PROZAC (fluoxetine)
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Why is Prozac prescribed?
Prozac is prescribed for the treatment of a continuing depression. The symptoms of major depression often include changes in appetite, sleep habits, and mind/body coordination; decreased sex drive; increased fatigue; feelings of guilt or worthlessness; difficulty concentrating; slowed thinking; and suicidal thoughts.

Prozac is also prescribed to treat obsessive-compulsive disorder. An obsession is a thought that won't go away; a compulsion is an action done over and over to relieve anxiety.

Prozac is thought to work by adjusting the balance of the brain's natural chemical messengers. It has also been used to treat obesity and eating disorders.
How should I take Prozac?
Prozac should be taken exactly as prescribed by your doctor.
Prozac usually is taken once or twice a day. To be effective, it should be taken regularly.
What if I miss a dose?
Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.
What side-effects could occur from taking Prozac?
Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Prozac.

More common side effects may include:
Abnormal dreams, abnormal thinking, agitation, allergic reaction, anxiety, bronchitis, chest pain, chills,cough, diarrhea, dizziness, drowsiness and fatigue, dry mouth, flu symptoms, frequent urination, hay fever, headache, inability to fall or stay asleep, increased appetite, indigestion, itching, joint pain, lack or loss of appetite, light-headedness, limb pain, muscle pain, nausea, nervousness, sinus inflammation, sore throat, stomach/intestinal disorder, sweating, tremors, weakness, weight loss, yawning

Less common side effects may include:
Abnormal ejaculation, abnormal gait, abnormal stoppage of menstrual flow, acne, altered sense of taste, amnesia, apathy, arthritis, asthma, bone pain, breast cysts, breast pain, brief loss of consciousness, bursitis, chills and fever, confusion, conjunctivitis, convulsions, dark, tarry stool, decreased sex drive, difficulty in swallowing, dilation of pupils, dry skin, ear pain, eye pain, exaggerated feeling of well-being, excessive bleeding, facial swelling due to fluid retention, fever, fluid retention, fluttery heartbeat, gas, hairloss, hallucinations, hangover effect, hiccups, high or low blood pressure, hives, hostility, infection, inflammation of the esophagus, inflammation of the gums, inflammation of the stomach lining, inflammation of the tongue, inflammation of the vagina, intolerance of light, involuntary movement, irrational ideas, irregular heartbeat, jaw or neck pain, lack of muscle coordination, low blood pressure upon standing, low blood sugar, migraine headache, mouth inflammation, muscle spasm, neck pain and
rigidity, nosebleed, ovarian disorders, paranoid reaction, pelvic pain, pneumonia, rapid breathing, rapid heartbeat, ringing in the ears, severe chest pain, skin inflammation, skin rash, thirst, tooth problems, twitching, uncoordinated movements, urinary disorders, vague feeling of bodily discomfort, vertigo, vision disturbances, vomiting, weight gain
Who should not take Prozac?
If you are sensitive to or have ever had an allergic reaction to Prozac or similar drugs such as Paxil and Zoloft, you should not take this medication. Make sure that your doctor is aware of any drug reactions that you have experienced.

Do not take this drug while using an MAO inhibitor. Serious, sometimes fatal, reactions have been known to occur when Prozac is used in combination with other antidepressant drugs known as MAO inhibitors, including Nardil and Parnate; and when Prozac is discontinued and an MAO inhibitor is started. Never take Prozac with one of these drugs or within 14 days of discontinuing therapy with one of them; and allow 5 weeks or more between stopping Prozac and starting an MAO inhibitor. Be especially cautious if you have been taking Prozac in high doses or for a long time.
If you are taking any prescription or nonprescription drugs, notify your doctor before taking Prozac.
What are possible drug interactions with Prozac?
Combining Prozac with MAO inhibitors is dangerous.
Do not drink alcohol while taking this medication.
If Prozac is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Prozac with the following:

Carbamazepine (Tegretol)
Diazepam (Valium)
Digitoxin (Crystodigin)
Drugs that impair brain function, such as Xanax
Flecainide (Tambocor)
Lithium (Eskalith)
Other antidepressants (Elavil)
Phenytoin (Dilantin)
Vinblastine (Velban)
Warfarin (Coumadin)
What if I am pregnant or nursing?
The effects of Prozac during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. This medication appears in breast milk, and breastfeeding is not recommended while you are taking Prozac.
What is the recommended dosage to take of Prozac?
The usual starting dose is 20 milligrams per day, taken in the morning. .
Dosages above 20 milligrams daily should be taken once a day in the morning or in 2 smaller doses taken in the morning and at noon.
The usual daily dose for depression ranges from 20 to 60 milligrams. For obsessive-compulsive disorder the customary range is 20 to 60 milligrams per day, though a maximum of 80 milligrams is sometimes prescribed.
Special warnings about Prozac
Unless you are directed to do so by your doctor, do not take this medication if you are recovering from a heart attack or if you have kidney or liver disease or diabetes.
Prozac may cause you to become drowsy or less alert and may affect your judgment. Therefore, driving or operating dangerous machinery or participating in any hazardous activity that requires full mental alertness is not recommended.
While taking this medication, you may feel dizzy or light-headed or actually faint when getting up from a lying or sitting position. If getting up slowly doesn't help or if this problem continues, notify your doctor.
If you develop a skin rash or hives while taking Prozac, discontinue use of the medication and notify your doctor immediately.
Prozac should be used with caution if you have a history of seizures. You should discuss all of your medical conditions with your doctor before taking this medication.
The safety and effectiveness of Prozac have not been established in children.
References and Bibliography
Prozac Pharmacology, Pharmacokinetics, Studies, Metabolism.
After sertraline and escitalopram, see: Top 200 Generic Drugs by Units in 2006PDF (19.4 KiB).
Wong, DT, Bymaster FP, Engleman EA (1995). "Prozac (fluoxetine, Lilly 110140), the first selective serotonin uptake inhibitor and an antidepressant drug: twenty years since its first publication". Life Sci 57 (5): 411-41.
Wong D, Horng J, Bymaster F, Hauser K, Molloy B (1974). "A selective inhibitor of serotonin uptake: Lilly 110140, 3-(p-trifluoromethylphenoxy)-N-methyl-3-phenylpropylamine". Life Sci 15 (3): 471–9.
Carlsson A, Wong DT (1997). "A note on the discovery of selective serotonin reuptake inhibitors". Life Sci 61 (12): 1203.
Swiatek, Jeff (August 2, 2001), "Prozac's profitable run coming to an end for Lilly", The Indianapolis Star
Electronic Orange Book. Food and Drug Administration (April 2007).
Patent Expiration Dates for Common Brand-Name Drugs.
Drug Treatments in Psychiatry: Antidepressants. Newcastle University School of Neurology, Neurobiology and Psychiatry (2005).
Prozac Medication Insert. Eli Lilly and Company Indianapolis, IN 46285, USA Literature revised December 4, 2006
Gerber PE, Lynd LD (1998). "Selective serotonin-reuptake inhibitor-induced movement disorders". Ann Pharmacother 32 (6): 692–8. 
Caley CF (1997). "Extrapyramidal reactions and the selective serotonin-reuptake inhibitors". Ann Pharmacother 31 (12): 1481–9.
NTP_CERHR Expert Panel Report on Reproductive and Developmental Toxicity of fluoxetine, Center for the Evaluation of Risks to Human Reproduction, April 2004
Fluoxetine Drug Information Provided by Lexi-Comp. Merck Manual (June 2007).
New York Times, Suicide Rises in Youth; Antidepressant Debate Looms


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