Why is Prozac the most recognized antidepressant?

Prozac (generic name: fluoxetine) was one of the first new antidepressants classified as an SSRI, and it is still popular. Prozac helps the body increase serotonin at low doses and norepinephrine at higher doses. Research has also demonstrated that, like most antidepressants, Prozac helps the brain produce more of the natural neurochemicals that heal brain cells and help new ones grow in damaged brain areas. Prozac has been used and studied extensively, and we understand it well. Over 23 million prescriptions for generic fluoxetine were filled in the United States last year.

Patients say that Prozac lowers the overall level of all their emotions, while highly charged negative emotions like strong sadness and anger move into the background. People are aware that negative emotions are present, but they do not break into conscious thought and are easy to ignore.

For some people, the dampening of emotions makes them feel numb or empty. People who are used to feeling strong emotions may miss them and the degree of mental excitement that goes along with them. On the other hand, people who find strong emotions intrusive may be quite satisfied with Prozac.

Many patients experience a slight feeling of activation with Prozac. This serves to counter symptoms of low energy caused by unipolar major depression. This activation also makes many people anxious and makes it harder for them to get to sleep. Clinical studies show that more than 15 percent of those taking Prozac experience anxiety, nervousness, and sleeplessness. Some physicians automatically prescribe antianxiety or sleeping medications for patients who are starting Prozac.

Unfortunately, Prozac has plenty of other side effects, no matter what you might have heard. At least 10 percent of Prozac users report nausea, diarrhea, dry mouth, dizziness, and tremors. It is not a good medication to take if there is any danger of bipolar disorder. Prozac, more often than not, causes mania in people with bipolar disorder.

Sexual side effects make great press, and there is now widespread knowledge that Prozac can alter the sexual response. In addition to the standard SSRI effect of delaying the time to orgasm, patients say they’ve experienced decreased sensation or numbness in the penis or vagina. Many people have discontinued taking Prozac because of sexual problems.

Prozac takes about seven hours to enter the bloodstream completely, and levels slowly rise until they plateau after about five weeks of treatment. Once in the bloodstream, active Prozac molecules break down into the chemical norfluoxetine, which stays in the body for three to six weeks. Prozac and its metabolite stay in the body even longer in elders or patients with liver or kidney problems. All this makes working with Prozac difficult, because it never seems to go away. Prozac is a good antidepressant, but there are better ones available with fewer problems.

Prozac comes in 10, 20, and 40-milligram generic tablets and capsules and a mint-flavored liquid containing 20 milligrams per teaspoon. A 20-milligram dose is usually more than enough, and even that may be a large dose for some people.