All you need to know about Prozac

Severe abstinence symptoms could happen in patients who suddenly discontinued Prozac therapy. It is supposed that adverse effects of the Prozac discontinuation are mild enough. There are two recommended strategies to manage with discontinuation syndrome:

1. To reduce gradually dose of Prozac;
2. To replace Prozac with the other SSRI agent, in situations when gradual changes off the Prozac dose is ineffective.

It was proved in some double-blind controlled studies.

There were some blind trials where discontinue of antidepressant therapy for a short time (4–8 days) with further renewal has been studied. It was found out that the most severe side effects had been caused with interruption of paroxetine. Interruption of Zoloft therapy induced severe adverse effects but milder then paroxetine. Prozac showed the best tolerance in that study. Slow elimination of Prozac from the body can explain that result.

32% of members of Prozac discontinued group complain about new or worsened side effects versus 27%of patients who continued treatment in a longer, 6 week-long, blind discontinuation study. Significantly higher 5-7% rate of dizziness at weeks 4-6 and 4% rate of somnolence at week 2 were reported by the patients who had interrupted therapy. Long Prozac half-life in the body was proved with withdrawal symptoms, lasting for a long time. People reported about dizziness persisting to the end of the study

Company Eli Lilly, Prozac manufacturer, doesn’t recommend those people who take monoamine oxidase inhibitors, pimozide (Orap) or thioridazine (Mellaril) to use Prozac . Patients having liver impairment should tell their health care professional about that fact because the elimination of Prozac and its metabolite norfluoxetine is about twice slower in these patients. It induces about double amplification of Prozac exposure. Significant intestinal bleeding can be result of combination of Ibuprofen with Prozac after a period of use.

Nausea (22% vs 9% for placebo), insomnia (19% vs 10% for placebo), somnolence (12% vs 5% for placebo), anorexia (10% vs 3% for placebo), anxiety (12% vs 6% for placebo), nervousness (13% vs 8% for placebo), asthenia (11% vs 6% for placebo) and tremor (9% vs 2% for placebo)are the common adverse effects caused with Prozac and greatly differing from placebo therapy.

7% of patients taking Prozac in clinical trials reported about rash or urticaria, sometimes serious. Discontinuation of the Prozac therapy leaded to that side effect in 32% of those patients. There are some reports about several cases of complications developed in patients with rash. Vasculitis and lupus-like syndrome were observed in those cases. Those systemic events gave occasion to death.

Akathisia is a common side effect of Prozac . It is often accompanied by purposeless movements of the feet and legs, constant pacing, and marked anxiety. Akathisia usually appears after the beginning of the Prozac therapy or increase of the dose. Reducing of Prozac dose, discontinuation of drug or treatment with propranolol can remove or relieve akathisia symptoms. There are proves that akathisia and suicidal attempts are relative. It was reported that there were patients who had been feeling better after the withdrawal of Prozac , but relapsed severe akathisia symptoms after resumption of Prozac therapy. The development of the akathisia forced those patients to wish to make quietus and that it had brought back about their prior suicide attempts. Physician should describe symptoms of akathisia to patients and staff because of coupling of akathisia with suicide and the distress. More rarely, Prozac can cause side effects related with movement disorders such as acute dystonia and tardive dyskinesia.

Increase of rate of poor adaptation of newborns can be resulted with taking Prozac during pregnancy. Mothers having Prozac therapy shouldn’t breastfeed because Prozac was found in milk. Prozac is classified by the American Association of Pediatrics as a drug for which the effect on the breastfeeding baby is still unknown but may be of great importance.