During the last several years, Prozac (whose generic name is fluoxetine hydrochloride) has become one of the most widely prescribed antidepressant drugs in the western world. Besides being used in treating depression, Prozac is used to treat obsessive-compulsive and bulimia nervosa. Prozac has also been used off-label (which means a use not reviewed by the FDA) to treat panic disorder. Under a different brand name (Sarafem), fluoxetine is also approved for the treatment of premenstrual dysphoric disorder (PMDD).
Of all the SSRIs, it is the oldest (SSRI stands for Selective Serotonin Reuptake Inhibitor. It works by slowing the reabsorbtion of the neurotransmitter, serotonin, in the brain, one of the brain's natural antidepressants. A higher level of serotonin boosts mood and effects a reduction in depressive symptoms.), with twenty years of research behind it now revealing long-term side effects. Prozac was the first SSRI put on the market in 1987, quickly becoming the most widely prescribed antidepressant medication ever. Sales of Prozac accounted for $1.2 billion of antidepressants in 1995, and over 6 million Americans use it regularly. Prozac's success has spawned other SSRIs, including Zoloft (sertraline hydrochloride) and Paxil (paroxetine hydrochloride). Prozac has few side effects when compared to the other, older anti-depressant drugs, and is considered better because "only" 17 percent of the people who try it have to stop because of negative experiences, compared with nearly a third (31 percent) of the patients taking tricyclic drugs). The reported side effects of Prozac, listed in percentage of incidence, include nausea (21 percent), headaches (20 percent), anxiety and nervousness (15 percent), insomnia (14 percent), drowsiness (12 percent), diarrhea (12 percent), dry mouth (9 percent), loss of appetite (9 percent), sweating and tremors (8 percent), and rashes (3 percent).
If you are experiencing a symptom that you didn’t have previously, like waking up suddenly in the night and not being able to get back to sleep, it's most probably a Prozac side effect. Prozac is commonly associated with insomnia, restlessness, nausea, and tension headaches. The symptom that you are experiencing is probably what is known as a “transient Prozac side effect,” This means that the side effect is not permanent and could disappear as soon as your body adjusts to taking the drug. Doctors report these normally go away within one to two weeks from the time Prozac was first taken.
Some symptoms are experienced for the duration of treatment but some doctors believe that just understanding what these are could be enough to reassure the sufferer. One possible Prozac side effect, which remains all through the time it is taken, is its effect on your sex life. It often reduces desire and can delay or interfere with orgasm, in both women and men. Fatigue and memory loss are other possible problems. These side effects will subside when you stop taking the drug.
Because the antidepressants known as tricyclics are an older class of drug (first developed in the 1950s), their patents have already run out, and the generic brands are more competitively priced. Some doctors will prescribe either doxepin or desipramine to be taken at bedtime in order to counter the insomnia that often occurs with Prozac.
Prozac is also more likely than other antidepressants to cause restlessness, insomnia (the most common one occurring in up to 33 percent of patients), and agitation. Some people have even experienced violent or destructive outbursts, and the drug's association with suicide remains controversial. Usually taken once a day either in the morning or evening, patients taking it at night have reported that their mind just won't shut off. They lie there in bed consumed with thinking about what they need to do the following day or week, or about what to wear the next day or very minor things that they don't need to think about when trying to sleep. Others say they have a restless sleep during the night and then wake up early hours of the morning (about 3am or 4am) and don't go back to bed till about 5:30am and then are awake again at 6:30am to 7:00am. Many times the doctor will also prescribe another drug such as benedryl or a low dose of a sedating antidepressant or a short acting hypnotic (such as Ambien, Sonata, or Temazepam). If you develop insomnia while taking Prozac, make sure to discuss this with your healthcare provider. There are other treatments that he or she might be able to recommend, including adjusting the Prozac dosage, when you take it, or trying another medicine like the newest SSRI, Serzone (nefazodone hydrochloride), which is especially useful in cases of agitation, anxiety, and insomnia.
If you are ever unhappy with how your doctor responds to your questions about medications and symptoms, be sure to get a second opinion. There are many stories about patients who, after complaining of side effects to their doctors, were ignored or brushed off with a brusque "you can't possibly be having such side effects." There are instances where doctors have even increased the dosage, only aggravating the problem. Your doctor doesn’t live inside your body, and only you know how you feel. You have the right to be heard by your health care provider, and to have your doctor work with you on fine-tuning or changing your medication as you need.
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