US Brand Name: Prozac

generic name: fluoxetine hydrochloride

Other Forms: Prozac Weekly, Sarafem (for PMDD), oral solution (It’s minty fresh! Really, it tastes like mint-flavored mouthwash.)

Class: antidepressants, specifically a Serotonin-Selective Reuptake Inhibitor (SSRI)

1.  Other brand names & branded generic names¹

• Adofen (Spain)
• Alzac 20 (Guatemala)
• Andep (India)
• Ansilan (Colombia)
• Auroken (Mexico)
• Deprexin (Bahamas; Barbados; Belize; Bermuda; Curacao; Guyana; Jamaica; Dutch Antilles; Puerto Rico; Singapore; Surinam; Trinidad)
• Deproxin (Thailand)
• Fluctin (Germany)
• Fluctine (Austria; Switzerland)
• Fludac (Benin; Burkina Faso; Ethiopia; Gambia; Ghana; Guinea; India; Ivory Coast; Kenya; Kuwait; Liberia; Libya Lebanon; Malawi; Mali; Mauritania; Mauritius; Morocco; Niger; Nigeria; Oman; Qatar; Republic of Yemen; Saudi Arabia; Senegal; Seychelles; Sierra Leone; South Africa; Sudan; Syria; Tanzania; Tunisia; Uganda; United Arab Emirates; Zambia; Zimbabwe)
• Flufran (India)
• Flunil (India)
• Fluox (Germany)
• Fluoxac (Mexico)
• Fluoxeren (Italy)
• Fluoxil (Dominican Republic)
• Fluox-Puren (Germany)
• Fluronin (Taiwan)
• Flusac (Thailand)
• Flutin (Colombia; Korea)
• Flutine (Israel; Thailand)
• Fluxen (Taiwan)
• Fluxetil (Singapore)
• Fluxetin (Singapore)
• Fluxil (Bahrain; Cyprus; Egypt; Hong Kong; Iran; Iraq; Israel; Jordan; Kuwait; Lebanon; Libya; Oman; Qatar; Republic of Yemen; Saudi Arabia; Syria; United Arab Emirates)
• Fontex (Denmark; Finland; Norway; Sweden)
• Foxetin (Korea)
• Lanclic (Korea)
• Lorien (South Africa)
• Lovan (Australia)
• Magrilan (Singapore)
• Margrilan (Bahrain; Cyprus; Egypt; Hong Kong; Iran; Iraq; Jordan; Kuwait; Lebanon; Libya; Oman; Qatar; Republic of Yemen; Saudi Arabia; Syria; Thailand; United Arab Emirates)

Modipran (Benin; Burkina Faso; Ethiopia; Gambia; Ghana; Guinea; Ivory Coast; Kenya; Kuwait; Liberia; Libya Lebanon; Malawi; Mali; Mauritania; Mauritius; Morocco; Niger; Nigeria; Oman; Qatar; Republic of Yemen; Saudi Arabia; Senegal; Seychelles; Sierra Leone; Sudan; Syria; Tanzania; Tunisia; Uganda; United Arab Emirates; Zambia; Zimbabwe)

• Neupax (Peru)
• Nopres (Indonesia)
• Nuzak (South Africa)
• Oxactin (United Kingdom)
• Oxedep (China; India)
• Pragmaten (Ecuador)
• Prizma (Israel)
• Proctin (Korea)
• Prodep (Benin; Burkina Faso; Ethiopia; Gambia; Ghana; Guinea; India; Ivory Coast; Kenya; Kuwait; Liberia; Libya Lebanon; Malawi; Mali; Mauritania; Mauritius; Morocco; Niger; Nigeria; Oman; Qatar; Republic of Yemen; Saudi Arabia; Senegal; Seychelles; Sierra Leone; South Africa; Sudan; Syria; Tanzania; Tunisia; Uganda; United Arab Emirates; Zambia; Zimbabwe)
• Rowexetina (Costa Rica; Dominican Republic; El Salvador; Guatemala; Honduras; Nicaragua; Panama)

Salipax (Bahamas; Barbados; Belize; Bermuda; Curacao; Guyana; Jamaica; Dutch Antilles; Puerto Rico; Surinam; Trinidad)

• Sanzur (South Africa)
• U-Zet (Taiwan)
• ZAC (Indonesia)
• Zactin (Australia; Singapore; Taiwan)
• Zepax (Colombia)
• Флуоксетин / Fluoxetine (Russia)

2.  FDA Approved Uses of Prozac

• Major Depression for adults.
• Obsessive-Compulsive Disorder
• Panic Disorder
• Bulima Nervosa
• Premenstrual Dysphoric Disorder (as Sarafem)

3.  Off-Label Uses

• Fibromyalgia
• Arthritis
• Chronic Fatigue
• Multiple Sclerosis
• Bipolar Depression
• Lupus
• Headaches
• Irritable Bowel Syndrome (IBS)
• Premature Ejaculation

4.  pros and cons

4.1  Pros

Prozac’s long half-life makes the issue of med compliance a little less of a big deal - hence the approval for depressed teenagers - and SSRI discontinuation syndrome is rarely anything like it is with other SSRIs, if it happens at all.

4.2  Cons

The sexual side effects and weight gain, if it happens, can be pretty bad.

5.  Side Effects

5.1  Typical Side Effects

The usual for SSRIs - headache, nausea, dry mouth, sweating, sleepiness or insomnia, and diarrhea or constipation, weight gain, loss of libido. Most everything will go away after a week or two, but the weight gain and loss of libido might stick around longer. Or permanently. Although weight gain is a coin toss.

5.2  Not So Common Side Effects

Rash, ‘flu-like symptoms, anger/rage.

5.3  Freaky Rare Side Effects

Bleeding gums, amnesia, anti-social reaction (oh, come on, like we’re not anti-social already), herpes (again, blaming the med for an STD), excessive hair growth, engorged breasts (a.k.a. porno boobs), involuntary tongue protrusion (according to the PI sheet / PDR one 77-year-old woman stopped sticking her tongue out at everyone after they stopped giving her Prozac (fluoxetine hydrochloride)).

6.  Interesting Stuff Your Doctor Probably Won’t Tell You

Prozac isn’t such a hot idea for anyone with diabetes, and not because of potential weight gain, rather it messes with your glycemic control.

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7.  Prozac’s Dosage and How to Take Prozac

Depression - 20mg in the morning, increasing by 20mg a day after at least a week, taken either in the morning or at noon until a maximum of 80mg a day is reached.

OCD & Bulima - 20mg in the morning, increasing by 20mg a day after at least a week, taken either in the morning or at noon until a maximum of 60mg a day is reached.

Panic - 10mg in the morning. Increase to 20mg, either all in the morning or split into morning and noon. Hold there for awhile before increasing. Although you can go up to 60mg a day, few people responded to anything above 20mg a day.

Like any SSRI I recommend starting out with half the recommended dosage (except for Panic, that’s as low as you can get) and then increasing to 20mg after a week. If you don’t feel anything go up to 30mg, but stay there until you’ve given it a try for a month, otherwise it’ll just be a pain in the ass to stop it. Even at 30mg you’ll know after a month if it’s going to do something for you.

Prozac Weekly - You just take the one capsule a week for everything. That’s it.

8.  How Long Prozac Takes to Work

Like all SSRIs anywhere from a couple days to over a month. If you don’t feel any positive benefit after six weeks, then you should talk to your doctor about either another SSRI or trying a med that hits another neurotransmitter. Because of the long time it takes to reach a steady state, you might want to give Prozac (fluoxetine hydrochloride) a full two months.

9.  How to Stop Taking Prozac

Your doctor should be recommending that you reduce your dosage by 10–20mg a day every 3–4 four days, if not more slowly than that.

Now, if you’re one of the rare people who start to experience SSRI discontinuation syndrome then you will have to look at reducing your dosage by 10mg a day every week. If you’re prone to the worst effects of discontinuation syndrome be prepared for a longer time. It is highly unusual for anyone on Prozac to experience severe symptoms of SSRI discontinuation syndrome, but it has happened. Here’s where you really have to balance the suckiness of what you’re dealing with in the way of side effects or whatever is forcing you to stop vs. SSRI discontinuation syndrome, because you’re looking at reducing your dosage by 10mg a day every month.
If you’re taking Prozac Weekly you’ll have to switch to the regular flavor to step down, as weekly is one size fits all. However, that extra-long half-life tends to make discontinuation less harsh, so you’ll probably be able to to get off of Prozac (fluoxetine hydrochloride) a lot sooner. In fact switching to Prozac (fluoxetine hydrochloride) from another SSRI or Effexor (venlafaxine) is a good way of dealing with the discontinuation syndrome of the meds with the shorter half-lives. As Prozac comes in a liquid form, you can always switch to that to wean yourself off the last bit really slowly, ml by ml.

10.  Prozac’s Half-Life & Average Time to Clear Out of Your System

Prozac (fluoxetine hydrochloride) has the longest half-life of any med I’ve written up, 9.3 days. That’s why there’s such an animal as Prozac Weekly. It also has an active metabolite, but with a shorter half-life. Thus it takes 45 days to fully clear out of your system.

11.  Days to Reach a Steady State

Four to five weeks.

12.  Discussion board

Crazy Meds’ Prozac discussion board

13.  Your Comments About and Experiences with Prozac

Tell us what you think about Prozac

Do you have any idea how hard it is to type, let alone remember the words? I’m sure you must.

Over 2 years ago my GP put me on antidepressant to control mild depression and severe anxiety. We tried nearly every one in the book but all raised my BP to very frightening levels.

Why I let myself to be talked into this I don’t know after suffering the horrors of discontinuing Paxil cold turkey a few years before. Then my husband died unexpectedly.I actually got through that and all the after stress (the funeral and memorial, packing up 25 years of memories, going through and dispensing with most of his possessions, leaving my beautiful gardens we had constructed and planted together, still working a full time job, moving in with my daughter, suffering shingles, moving to a place of my own)all drug free.I guess it all kept me so busy I didn’t have time to process for a year or so. Then the depression and anxiety.

I had been seeing a tdoc since my husband’s death. As I was having so much trouble with SSRIs, they agreed I should see a pdoc. She has set me on a course of drugs that I can hardly list, the most recent of which is Pristiq for depression, Xanax for anxiety and zolpidem for insomnia. I have never felt worse in my entire life.

After treating my on another course of SSRSs, she came to the dx of bipolar2. I’m really not sure that is correct. Seems to be the dx du jour. However, I let her add lamotragine to the list. Worked up slowly, 25mg at a time to 200mg, then added 50mg until I was up to 600mg. Then she cut back to 500mg. She didn’t inform me of all the side effects of the lamotragine except for the possibility of rash. I began having the problems listed on this site - not remembering words and events, loss of co-ordination, trouble concentrating, loss of appetite. I would find myself in a room and not remember going there. I wrote cryptic messages to myself with felt pen on my leg, would find it in the morning and not remember ever writing it. one of these I believed to be the date of my birth and what will be the date of my death. They both add up to number 11. In other words, I began having psychotic behavior I had never had before. Very unsettling.

At that point, she gave me Prozac to wean me off the Pristiq. I was to take the Prozac for 10 days. By day 3 I couldn’t function. Severe nausea and vomiting, headache, tremors and unbearable tightness and pain in my neck and shoulders. When I turn my head, it sounds like popcorn. I called my pdoc and she told me just to stop taking the Prozac and eat the BRAT diet. Then things got really bad. All the previous symptoms intensified. I haven’t been able to go to work for 10 days. This is not good - both for my income and for keeping my job. Thank God for FMLA!

This has been going on for the past 10 days. The vomiting stopped but I still have constant nausea. My head is throbbing, tremors are much worse, light-headed, dizzy and no balance. I walk like I’m drunk.

Cut to the chase - is it the discontinuation of the Pristiq, bad reaction to the Prozac, delayed reaction to high dose of lamotragine, mixing all of these with zolpidem, or all of the above? Has anyone else had a similar experience and what was the cause? How long did it last? Will I ever feel “normal” again? I have gone from a functioning human being to being a basket case. I want to get off all these meds totally. How long will it take me to wean off the lamotragine? Along with zolipedem, those are the only meds I am presently taking. I’m all for exploring Chinese medicine, acupuncture, high dodes of Omega-3 and taking up Qi Gong. Couldn’t possibly be worse than what I am presently experiencing!

Thanks for listening and hope someone responds.

Overall I have had a good experience with Prozac. I have had some anxiety and dry eyes with Prozac but also improved mood and energy levels.

Now if you want to read a lot more details of my experience read below. It is long so I will not blame you if you do not read any of it or all of it:

I initially started on 10mg doses of Prozac for depression, anxiety, and OCD.

After two days worth of that dose I was extremely drowsy.

I stopped the Prozac and needed a few days to recover from that drowsiness. I started back on Prozac but on 2.5 mg a day. On that dose I noticed some anxiety and dry eyes. As far as the benefits I noticed a better mood and a dramatic increase in energy. At that point I was quite satisfied with Prozac - I gave it a 4 out of 5 stars on askapatient.com.

About a month into using Prozac I noticed myself being drowsy one evening. I did not link this to the medication and I took Prozac for another day or two.

I stopped taking Prozac while I had drowsiness. The issue was that I was drowsy for a good 17 days straight. I blamed all 17 days on Prozac though I will explain later how that was not fair. Since I was drowsy for 17 days straight I got my psychiatrist to switch me over to Celexa.

I figured out this week that it was probably the depression itself that was making me drowsy after the first days of stopping Prozac. However I will note that I think the drowsiness of first few days of the 17 was due to the Prozac.

Anyways this is how I came to the conclusion that most of the 17 days of drowsiness were due to the depression itself: A few weeks ago I was on Celexa for a few days before noticing drowsiness. I stopped the Celexa and waited for the drowsiness to stop. I waited two weeks for the drowsiness to stop but it did not.

This week I did some math using the 35 hour half life of Celexa to calculate how long it would take Celexa to leave my body. I calculated it should have been about 7.5 days for it to clear my system (I read that it takes about 5 half lives for a drug to leave your system entirely and 35 hours is about a day and a half; five times 1.5 days is 7.5 days). I also did not think my body had impaired detoxification abilities since I had liver and kidney tests done six months ago indicating they are fine.

That led me to think that it was the depression itself that made me drowsy for at least part of those two weeks. I will note that my psychiatrist doubted that Prozac made me drowsy for 17 days and thought it could be depression.

Anyways after thinking it was the depression itself that was making me drowsy I took Celexa the next morning and within an hour the drowsiness lifted and I felt more awake.

That same day I also took Zyrtec because I had an allergy shot. Around 3PM I felt the need to urinate and was not able to get anything out. I was able to urinate later on in the afternoon though. Then at 9:40 PM I needed something like ten to twenty seconds before I could urinate. This happened two more times later that night.

I blamed Celexa for that urinary retention issue and decided not to take Celexa any more.

I did look up urinary retention on the internet and found that antihistamines, such as Zyrtec can cause the problem. I read on wikipedia that Zyrtec has a half life of 8.3 hours. Matching up with that short half life my urinary retention issue went away after a day.

So because of that short episode of urinary retention I skipped a day of Celexa. I did notice drowsiness come on again.

However I took Celexa today and the drowsiness went away again.

All this leads me to believe that the Prozac was only the culprit for the first few days of the drowsiness I experienced for 17 days; the rest of it was probably from the depression itself.

Anyways to conclude this review I have one recommendation for anyone who is willing to try this: If you find that the side effects for a SSRI are too unbearable - try cutting the tablet into quarters, eighths, etc. If you are like me and need a dose much smaller than the standard dose you may even want to go smaller than an eighth. At that point since you are trying to cut really small pieces with a medicine cutter you may not get pieces of the same size. You then have the issue of taking different amounts of medication each day.

To deal with that issue I am planning to buy a milligram scale to help me take the same dose every day. With a scale I know if the cut piece is too large or small.

I did find that Amazon has a milligram scale for $30.

Since this is a few months later you are probably in a different space, but I’ll respond anyway. So sorry to hear that you had such a bad time. The only of those drugs I’ve had experience with are lamotrigine and prozac. The dose of lamotrigine you had was pretty crazy high, and from my experience, it may well have been the culprit with all of the cognitive things. I am on 250 lamotrigine and I too have problems with word retrieval and memory (though what got my memory most has been lithium). I also had loss of coordination and trouble concentrating with lamotrigine. Some of that has gotten better with time, or maybe I am just used to them now.

Your experience with discontinuing Pristiq sounds a lot like discontinuation syndrome to me (I don’t know why they don’t call it withdrawal!) Especially with it getting worse when taking away the Prozac. Did your doctor think that at all? Do you feel like this pdoc is good for you? If your insurance will allow it, you could get a second opinion if you wanted to.

I also have a bipolar 2 diagnosis. It came after 35 years of my first visit to a pdoc. For me it has been a godsend to have the diagnosis as it explains so much about my life and as SSRIs alone have been awful for me. We are just now adding a little bit of Prozac to Lamotrigine and Lithium, in the hopes it will help improve the depression without destabilizing me further. I have my fingers crossed.

Hopefully by now things are better for you - I hope so!

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Enter your own Comments & Experiences with Prozac here.
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14.  Full US PI sheet, Global SPCs & PILs, check for drug-drug interactions

Prozac Full US Prescribing Information / PI Sheet

Check for drug-drug interactions

15.  Bibliography

Physicians’ Desk Reference Edition 56 Maria Deutsch & Anu Gupta, Drug Information Specialists, et al. © 2002. Published by Medical Economics Company.

Instant Psychopharmacology 2nd Edition Ronald J. Diamond M.D. © 2002. Published by W.W. Norton

A Primer of Drug Action Robert M. Julien, M.D., Ph. D. © 2001. Ninth Edition.

The Complete Guide to Psychiatric Drugs Edward Drummond, M.D. © 2000. Published by John Wiley & Sons, Inc.

Healing Anxiety & Depression Daniel G. Amen, M.D., and Lisa C. Routh, M.D. © 2003. Published by G.P. Putnam’s Sons.

Mosby’s 2004 Drug Guide David Nissen PharmD, Editor.© 2004. An imprint of Elsevier.

¹ The term "branded generic" has three meanings:
1) A generic drug produced by a generics manufacturer that is a wholly-owned subsidiary of the company that makes the branded version. E.g. Greenstone Pharmaceuticals makes gabapentin, and they are owned by Pfizer, who also own Parke-Davis, the makers of Neurontin.
2) A branded generic is also a generic drug given a 'brand' name by the manufacturer (e.g. Teva's Budeprion), but otherwise has the same active ingredient as the original branded version (Wellbutrin).
3) A branded generic is also a generic drug given a 'brand' name by the manufacturer (e.g. Sanofi-Aventis' Aplenzin, which is bupropion hydrobromide) and uses a salt of the active ingredient that is different from the original branded version and other generics (Wellbutrin, Budeprion and all the others are bupropion hydrochloride). We aren't sure if that really makes a difference or not. The FDA says they're the same thing. As usual, the data are contradictory, but most evidence indicates that the FDA is right and the differences are negligible.
For our purposes a "branded generic name" refers to the second and third definitions.

Date created 25 Apr 2011 - 12:30 Page Creator: JerodPoore Last edited by:

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