tell me about prozac...please...pros and cons?

Question

I have a close family member who was prescribed prozac for anxiety...I need to know why this drug is so scary...thanks so much...

Answer 1

I have taken it for almost 6 years. I could taper it off, though it was difficult. It is one of the safest antidepressant ever made. It belongs to a class of SSRI (Selective Serotonin Reuptake Inhibitors). All drugs in this class cause Sexual Dysfunction in 90% of men treated with it. It can be solved in many ways. Drug holidays with short acting SSRIs, and Sildenafil, Bupropion or Buspirone with long acting SSRIs like Prozac. If it is only anxiety Bupropion XL alone is enough.

You want to know more about Prozac (Fluoxetine), so read:

Fluoxetine hydrochloride is an antidepressant drug used medically in the treatment of depression, obsessive-compulsive disorder, bulimia nervosa, premenstrual dysphoric disorder and panic disorder. Fluoxetine is also used (off-label) to treat many other conditions, such as ADHD. Fluoxetine was derived from diphenhydramine, an antihistamine found to inhibit reuptake of the neurotransmitter serotonin.

Compared to other popular selective serotonin reuptake inhibitors (SSRIs), fluoxetine has a strong energizing effect. This makes fluoxetine highly effective in treatment of clinical depression cases where symptoms like depressed mood and lack of energy prevail. Although stimulating, it is also approved for a variety of anxiety disorders, including panic disorder and obsessive compulsive disorder.

Trade Names
Fluoxetine is sold under the brand names Prozac, Symbyax (compounded with olanzapine), Sarafem, FLUX (Pakistan), Fontex (Sweden), Foxetin (Argentina), Ladose (Greece), Fluctin (Austria, Germany), Prodep (India), Fludac* (India) Oxetin (Bosnalijek,Bosnia and Herzegovina), Seronil (Finland) and Lovan (Australia).

It is also available under many generic names "fluoxetine XXX", xxx being the name of the laboratory

History
Prozac was invented at Eli Lilly by a team headed by Dr. Ray W. Fuller, with Drs. Bryan B. Molloy and David T. Wong. They were later awarded the Pharmaceutical Discoverer's Award from NARSAD (National Alliance for Research on Schizophrenia and Depression) for this. The molecule of Prozac has its origins in Diphenhydramine. In the 1960s it was found that diphenhydramine inhibits reuptake of the neurotransmitter serotonin. This discovery led to a search for viable antidepressants with similar structures and fewer side effects, culminating in the invention of fluoxetine (Prozac), a selective serotonin reuptake inhibitor (SSRI). A similar search had previously led to the synthesis of the first SSRI zimelidine from chlorpheniramine, also an antihistamine.

FDA approval and marketing campaign
Eli Lilly's Prozac was approved by the FDA on December 29, 1987 and introduced in the US at the beginning of 1988. The drug became very popular, with millions around the world having taken the medication. In the fall of 2001, Eli Lilly lost a patent dispute with Barr Laboratories and now fluoxetine hydrochloride is manufactured by many companies. Prozac's popularity and selling success has been aided greatly by Lilly's extensive marketing campaign for the drug, considered one of the most successful in the history of American pharmaceuticals.

Indications

Approved

FLUOX brand Fluoxetine
Prozac oral capsulesFluoxetine hydrochloride is approved in the United States to treat depression, obsessive-compulsive disorder, bulimia nervosa, premenstrual dysphoric disorder and panic disorder. In the United Kingdom, it is approved to treat depression with or without anxiety, bulimia nervosa, and obsessive-compulsive disorder.

In December 2003 the Food and Drug Administration (FDA) approved Symbyax to treat bipolar depression. Symbyax is a combination of fluoxetine and olanzapine. (However, the pure form of fluoxetine can cause mania, mixed-states, rapid cycling and psychosis in bipolar patients, particularly if the patient is not also taking a mood stabilizer.)

Unapproved/Off-label/Investigational
In 2003, Michel Harper, Fukodome Takayasu, and Andrew G. Engel reported that fluoxetine given over a period of three years at doses of up to 80-120 mg/day to two patients with slow-channel congenital myasthenic syndrome who were allergic to quinidine resulted in substantial subjective and objective improvement in muscle strength.

Fluoxetine is also often prescribed in the therapy of anorexia nervosa, mainly due to comorbidities between this disorder and other psychiatric disorders, such as clinical depression. The efficacy of fluoxetine administration to patients with anorexia nervosa has come into question in a recent publication of a randomized controlled trial.

Mechanism of action
Per the prescribing label, the mechanism of action of fluoxetine is unknown. Recent research indicates that fluoxetine may increase the production of new neurons (brain cells) in adult brain (adult neurogenesis) and that it interacts with the system of "clock genes", the transcription factors involved in drug abuse and possibly obesity.

Atypical SSRI
In a study comparing the effects of fluoxetine, paroxetine, sertraline, citalopram, and fluvoxamine on extracellular concentrations of serotonin, dopamine, and norepinepherine in the prefrontal cortex, only fluoxetine showed robust and sustained increases in extracellular concentrations of norepinephrine and dopamine after acute systemic administration, suggesting that fluoxetine is an atypical SSRI.

Interactions
Fluoxetine has a wide range of published interactions, notably with monoamine oxidase inhibitors (serotonin syndrome).

Side effects
Common adverse effects include akathisia, rage, and anxiety, which is possibly associated with an interaction of fluoxetine with the pineal gland, in addition to restlessness and insomnia. Weight loss, trembling, weakness, skin rash, anorgasmia, itching, and a decrease in sexual drive, have also been reported. It has been reported to cause subsequent weight gain .

Like other SSRIs, an overdose of fluoxetine or combining it with other antidepressants can lead to serotonin syndrome.

Metabolism
Fluoxetine is eliminated very slowly by the human body. The half-life of fluoxetine after a single dose is two days and, after multiple dosing, four days. The liver then metabolizes fluoxetine into norfluoxetine, a desmethyl metabolite, which is also a serotonin reuptake inhibitor; norfluoxetine has an even longer half-life, i.e. 8.6 and 9.3 days for single and repeated dosage respectively. These long half-lives may be helpful in those patients with compliance issues, but fluoxetine is most effective when taken daily. Other SSRIs have, by comparison, a very short half-life.

Some professionals feel that it is fluoxetine's long half-life that gives it much of its therapeutic utility, however this has never been proven under rigorous scientific study. Nevertheless, its long half life is also relevant because suddenly discontinuing SSRIs is known to produce both somatic and psychological withdrawal symptoms, a phenomenon known as "SSRI discontinuation syndrome". It is generally accepted that fluoxetine´s withdrawal symptoms are much smoother than with other SSRIs, as the substance takes several days to completely leave the system. Fluoxetine is a potent CYP2D6 inhibitor, which can decrease metabolism of other medications.

Formulations
Fluoxetine is sold in capsules containing 10, 15, 20, 40, or 90 mg of active ingredient, in tablets containing 10 mg, or 20 mg or in an oral suspension with concentration of 20 mg/5 ml.

Prozac Weekly is 90 mg of regular enteric-coated fluoxetine, taken every 7 days. These capsules resist dissolution until reaching a segment of the gastrointestinal tract where the pH exceeds 5.5. The enteric coating delays the onset of absorption of fluoxetine 1 to 2 hours relative to the immediate-release formulations.

Controversy
In the late 1990s, backlash grew against Prozac. Prozac's manufacturer, Eli Lilly and Company, which had earned billions from the drug's success became the target of numerous accusations (see David Healy affair). Lawsuits amounting to millions were instigated, contending that the drug made users feel suicidal and/or caused other serious side effects. The accusations and lawsuits have been unsuccessful in stemming the prescription and use of the medication, as well as in making the accusers some of Lilly's profits. Recently, the US FDA considered similar controversial issues regarding Prozac and its use in children and adolescents; it issued a "black box warning" (its most serious warning) for Prozac and other antidepressants (SSRI's and antidepressants of related classes) due to findings of increased suicidal tendency in some children and adolescents on the drugs.

A more recent controversy embroiled Lilly, and a class action lawsuit has been filed after several people received in the mail free samples of Prozac Weekly™. The suit alleges that the samples' recipients' right to privacy was mishandled.

In August 2004 a report by the Environment Agency found trace amounts of fluoxetine in UK drinking water, although the Drinking Water Inspectorate said that it was unlikely to pose a health risk. However, the effects from ingestion of fluoxetine in drinking water have not been investigated.

In January, 2005, the British Medical Journal leaked official Eli Lilly documents from the 1980s suggesting there was a link between fluoxetine and suicide and psychosis. It was originally claimed that the documents had not been previously disclosed, and they were subsequently provided to the FDA for further investigation. However, Eli Lilly insisted that the documents had been released in earlier litigation.[16] The British Medical Journal ultimately retracted its claim that the documents had not been previously disclosed, and apologized to Eli Lilly.

Advertisements for Prozac have claimed for years that the medication works by correcting a chemical imbalance in the brain, a claim that is not supported by the product label and has been confirmed as false by the head of the FDA psychopharmacological drugs committee . Yet, these claims are likely to have led to the drugs popularity.

Prozac for children
On 7th June 2006, the European Medicines Agency had announced that Prozac could be prescribed for children as young as 8 years old. They had concluded that the benefits of Prozac outweighed the risks in children with moderate to severe depression who had failed to respond to psychological therapy. However, they have warned that the drug should only be used in combination with on-going therapy and not as a stand alone treament .

Post SSRI Sexual Dysfunction (PSSD) is a type of sexual dysfunction caused directly by the previous use of SSRI antidepressants. While apparently uncommon, it can last for months, years, or sometimes indefinitely after the discontinuation of SSRIs. It may represent a specific subtype of Persistent Adverse Neurological Effects following SSRI discontinuation

One or more of the following sexual symptoms persist or begin after the discontinuation of SSRIs.

Decreased or absent libido
Impotence or reduced vaginal lubrication
Difficulty initiating or maintaining an erection or becoming aroused
Persistent sexual arousal syndrome despite absence of desire
Muted, delayed or absent orgasm (anorgasmia)
Reduced experience of pleasure during orgasm (ejaculatory anhedonia)
Premature ejaculation
Weakened penile, vaginal or clitoral sensitivity
Genital anesthesia
Loss or decreased response to sexual stimuli
Reduced semen volume
Priapism

It is well known that the selective serotonin reuptake inhibitors (SSRIs) can cause various types of sexual dysfunction. Initial studies found that such side effects occur in less than 10% of patients, but those studies relied on unprompted reporting, so the frequency of such problems was underestimated. In more recent studies, doctors have specifically asked about sexual difficulties, and found that they are present at between 83% and 98% of patients.

However, while sexual dysfunction is obviously very common while taking SSRIs, the problem of persistent dysfunction after discontinuation does not appear to be as frequent, or at least not as well-known or researched. Onset of sexual problems often occurs during, and sometimes after, extended SSRI use but there have been reports of fairly rapid onset as well. It appears as though the majority of people regain their sexual function after stopping SSRIs, but a minority do not, and are faced with the tardive symptoms of Post SSRI Sexual Dysfunction (PSSD).
It is currently not known what causes PSSD.

If the person develops any kind of sexual dysfunction switch to Bupropion XL or Mirtazapine.

Answer 2

I was proscribed Prozac by a doctor to help me quit smoking. My PC doc told me that Prozac was a great drug, much maligned by the press over a few incidents involving people who had violent tendencies before taking the drug.
I'm told that while Prozac was developed as an anti-depressant, its best used for treating Obsessive-Compulsive Disorder which may be why you doctor chose this drug to treat your family member.
After a while I ran out and didn't refill. I didn't taper off, and I didn't get violent and I didn't start smoking for another two years, and then did only because I chose to.

Answer 3

This drug has different side effects on everyone.I take 20mg a day. My 14 year old was on it and he came to me telling me he was thinking about killing his brother and sister and he wanted me to help him with those thoughts.We put him in the hospital and they took him off it. My brother would become homicidal too when he was on it also.He made my dad leave him on the side of the road because he didn't want to hurt my dad.I don't have those side effects.everyone is different. I would definitely make sure the person is aware that these symptoms can happen so the know its the meds if the have homicidal or suicidal thoughts.It is also worse on teenagers.watch for signs.

Answer 4

Because it didn't work well for someone and it got blown out of proportion. It is not addictive, nor does it have many side effects. I took it for 2yrs. for PMDD (Pre-menstrual dysphoric disorder), or very severe pms. It is not a "happy" pill, like some think. It is simply a mood "stabilizer" meaning it is supposed to level off your moods. So during my menstrual cycle I didn't feel happy, or dopey, I simply felt the same as I did the rest of the month. It worked great for me. It's just not for everyone. So don't know why it got a bad rep.

Answer 5

GO to webmd.com and do a search, very helpful. HOWEVER it depends on why they are taking it. Are they having problems with depression or are they bi-polar? Bipolar should never take prozac as it makes their moods swings worse

Answer 6

weight loss with Prozac?

Answer 7

Premature ejaculation is caused by specific things that you do before and during sex. Most of the time without even realizing it. Read here https://tr.im/d1vwN

Premature ejaculation is not some gene you're born with, the result of your penis size or a part of your personality that you can never change.

Answer 8

Lost none to the terrorists, lost a few to our government in the name of security though. If the goal of the terrorists was to eliminate our freedoms, then our government has given them what they want.

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Answer 9

prozacpros cons

Answer 10

http://www.crazymeds.org/prozac.html