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PROZAC


GENERIC NAME: fluoxetine (floo OX e teen)
BRAND NAMES: prozac, prozac Weekly, Rapiflux, Sarafem
DRUG CLASS AND MECHANISM: Fluoxetine is an oral drug that is used for
treating depression. It is in a class of drugs called selective
serotonin reuptake inhibitors (SSRIs), a class that also contains
citalopram (Celexa), paroxetine (Paxil) and sertraline (Zoloft).
Fluoxetine affects neurotransmitters, the chemicals that nerves within
the brain use to communicate with each other. Neurotransmitters are
manufactured and released by nerves and then travel and attach to
nearby nerves. Thus, neurotransmitters can be thought of as the
communication system of the brain. Serotonin is one neurotransmitter
that is released by nerves in the brain. The serotonin either travels
across the space between nerves and attaches to receptors on the
surface of nearby nerves or it attaches to receptors on the surface of
the nerve that produced it, to be taken up by the nerve and released
again (a process referred to as re-uptake).
Many experts believe that an imbalance among neurotransmitters is the
cause of depression. Fluoxetine works by preventing the reuptake of
one neurotransmitter, serotonin, by nerve cells after it has been
released. Since uptake is an important mechanism for removing released
neurotransmitters and terminating their actions on adjacent nerves,
the reduced uptake caused by fluoxetine increases free serotonin that
stimulates nerve cells in the brain. The FDA approved Fluoxetine in
December 1987.

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PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Capsules: 10, 20, and 40 mg. Capsules (delayed release):
90 mg. Tablets: 10, 15, and 20 mg. Oral suspension: 20mg/5ml

STORAGE: Fluoxetine should be stored at room temperature 15-30°C
(59-86°F).

PRESCRIBED FOR: Fluoxetine is used for treating depression, bulimia,
obsessive-compulsive disorder (OCD), panic disorder, and premenstrual
dysphoric disorder (PMDD). It also is used in combination with
olanzapine (Zyprexa) for treatment of resistant depression and
treatment of depression associated with bipolar disorder.

DOSING: Depression in adults is treated with 20-80 mg of fluoxetine
daily. The recommended dose for treating depression in children is
10-20 mg daily. After 13 weeks of daily administration, once weekly
dosing may be effective in some patients.

Bulimia is treated with 60 mg of fluoxetine daily. Long-term treatment
for up to 52 weeks has been shown to be beneficial in maintaining
remission.

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Obsessive-compulsive disorder in adults and children is treated with
20-60 mg daily and panic disorder is managed with 10-60 mg daily. The
recommended regimen for PMDD is 20 mg administered every day of the
menstrual cycle or daily for 14 days prior to the onset of
menstruation through the first day of menses.

The recommended treatment for resistant depressionis 20-50 mg of
fluoxetine and 5-20 mg olanzapine once daily in the evening while the
recommended treatment for depression associated with bipolar disorder
is 20-50 mg fluoxetine and 5-12.5 mg olanzapine once daily in the
evening

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DRUG INTERACTIONS: Fluoxetine should not be taken with any of the
monoamine oxidase inhibitor (MAOI) class of antidepressants [for
example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine
(Parnate), selegiline (Eldepryl), and procarbazine (Matulane)] or
other drugs that inhibit monoamine oxidase [for example, linezolid
(Zyvox)]. Such combinations may lead to confusion, high blood
pressure, tremor, hyperactivity, coma, and death. Fluoxetine should
not be administered for at least 14 days after stopping MAOIs. Because
fluoxetine is active in the body for several weeks, MAOIs should not
be administered for at least 5 weeks after fluoxetine has been
stopped.Similar reactions occur when fluoxetine is combined with other
drugs, for example, tryptophan, St. John's wort, meperidine (Demerol),
and tramadol (Ultram) that increase serotonin in the brain.

Prozac side effects

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Get emergency medical help if you have any of these signs of an
allergic reaction: skin rash or hives; difficulty breathing; swelling
of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms
such as: mood or behavior changes, anxiety, panic attacks, trouble
sleeping, or if you feel impulsive, irritable, agitated, hostile,
aggressive, restless, hyperactive (mentally or physically), more
depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you experience any of these serious side
effects from using Prozac:

* severe blistering, peeling, and red skin rash;
* very stiff (rigid) muscles, high fever, sweating, fast or uneven
heartbeats, tremors, overactive reflexes;
* nausea, vomiting, diarrhea, loss of appetite, feeling unsteady,
loss of coordination; or
* headache, trouble concentrating, memory problems, weakness,
confusion, hallucinations, fainting, seizure, shallow breathing or
breathing that stops.

Less serious Prozac side effects may include:

* cold symptoms such as stuffy nose, sneezing, sore throat;
* drowsiness, dizziness, feeling nervous;
* mild nausea, upset stomach, constipation;
* increased appetite, weight changes;
* sleep problems (insomnia);
* decreased sex drive, impotence, or difficulty having an orgasm;
or
* dry mouth.

This is not a complete list of side effects and others may occur. Call
your doctor for medical advice about side effects. You may report side
effects to FDA at 1-800-FDA-1088.

See also: Prozac information from Drugs.com side effects (in more
detail)
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