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PROZAC

PROZAC
Prozac

DESCRIPTION / DEFINITIONS: Prozac® (fluoxetine hydrochloride) is a selective serotonin reuptake inhibitor.

ABUSE: Prozac is a drug prescribed for the treatment of depression.

ADDICTION / DEPENDENCE: Half life and metabolism, Black Box Warning.

SIDE EFFECTS: Heart attack, suicide, paranoid reactions (see list below).

WITHDRAWAL SYMPTOMS: Nausea, insomnia, electric shock like sensations (see list below).

TREATMENT: Medical detoxification.

DESCRIPTION / DEFINITIONS

Prozac® (fluoxetine hydrochloride) is a selective serotonin reuptake inhibitor ("SSRI"). Although there are no medical tests to determine if a person has insufficient serotonin, SSRI drugs like Prozac increase the amount of serotonin in the brain. According to its label, "The antidepressant, antiobsessive compulsive, and antibulimic actions of fluoxetine are presumed to be linked to its inhibition of CNS neuronal uptake of serotonin."

ABUSE

Prozac is a drug prescribed for the treatment of depression.

ADDICTION / DEPENDENCE

HALF LIFE AND METABOLISM

The biological half life of a substance is the time it takes for a drug to lose half of its pharmacologic activity. This is significant because it affects how soon withdrawal symptoms may appear.

The half life of Prozac is an average of 48 to 72 hours.

Prozac is mainly metabolized through the P450 pathway in the liver and the enzymes primarily handling the metabolism is CYP2D6.

The CYP enzymes are the major enzymes involved in drug metabolism, and since many drugs may increase or decrease the activity of various CYP isozymes, this is a major source of adverse drug interactions, since changes in CYP enzyme activity may affect the metabolism and clearance of various drugs. For example, if one drug inhibits the CYP-mediated metabolism of another drug, the second drug may accumulate within the body to toxic levels, possibly causing an overdose.

BLACK BOX WARNING

The Food and Drug Administration (FDA) has decided that some drugs pose very serious risks and have required these drugs have what is called a black box warning. Prozac has a black box warning. Here is the warning.

WARNING: Suicidality and Antidepressant Drugs

Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of Prozac or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Prozac is not approved for use in pediatric patients.

(See WARNINGS: Clinical Worsening and Suicide Risk, PRECAUTIONS: Information for Patients, and PRECAUTIONS: Pediatric Use.)

SIDE EFFECTS

The following information is taken from the Prozac label:

  • abnormal dreams

  • abnormal ejaculation

  • abnormal electroencephalogram

  • abnormal gait

  • abnormal vision

  • abortion

  • acne

  • acute abdominal syndrome

  • acute brain syndrome

  • agitation

  • akathisia

  • albuminuria

  • alcohol intolerance

  • alkaline phosphatase increased

  • alopecia

  • amenorrhea

  • amnesia

  • anemia

  • angina pectoris

  • anorexia

  • anorgasmia

  • antisocial reaction

  • anxiety

  • apathy

  • aphthous stomatitis

  • aplastic anemia

  • apnea

  • arrhythmia

  • arthritis

  • arthrosis

  • asthma

  • ataxia

  • atelectasis

  • atrial fibrillation

  • biliary pain

  • blepharitis

  • blood dyscrasia

  • bloody diarrhea

  • bone pain

  • bradycardia

  • breast engorgement

  • breast enlargement

  • breast pain

  • buccoglossal syndrome

  • BUN increased

  • bursitis

  • cataract

  • cerebral embolism

  • cerebral ischemia

  • cerebrovascular accident

  • chest pain

  • chills

  • cholecystitis

  • cholelithiasis

  • cholestatic jaundice

  • chondrodystrophy

  • circumoral paresthesia

  • CNS depression

  • CNS stimulation

  • colitis

  • coma

  • confusion

  • congestive heart failure

  • conjunctivitis

  • constipation

  • contact dermatitis

  • cough decreased

  • creatine phosphokinase increased

  • cystitis

  • deafness

  • dehydration

  • delusions

  • depersonalization

  • diabetes mellitus

  • diabetic acidosis

  • diarrhea

  • diplopia

  • dizziness

  • dry eyes

  • dry mouth

  • duodenal ulcer

  • dysarthria

  • dyskinesia

  • dyspepsia

  • dysphagia

  • dystonia

  • dysuria

  • ear pain

  • ecchymosis

  • eczema

  • emotional lability

  • emphysema

  • enteritis

  • eosinophilic pneumonia

  • epidermal necrolysis

  • epistaxis

  • eructation

  • erythema multiforme

  • erythema nodosum

  • esophageal ulcer

  • esophagitis

  • euphoria

  • exfoliative dermatitis

  • exophthalmos
  • extrapyramidal syndrome

  • extrasystoles

  • eye hemorrhage

  • face edema

  • fecal incontinence

  • female lactation

  • fever

  • fibrocystic breast

  • flatulence

  • flu syndrome

  • foot drop

  • furunculosis

  • gastritis

  • gastroenteritis

  • gastrointestinal hemorrhage

  • generalized edema

  • glaucoma

  • glossitis

  • glycosuria

  • gout

  • gum hemorrhage

  • gynecomastia

  • hallucinations

  • headache

  • heart arrest

  • heart block

  • hematemesis

  • hematuria

  • hemoptysis

  • hemorrhage

  • hemorrhage of colon

  • hepatic failure/necrosis

  • hepatitis

  • herpes zoster

  • hiccup

  • hirsutism

  • hostility

  • hyperacusis

  • hyperchlorhydria

  • hypercholesteremia

  • hyperesthesia

  • hyperkalemia

  • hyperkinesia

  • hyperlipemia

  • hyperprolactinemia

  • hypertension

  • hypertonia

  • hyperuricemia

  • hyperventilation

  • hypesthesia

  • hypocalcemia

  • hypochromic anemia

  • hypoglycemia

  • hypokalemia

  • hypomenorrhea

  • hypotension

  • hypothermia

  • hypothyroidism

  • hypoventilation

  • hypoxia

  • immune–related hemolytic anemia

  • impotence

  • incoordination

  • increased appetite

  • increased salivation

  • insomnia

  • intentional injury

  • intentional overdose

  • intestinal obstruction

  • iritis

  • iron deficiency anemia

  • kidney failure

  • kidney pain

  • larynx edema

  • leg cramps

  • leukopenia

  • leukorrhea

  • libido decreased

  • libido increased

  • liver fatty deposit

  • liver function tests abnormal

  • lung edema

  • lymphedema

  • lymphocytosis

  • maculopapular rash

  • malaise

  • melena

  • menorrhagia

  • metrorrhagia

  • migraine

  • misuse/abuse

  • mouth ulceration

  • movement disorders

  • myasthenia

  • mydriasis

  • myocardial infarction

  • myoclonus

  • myopathy

  • myositis

  • nausea

  • nervousness

  • neuralgia

  • neuritis

  • neuroleptic malignant syndrome
  • neuropathy

  • neurosis

  • nocturia

  • oliguria

  • optic neuritis

  • osteomyelitis

  • osteoporosis

  • pallor

  • palpitation

  • pancreatitis

  • pancytopenia

  • paralysis

  • paranoid reaction

  • parosmia

  • pelvic pain

  • peptic ulcer

  • peripheral edema

  • peripheral vascular disorder

  • personality disorder

  • petechia

  • petechial rash

  • pharyngitis

  • phlebitis

  • photophobia

  • photosensitivity reaction

  • pneumothorax

  • polyuria

  • postural hypotension

  • priapism

  • pruritus

  • psoriasis

  • psychosis

  • pulmonary embolism

  • pulmonary hypertension

  • purpura

  • purpuric rash

  • pustular rash

  • QT prolongation

  • rectal hemorrhage

  • reflexes decreased

  • reflexes increased

  • rheumatoid arthritis

  • salivary gland enlargement

  • scleritis

  • seborrhea

  • serotonin syndrome

  • SGPT increased

  • shock

  • sinusitis

  • skin discoloration

  • skin ulcer

  • sleep disorder

  • somnolence

  • Stevens–Johnson syndrome

  • stomach ulcer

  • stomach ulcer hemorrhage

  • stomatitis

  • strabismus

  • stridor

  • stupor

  • sudden unexpected death

  • suicidal ideation

  • suicide attempt

  • sweating

  • syncope

  • tachycardia

  • taste loss

  • taste perversion

  • tenosynovitis

  • thinking abnormal

  • thirst

  • thrombocythemia

  • thrombocytopenia

  • thrombocytopenic purpura

  • thrombophlebitis

  • thrombosis

  • tinnitus

  • tongue edema

  • torsades de pointes

  • tremor

  • urinary frequency

  • urinary incontinence

  • urinary retention

  • urinary urgency

  • uterine fibroids enlarged

  • uterine hemorrhage

  • vaginal bleeding after drug withdrawal

  • vaginal hemorrhage

  • vascular headache

  • vasodilatation

  • vasospasm

  • ventricular arrhythmia

  • ventricular extrasystoles

  • ventricular fibrillation

  • ventricular tachycardia

  • vertigo

  • vesiculobullous rash

  • violent behavior

  • visual field defect

  • vomiting

  • weight gain

  • weight loss

  • yawn

WITHDRAWAL SYMPTOMS

Prozac can be a very difficult drug to stop taking. Here are some of the Prozac withdrawal symptoms:

  • agitation

  • confusion

  • depression

  • diarrhea

  • dizziness

  • dreams, including vivid dreams

  • drowsiness

  • electric shock-like sensations
  • fatigue/malaise

  • feelings of being hot or cold

  • feelings of unreality

  • flatulence

  • flu-like feelings

  • headache

  • insomnia
  • irritability

  • mood swings

  • muscle spasms

  • nausea

  • other strange tingling or painful sensations

  • sweating

  • tremor

TREATMENT

Withdrawal from Prozac should only be done under the care of a health practitioner. The safest way is to withdraw at an inpatient medical detox facility with a protocol that includes hydration, vitamins and supplements for biological balancing. Call us to talk to a Detox Advisor.
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