Important precautions and possible side effects for the taking of Prozac.
What Precautions Should Be Taken with the use of Prozac?
The very first precaution before taking Prozac, is to ensure that you have a proper prescription from your doctor for it's use.Prozac is an important drug but must be used under proper guidance. One of the more serious potential side effects of any antidepressant medication, including Prozac, is an increase in or new appearance of suicidal thoughts. Patients who experience suicidal ideation need to seek medical help immediately. They should not discontinue Prozac, however, without being instructed to do so by a health care professional.
Sudden discontinuation of Prozac can cause withdrawal symptoms. This is known as SSRI withdrawal syndrome or SSRI discontinuation syndrome. The symptoms vary from person to person, but can include flu-like symptoms, as well as changes to vision or other senses. Prozac has a half-life of approximately 5 weeks, meaning that 5 weeks after stopping the drug, half of it is still detectable in the body. This makes the discontinuation symptoms less severe with Prozac than with other, shorter acting SSRIs. Patients should still adhere to a tapering protocol when discontinuing Prozac. The medication should gradually be decreased over a period of time, rather than stopped abruptly. Patients who experience a return of depressive symptoms (or other symptoms that led to their Prozac prescription in the first place) should consult a physician about their options, including finding alternative therapies or reinitiating Prozac therapy.
While depression can exist as a stand-alone diagnosis for some patients, for others it is part of a manic-depressive cycle with bipolar disorder. Patients should be carefully screened to make sure that their depression symptoms are not part of a larger cycle of bipolar disorder, which could necessitate additional medication beyond Prozac therapy.
Serotonin syndrome, as described above, is a toxic side effect and should be taken seriously. Symptoms of serotonin syndrome should prompt immediate medical attention.
While loss of sexual function is a common side effect of Prozac, occasionally men may experience prolonged and uncomfortable erections while on Prozac. Patients who experience this side effect should consult a physician.
Prozac may alter blood sugar levels in patients with diabetes. Diabetic patients on Prozac therapy should be extra vigilant about blood sugar monitoring, especially when therapy is initially commenced and any time dosing is increased.
Patients should inform their physicians about any other medications they are taking before initiating Prozac therapy. This includes over-the-counter drugs, especially supplements taken for mood, such as St. John’s wort or tryptophan.
Because Prozac can cause drowsiness or altered cognition, patients should refrain from driving or operating heavy machinery until they see how Prozac affects them.
The use of alcohol is not recommended during Prozac therapy. Patients who need to take Prozac long term should discus alcohol consumption with their physicians.
Prozac has been known to cause or exacerbate long QT syndrome, a conduction delay that can result in cardiac arrhythmias, some fatal. Patients who have long QT syndrome or who take medications that can predispose them to long QT syndrome should receive extra electrocardiogram monitoring and close monitoring of symptoms when initiating Prozac therapy or increasing their Prozac dose.
Older adults may be more susceptible to the side effects of Prozac. In particular, increased bleeding while on anticoagulant therapy or low salt levels (hyponatremia) while on diuretics may occur. Dosing of Prozac may need to be adjusted accordingly.
Pregnant patients or patients who may become pregnant should not be put on Prozac therapy unless no alternatives are present. Babies born to mothers who take Prozac during the last trimester of pregnancy have shown withdrawal symptoms. Prozac is excreted in breast milk; nursing mothers should refrain from taking Prozac and discuss alternatives with their prescribers or practice “pump and dump” nursing if Prozac needs to be taken short term.
Prozac has many known drug interactions (nearly 1,000). Careful documenting of patient medications needs to be undertaken when initiating Prozac therapy to prevent harmful interactions. Patients should be sure to tell medical professionals they are taking Prozac when seeking care or obtaining new prescriptions, even for routine health care concerns.
Prozac is eliminated primarily through the liver. If a patient has hepatic impairment, use of Prozac should be approached with caution. Dosage adjustments may need to be implemented to reduce strain on the liver. Patients with renal (kidney) impairments, however, generally do not need to have their Prozac dosing adjusted.
What are the side effects of Prozac?
Possible common side effects of Prozac include
loss of appetite
sinus irritation or congestion
Patients who have an allergy (hypersensitivity) to Prozac may experience itching, rash, hives, swelling, hoarseness, difficulty swallowing, or difficulty breathing.
A condition known as serotonin syndrome can sometimes occur with Prozac, in which case the patient is experiencing the release or storage of too much serotonin. This most often happens when Prozac is prescribed with another antidepressant medications. Symptoms of serotonin syndrome are restlessness or agitation, very fast heart beat with high blood pressure, hallucinations, high body temperature, loss of coordination, nausea, vomiting, diarrhea, overactive reflexes, and rapidly fluctuating blood pressure. Patients experiencing these symptoms should seek medical attention immediately.
Another known side effect of long-term SSRI use, including Prozac, is sexual dysfunction. Patients may experience loss of interest in sex, difficulty becoming aroused, difficulty maintaining an erection, and difficulty achieving orgasm.
Some patients also experience weight gain while taking SSRIs, including Prozac. Patients should discuss with their doctors the benefits of Prozac therapy versus any adverse events.
Increased thoughts of suicide (suicidal ideation) have been associated with antidepressant use, including use of Prozac. Sometimes patients who have been lethargic due to depression find themselves more able to act on thoughts of suicide once on an antidepressant medication. Patients experiencing any suicidal ideation while on Prozac therapy should seek medical attention immediately.
What are the symptoms of Prozac overdose?
Prozac can have a variety of overdose symptoms. Because many patients who take Prozac suffer from depression, intentional overdose is more common than with many other drugs. It can be difficult to know if the overdose symptoms are due to Prozac or to other substances, including alcohol, that are ingested at the same time as high doses of Prozac. Common overdose symptoms include tachycardia (rapid heartbeat), drowsiness, nausea, vomiting, and tremor. In severe cases, cardiac conduction problems (arrhythmias) and seizures have been documented. There have been fatalities associated with Prozac overdose. Patients experiencing symptoms of Prozac overdose need to be seen immediately in the emergency department. The local poison control center should be contacted until help via ambulance arrives.
What is the history of Prozac?
Prozac was discovered in the early 1970s by David T. Wong, a scientist working for the pharmaceutical company Eli Lilly. He published the first article about the drug in 1974. A new drug application was filed with the US Food and Drug Administration in 1977. It wasn’t marketed until nearly a decade later, when the FDA gave it its approval in 1987, although it had been sold in Belgium a year earlier. Within a year, sales of Prozac had reached $350 million, an astronomical sum for a new drug.
Until the development of SSRIs, clinicians were limited to older antidepressant and anti-anxiety drugs that had more side effects but were less efficacious. The development of Prozac is linked with an increased awareness and de-stigmatization of mental illness in society. Prozac is the most widely used antidepressant in history and has been the subject of several best-selling books. While it is available now in generic form, is still prescribed around the world to millions of patients. It is one of only four antidepressant medications that airline pilots are permitted to take.