs they would respond to. You can visit the page on depression and have your doctor help you decide. Alternatives to Prozac include 5-htp, SAM-e, tryptophan, fish oils, Mind Power Rx or a combination.

Q. I 've been very concerned about my fingernails for the last several months. I feel that it's related to the fact that my Prozac dosage has been doubled for several months now, and maybe that's the reason why my nails are in such bad shape lately.
   A. We have not had reports of Prozac or an SSRI influencing nails before.

 

Q. Are you aware of problems with taking SAM-e or 5HTP or any other alternative supplements while trying to wean from Prozac?
Do you recommend a "weaning program"; e.g., how to skip days on the drug and supplement with something else to maintain the appropriate balance so as not to bottom out and then endure the emotional pain of trying to get back up to speed with alternative help OR returning to Prozac? I understand that 5HTP does not mix well with Prozac. What about 5HTP alone? I don't want to encourage a "serotonin syndrome".
   A. Each person taking Prozac medication responds in a different way and needs a different dosage. Each person taking Prozac medication along with natural supplements will respond in a different way depending on many variables including dosage, severity of depression, length of time taking the medications, etc. There is no simple answer to weaning off Prozac or other statin drugs and using natural supplements. The best one can say is to reduce the medication dosage gradually while using a low dosage of the supplements although if the depression is mild a person could stop the Prozac quickly. There is no single regimen that would apply to everyone. Ideally one should try each natural supplement by itself for a week or two rather than combining them. For instance it is a good idea to try 5-HTP by itself and SAM-e supplement by itself rather than taking them together.

 

Q.  I am suffering moderate ED and decrease in libido. My physician has run tests and all appears in normal limits. I have tried Levitra with some improvement but somewhat disappointing. Under the doctors guidance I have weaned off of Prilosec and fluoxetine Prozac. I am nearly complete with the elimination of Prozac, now take one 20mg every five days and will stop entirely in a week. I feel fine. Head actually is clearer that it has been in some time. No sign of the weariness I suffered ten years ago when I started the Prozac. I believe I am experiencing a slight improvement in the libido.

 

Q. A family member has, according to Vanderbilt University medical center in Nashville TN, a receptor problem. After being on Prozac medication for 20 years he developed serotonin syndrome effect to it and all anti-depressants. Flu like symptoms, teeth chattering. He has been trying to take 5 htp only 10mg every 4 days and same thing happens. 47 year of age, has had open heart surgery for rapid heart beat in 1984, got hepatitis C from blood transfusion during surgery, suffers from allergies chronic fatigue syndrome, and now major depression.

 

Re: weaning off Prozac. I've been attending a state hospital for the past 7 years as an out patient and the doctors there have kept me on the meds for over 7 years. I'm a 25 year old male from South Africa and it's really worrying me as every time I try to wean myself off it i experience withdrawal symptoms such as aggression and a heightened sense of depression. The medication hasn't helped me much but caused me worse side effects and the state doctors that i've seen, advise to put me on another medication which has even worse side effects as they say I'm still struggling with depression and the symptoms i feel when i try to wean off the meds are symptoms of my depression not withdrawal. I really feel i can do without the meds all i need is self motivation as that's what has helped me thus far not the meds because even on the meds i still experienced major depression in the past, but when i ask the doctors for advice no one seems to give the same answer everyone has a different theory some doctors even say i can stop it immediately! I'm really concerned as I've even consulted doctors in the private sector and the advice they've given me isn't any different, please can you advice as I do not know where to turn to next and it's beginning to effect my performance at work and in my social life.