Prozac (Fluoxetine) – Efeitos colaterais, dosagem, interações


P: O Prozac causa ganho de peso? E como o peso é afetado ao sair do Prozac?

R: Em algumas pessoas, o Prozac ajuda a reduzir o apetite. Você deve ter uma boa dieta equilibrada quando você está saindo deste medicamento.

P: O Prozac causa ganho de peso? E como o peso é afetado ao sair do Prozac?

R: O ganho de peso foi relatado como um efeito colateral frequente do Prozac, ocorrendo em mais de 1% das pessoas que o tomam. Converse com seu médico sobre uma alternativa ao Prozac se você estiver preocupado com o ganho de peso.

P: Estou tomando a marca genérica do Prozac recentemente, em vez do nome da marca, devido à acessibilidade. Meu peso subiu alguns quilos. Isso é possível?

R: A forma genérica do Prozac não deve causar um aumento de peso, uma vez que todos os ingredientes ativos são os mesmos e devem atender aos mesmos padrões da FDA. Converse com seu médico para se certificar de que não há outros problemas médicos que possam estar causando o ganho de peso.

P: O Prozac causa ganho de peso? Eu me exercito e como muito bem, mas não consigo diminuir o peso.

R: Os inibidores seletivos da recaptação da serotonina (ISRSs), a classe de medicamentos incluindo o Prozac (fluoxetina), têm sido associados a mudanças no peso. Os pacientes devem entrar em contato com seu médico para quaisquer alterações em sua condição médica, incluindo ganho de peso incomum. Para informações mais específicas, consulte seu médico ou profissional de saúde. Você também pode encontrar informações úteis em

P: O uso prolongado de 50 mg de Prozac por dia pode causar câncer ou qualquer tipo de doença orgânica ou sanguínea?

R: O Prozac é um dos antidepressivos mais antigos no mercado atualmente. Com 20 anos de prescrição e relato de efeitos colaterais, não há efeitos adversos a longo prazo conhecidos relacionados à medicação.

P: O Prozac semanal pode causar dores no peito e palpitações?

R: As informações de prescrição do Prozac semanal listam as palpitações como um efeito colateral frequente da medicação, ocorrendo em 1 de cada 100 pacientes. Você deve conversar com seu médico sobre qualquer tipo de dor no peito que esteja sentindo.

P: Atualmente estou tomando Prozac 10 mg e estou pensando se isso pode estar afetando meu peso, a inchação / vermelhidão no meu rosto?

R: De acordo com a literatura disponível para o Prozac (fluoxetina), as alterações no peso foram um efeito colateral relatado. Os estudos mostraram que vários tipos de efeitos colaterais dermatológicos foram relatados. Se tiver sintomas incomuns ou incômodos durante o uso de Prozac (fluoxetina), converse com seu médico para determinar a causa. Para obter informações adicionais sobre o Prozac (fluoxetina), visite nosso site:.

Q: Tikosyn interage com o Prozac?

R: É sempre importante estar ciente dos medicamentos que você toma e possíveis interações medicamentosas. De acordo com a informação de prescrição, Tikosyn e Prozac podem interagir e causar efeitos colaterais potencialmente perigosos. Você pode conversar com seu médico para discutir outras opções de tratamento. Para informações adicionais sobre o Tikosyn ou Prozac, você pode querer visitar nosso site, e.

P: Meu filho adolescente está tomando Prozac. Quais são os efeitos colaterais e quais são os riscos de ter sua dose aumentada toda vez que ele visita o médico? O médico aumentou a dose sem levar em conta minhas preocupações como pai. Meu filho tem apenas 13 anos de idade.

R: Em alguns casos, um médico iniciará um paciente com uma dose baixa de um medicamento como o Prozac. Isso pode ser feito para minimizar a chance de efeitos colaterais, particularmente nos estágios iniciais do tratamento, e tentar encontrar a menor dose efetiva. O médico geralmente fará com que o paciente venha para consultas de acompanhamento para avaliar como o medicamento está funcionando e como o paciente está tolerando a medicação. Durante estas avaliações, o médico pode decidir aumentar a dose. Essa estratégia é às vezes chamada de "começar baixo e ir devagar". É uma tentativa de obter o melhor efeito de um medicamento – o maior benefício com menos riscos. Os doentes que tomam Prozac devem contactar o seu médico se apresentarem sintomas novos ou agravantes, como alterações de humor ou comportamento, ansiedade, ataques de pânico, dificuldade em dormir ou se sentirem impulsivos, irritáveis, agitados, hostis, agressivos, inquietos, hiperactivos ( mentalmente ou fisicamente), mais deprimidos, ou ter pensamentos suicidas ou prejudicar a si mesmos. Alguns efeitos colaterais graves do Prozac são convulsões (convulsões); tremores; tremores; rigidez muscular ou espasmos; vermelho, bolhas, descamação da pele; erupção cutânea; problemas com equilíbrio ou coordenação; e agitação, confusão, sudorese ou batimentos cardíacos acelerados. Os efeitos secundários menos graves do Prozac são sonolência, tonturas, fraqueza, corrimento nasal, dores de garganta, dores de cabeça, sintomas de gripe, náuseas, diarreia, alterações do apetite, alterações de peso, diminuição do desejo sexual, impotência, dificuldade em ter orgasmo, boca seca e aumento da sudorese. Você deve relatar quaisquer efeitos colaterais que seu filho possa estar tendo do Prozac.

Q: Você pode tomar Prozac com a pílula de dieta Alli?

A: Alli é um medicamento para perda de peso que bloqueia a absorção de algumas gorduras consumidas pelas pessoas. Prozac é um antidepressivo usado para tratar condições de ansiedade, depressão, pânico e transtorno obsessivo compulsivo. Não há interações medicamentosas conhecidas entre Alli e Prozac. Não inicie nem interrompa qualquer novo tratamento sem primeiro consultar o seu médico.

Q: A fluoxetina (Prozac) faz você ganhar peso?

R: As alterações de peso são efeitos colaterais comuns com os inibidores seletivos da recaptação da serotonina (ISRSs), a classe de medicamentos que inclui o Prozac (fluoxetina). Há uma variedade de medicamentos nesta classe e alguns causam mais ganho de peso do que outros. Agentes de troca podem ou não ajudar. Consulte o seu médico sobre qualquer ganho de peso incomum e para ver se a troca de medicamentos é adequada com base em suas circunstâncias específicas. Não pare ou altere a quantidade de medicação que você toma sem falar primeiro com seu médico. Você também pode encontrar informações úteis em Sarah Lewis, PharmD

Q: Eu tenho tomado Prozac e Wellbutrin juntos por 2 anos. Eu tenho que levá-los para sempre?

R: Tanto o Prozac (fluoxetina) quanto o Wellbutrin (bupropiona) são antidepressivos normalmente usados ​​para tratar a depressão, embora possam ser usados ​​para outros fins. O seu médico irá reavaliar periodicamente o seu progresso com estes medicamentos para determinar se eles ainda são necessários. Seu médico é mais capaz de orientar suas decisões de tratamento com base em suas circunstâncias específicas. Não pare ou altere a quantidade de medicação que você toma sem falar primeiro com seu médico. Você também pode encontrar informações úteis em

Q: Quanto tempo demora para o Prozac sair do corpo?

A: Prozac (fluoxetina) tem uma eliminação lenta. A taxa de eliminação depende de vários fatores, incluindo por quanto tempo o paciente está recebendo o medicamento, o metabolismo individual do paciente, etc. O Prozac é decomposto no organismo por um metabólito ativo chamado norfluoxetina. A norfluoxetina pode ter uma semi-vida de 4-16 dias, dependendo da duração da terapia da medicação. A meia vida é a quantidade de tempo que leva para metade da droga ser eliminada do corpo. Essa meia-vida longa pode fazer com que a substância ativa permaneça no corpo por semanas após a interrupção da dosagem. Jennyfer Marisco, RPh

Q: A fluoxetina (Prozac) pode ser tomada com Adipex (phentermine)?

Q: Prozac pode causar queda de cabelo?

R: A perda de cabelo, também chamada de alopecia, é um efeito colateral raro, mas possível, do Prozac (fluoxetina). É sempre uma boa idéia verificar com o seu médico em assuntos como este. Aqui está um link para mais informações sobre o Prozac:. Gregory Latham, RPh

P: Recentemente descontinuei o uso do Prozac sob a direção do meu médico. Uma das razões pelas quais descontinuei a medicação foi devido a tontura e sudorese durante a noite. Quando interrompi a medicação antes, esses sintomas pareciam desaparecer. Desta vez, no entanto, estou tendo ondas de calor e rubor e estou suando e quente durante o dia e a noite. Tenho 47 anos de idade. Você acha que meus sintomas são de interromper o Prozac ou o início da perimenopausa?

R: Como a primeira vez que você parou o Prozac, os sintomas desapareceram e, dessa vez, eles não desapareceram, parece que esse pode ser o início da menopausa. Você deve discutir isso com seu médico para que eles possam determinar se esta é a condição médica que está ocorrendo e não diferente. Eu incluí um site com mais informações para você. Gerald R. Levy, RPh

P: Quão jovem é jovem demais para começar a tomar o Prozac?

R: Existem doses aprovadas do Food and Drug Administration para o Prozac para crianças a partir dos 7 anos. É claro que há um risco adicional para os jovens que usam o Prozac. Um aviso de caixa preta é anexado ao Prozac e basicamente afirma que há um aumento no risco de suicídio em crianças, adolescentes e adultos jovens que usam este medicamento. Como sempre, converse com seu médico e expresse suas preocupações antes de tomar qualquer novo regime de medicação. Você quer se sentir confortável com a medicação que você está colocando em seu corpo. Megan Uehara, PharmD

Q: Minha filha tem depressão. Ela tomou Prozac, mas isso a fez se sentir apática. Existe outro antidepressivo que tenha menos efeitos colaterais?

A: Infelizmente, sua pergunta não tem uma resposta simples. O tratamento com antidepressivos é extremamente específico do paciente. Muitas vezes, é baseado em tentativa e erro para encontrar o equilíbrio adequado entre os resultados terapêuticos desejados e os efeitos colaterais indesejados. Se ela estiver sentindo efeitos colaterais incômodos, sua filha pode entrar em contato com seu médico para discutir outras opções de tratamento. Você também pode encontrar informações úteis sobre Prozac em. Beth Isaac, PharmD

Q: Eu tenho depressão e ansiedade. Estou muito estressado por ficar em casa por quase três anos com meus filhos de 4 anos e 9 meses de idade. Devo tomar 10 mg de Prozac ou esperar para ver se tudo desaparece? Eu estou nervosa, isso vai fazer sexo problemático ou causar efeitos colaterais sérios que eu não tenho. Eu enchi a receita, mas não a tomei por cinco dias porque estou muito nervosa. O que você recomenda?

R: Estou curioso para saber como você veio pelo Prozac (fluoxetina). É algo que foi prescrito para você ou para outra pessoa? Existem efeitos colaterais sexuais. No entanto, 10 mg é uma dosagem bastante baixa e não é necessariamente eficaz para todas as pessoas. O maior problema com o Prozac é que sua latência pode ser de até seis semanas até que uma melhora seja notada. Eu entraria em contato com um provedor e pediria que eles sugerissem algo que pudesse entrar em vigor em um curto período de tempo se eles parecessem adequados. Matt Curley, PharmD

P: Você pode me dizer quais são os sintomas exatos para a retirada do Prozac? Você pode sofrer ondas no cérebro toda vez que seu coração bater?

R: De acordo com o folheto informativo do Prozac, segue-se uma lista de sintomas que podem ocorrer após a descontinuação do Prozac. Estes sintomas incluem: humor disfórico (sentir-se ansioso, deprimido ou desconfortável); irritabilidade e agitação; tontura; distúrbios sensoriais, como sensações de choque elétrico; ansiedade; confusão; dor de cabeça; cansaço; insônia (incapacidade de dormir); labilidade emocional (reações emocionais excessivas); e hipomania. Esta pode não ser uma lista completa dos efeitos colaterais da interrupção e outros podem ocorrer. Informe o seu médico sobre qualquer efeito colateral incomum ou incômodo. Kristen Dore, PharmD

Q: Eu estou atualmente com 40 mg de Prozac. Ainda me sinto muito deprimido (embora muito menos ansioso). Eu tenho alguma esperança de reduzir a depressão em 60 mg ou o Prozac simplesmente não vai fazer isso? Todos os SSRIs serão incompatíveis comigo para depressão se o Prozac for?

A: Você tem muitas opções disponíveis para você. O mais importante é conversar com seu médico sobre seu tratamento atual e sua insatisfação. Seu médico pode optar por aumentar sua dosagem. A dose máxima em adultos do Prozac para o tratamento da depressão é de 80 mg por dia. Existem também vários outros medicamentos disponíveis na mesma classe que o Prozac (SSRI) ou em outras classes de medicamentos. Como sempre, converse com seu médico sobre seus medicamentos e não altere sua dosagem do medicamento sem falar com seu médico primeiro. Em anexo, há um link para informações adicionais fornecidas pela Everyday Health sobre como encontrar o medicamento certo para tratar a depressão:. Jen Marsico RP

P: O Prozac é realmente seguro para uma vida inteira com 50 mg por dia? Eu sou do sexo masculino e 66. É seguro com nutrientes naturais / suplementos de diluentes de sangue, como óleos de peixe, vitamina E e outros? O informativo diz: "Prossiga com cautela com qualquer coisa que afete a ação plaquetária". É seguro se você também é um bebedor de cacau pesado em vista do teor relativamente alto de inibidor de triptofano e monoamina oxidase do cacau?

R: Sua pergunta é se o Prozac (fluoxetina) é seguro para uma vida inteira de 50 mg por dia. Você também perguntou se é seguro tomar anticoagulantes naturais e se você é um bebedor pesado de cacau. De acordo com a Lexi-Comp, o Prozac é doseado entre 20 mg e 60 mg por dia, dependendo da indicação. A quantidade máxima recomendada é de 80 mg / dia. Infelizmente, não posso dizer de uma forma ou de outra se a medicação será segura para sua vida inteira. Existem muitos fatores que contribuem para isso. No entanto, vou dizer que, ao avaliar a medicação, o paciente e o médico devem levar em consideração os benefícios e os riscos associados à medicação. Se você começar a sentir reações adversas da medicação ou se não for um tratamento eficaz, você e seu médico podem precisar considerar outra terapia. De acordo com a Lexi-Comp, o Prozac pode interagir com medicamentos que afinam o sangue ou têm efeitos antiplaquetários. Por favor, fale com o seu médico para saber se deve tomar os óleos de peixe e a vitamina E enquanto toma Prozac. De acordo com a Lexi-Comp, a recomendação sobre o manejo dessa interação, se for necessário para o paciente estar na combinação, é monitorar de perto o paciente quanto a sinais e sintomas de sangramento ou hematomas excessivos. A terapia deve ser monitorada pelo seu médico. Eu entendo seu raciocínio com preocupações sobre o cacau e o Prozac, mas não consegui encontrar nenhuma informação bem documentada sobre isso. A Lexi-Comp não mencionou nada nas considerações dietéticas específicas do cacau e do Prozac. No entanto, há menção de que a cafeína deve ser evitada durante a medicação e, por vezes, o cacau contém cafeína. Eu me deparei com um artigo de pesquisa que levantou a hipótese de que, após um paciente tomando Prozac comer chocolate, ele desenvolveu uma erupção cutânea que pode ter sido atribuída ao paciente ser muito sensível à atividade no sistema serotoninérgico na área juncional dérmica e epidermo-dérmica. Como sempre, converse com seu médico sobre questões que você tem sobre seus medicamentos e interações entre medicamentos e suplementos. Sempre fale com o seu médico antes de começar a tomar suplementos, para que possa ser determinado se o suplemento é apropriado para você. Jen Marsico RPh

Q: Eu tenho transtorno disfórico pré-menstrual (TDPM) e estava tomando Prozac. Eu experimentei um ganho de peso de 25 quilos em 18 meses. Parei de tomar há 4 semanas, mas sinto que meu metabolismo foi afetado por isso. Eu estou vendo o que eu como e malhando, mas o peso não está saindo. O metabolismo pode ser afetado depois de parar a medicação?

R: De acordo com o folheto informativo do Prozac (fluoxetina), o fármaco tem uma meia-vida longa de eliminação, o que significa que demora muito tempo para o medicamento ser eliminado do seu organismo. Mesmo quando a dosagem é interrompida, a substância ativa permanece no corpo por semanas. A quantidade depende das características individuais do paciente, do regime de dosagem prévio e da duração da terapia anterior no momento em que o medicamento é interrompido. Sua taxa metabólica basal é a quantidade de energia que seu corpo queima em repouso. Uma maneira eficaz de influenciar o metabolismo é através do exercício. Para mais informações sobre o metabolismo, exercícios e perda de peso, visite e consulte o seu médico. Você é encorajado a relatar quaisquer efeitos colaterais negativos dos medicamentos prescritos a seu médico e à Food and Drug Administration (FDA) visitando www.fda.gov/medwatch ou ligando para 1-800-FDA-1088. Michelle McDermott, PharmD

P: Eu fui diagnosticado com depressão em janeiro de 2010, e meu médico me colocou no Prozac. Eu li sobre o ganho de peso a longo prazo do Prozac como um dos principais efeitos colaterais do medicamento. Estou preocupado porque tenho lutado contra um distúrbio alimentar há cinco anos e estou pensando em me livrar do remédio se isso inevitavelmente levar ao ganho de peso. O que você aconselha?

R: Os medicamentos para depressão mais amplamente utilizados no mercado são os inibidores seletivos da recaptação da serotonina (ISRSs) e os inibidores seletivos da recaptação da serotonina e noradrenalina (ISRNs). Essas drogas são amplamente prescritas porque seus efeitos colaterais são limitados. No entanto, eles ainda têm alguns efeitos colaterais. Ganho de peso pode ser um efeito colateral comum de ambas as classes de drogas. No entanto, os pacientes podem reagir de maneira diferente a medicamentos diferentes dentro dessas classes. Se os efeitos colaterais, como o ganho de peso, ocorrerem e se tornarem um problema para você, às vezes ajudará a trocar os medicamentos. Verifique se o seu médico está ciente de seu histórico médico, incluindo o transtorno alimentar. Consulte o seu médico se ocorrer ganho de peso para ver se a troca de medicamentos é adequada para você. SSRIs disponíveis, que afetam a serotonina, incluem paroxetina (Paxil), fluoxetina (Prozac), fluvoxamina (Luvox), sertralina (Zoloft), escitalopram (Lexapro) e citalopram (Celexa); Os SNRIs, que afetam a serotonina e a norepinefrina, incluem venlafaxina (Effexor), duloxetina (Cymbalta) e mirtazapina (Remeron). Não pare ou altere a quantidade de medicação que você toma sem falar primeiro com seu médico. Parar repentinamente o Prozac pode levar a sérios efeitos colaterais de abstinência. Parar o Prozac só deve ser feito sob a supervisão de um médico que possa orientá-lo no ajuste gradual da dose. Você também pode encontrar informações úteis em. Sarah Lewis, PharmD

Q: Qual é a melhor maneira de parar de tomar Prozac 40 mg por dia?

R: Você gostaria de trabalhar com seu médico para chegar a uma redução gradual da dose ao longo do tempo para descontinuar este medicamento. Uma interrupção abrupta do Prozac (fluoxetina) pode causar uma síndrome de descontinuação, incluindo cefaléia, letargia, desconforto gastrointestinal, insônia, pesadelos, tontura, vertigem, tremor, agitação, ansiedade, irritabilidade e confusão mental. Você também pode encontrar informações úteis sobre depressão em.

P: Você já ouviu falar do Prozac sendo prescrito para enxaquecas menstruais?

R: Embora a enxaqueca menstrual não seja uma indicação aprovada pelo FDA para o Prozac (fluoxetina), ela é às vezes prescrita para enxaquecas menstruais. Prozac é aprovado para transtorno disfórico pré-menstrual (PMDD). Dores de cabeça são um sintoma de PMDD. PMDD sintomas geralmente ocorrem após o meio de um ciclo mensal após a ovulação e geralmente piora durante a semana antes da menstruação. O Prozac pode ser uma prevenção eficaz contra a dor de cabeça entre a ovulação e a menstruação. Se as enxaquecas continuarem a romper mesmo durante o uso do Prozac, a dose pode ser aumentada imediatamente antes da menstruação. A dosagem terá que ser determinada por um médico e é sempre bom falar com seu médico sobre quaisquer preocupações que você possa ter. Megan Uehara, PharmD

P: Quando comecei a tomar o Prozac, perdi o apetite. Agora parece que estou sempre morrendo de fome. Isso poderia ser a medicação?

R: A perda de peso é listada como uma reação comum ou efeito colateral de tomar o Prozac (fluoxetina). Os efeitos colaterais podem ser específicos do paciente. Verifique com seu médico antes de fazer qualquer alteração em suas drogas ou doses. Clique no link a seguir para obter informações adicionais:.

P: O Prozac faz você ganhar peso?

A: Prozac (fluoxetina) () relatou efeitos adversos de problemas de peso. A anorexia (falta de apetite) foi relatada em 4% a 17% dos pacientes estudados durante os ensaios clínicos. A perda de peso também foi relatada em 2 por cento e aumento do apetite, ganho de peso e perversão do paladar também foram relatados. Aumento do apetite pode ser um fator em pacientes que notam ganho de peso durante o uso do Prozac. No entanto, tenha em mente que existem muitas causas para o ganho de peso, além dos possíveis efeitos colaterais dos medicamentos. Como sempre, converse com seu médico sobre as perguntas que você tem sobre seus medicamentos e os efeitos colaterais associados. Se você está tentando perder peso, o link em anexo irá fornecer informações valiosas da Everyday Health sobre perda de peso:. Jen Marsico, RPh

Q: Meu médico aumentou minha dose de Prozac. Desde então, tenho tido problemas em ficar acordado à tarde, especialmente depois do almoço. Este Prozac extra poderia estar causando isso?

R: Você provavelmente está certo sobre isso. Um dos efeitos colaterais do Prozac é a sonolência e isso pode ser o que está causando cansaço à tarde. Para algumas pessoas, esse efeito desaparece após um período de tempo até que os níveis da droga se tornem mais nivelados no corpo. Se isso é muito incômodo para você, tente falar com seu médico para ver se você pode trocar medicamentos ou se há alguma outra recomendação que eles possam ter. Megan Uehara, PharmD

P: O uso do Prozac vai me fazer ganhar peso e ficar com fome o tempo todo?

R: O Prozac (fluoxetina) pode afetar as mudanças de peso. Se você observar alterações anormais no seu peso, converse com seu médico. Todas as drogas desta classe podem ter efeitos colaterais de mudança de peso. Cada um pode afetar cada pessoa de forma diferente. Você deve discutir isso com o seu provedor antes de tomar .. Para mais informações você pode ir para Gerald Levy, RPh

P: Poderia levar o Prozac a atrasar a fala ou a gagueira?

R: O Prozac (fluoxetina) lista uma mudança na fala e na gagueira como possíveis efeitos colaterais. Se você está tendo esse efeito colateral, e não é tolerável, você pode querer consultar o seu médico para ver se uma medicação alternativa pode ser melhor para você. Existem muitos antidepressivos disponíveis e alguns funcionam melhor que outros para as pessoas. Se você quiser mais informações sobre depressão e medicamentos, visite nossos links em: e. Patti Brown, PharmD

Q: Atualmente eu tomo Prozac e Abilify. Então eu tomo Centrum e às vezes óleo de peixe e óleo de vitamina E. Esta é uma combinação segura?

R: O Prozac (fluoxetina) é um inibidor seletivo da recaptação da serotonina (ISRS) aprovado para o tratamento de depressão maior (incluindo depressão pediátrica), transtorno obsessivo-compulsivo (em populações adultas e pediátricas), bulimia nervosa, transtorno do pânico e transtorno disfórico pré-menstrual . Abilify (aripiprazol) é um antipsicótico atípico e antidepressivo usado no tratamento da esquizofrenia, transtorno bipolar e depressão clínica. De modo geral, as interações medicamentosas se enquadram em três categorias principais: Interações medicamentosas (ou seja, prescrição, venda livre, herbais, suplementos alimentares) ocorrem quando dois ou mais medicamentos reagem um com o outro. Interações medicamentosas (alimentos / bebidas) resultam de drogas que reagem com alimentos ou bebidas. Interações fármaco-doença podem ocorrer quando uma condição médica existente torna certas drogas potencialmente prejudiciais. Com Abilify e Prozac, o uso concomitante de dois ou mais medicamentos que têm o potencial de deprimir a função do SNC (seja como intenção terapêutica ou como efeito colateral) é frequentemente clinicamente apropriado. No entanto, é importante reconhecer que o risco de efeitos indesejados pode aumentar com esse uso. É importante monitorizar os efeitos depressores do SNC aditivos se dois ou mais depressores do SNC forem utilizados concomitantemente. Para obter informações mais detalhadas, consulte seu médico ou farmacêutico para obter orientação com base em sua condição específica e nos medicamentos atuais, especialmente antes de tomar qualquer ação. Shereen A. Gharbia, PharmD

P: Qual a diferença entre o Prozac e o Zoloft?

A: Prozac (fluoxetina) e Zoloft (sertralina) são ambos antidepressivos classificados na classe dos inibidores seletivos da recaptação da serotonina (ISRS). O Prozac e o Zoloft são aprovados para o tratamento de depressão grave (incluindo depressão pediátrica), transtorno obsessivo-compulsivo (em populações adultas e pediátricas), bulimia nervosa, transtorno de pânico e transtorno disfórico pré-menstrual. Evidências sugerem que o Zoloft (sertralina) pode funcionar melhor que o Prozac (fluoxetina) para alguns subtipos de depressão. Os efeitos colaterais comuns a ambos são náusea, falha na ejaculação, insônia, diarréia, boca seca, sonolência, tontura, tremor e diminuição da libido. Para quaisquer preocupações imediatas, consulte seu médico. Joseph Hall, RPh

P: Estou deprimido, agora no Prozac, 4 semanas com 20 mg e 2 semanas com 40 mg. Quanto tempo leva para atingir seu potencial?

A: Prozac (fluoextine) () pertence à classe de medicamentos chamados inibidores seletivos da recaptação da serotonina (SSRIs). Prozac afeta as substâncias químicas no cérebro que se tornam desequilibradas e causam depressão, ansiedade e sintomas obsessivo-compulsivos. () O Prozac pode ser tomado com ou sem alimentos e a qualquer hora do dia. Pode demorar pelo menos 4 a 6 semanas para o medicamento começar a funcionar. Não pare de tomar o Prozac abruptamente sem primeiro falar com o médico, pois isso pode causar efeitos colaterais indesejados. Efeitos colaterais comuns do Prozac incluem dor de cabeça, náusea, insônia, sonolência, boca seca, diarréia. Kimberly Hotz, PharmD

P: Tenho tomado 20mg de Prozac e agora sou aconselhado a tomar metade da dose de Zoloft. Que mg de Zoloft é igual a 10 mg de Prozac?

A: O Prozac (fluoxetina) é um antidepressivo inibidor seletivo da recaptação da serotonina (ISRS). Prozac é aprovado pelo FDA para uso em transtorno depressivo maior, bulimia nervosa, transtorno obsessivo compulsivo, transtorno disfórico pré-menstrual, transtorno do pânico e transtorno bipolar. Zoloft (sertralina) também é um antidepressivo SSRI. Zoloft é aprovado pelo FDA para tratamento de depressão maior, transtorno obsessivo compulsivo, transtorno de pânico, transtorno de estresse pós-traumático, transtorno disfórico pré-menstrual e transtorno de ansiedade social. A dose mais baixa de Prozac disponível em cápsulas é de 10 mg. A dose mais baixa de Zoloft disponível em comprimidos é de 25 mg. 10mg de Prozac seria aproximadamente equivalente a 25mg de Zoloft. Laura Cable, PharmD

P: Como faço para sair do Prozac?

A: Prozac (fluoextine) () pertence à classe de medicamentos chamados inibidores seletivos da recaptação da serotonina (SSRIs). Prozac afeta as substâncias químicas no cérebro que se tornam desequilibradas e causam depressão, ansiedade e sintomas obsessivo-compulsivos. () O Prozac pode ser tomado com ou sem alimentos e a qualquer hora do dia. Pode demorar pelo menos 4 a 6 semanas para o medicamento começar a funcionar. Não pare de tomar o Prozac abruptamente sem primeiro falar com o médico, pois isso pode causar efeitos colaterais indesejados. Efeitos colaterais comuns do Prozac incluem dor de cabeça, náusea, insônia, sonolência, boca seca, diarréia. Consulte o seu médico sobre como descontinuar com segurança o Prozac. Quando seu médico prescrever um novo medicamento, certifique-se de discutir todos os seus medicamentos prescritos e medicamentos de venda livre, incluindo suplementos alimentares, vitaminas, vegetais, minerais e ervas, assim como os alimentos que ingere. Mantenha sempre uma lista atual dos medicamentos e suplementos que você toma e revise-a com seus profissionais de saúde e seu farmacêutico. Se possível, use uma farmácia para todas as suas prescrições e produtos vendidos sem receita. Isso permite que seu farmacêutico mantenha um registro completo de todos os medicamentos prescritos e avise sobre interações medicamentosas e efeitos colaterais. Para obter informações mais específicas ou se tiver dúvidas sobre o Prozac não funcionar de forma eficaz, consulte o seu médico ou farmacêutico para obter orientação com base no seu estado de saúde e nos medicamentos atuais, especialmente antes de tomar qualquer ação. Kimberly Hotz, PharmD

P: Eu tomo Prozac e me pergunto se também posso tomar flor de maracujá para estresse e ansiedade. Haverá uma interação entre isso e o Prozac?

R: Há relatos de que o aumento da sedação ou da pressão arterial baixa pode resultar da ingestão de flor de maracujá junto com antidepressivos, incluindo o Prozac. Converse com seu médico antes de tomar quaisquer vitaminas ou suplementos, pois muitos deles podem interagir com a medicação que você está tomando. Para mais informações sobre o Prozac, vá para. Gerald S. Levy, RPh

P: O Prozac causaria suor excessivo e baixo nível de sódio no sangue?

A: O Prozac (fluoxetina) é classificado como inibidor seletivo da recaptação da serotonina (ISRS). Prozac é aprovado para o tratamento da depressão, tratamento de compulsão alimentar e vômitos em pacientes com bulimia nervosa, transtorno obsessivo compulsivo (TOC), transtorno disfórico pré-menstrual (TDPM), transtorno de pânico e em combinação com outros medicamentos para depressão bipolar. De acordo com referências médicas, a diaforese é um possível efeito colateral associado ao uso do Prozac e tem sido relatado em pacientes estudados com incidência de 2% a 8%. A diaforese é definida como sudorese excessiva. A hiponatremia é listada como um possível efeito colateral do Prozac com uma incidência menor que 1%. A hiponatremia é definida como uma condição em que o nível de sódio no sangue é baixo. Se você acha que está tendo um efeito colateral de sua medicação, fale com seu médico. Não pare de tomar ou mude a dose do medicamento sem falar primeiro com o seu médico. Para informações mais específicas, consulte o seu médico ou farmacêutico para obter orientação com base no seu estado de saúde e nos medicamentos atuais, especialmente antes de tomar qualquer ação. A transpiração excessiva pode ter várias causas. Everyday Health fornece um verificador de sintomas em relação à transpiração excessiva. Clique aqui para acessar o verificador de sintomas. Algo a ter em consideração é que o baixo teor de sódio pode ser causado pela transpiração excessiva. Jen Marsico, RPh

Q: O Prozac tem algum efeito secundário? Se sim, qual é a alternativa? É possível tomar Prozac por toda a minha vida, como sendo aconselhado?

R: Todos os medicamentos têm efeitos colaterais em potencial e todos reagem aos medicamentos de maneira diferente. Embora muitos efeitos colaterais possam estar relacionados, você pode obter um, vários ou nenhum dos efeitos colaterais listados. O Prozac (fluoxetina) é um antidepressivo inibidor seletivo da recaptação de serotonina usado no tratamento da depressão, distúrbios alimentares, transtorno disfórico pré-menstrual e transtorno do pânico. É possível tomar um antidepressivo indefinidamente. Os efeitos colaterais mais comuns com o Prozac são insônia, sonolência, sonolência, náusea e anorexia. Outros efeitos colaterais com o Prozac incluem diarréia, boca seca, ansiedade e fraqueza. Esta não é uma lista completa dos efeitos colaterais associados ao Prozac. Laura Cable, PharmD

P: O Prozac causa ganho de peso?

R: As drogas podem causar ganho de peso de várias maneiras diferentes. Some can increase appetite or make you crave certain types of foods like those high in carbohydrates or fat. Other medications may slow down metabolism or cause fluid retention. However, the effect of prescription drugs on body weight is complex. Some drugs have no effect on weight, while others cause weight gain or weight loss. Also, the same medications can cause weight gain in certain individuals and weight loss in others. There are also drugs that initially cause weight loss and then lead to weight gain with long-term use. Most prescription medications associated with changes in body weight affect the central nervous system. These include antidepressants like monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, and selective serotonin reuptake inhibitors (SSRIs). Mood stabilizers (lithium, valproic acid), antipsychotics, and anticonvulsants have also been linked with weight gain. Prozac (fluoxetine) is an SSRI which may lead to weight gain or loss. Other drugs that have been reported to cause weight gain include diabetes medications (insulin, sulfonylureas, and thiazolidinediones), antihypertensive drugs, certain hormonal contraceptives, corticosteroids, antihistamines, some chemotherapy regimens, and antiretroviral protease inhibitors. If you think a drug you are taking is causing weight gain, tell your health care provider. Do not stop any medication or change the dose without first talking to your provider. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Laura Cable, PharmD., BCPS

Q: I take many vitamins and a few prescriptions; and I tremble all the time. Do any of my medications (meloxicam, Prozac, trazodone, vitamin, folic acid, iron, calcium and cranberry pills) cause this?

A: Tremor is a possible side effect of both Prozac (fluoxetine) and Desyrel (trazodone). Fluoxetine can cause the following nervous system side effects: tremor, headache, anxiety, nervousness, insomnia, drowsiness, sedation, dizziness, jitteriness, and fatigue. The most common side effects of trazodone are: tremor, blurred vision, constipation, decreased appetite, drowsiness, dizziness, dry mouth, headache, light-headedness, muscle aches, nausea, nervousness, and sleeplessness. This is not a complete list of the side effects associated with fluoxetine and trazodone. For more specific information, consult with your doctor or pharmacist Trazodone and fluoxetine can also cause serotonin syndrome, which can be a life-threatening condition. This is rare, but it is more likely when these medications are used together. Symptoms of serotonin syndrome include: sudden muscular contraction, tremor, rigidity, the inability to coordinate movements, irritability, altered consciousness, increased heart rate, hyperthermia, excessive sweating, shivering, abdominal cramping, nausea, vomiting, and diarrhea. You should consult your physician regarding the risks of taking trazodone and fluoxetine together verses the benefits of this combination. The following medications can also increasing the risk of serotonin syndrome: chlorpheniramine, cyclobenzaprine (Flexeril), dextromethorphan (Robitussin DM, etc), meperidine (Demerol), methadone, pentazocine (Talwin), sibutramine (Meridia), St. John's Wort (Hypericum perforatum), tramadol (Ultram), and tricyclic antidepressants. When your doctor prescribes a new medication, be sure to discuss all your prescription and over-the-counter drugs, including dietary supplements, vitamins, botanicals, minerals, and herbals, as well as the foods you eat. Always keep a current list of the drugs and supplements you take and review it with your healthcare providers and your pharmacist. If possible, use one pharmacy for all your prescription medications and over-the-counter products. This allows your pharmacist to keep a complete record of all your prescription drugs and to advise you about drug interactions and side effects. Burton Dunaway, PharmD

Q: I temporarily increased my dose of fluoxetine from 10 mg to 30 mg before having sex for the first time in 18 months to combat premature ejaculation. It worked great the first time I had sex with my girlfriend, but the second, 3rd and 4th times last weekend, I couldn't climax. Did I overdose on it? I'm back to 10 mg per day now, 2,500 miles from my girlfriend.

A: Prozac (fluoxetine) is a medication that is used to treat depression, anxiety or panic disorders. It is in a class of drugs called selective serotonin reuptake inhibitors (SSRIs) and is commonly related to sexual disorders. The prescribing information on fluoxetine states that up to 11 percent of patients taking this medication experience a decrease in sex drive. This medication also causes ejaculation issues in up to 7 percent of patients taking fluoxetine. For more information on fluoxetine, click on this link: There is no way to know if you will experience sexual side effects from a medication before taking it. Sometimes, a patient will not experience any issues until the dosage of a medication is raised. The usual course of action is to decrease the dosage or switch to another medication to try to alleviate the issue. The best thing to do is have a discussion with your physician about your side effects and he or she will be better enabled to help you resolve the problem. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Lori Poulin, PharmD

Q: What are the side effects of Prozac?

A: Prozac (fluoxetine) is a medication that is used to treat depression, anxiety or panic disorders. It is in the family of medications called selective serotonin reuptake inhibitors (SSRIs). This medication works on a chemical in the brain called serotonin, which helps transmit signals from one nerve to another in the brain. When this chemical becomes unbalanced, it causes a variety of different conditions, like depression. This medication helps to balance out serotonin to near normal levels, helping to alleviate the symptoms you experience. For more information on Prozac, click on this link: The prescribing information for Prozac lists the following as the most common side effects of the medication: insomnia, nausea , weakness, diarrhea, headache, loss of appetite, dry mouth, nervousness, decreased sex drive, drowsiness. This is not a complete list of the side effects associated with Prozac. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. When your doctor prescribes a new medication, be sure to discuss all your prescription and over-the-counter drugs, including dietary supplements, vitamins, botanicals, minerals, and herbals, as well as the foods you eat. Always keep a current list of the drugs and supplements you take and review it with your healthcare providers and your pharmacist. If possible, use one pharmacy for all your prescription medications and over-the-counter products. This allows your pharmacist to keep a complete record of all your prescription drugs and to advise you about drug interactions and side effects. Tell your health-care provider about any negative side effects from prescription drugs. You can also report them to the U.S. Food and Drug Administration by visiting www.fda.gov/medwatch or by calling 1-800-FDA-1088. Lori Poulin, PharmD

Q: What are the side efects for Prozac?

A: Prozac (fluoxetine) is a medication that is used to treat depression, anxiety or panic disorders. It is in the class of medications called selective serotonin reuptake inhibitors (SSRIs) and work by balancing out the chemical serotonin in the brain that is causing the symptoms. The prescribing information on Prozac lists the following as common side effects of the medication: insomnia, nausea, weakness, headache, diarrhea, loss of appetite, dry mouth, drowsiness and sexual side effects. This is not a complete list of side effects, for more information click on this link: //www.everydayhealth.com/drugs/prozac For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Lori Poulin, PharmD

Q: Can you tell me more about Prozac?

A: Prozac (fluoxetine) is used to treat depression or obsessive-compulsive disorder (OCD) in adults and children. It is also used to treat bulimia and panic disorder in adults. It may also be used for other conditions as determined by your doctor. Prozac is a selective serotonin reuptake inhibitor (SSRI). It works by restoring the balance of serotonin, a natural substance in the brain, which helps to improve certain mood problems. All medicines may cause side effects, but many people have no, or minor, side effects with fluoxetine. The most common side effects of Prozac are drowsiness, dizziness, anxiety, abnormal dreams, decreased sexual desire or ability, diarrhea, dry mouth, flu-like symptoms, flushing, sweating, loss of appetite, nausea, and trouble sleeping. Some medicines may interact with fluoxetine. Tell your physician if you are taking any other medicines. Do not suddenly stop taking fluoxetine without checking with your doctor. Withdrawal symptoms such as mood changes, numbness or tingling of the skin, dizziness, confusion, headache, trouble sleeping, or unusual tiredness may occur. For more information visit the Everyday Health Depression Center at: or to submit another question return to . Burton Dunaway, PharmD

Q: I recently read that medications can cause bad dreams. I take a low dose of Prozac every other day to help with a mild case of anxiety. Since my Mom passed away five years ago, I have had many upsetting dreams about her being sick. She had a terrible fall and I watched her die in ICU in the hospital. She and I were very close and while I manage my grief well, I still regularly feel sad and upset about what happened to my Mom. Any idea that the medication could be contributing to the bad dreams? I never used to have disturbing dreams. Any recommendations on what I might do to stop or at least minimize these terrible dreams?

A: Prozac (fluoxetine) is a selective serotonin reuptake inhibitor agent prescribed for the treatment of depression, obsessive compulsive disorder, panic disorder and premenstrual dysphoric disorder. A search of the prescribing literature lists abnormal dreams as a common side effect and recommends that if this side effect becomes bothersome, medical intervention is recommended. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action.

Q: How does bourbon interact with Prozac? Can it cause excessive bruising?

A: Prozac (fluoxetine) is in a class of drugs called selective serotonin reuptake inhibitors (SSRIs). Prozac is used to treat depression, obsessive-compulsive disorder, certain eating disorders, and panic attacks. Prozac works by increasing the amount of serotonin in the brain. Serotonin is a natural chemical that assists in maintaining mental balance. Generally speaking, drug interactions fall into three main categories: Drug-drug (i.e., prescription, over-the-counter, herbals, dietary supplements) interactions occur when two or more drugs react with each other. Drug-diet (food/drink) interactions result from drugs reacting with foods or drinks. Drug-disease interactions may occur when an existing medical condition makes certain drugs potentially harmful. No significant interactions between Prozac and bourbon (specifically) were identified; however, this does not necessarily mean no interactions exist. However, according to Prozac

Q: I am one of the slow reactors to the benefits of Prozac. And I do drink coffee – maybe 6 cups a day. Can it interfere with Prozac taking effect?

A: Prozac (fluoxetine) is in a class of drugs called selective serotonin reuptake inhibitors (SSRIs). Prozac is used to treat depression, obsessive-compulsive disorder, certain eating disorders, and panic attacks. Prozac works by increasing the amount of serotonin in the brain. Serotonin is a natural chemical that assists in maintaining mental balance.

Q: Does Prozac cause weight gain?

A: Prozac (fluoxetine) is classified as a selective serotonin reuptake inhibitor (SSRI) antidepressant. Prozac is approved for the treatment of depression, binge-eating, and vomiting in patients with bulimia, obsessive compulsive disorder (OCD), premenstrual dysphoric disorder (PMDD), panic disorder and with other medication to treat bipolar disorder. According to medical references, weight gain is a possible reported side effect of Prozac. Increased appetite and weight loss are also listed side effects of the medication. These are not a complete list of side effects associated with the use of Prozac. Drugs can cause weight gain in several different ways. Some can increase appetite or make you crave certain types of foods like those high in carbohydrates or fat. Other medications may slow down metabolism or cause fluid retention. However, the effect of prescription drugs on body weight is complex. Some drugs have no effect on weight, while others cause weight gain or weight loss. Also, the same medications can cause weight gain in certain individuals and weight loss in others. There are also drugs that initially cause weight loss and then lead to weight gain with long-term use. Most prescription medications associated with changes in body weight affect the central nervous system. These include antidepressants like monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, and selective serotonin reuptake inhibitors (SSRIs). Mood stabilizers (lithium, valproic acid), antipsychotics, and anticonvulsants have also been linked with weight gain. Other drugs that have been reported to cause weight gain include diabetes medications (insulin, sulfonylureas, and thiazolidinediones), antihypertensive drugs, certain hormonal contraceptives, corticosteroids, antihistamines, some chemotherapy regimens, and antiretroviral protease inhibitors. If you think a drug you are taking is causing weight gain, tell your health care provider. Do not stop any medication or change the dose without first talking to your provider. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Jen Marsico, RPh

Q: Can Prozac cause dry skin?

A: Prozac (fluoxetine) is an antidepressant that belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs). SSRIs affect chemicals in the brain that may become unbalanced and cause depression, panic, anxiety, or obsessive-compulsive symptoms. Prozac is used to treat major depressive disorder, bulimia nervosa (an eating disorder) obsessive-compulsive disorder, panic disorder, and premenstrual dysphoric disorder (PMDD). Common side effects of Prozac include drowsiness, dizziness, nervousness, mild nausea, upset stomach, constipation, increased appetite, weight changes, insomnia, decreased sex drive, impotence, and dry mouth. A search of a drug database and the prescribing information for Prozac did not specifically list dry mouth as a possible side effect. This is not a complete list of the side effects associated with Prozac. Sarah Lewis, PharmD

Q: Can the antidepressant, Prozac or its generic equivalent, cause extreme fatigue? My family doctor says no, but now I want your opinion.

A: Prozac (fluoxetine) is classified as a selective serotonin reuptake inhibitor (SSRI) antidepressant medication. Prozac is approved for the treatment of depression, binge eating and vomiting in patients with bulimia nervosa, obsessive compulsive disorder (OCD), premenstrual dysphoric disorder (PMDD), panic disorder and for the treatment of certain patients with bipolar depression in combination with other medications. According to medical references, somnolence is a common reported side effect of studied patients taking Prozac. It has been reported in 5% to 17% of studied patients taking the medication. Somnolence is defined as drowsiness, a state of near sleep, a desire for sleep or sleeping for excessive periods of time. If you think that you are experiencing a possible side effect from your medication, talk to your physician. Do not stop taking or change the dose of your medication without first talking to your physician. Keep in mind that extreme fatigue can be caused by many other factors besides possible side effects of medications. Sleep issues can be associated with some of the medical conditions that Prozac is used to treat. By talking with your physician, the extreme fatigue can be properly diagnosed. Treatment options can be explored after the diagnosis has been made. Jen Marsico, RPh

Q: Will Prozac cause bloating, cramping and gas?

A: Prozac (fluoxetine) is an SSRI (selective serotonin reuptake inhibitor) which is used to treat depression, and bloating, cramping, and gas are not listed side effects. Common side effects from Prozac (fluoxetine) include drowsiness, dizziness, nervousness, insomnia, dry mouth, cold symptoms, such as stuffy nose, sneezing, and sore throat, increased appetite, weight gain, and decreased sex drive, impotence, or difficulty having and orgasm. You may want to discuss using Gas-X (simethicone) to help treat your symptoms, as it makes the gas bubble break down into many smaller sizes, which are easy to pass. This is not a complete list of the side effects associated with Prozac (fluoxetine). Patti Brown, PharmD

Q: Can Prozac 60 mg per day cause severe fatigue, daytime sleepiness, and increased snoring?

A: Prozac (fluoxetine) is classified as a selective serotonin reuptake inhibitor (SSRI) antidepressant. Prozac is approved for the treatment of depression, binge eating and vomiting in moderate to severe bulimia nervosa, obsessive compulsive disorder (OCD), premenstrual dysphoric disorder (PMDD), panic disorder and in combinations with other medications to treat bipolar depression. According to medical references, somnolence (drowsiness) is a possible side effect associated with the use of Prozac. Somnolence has been reported with an incidence of 5% to 17% of studied patients taking the medication. If you think that you are experiencing a side effect from your medication, talk with your physician. Do not stop taking or change the dose of your medication without first talking to your physician. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Jen Marsico, RPh

Q: My doctor increased my Prozac from 40 mg daily to 60 mg. Since then, I have been having trouble staying awake in the afternoon, especially after lunch. Could the higher prozac dose be causing this?

A: One of the side effects of Prozac is drowsiness and so this may be what is causing you to be tired in the afternoon. For some people, this effect does go away after a period of time when the drug levels become more level in the body. If this is too bothersome for you, try speaking with your doctor to see if you can switch medications or if there is some other recommendation they may have. Megan Uehara, PharmD

Q: Would taking Prozac cause me to have a delay in speaking or studder?

A: According to the prescribing information available for Prozac (fluoxetine), change in speech and stuttering are reported as possible side effects. If you are experiencing this side effect, and it is not tolerable, you may want to consult your doctor to see if an alternative medication may be better for you. There are many antidepressants available, and some work better than others for people. For more information on depression: Patti Brown, PharmD

Q: Does Prozac have any long-term health risks?

A: Prozac (fluoxetine) is a selective serotonin reuptake inhibitor (SSRI) antidepressant used to treat major depressive disorder, eating disorders, obsessive-compulsive disorder, premenstrual dysphoric disorder, and panic disorder. Many patients have been on Prozac for many years without adverse effects. Prozac is considered safe to use long term if needed. Warnings from the prescribing information for Prozac include the following. Prozac like all antidepressants can increase the risk of suicidal thinking and behavior in children and young adults, especially when the medication is first started. Prozac may worsen psychosis in some patients or cause mania in patients with bipolar disorder. Prozac should be used with caution in patients with seizure disorders, liver or kidney disease, and history of heart disease. Prozac may cause weight changes, sleep changes, and sexual dysfunction. Patients who have been on Prozac long term and wish to stop the medication will need to taper the dose down to prevent withdrawal symptoms. This is not a complete list of the side effects associated with Prozac. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. When your doctor prescribes a new medication, be sure to discuss all your prescription and over-the-counter drugs, including dietary supplements, vitamins, botanicals, minerals, and herbals, as well as the foods you eat. Always keep a current list of the drugs and supplements you take and review it with your health care providers and your pharmacist. If possible, use one pharmacy for all your prescription medications and over-the-counter products. This allows your pharmacist to keep a complete record of all your prescription drugs and to advise you about drug interactions and side effects. Laura Cable, Pharm.D., BCPS

Q: My daughter takes Prozac and she doesn't swallow the pills, so I open up the capsule and put it in pudding. Is that making any difference in the medication?

A: I could find nothing saying that Prozac causes any problems being used the way you described. I would recommend she swallow the pudding and not chew it. Prozac is also available in a 20 mg/teaspoonful liquid both in brand name and generic. I don't know if this would be any easier for her or not but it is always an option.

Q: I'm taking Prozac and wonder if it's causing the skin discoloration I'm getting on my back?

A: There is no indication that Prozac (fluoxetine) would cause this symptom. If this condition persists, please see your physician or dermatologist. Joseph Hall, RPh

Q: Can being on Prozac make you loss your sexual drive?

A: Unfortunately, a common side effect of Prozac (the generic is fluoxetine) and other SSRIs (selective seratonin reuptake inhibitors) like it is a decrease in sex drive. Depression can also decrease sex drive. To help with this, it's recommended that you take your regular dose after the time you would normally expect to have sex. This gives more time until the next time you want to have sex, and the drug should cause less of the side effect by then. Your doctor could also prescribe a medication to help with a low sex drive. And you could talk to your doctor about taking a "drug holiday," scheduling a day or two off of the drug each week. If none of these options work, you may need to try a different antidepressant. Always discuss the options with your doctor first to see what would be the best choice for you. For more information on depression, go to . Patti Brown, PharmD

Q: What are the possible Prozac withdrawal symptoms?

A: There are possible Prozac (fluoxetine) withdrawal symptoms which may be associated with abrupt discontinuation of the medication. According to the prescribing information for Prozac, during marketing of Prozac, serotonin norepinephrine reuptake inhibitors (SNRIs) and selective serotonin reuptake inhibitors (SSRIs), there were spontaneous reports of withdrawal symptoms which occurred upon discontinuation of these medications, particularly when discontinuation was abrupt. Possible Prozac withdrawal symptoms may include dysphoric mood, irritability, agitation, dizziness, sensory disturbances, such electric shock sensations, anxiety, confusion, headache, lethargy, excessive emotional reactions and frequent mood changes, insomnia and hypomania. Marketing research indicated that most of these reactions were typically self-limiting and did not require treatment. However, there were reports of serious symptoms associated with discontinuation. Patients are advised against abrupt discontinuation of Prozac. Patients are also advised to take Prozac exactly as prescribed and should not alter the dosing regimen or discontinue treatment with Prozac without consulting their health care provider. Patients should be appropriately monitored, by their health care provider, for these symptoms during the discontinuation period. To avoid the possible Prozac withdrawal symptoms, it is recommended for patients to gradually reduce the dosage of Prozac rather than abruptly discontinue treatment. An appropriate tapering period which implements a gradual dosage reduction should be under the supervision of a health care provider. As a result of the long elimination half-lives of Prozac and its active metabolite, norfluoxetine, concentrations in the blood gradually decrease upon appropriate discontinuation of treatment which minimizes the risk for developing the possible Prozac withdrawal symptoms. Typically, even when treatment has been discontinued, active drug substances remain in the body for weeks, depending on patient specific characteristics, as well as previous dosing regimen and length of treatment.

Q: What is the recommended Prozac dosage?

A: The recommended Prozac (fluoxetine) dosage depends upon the indication for treatment. Prozac is a selective serotonin reuptake inhibitor (SSRI) antidepressant indicated for major depressive disorder, obsessive-compulsive disorder, bulimia and panic disorder, with or without agoraphobia. For the treatment of major depressive disorder in adults, the initial Prozac dosage is 20 mg per day administered in the morning. The usual recommended Prozac dosages range from 20 to 80 mg per day. According to clinical studies, 20 mg per day is typically an adequate Prozac dosage to achieve a satisfactory therapeutic response in most cases of major depressive disorder. Dosages greater than 20 mg per day may be administered once daily in the morning or twice daily (morning and noon) if necessary. Maximum daily doses should not exceed 80 mg per day. Prozac has also been proven effective for once weekly administration. For the treatment of major depressive disorder in the pediatric population, 8 years of age and older, the usual recommended Prozac dosage is 10 to 20 mg per day. Treatment with Prozac for major depressive disorder may require four weeks or longer before the full pharmacologic effect is observed. For the treatment of obsessive-compulsive disorder in adults, the initial Prozac dosage is 20 mg per day administered in the morning. The usual recommended Prozac dosages range from 20 to 60 mg per day. However, 80 mg per day dosages have been well tolerated in clinical studies. The maximum daily dose is 80 mg. For the treatment of obsessive-compulsive disorder in adolescents and higher weight children, 7 years of age and older, the usual recommended Prozac dosage is 20 to 60 mg per day with an initial dosage of 10 mg per day. For lower weight children, 20 to 30 mg per day is recommended. For the treatment of bulimia nervosa in adults, the usual recommended Prozac dosage is 60 mg per day administered in the morning. In some patients, dose titration over several days may be advisable. For the treatment of panic disorder in adults, the initial Prozac dosage is 10 mg per day. According to the prescribing information, the dosage should be increased to 20 mg daily after one week of treatment. The usual recommended Prozac dosage is 20 mg per day administered in the morning. During clinical trials, patients were administered dosages ranging from 10 to 60 mg. A dosage of 20 mg was most frequently administered to patients during clinical trials. For all indications of Prozac, it may require four weeks of treatment or longer before patients experience improvements in symptoms. It is essential for patients to continue with treatment exactly as directed to achieve desired therapeutic outcomes.

Q: What is the difference between generic and brand Prozac?

A: In most patients, there is no significant difference between generic and brand Prozac (fluoxetine). There is currently a generic equivalent available for Prozac, known as fluoxetine. The U.S. Food and Drug Administration (FDA) requires that generic medications be bioequivalent to the brand-name medication and, therefore, exert the same pharmacologic effects in the body. Generic medications are considered, by the FDA, to be therapeutically identical to the brand-name counterparts in dose, strength, route of administration, safety, efficacy and indication for use. Generic medications will appear differently and may have different inactive ingredients, however, the labeling and directions for use remain the same. For most medications, generic equivalents are a lower-cost alternative to the more expensive brand-name medication, and the majority of patients observe no changes in therapeutic effect. However, some patients may experience a change in therapeutic effect and, subsequently, must continue treatment with the brand-name medication. Generic Prozac, fluoxetine, is a selective serotonin reuptake inhibitor (SSRI) antidepressant which is approved for the treatment of major depressive disorder, obsessive-compulsive disorder (OCD), panic disorder and bulimia nervosa. Frequently reported side effects for generic Prozac are similar those observed in patients being treated with the brand-name medication and may include abnormal dreams, abnormal ejaculation, anorexia, anxiety, asthenia, diarrhea, dry mouth, dyspepsia, flu syndrome, impotence, insomnia, decreased libido, nausea, nervousness, pharyngitis, rash, sinusitis, somnolence, sweating, tremor, vasodilatation and yawn. The warnings and precautions associated with Prozac are also possible with the generic fluoxetine. According to the prescribing information for Prozac, warnings and precautions, possible with treatment, include clinical worsening of depression and suicide risk, serotonin syndrome or neuroleptic malignant syndrome-like reactions, allergic reactions and rash, activation of mania or hypomania, seizures, altered appetite and weight, abnormal bleeding, hyponatremia, possibility of anxiety and insomnia, potential for cognitive and motor impairment and long half-life affecting changes in dosage. Fluoxetine, generic Prozac, should be administered exactly the same as the brand-name medication. Fluoxetine is typically taken once daily and administered in the morning.

Q: Is Prozac for insomnia?

A: Prozac (fluoxetine) is not indicated for insomnia treatment by the U.S. Food and Drug Administration (FDA). Prozac is approved by the FDA for the treatment of several other medical conditions including depression, obsessive-compulsive disorder, bulimia nervosa and panic disorder. During clinical trials, one of the most commonly observed adverse reactions in patients being treated with Prozac, for any indication, was insomnia. During placebo-controlled clinical trials for major depressive disorder, Prozac caused insomnia in 16% of patients being evaluated. In trials evaluating Prozac for obsessive-compulsive disorder, 28% of patients reported insomnia as an adverse reaction associated with treatment. During the clinical trials of bulimia, 33% of patients reported experiencing insomnia caused by Prozac. Finally, in the clinical studies of patients with panic disorder, Prozac precipitated insomnia in 10% of patients. Overall, for all indications combined, the incidence of Prozac causing insomnia was reported by 19% of patients. According to the prescribing information, insomnia was one of the most common adverse reactions associated with discontinuation of Prozac in patients with bulimia, with 2% of patients discontinuing treatment. Patients should be advised to take Prozac exactly as directed by their health care provider. If patients experience unpleasant or bothersome adverse reactions, such as insomnia, they are also advised not to change their dosing regimen or discontinue treatment without consulting with their health care provider.

Q: What is Prozac?

A: Prozac (fluoxetine) is an antidepressant categorized as a selective serotonin reuptake inhibitor (SSRI). Prozac is approved, by the U.S. Food and Drug Administration (FDA) for the acute and maintenance treatment of major depressive disorder in adult and pediatric patients aged 8 to 18 years, the acute and maintenance treatment of obsessive-compulsive disorder in adult and pediatric patients aged 7 to 17 years, the acute and maintenance treatment of bulimia nervosa in adult patients and the acute treatment of panic disorder, with or without agoraphobia in adult patients. Prozac is typically administered in the morning and the recommended dosage depends on indication for use. Prozac is available in a capsule formulation in 10 mg, 20 mg and 40 mg strengths. Prozac is also available in a capsule formulation for weekly administration in 90 mg strength. The concomitant use of Prozac with a monoamine oxidase inihibitor (MAOI) is contraindicated. Do not use Prozac with an MAOI or within 14 days of discontinuing treatment with an MAOI to avoid a potentially dangerous drug interaction. At least five weeks should be allowed after discontinuation of Prozac treatment prior to initiation of treatment with an MAOI because of the long half-life of Prozac. Prozac is also contraindicated in patients being treated with pimozide and thioridazine because of dangerous drug interactions. Do not use thioridazine within five weeks of discontinuing Prozac treatment. There are several warnings and precautions associated with Prozac treatment that patients should discuss in detail with their health care provider and understand fully prior to initiation of treatment. According to the prescribing information, the warnings and precautions, possible with Prozac treatment, include clinical worsening of depression and suicide risk, serotonin syndrome or neuroleptic malignant syndrome-like reactions, allergic reactions and rash, activation of mania or hypomania, seizures, altered appetite and weight, abnormal bleeding, hyponatremia, possibility of anxiety and insomnia, potential for cognitive and motor impairment and long half-life affecting changes in dosage. The most commonly observed adverse reactions, reported in 5% or more of patients studied in clinical trials, included abnormal dreams, abnormal ejaculation, anorexia, anxiety, asthenia, diarrhea, dry mouth, dyspepsia, flu syndrome, impotence, insomnia, decreased libido, nausea, nervousness, pharyngitis, rash, sinusitis, somnolence, sweating, tremor, vasodilatation and yawn. Prozac is extensively metabolized (broken down) in the liver by the cytochrome P450 system and, therefore, has the potential to interact with several medications. It is essential for patients to inform their health care provider of all medications they are currently taking, including prescription medications, over the counter products and dietary or herbal supplements. Treatment with Prozac, for all indications, may require four weeks of treatment or longer before patients experience improvements in symptoms. It is essential for patients to continue with treatment exactly as directed to achieve desired therapeutic outcomes.

Q: What are the benefits and risks of Prozac?

A: There are several benefits and risks of Prozac (fluoxetine). For most patients, the benefits outweigh the risks of treatment with Prozac. However, there are still various risks a patient should be aware of prior to initiation of therapy. The benefits of Prozac extend across many medical conditions. Prozac, a selective serotonin reuptake inhibitor (SSRI) antidepressant, is a proven effective treatment option and has demonstrated benefits in patients with major depressive disorder, obsessive-compulsive disorder, panic disorder and bulimia. In addition, Prozac has proven benefits for major depressive disorder and obsessive-compulsive disorder in the pediatric population as well. There are no drug treatments that are not without risk, including Prozac. One of the risks of Prozac treatment is the commonly occurring side effects. The most commonly reported side effects in patients treated with Prozac include abnormal dreams, abnormal ejaculation, anorexia, anxiety, asthenia, diarrhea, dry mouth, dyspepsia, flu syndrome, impotence, insomnia, decreased libido, nausea, nervousness, pharyngitis, rash, sinusitis, somnolence, sweating, tremor, vasodilatation and yawn. The commonly observed side effects were reported by at least 5% of patients receiving Prozac in clinical trials. Other risks of Prozac include several warnings and precautions which may occur with treatment. There is a risk of clinical worsening of depression symptoms and risk of suicide in both the adult and pediatric population. Clinical trials revealed that antidepressant drugs increase the risk of suicidality in children, adolescents and young adults ages 18 to 24 with major depressive disorder and other psychiatric disorders. According to the prescribing information, all patients being treated with antidepressants, including Prozac, for any indication should be closely monitored and observed for clinical worsening, suicidality and unusual changes in behavior, especially during the first few months of therapy or during times of dosage adjustments. Patients should be monitored for the following symptoms, anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathesia, hypomania and mania. These symptoms have been reported in adults and the pediatric population being treated with antidepressants for major depressive disorder, in addition to other psychiatric and nonpsychiatric indications. It is important to advise patients taking Prozac to be aware of the risk for serotonin syndrome or neuroleptic malignant syndrome (NMS)-like reactions that may occur with SSRIs alone or with the concomitant use of Prozac and other serotonergic medications, such as the triptans (medications used to treat migraine headaches), tramadol, serotonin-norepinephrine reuptake inhibitors (SNRIs), such as Cymbalta (duloxetine), Effexor (venlafaxine) or Pristiq (desvenlafaxine), or other SSRIs. Symptoms of serotonin syndrome or NMS-like reactions include agitation, confusion, increased heart rate and blood pressure, sweating, headache, diarrhea, loss of muscle coordination, and possibly fever and seizures. Seek immediate medical attention if you experience any of these signs and symptoms. Prozac may cause an increased risk for bleeding. Patients taking Prozac should discuss the concomitant use of Prozac with non-steroidal anti-inflammatory drugs (NSAIDs), including ibuprofen and naproxen, aspirin, warfarin or other medications that affect coagulation with their physician to avoid an increased risk for bleeding. Before taking any of these medications, it is important to consult with your physician and call your physician immediately if you experience any bleeding or bruising. Hyponatremia (low levels of sodium in the blood) has been reported as a result of Prozac treatment. It is important to be aware of the signs and symptoms associated with hyponatremia so you can recognize them if they occur. Signs and symptoms include headache, difficulty concentrating, memory impairment, confusion, weakness, unsteadiness, hallucination, passing out, seizure, coma, respiratory arrest and death. Patients should discuss the benefits and risks of Prozac with their health care provider prior to initiation of treatment.

Q: What is the difference between Cymbalta versus Prozac?

A: There are a number of differences between Cymbalta (duloxetine) versus Prozac (fluoxetine). The main differences between Cymbalta versus Prozac include mechanism of action, the way in which the drug works in the body, and indications for use approved by the U.S. Food and Drug Administration (FDA). Cymbalta is a potent inhibitor of both serotonin and norepinephrine reuptake in the central nervous system, while Prozac is a much more potent inhibitor of serotonin reuptake than norepinephrine. The only common indication between Cymbalta and Prozac is major depressive disorder. Cymbalta belongs to a class of antidepressants known as serotonin norepinephrine reuptake inhibitors (SNRI) and is indicated for the treatment of major depressive disorder, generalized anxiety disorder, diabetic peripheral neuropathic pain, fibromyalgia and chronic musculoskeletal pain. Prozac belongs to a different class of antidepressants known as selective serotonin reuptake inhibitors (SSRI) and is indicated for the treatment of major depressive disorder, obsessive-compulsive disorder, panic disorder and bulimia nervosa. Another difference between Cymbalta versus Prozac is approved use in the pediatric population. While Prozac is currently approved, by the FDA, for the treatment of major depressive disorder and obsessive-compulsive disorder in the pediatric population, both in children and adolescents, the safety and effectiveness of Cymbalta in the pediatric population has not been established. Another difference between Cymbalta versus Prozac is there is currently no generic equivalent available for Cymbalta, while Prozac is available in a generic form, known as fluoxetine. Cymbalta and Prozac have similar adverse reactions and warnings and precautions associated with treatment. However, Cymbalta has been associated with an increased risk of mydriasis (prolonged dilation of the pupils of the eye) and should be used cautiously in patients with controlled narrow-angle glaucoma. Patients should be advised to discuss with their health care provider if they have a past medical history of glaucoma prior to initiation of treatment with Cymbalta. Another difference between Cymbalta versus Prozac, with regard to warnings and precautions, Cymbalta treatment was observed to worsen glycemic control in some patients with diabetes during clinical trials.

Q: How do I take Prozac for depression?

A: To take Prozac (fluoxetine) for depression, patients should be advised that treatment may require four weeks or longer before the full therapeutic effect of Prozac is observed. It is essential for patients to take Prozac for depression exactly as prescribed by a health care provider and not to adjust the dosing regimen or discontinue treatment with Prozac without the supervision of their doctor. Prozac is indicated for the treatment of depression in adult and pediatric patients, aged 8 to 18 years. To take Prozac for depression, the initial adult dose is 20 mg per day administered in the morning. The usual dosage of Prozac for depression ranges from 20 to 80 mg daily. During clinical trials for depression, 20 mg daily was an adequate dosage, in most patients, to achieve a desired therapeutic outcome. Research suggests that dosages higher than 20 mg per day may be administered once daily in the morning or may be administered twice daily when necessary, in the morning and at noon. To take Prozac for depression, the maximum daily dose is 80 mg. Prozac for weekly administration is also effective for treating depression in adults. To take Prozac for depression in children and adolescents, age 8 and older, the usual dose of Prozac is 10 to 20 mg daily. For both adult and pediatric patients, an increase in dosage of Prozac may be considered after several weeks of treatment if a less than satisfactory clinical improvement is observed. It is essential that patients are periodically monitored and reassessed to determine if further treatment is required. When taking Prozac for depression, doses are typically administered in the morning unless otherwise instructed. Patients taking Prozac for depression should be informed regarding the most commonly observed adverse reactions. During clinical trials, adverse reactions reported in 5% of patients or greater included abnormal dreams, abnormal ejaculation, anorexia, anxiety, asthenia, diarrhea, dry mouth, dyspepsia, flu syndrome, impotence, insomnia, decreased libido, nausea, nervousness, pharyngitis, rash, sinusitis, somnolence, sweating, tremor, vasodilatation and yawn. Prior to beginning treatment with Prozac for depression, it is essential to inform your physician of any other medications you are currently taking, including prescription medications, over the counter products and dietary or herbal supplements to avoid potentially dangerous interactions.

Q: How can I lose weight after Prozac?

A: In placebo-controlled clinical trials for major depressive disorder, obsessive-compulsive disorder and bulimia nervosa, altered appetite and weight after beginning Prozac treatment was reported. In clinical studies of Prozac for major depressive disorder, 11% of patients reported anorexia and 1.4% of patients reported weight loss. Similarly, in trials of Prozac for obsessive-compulsive disorder, 17% of patients reported anorexia and one patient discontinued treatment as a result. In studies evaluating Prozac for bulimia, 8% of patients reported anorexia and lost a minimal amount of weight. The incidence of patients experiencing weight loss for all indications of Prozac combined was 2%. Patients did not report weight gain or difficulty losing weight during clinical studies or postmarketing experience with Prozac. Prozac is a potent inhibitor of neuronal serotonin reuptake in the central nervous system and therefore categorized as a selective serotonin reuptake inhibitor (SSRI). Prozac is used for the treatment of bulimia, panic disorder, obsessive-compulsive disorder and major depressive disorder. The tools with which to lose weight after Prozac are the same as those for any other individual attempting to lose weight. In general, irrespective of drug therapy, the safest and most effective method for long-term weight loss is proper diet and exercise. Eating a healthy, well-balanced diet full of fruits, vegetables and whole grains while limiting sugar, processed foods and alcohol typically people lose weight. According to the National Heart Lung and Blood Institute (NHLBI), a part of the National Institutes of Health (NIH), to lose weight it is essential for individuals to make lifestyle changes which focus on reducing calories from food and drink, a healthy eating plan and proper portion control. Furthermore, the NHLBI outlines a healthy eating plan to control portion sizes and include fruits, vegetables, whole grains and fat-free or low-fat dairy products. A healthy eating plan should also include lean meats, poultry, fish, beans, eggs and nuts and be low in saturated fat, trans fat, cholesterol, sodium and added sugars. To safely and effectively lose weight, in general and after Prozac, individuals need to expend more calories than they take in. Essentially, individuals need to reduce their daily caloric intake from food and beverages and increase calories burned through physical exercise. An appropriate diet and exercise regimen should initially be under the guidance of a physician.

Q: How can I treat bipolar disorder with Prozac?

A: To treat bipolar disorder with Prozac (fluoxetine), another medication must be prescribed in combination. Prozac is not currently approved as monotherapy for the treatment of depressive episodes associated with bipolar disorder. The active ingredient in Prozac, fluoxetine, is available in combination with another medication, olanzapine, and is marketing under the name Symbyax (olanzapine/fluoxetine). Symbyax is approved by the U.S. Food and Drug Administration (FDA) for the acute treatment of depressive episodes associated with bipolar disorder in adults. To treat bipolar disorder with Prozac in combination with olanzapine most physicians will prescribe combination Symbyax. The efficacy of Symbyax for the acute treatment of depressive episodes associated with bipolar disorder was established in controlled studies. Symbyax should be administered once daily in the evening. To treat depressive episodes associated with bipolar disorder with Symbyax, treatment is typically initiated with the 6 mg/25 mg strength capsules. While both Prozac and olanzapine individually can be administered without regard to meals, the effect of food on Symbyax specifically has not been evaluated. According to the prescribing information for Symbyax, dosage changes should be assessed according to efficacy and patient tolerability. The ideal duration of treatment with Symbyax is unknown and patients should be periodically reassessed by a health care provider to determine if continued treatment is necessary. The most common adverse reactions observed during clinical trials, reported by 5% or more of patients being treated with Symbyax, included disturbance in attention, dry mouth, fatigue, hypersomnia, increased appetite, peripheral edema, sedation, somnolence, tremor, blurred vision and increased weight. Patients should be advised to avoid alcohol while being treated with Symbyax. To treat bipolar disorder with Symbyax, it is important for patients to take this medication exactly as prescribed even after mood symptoms improve. Patients should also be advised not to adjust their dosing regimen or discontinue treatment with Symbyax without the supervision of their health care provider.

Q: What condition is Prozac used for? Is it used in weight reduction? Is it safe? What are the side effects?

A: Prozac (fluoxetine) is a medication that is used to treat depression, panic disorder, obsessive compulsive disorder (OCD), depression associated with bipolar disorder, as well as other conditions. It is in the class of medications called selective serotonin reuptake inhibitors (SSRIs) and works by bringing a balance to serotonin in the brain that may be the cause of symptoms. The prescribing information on Prozac lists the following as the most common side effects associated with the medication: insomnia, nausea, diarrhea, headache, loss of appetite, drowsiness, anxiety, tremor, dry mouth, decreased sex drive, yawning, indigestion, dizziness and sweating. Prozac is not approved by the U.S. Food and Drug Administration (FDA) for weight loss. Weight loss appears to be a side effect that occurs in up to 2 percent of patients taking Prozac. It is not entirely clear why this medication causes weight loss, although it is generally a small amount. It may be due to the side effects of loss of appetite, diarrhea and nausea that may contribute to the weight loss. Lori Poulin, PharmD

Q: My doctor recently told me to try to increase my 20 mg of Prozac to 40 mg. I tried it, and it made me exhausted during the day and woke me up in the middle of the night. What do you recommend?

A: Prozac (fluoextine) belongs to the class of drugs called selective serotonin reuptake inhibitors (SSRIs). Prozac affects the chemicals in the brain that become unbalanced and cause depression, anxiety, and obsessive compulsive symptoms. Common side effects of Prozac include dry mouth, drowsiness, nausea, and weight changes. Other side effects of Prozac include gas, sleep problems, and loss of appetite. Prozac may also cause insomnia. It is important to consult with your health care provider regarding the symptoms that you are experiencing. Prozac may be taken with or without food and at anytime of the day. It may take at least 4 to 6 weeks for the medication to start working. Do not stop taking the Prozac abruptly without first talking to the doctor because this could cause unwanted side effects. This is not a complete list of the side effects associated with Prozac. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Kimberly Hotz, PharmD

Q: Is it possible to become tolerant to the effects of Prozac?

A: Prozac (fluoxetine) is a selective serotonin reuptake inhibitor (SSRI) approved for the treatment of major depression (including pediatric depression), obsessive-compulsive disorder (in both adult and pediatric populations), bulimia nervosa, panic disorder and premenstrual dysphoric disorder. The most common side effects with Prozac include abnormal dreams, abnormal ejaculation, anorexia, anxiety, asthenia (weakness), diarrhea, dry mouth, dyspepsia, flu syndrome, impotence, insomnia, libido decreased, nausea, nervousness, pharyngitis, rash, sinusitis, somnolence, sweating, tremor, vasodilatation, and yawn. With antidepressants, it is possible to have a worsening of symptoms. Contact your doctor right away if you have any new or worsening symptoms of depression. You should also call your doctor if you are experiencing mood or behavior changes, anxiety or panic attacks, sleep problems, impulsivity, irritability, agitation, hostility, aggression, restlessness, hyperactivity, or if you are having thoughts of suicide or hurting yourself. Worsening of symptoms may be more likely to occur during the first few months of therapy and during dosage changes (either increasing or decreasing doses). Do not change the amount of medication you take without talking to your doctor first. Sarah Lewis, PharmD

Q: Does Prozac cause problems with eyesight?

A: Prozac (fluoxetine) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. Prozac is approved, by the U.S. Food and Drug Administration (FDA), for the treatment of major depressive disorder, depressive episodes associated with bipolar disorder, obsessive-compulsive disorder (OCD), bulimia nervosa, and panic disorder. Some of the most common side effects associated with Prozac include insomnia, headache, weakness, nausea, runny nose, drowsiness, diarrhea, and anorexia. According to the prescribing information for Prozac, abnormal vision and visual field defects were reported as potential side effects occurring in 4 percent and less than 1 percent respectively of patients taking Prozac during clinical trials. Prozac may be taken with or without food. If Prozac causes an upset stomach, it may be helpful to take it with food. Prozac may take several weeks to work after treatment is first started. Prozac will only work if taken daily and exactly as prescribed. Prozac should not be taken on an as needed basis. If Prozac needs to be discontinued, the dose should be slowly tapered down, under the supervision of a health care provider, rather than suddenly stopped to prevent withdrawal symptoms. Patients who are taking Prozac should avoid alcohol use. Do not stop taking your medication without first taking to your doctor. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Laura Cable, PharmD

Q: What are the side effects of a Prozac overdose?

A: Prozac (fluoxetine) is prescription medication commonly used to treat depression, generalized anxiety disorder, obsessive-compulsive disorder, and panic disorder. Prozac should be taken regularly, at the same time every day, with or without food. Prozac can be taken at any time during the day, but should be taken around the same time every day. Pick a time that is easy to remember and works well with your schedule and other medications you might be taking. It can take four weeks or longer before you see the benefits of Prozac. Take Prozac exactly as prescribed. Do not stop taking Prozac without first talking to your healthcare provider. Stopping Prozac suddenly could result in withdrawal side effects. Common side effects associated with treatment with Prozac include headache, dry mouth, nausea, diarrhea, sweating, flushing, blurred vision, changes in appetite and sex drive. This is not a complete list of side effects associated with Prozac. If you experience any symptoms that are unusual or bothersome, contact your healthcare provider. Too much Prozac can cause a life-threatening condition known as serotonin syndrome. Signs and symptoms of serotonin syndrome may include agitation, restlessness, confusion, rapid heart rate, dilated pupils, loss of muscle coordination, heavy sweating, diarrhea, headache, shivering, and goose bumps. Contact your doctor immediately if you have any of these serious symptoms of serotonin syndrome or think you have taken a Prozac overdose. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Jennifer Carey, PharmD

Q: I stopped taking Prozac but continued with Wellbutrin. I am dizzy a lot since this change. Is it connected?

A: Prozac (fluoxetine) is an antidepressant which belongs to a class of medications called selective serotonin reuptake inhibitors (SSRIs). Prozac is used for the treatment of depression, obsessive-compulsive disorder (OCD), certain eating disorders, and panic attacks. Prozac helps treat depression by raising the amount of serotonin, a natural substance in the brain, that assists in maintaining mental balance. Prozac is usually taken once daily. Take Prozac at around the same time every day. Follow the directions on your prescription label carefully, and take Prozac exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Prozac usually takes about four to five weeks, or maybe longer, before you feel the full benefit of this drug. Continue to take Prozac even if you feel better. Do not stop taking Prozac without talking to your doctor first. If you suddenly stop taking Prozac, you may experience withdrawal symptoms such as mood changes, irritability, agitation, dizziness, numbness or tingling in the hands or feet, anxiety, confusion, headache, tiredness, and difficulty falling asleep or staying asleep. Since you are experiencing dizziness, it may be due to the withdrawal symptoms. You may have stopped taking your Prozac dose too abruptly. Consult with your doctor about lowering your dose more gradually. Then discuss other treatment options that would benefit your medical condition. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Anissa Lee, RPh

Q: I'm currently taking Prozac. My depression seems to be getting worse. Could I double my daily dose?

A: Prozac (fluoxetine) is an antidepressant classified as a selective serotonin reuptake inhibitor (SSRI). Prozac is used to treat depression and anxiety. It can take approximately one month to see the full effects of this class of medications. However, there should be some improvement within the first few days of taking it. If you have been taking Prozac for a couple of weeks, and there is no improvement, you may want to ask your doctor to consider treatment with a different antidepressant. If there has been some improvement, your doctor may decide to increase the dose to 40 mg. The maximum dose of Prozac is 80 mg, but most people respond to the medication at lower doses. There are many affordable alternative SSRIs, including Zoloft (sertraline), Paxil (paroxetine), and Celexa (citalopram). They are all available in a generic form. Everyone responds differently to medications. With treatment with SSRIs, one medication may work well for one person, but not be optimal for someone else. It takes some time, but it is a matter of finding the right fit for your specific situation. Once you have been on an SSRI for an extended period of time, you should not stop taking it all of a sudden, as it can bring on extreme depression and anxiety. The medications should be tapered down when stopping, especially at high doses. If your doctor changes you to a different medication, there may be a cross-taper (coming down on one medication, while going up in dose on the new medication. There are also other types of antidepressants that can be used if treatment with an SSRI is not right for you. It is important to work with your doctor to find the right medication at the right dose for you. It is extremely important not to increase your current dose dose without the approval from your doctor. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Patti Brown, PharmD

Q: Can Prozac cause lymphoma?

A: There was no mention in the prescribing information in regards to an increased risk of lymphoma caused by treatment with Prozac (fluoxetine). According to the medical literature, it appears Prozac is being studied as having a role in the treatment of Burkitt