Prozac

Prozac side effects: Prozac was the first of the SSRI antidepressants to be brought to market and was initially very well received because of the relative lack of Prozac side effects and because of its effectiveness as an antidepressant. There were some early problems related to Prozac side effects and the media campaign brought against Prozac by the Church of Scientology.

Prozac is usually begun at either 10 mg or 20 mg Prozac dosage and the typical therapeutic dosages from 10 mg to 60 mg. The most common Prozac side effects are minor gastrointestinal upset and some anxiety in the first few days to weeks of therapy and these Prozac side effects are usually transient.

Like box warning: the FDA mandates a black box warning for the use of Prozac in patients under 25 years of age. Increased risk of suicide has been noted in this age range and although this been no documented increase of suicidality in patients over 25 years of age and actually decrease risk of suicide in patients over 65 years of age younger patients appear to be at increased risk of suicide and the physician, family and patient need to be aware of this and take appropriate precautions of this risk.

Common Prozac side effects: the nausea that many patients develop early after the onset of symptoms usually resolve within a few weeks but other gastrointestinal Prozac side effects are fairly common and include diarrhea, lack of appetite, dyspepsia, and asthenia. Neuropsychological Prozac side effects include anxiety, tremor, and nervousness. Probably the most common bothersome Prozac side effect is sexual dysfunction usually manifest in men by delayed ejaculation and by women as difficulty achieving orgasm. Unfortunately this Prozac side effect does not usually resolve over time and is often not dose-related. Insomnia is occasionally noted with Prozac use but is usually less the problem with the Prozac is dosed in the morning which is the usual recommendation. Other miscellaneous Prozac side effects can include flulike syndrome, rash, abnormal vision, various urinary disorders, and headache.

Serious Prozac side effects: the most worrisome serious Prozac side effect is suicidality. This is felt to be more common in patients under age 25 but can be noted in patients of any age usually early onset of therapy. Worsening depression can be a less serious but probably related Prozac side effect. Allergic reactions including anaphylactoid reactions and serum sickness can be serious Prozac side effects. Neuropsychological serious Prozac side effects can include mania which is often unmasked bipolar disorder, neuroleptic malignant syndrome, extrapyramidal symptoms, seizures, and Prozac withdrawal syndrome. The Prozac withdrawal syndrome is less common than the SSRI withdrawal syndrome from most other medications in the class because of the extreme long Prozac half-life. The Prozac half-life is up to four days in some individuals. Serotonin syndrome is a potential serious Prozac side effect and patients are at higher risk to develop this if there aren’t other serotonergic medications. Dermatologic serious Prozac side effects can include various severe rashes including erythema multiforme. Priapism an erection that lasts more than several hours and can be damaging to the structure of the penis can manifest as a urologic emergency requiring urologic intervention. Acute’,, abnormal platelet function and bleeding, vasculitis, serum sickness, and hypotension are other serious potential Prozac side effects. When women during pregnancy take Prozac the fetus can manifest serious Prozac side effects including persistent pulmonary hypertension in fetuses over 20 weeks gestation, and neonatal serotonin syndrome in the third trimester, and neonatal withdrawal when Prozac is used by third trimester.

Cautions and contraindications: Prozac is contraindicated for use with the nonselective MAO inhibitors, pimozide, and thioridazine. You should be avoided or an alternative considered with many medications. This article will mention only the more common of these and the reader should refer to the prescriber’s manufacturers guidelines or their pharmacist for more comprehensive information. Common medications where alternatives need to be considered or the medication avoided include diazepam, haloperidol, clopideogrel, the selective MAO inhibitors, all of the other SSRIs, the herbal medications St. John’s wort, sumotriptan, and venlafaxine. More careful monitoring or modification of treatment may be needed in combination with a thiazide diuretics, carbamazepine, carvedilol, cyclophosphamide, cyproheptadine, various nonsteroidal anti-inflammatory medications including ibuprofen and Naprosyn, oxytocin, propranolol, promethazine, most of the beta blocker class of medications, and warfarin. Again this list of medications is only of some of the more commonly used drugs with potential Prozac side effects when used in combination or drug interactions and should not be considered a complete list. Less likely to cause serious drug interactions are aspirin, acetaminophen, amiodarone, benzodiazepines, marijuana, cocaine, dipyridamole, various herbal and supplemental products including garlic, ginger, ginkgo biloba, green tea and ginseng. The TB drug isoniazid, lithium, the statins where the CYP 3A4 substrate is dominant, tamoxifen, and tramadol also have potential drug interactions. This list is so extensive primarily because of the extensive hepatic CYP 450 system metabolism usually utilizing this CYP 3A4 pathway.

Pregnancy and lactation: Prozac is pregnancy category C with various trimester specific cautions. Prozac safety in lactation is unknown.

Unusual Prozac side effects: the sexual dysfunction noted with Prozac is unusual in that it fairly specific to orgasmic function but is a side effect common to the entire SSI are I class of medications. Hyponatremia is an uncommon but somewhat unusual Prozac side effect.

Prozac is now available as the generic fluoxetine and is among the inexpensive generic medications available at most discount pharmacies. Its long half-life make it unsuitable for the elderly in most cases but give it the benefit of not requiring a long taper because the prolonged half-life provides for natural taper as the drug is illuminated from the patient’s body over several weeks.Prozac side effects: Prozac was the first of the SSRI antidepressants to be brought to market and was initially very well received because of the relative lack of Prozac side effects and because of its effectiveness as an antidepressant. There were some early problems related to Prozac side effects and the media campaign brought against Prozac by the Church of Scientology.

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