Prozac is a pharmacological agent that belongs to the class of bicyclic antidepressants with a stimulating effect. In the instructions for use, Prozac is described as an effective medication that allows you to eliminate or weaken a depressed state, fears and anxiety, stabilize mood, a sense of inner comfort, and increase resistance to emotional stress. An antidepressant does not cause a hypnotic effect, acute dependence and addiction, but is dispensed exclusively by prescription.
Material Content:
Release forms and composition
The pharmaceutical product was developed by a Swiss company and is produced in France in the form of opaque creamy green capsules made of hard gelatin containing 20 mg of the therapeutic substance in the form of a white fine powder. Outside, food ink is marked with the LILLY logo, which indicates part of the name of the pharmaceutical company Eli Lilly, and code 3105.
The therapeutic basis of the drug is fluoxetine in the form of hydrochloride. Together with medical instructions, 1 or 2 cell packs of thermoplastic and aluminum foil containing 14 capsules are placed in a pack.
Inactive constituents of the drug are necessary for the shaping, stabilization and preservation of the pharmaceutical product.
The pharmaceutical effect of the drug is based on the blockade of neuronal reuptake of the “hormone of happiness” - the brain neurotransmitter serotonin, through which an electrochemical pulse is transmitted between cells.
An antidepressant promotes an increase in serotonin in the space between neurons (synapse) of the brain, eliminating the deficiency of this active substance, which is involved in the management of the central nervous system and ensures its stable functions. The lack of this neurotransmitter, according to experts, is one of the reasons for the development of depressive states.
Prozac has an antidepressant effect while stimulating the effect on the nervous system.
The therapeutic result of the medication is manifested in the following effects:
- relieves emotional and mental stress, a sense of anxiety and fears;
- the feeling of depression, irritability, nervousness is eliminated;
- mood improves, sleep stabilizes;
- functions of the autonomic nervous system return to normal: the phenomena of arrhythmia, jumps in blood pressure, dizziness, digestive upsets, pain in the abdomen, behind the sternum, in the head, due to an oppressed mood, are eliminated.
When is Prozac prescribed
Fluoxetine (the active substance Prozac) is a derivative of propylamine, is a selective (selective) serotonin reuptake inhibitor and belongs to the class of psychotropic drugs SSRIs.
Indications:
- Depressive states, anxious neurosises, which are expressed in a depressed mood, fears, apathy, lethargy and inability to focus on the background of a breakdown and high fatigue (for 2 to 4 weeks), loss of joy in life, pessimism, reduced self-esteem, weight loss or weight gain from - due to overeating, sleep problems, reduced ability to work due to constant depression and apathy.
- Neurosis of obsessive states (obsessive-compulsive syndrome), which is expressed in the development of obsessive thoughts, ideas (idea-fix), inadequate experiences and ritual actions. This can manifest itself in morbid cleanliness, excessive superstition, fear of being robbed, losing money, things, in sexual or religious obsessive images and related “rituals”.
- Phobic disorders (fears) - a persistent fear of “dirt”, germs, infection (misophobia), claustrophobia, fear of large spaces and an abundance of people (agoraphobia), an obsessive fear of getting cancer, AIDS (nosophobia), going crazy (lysophobia).
- Bulimia nervosa (an eating disorder), which is manifested in constant overeating, obsession with excess weight, inducing artificial vomiting after eating, as well as starvation, uncontrolled use of laxatives. At the same time, such patients are characterized by low self-esteem, reduced blood pressure, sudden changes in weight, genitourinary problems, dehydration, inflammation and ulceration of the esophagus due to provoking vomiting.
- Panic attacks - bouts of unmotivated fear, anxiety, accompanied by a sharp increase in pressure, palpitations (up to 130 - 150 beats / min), acute weakness in the legs, chest tightness, pain in the heart and stomach, diarrhea, sweating, trembling limbs. Prozac for panic disorders is prescribed exclusively in combination with tranquilizers, which the doctor selects, within 7 to 9 weeks from the start of the course, in order to prevent the development of severe attacks provoked by the stimulating effect of the antidepressant.
- Premenstrual neurosis (depressive apathy, irritability, swelling of the chest, bloating).
- Obesity. The antidepressant Prozac has an anorexigenic property - it suppresses hunger by influencing saturation centers in the brain, while improving mood, which allows you to lose weight without suffering from a "shortage" of sweet-fatty foods.
Prozac is preferred for depression, occurring with motor inhibition, drowsiness.
Important! Fluoxetine is not prescribed for patients with motor and mental excitement, thoughts of suicide - since it is able to aggravate these manifestations and worsen the patient's condition.
Fluoxetine is well absorbed and distributed in tissues. The maximum amount in the blood is recorded 6 to 8 hours after taking the pill. Communication with blood proteins is significant. The equilibrium (stationary) content of the active substance, which is observed in serum upon regular entry into the body, is achieved at 4 - 5 weeks of taking Prozac.
The maximum therapeutic effect of Prozac manifests itself at 4-6 weeks of treatment and lasts up to 3 weeks after the withdrawal of the drug.
The enzymatic treatment of the therapeutic component takes place in the liver to the pharmacologically active metabolite (intermediate) of norfluoxetine and a number of other inactive metabolites, which are removed with urine. The time for which half the dose is removed is 4–6 days (excretion of norfluoxetine can last up to 14–16 days).
Instructions for use of the drug
Depressive and obsessive conditions, bulimia: the initial dose is once a day, 20 mg in the morning or afternoon (up to 14-15 hours). With weak pathological manifestations, you can start with 10 mg per day. After 20-30 days, if strong undesirable effects are not observed, the daily amount of fluoxetine can be increased to 60 mg, dividing it by 2-3 times.
In depressive conditions, tablets are taken without regard to food, in bulimia - with food.
Premenstrual syndrome: it is recommended to take no more than 20 mg per day.
The maximum allowable daily amount of an antidepressant is 80 mg. People over 55-60 years old, patients with hepatic-renal diseases, the dose is limited to 20-40 mg.
Prozac tablets are taken for a long time, since its therapeutic effect is manifested at 3-5 weeks of therapy. The duration of treatment is determined by a neurologist, psychotherapist.
During pregnancy and lactation
Medical data on the effects of Prozac on pregnancy, the development of the embryo, fetus and baby are mixed, therefore, an antidepressant is prohibited for the treatment of nursing mothers and pregnant patients. The drug can be prescribed only in conditions that pose a high threat to the patient’s health, if there are no other, safer pharmaceuticals.
Prozac can cause fetal malformations, miscarriages and early childbirth, increase the risk of low weight in a newborn. There is a doctors opinion that taking fluoxetine in the first 13 weeks of gestation increases the risks of cardiac abnormalities in the fetus, impaired mental development in children, in particular, the development of autism.
The use of fluoxetine by a pregnant woman from 6 to 9 months of pregnancy can cause severe neurological manifestations of the "withdrawal syndrome" in infants (overexcitation, shortness of breath, insomnia, motor disorders), as well as the risk of pulmonary hypertension.
Fluoxetine penetrates into breast milk, therefore, during the treatment, the baby is transferred to feeding with milk mixtures.
Antidepressant Compatibility with Alcohol
Prozac, like other SSRIs, is not allowed to be taken against the background of alcoholic beverages in order to avoid amplification or development of side effects from the drug. Combination with ethanol can lead to disorders such as blood pressure spikes, delirium, arrhythmia, depressive psychosis, disturbances in the flowing properties of blood, and impotence.
Drug interaction
Prozac and its metabolite, norfluoxetine, are removed from the body for a long time, which should be taken into account when combining fluoxetine with other drugs, as well as when replacing it with another antidepressant.
| Pharmacological Products | Effects in parallel Reception with Prozac |
|---|---|
| Tramadol, triptans | risk of serotonin syndrome, narrowing of the heart vessels and hypertension |
| CNS depressant medications, ethanol | significant increase in depression of the nervous system, risk of seizures |
| Inhibitors of MAO, antipsychotics, Haloperidol, drugs with trifluoperazin, fluphenazine, maprotiline, sulpiride, perphenazine, periciazine, metoclopramide, pimozide | risk of extrapyramidal disorders |
| Tools with lithium | increased neurotoxicity |
| MAO antidepressants, furazolidone, procarbazine, tryptophan | serotonin syndrome (overexcitation, disorientation, manic behavior, convulsions, a sharp increase in pressure, vomiting, diarrhea) |
| Macrolide antibiotics (Erythromycin, Romicin) | intoxication, psychoses |
| Benzyl diazepines tranquilizers, propaphenone, carbamazepine, three and tetracyclic antidepressants, trazodone, diazepam, metoprolol, phenytoin, terfenadine, alprazolam, barbiturates, beta-adrenoblockers, drugs based on Hypericum perforatum, telecilodinocin, telecilodinocin, flecindexinetinolisinecin, flecindecinidecin, flecindinin | amplification of all adverse reactions and the actions of the drugs themselves |
| Anticoagulants (Warfarin) and other drugs that affect the blood coagulation system (Aspirin, Ibuprofen, Paracetamol, Diclofenac, Xefocam, Ketoprofen) | risk of bleeding, cerebral hemorrhage |
| Nifedipine, Verapamil and other calcium channel blockers | nausea, swelling, headache |
| Hypoglycemic agents for diabetes | strengthening their action and the development of hypoglycemia and then increasing hyperglycemia |
| Electroconvulsive Therapy (ECT) | prolonged epileptic seizures |
| Dextromethorphan | hallucinations |
| Digoxin | increased digoxin concentrations and the risk of cardiotoxicity |
| Imipramine, desipramine | increase in blood concentration up to 10 times with prolonged persistence after withdrawal of Prozac |
Contraindications, side effects and overdose
Contraindications:
- intolerance to any components of the medication;
- the presence of suicidal thoughts (absolute prohibition) - Prozac carries a mortal danger for patients with a tendency to suicide;
- bipolar depression (risk of manic conditions);
- age up to 18 years, pregnancy, breastfeeding;
- concurrent administration of Prozac with MAO inhibitors, Pimozide, Thioridazine (interval of at least 5 weeks between treatment with these medical supplies);
- glaucoma, weakening of the tone of the bladder;
- severe renal pathology;
- benign prostate tumor;
- convulsive seizures.
Very carefully, reducing the dosage, use Prozac for weakened work of the heart, liver and kidneys (especially in patients with CC less than 10 ml / l who are not undergoing hemodialysis), vascular diseases, diabetes mellitus, in elderly or debilitated patients (probability of convulsive attacks).
A long period of fluoxetine excretion causes a lower risk of withdrawal syndrome with a sharp cessation of intake, but the side effects of Prozac persist longer than other SSRIs.
Possible adverse reactions and their frequency
| 10 out of 100 patients and more often | In 2–10 cases | 2-10 out of 1000 patients | 1 out of 1000 and less |
|---|---|---|---|
| Watery stools, nausea, weakness, headache, agitation, insomnia (eliminate the appointment of a tranquilizer) | Arrhythmia, hot flashes, dry mouth, vomiting, weight loss, yawning, dizziness, drowsiness, finger shake, nightmares, nervousness, decreased attention, sex drive, sweating, itchy skin, rashes of various kinds, urticaria, loss of vision, frequent urges urination, ejaculation and erection disorders, uterine bleeding, heavy periods, menopause bleeding | Decreased blood pressure, difficulty swallowing, taste perversion, muscle twitching, tics, motor-mental agitation, impaired coordination, nocturnal gnashing of teeth, lack of orgasm, impaired mental activity, hair loss, painful erection, hemorrhage under the skin, urinary retention, dilated pupil, serotonin syndrome | Vasculitis, pain in the esophagus, chills, fever, involuntary body movements, cramps, mania, Quincke's edema, light intolerance, very rarely anaphylactic reactions, serum sickness, drop in sodium in the blood |
With the development of acute or severe adverse events, including overexcitation, panic, lethargic phenomena, swelling of the eyelids, larynx, tongue, respiratory disorders, progressive disorders of the kidneys, liver, you should either adjust the dose in the direction of decrease, or immediately stop taking Prozac.
During the period of taking Prozac capsules, you should not drive vehicles, engage in hazardous activities or activities where you need increased attention, accuracy and a quick reaction (including the work of a surgeon, nurse, dentist, air traffic controller).
Overdose signs include:
- convulsions, lethargy or overexcitation, vomiting, tachycardia;
- respiratory disorders, motor disorders;
- psychopathic, manic states;
- pressure drop, arrhythmia, and ventricular fibrillation;
- stupor, coma, cardiac arrest.
Such conditions require emergency hospitalization of the patient and intensive care in the hospital. Forcing diuresis, blood transfusion, hemodialysis are unproductive.
Analogs of the drug Prozac
Known analogues of Prozac, containing an identical therapeutic substance: Fluoxetine, Prodep, Deprex, Fluval, Portal, Profluzak, Deprenon, Phloxet.
