PROzac

• Major Depressive Disorder (MDD)
• Obsessive-Compulsive Disorder (OCD)
• Panic Disorder
• Bulimia Nervosa
• Premenstrual Dysphoric Disorder (PMDD)

• Generalized Anxiety Disorder (GAD)
• Post-Traumatic Stress Disorder (PTSD)
• Social Anxiety Disorder
• Fibromyalgia
• Chronic Pain Management
• Autism Spectrum Disorder-related symptoms
• Migraine Prevention

Major Depressive Disorder (MDD):

Ages 8-18: Start with 10 mg once daily. After one week, increase to 20 mg once daily. Maximum dose: 20 mg/day (can be increased under supervision up to 60 mg/day).

Obsessive-Compulsive Disorder (OCD):

Ages 7-17: Start with 10 mg once daily. After two weeks, increase to 20 mg once daily. Maximum dose: 20-60 mg/day, depending on response.

Panic Disorder, Bulimia Nervosa

It is not typically recommended for pediatric use due to insufficient data in younger populations.

MAOIs: Do not use Prozac with monoamine oxidase inhibitors (MAOIs) or within 14 days of stopping an MAOI due to the risk of serotonin syndrome.

Pimozide or Thioridazine: Risk of QT prolongation and severe heart issues.

Hypersensitivity: Do not use Prozac in individuals with a known allergy to fluoxetine or its ingredients.

Concurrent use with linezolid or intravenous methylene blue: Increased risk of serotonin syndrome.

Be Patient with Onset: Prozac can take several weeks (4 to 6 weeks) to reach its full effect, so continue taking it as prescribed, even if you don’t feel better immediately.

Take at the Same Time Daily: Consistency is key. Taking Prozac simultaneously every day helps maintain steady levels in your body. It’s often best taken in the morning to avoid insomnia.

Monitor for Side Effects: Common side effects like nausea, headaches, or sleep disturbances often improve after a few weeks. If side effects persist or worsen, contact your healthcare provider.

Avoid Alcohol: Alcohol can increase drowsiness and other side effects while taking Prozac, so it’s best to avoid or limit alcohol consumption.

Don't Stop Abruptly: Stopping Prozac suddenly can cause withdrawal symptoms like irritability, dizziness, and mood changes. Always consult your doctor before discontinuing.

Interaction Check: Make sure your pharmacist reviews all your medications, as Prozac can interact with many drugs, including over-the-counter supplements and herbal products.

Serotonin Syndrome Warning: Be aware of the signs of serotonin syndrome, like agitation, confusion, or rapid heartbeat, especially if you are taking other serotonergic medications. Contact your doctor if these symptoms occur.

• Nausea
• Headache
• Drowsiness or fatigue
• Insomnia or difficulty sleeping
• Dry mouth
• Dizziness
• Loss of appetite or weight loss
• Sweating
• Anxiety or nervousness
• Diarrhea or upset stomach

• Suicidal thoughts or behavior (especially in young adults, children, and adolescents)
• Severe allergic reactions: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, or trouble breathing
• Seizures
• Mania or hypomania: symptoms include extreme mood swings, overexcitement, or impulsive behavior
• Unusual bleeding or bruising
• Low sodium levels (hyponatremia): symptoms include headache, confusion, weakness, or seizures
• Irregular or fast heartbeat (QT prolongation)
• Severe liver problems: symptoms include yellowing of the skin/eyes, dark urine, or severe stomach pain
• Vision changes, such as blurred vision or eye pain

Increased risk of suicidal thoughts: Especially in children, adolescents, and young adults, particularly when starting the medication or changing the dose.

Serotonin syndrome risk: This may occur when combined with other serotonergic drugs, leading to life-threatening symptoms like rapid heartbeat, confusion, and muscle rigidity.

QT prolongation: This may cause serious heart rhythm problems, especially in people with heart conditions or when used with other drugs that affect heart rhythm.

Mania or hypomania: Risk of triggering manic episodes in people with bipolar disorder.

Low sodium levels (Hyponatremia): Particularly in older adults or those on diuretics, which can cause confusion, weakness, and seizures.

Bleeding risk: Increased risk of bleeding, especially when taken with blood thinners or NSAIDs like ibuprofen.

Withdrawal symptoms: Stopping Prozac suddenly can cause withdrawal effects like irritability, nausea, dizziness, and sleep disturbances. Always taper off gradually under medical supervision.

Glaucoma warning: May increase the risk of angle-closure glaucoma in individuals predisposed to the condition.

Liver impairment: Use with caution in individuals with liver disease, as Prozac is metabolized in the liver.

Pregnancy and breast-feeding: Use during pregnancy may carry risks to the fetus, and fluoxetine can pass into breast milk, so consult with a healthcare provider.

Selective Serotonin Reuptake Inhibitors (SSRIs):

• Sertraline (Zoloft)
• Escitalopram (Lexapro)
• Citalopram (Celexa)
• Paroxetine (Paxil)

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs):

• Venlafaxine (Effexor XR)
• Duloxetine (Cymbalta)

Atypical Antidepressants:

• Bupropion (Wellbutrin)
• Mirtazapine (Remeron)

Tricyclic Antidepressants (TCAs):

• Amitriptyline
• Nortriptyline (Pamelor)

Monoamine Oxidase Inhibitors (MAOIs):

• Phenelzine (Nardil)
• Tranylcypromine (Parnate)

Other Alternatives:

• Buspirone (Buspar) – for anxiety
• Trazodone – often used for depression and insomnia