Prozac Fluoxetine side effects

The following year, the British National Formulary, a joint publication of the British Medical Association and Royal Pharmaceutical Society of Great Britain (1991), listed suicidal ideation and violent behavior as fluoxetine side effects. Also in 1991,1 published Toxic Psychiatry, in which I observed for the first time that Prozac was producing a continuum of overstimulation that included akathisia, agitation, anxiety, insomnia, depression and mania, and, in the extreme, suicide and violence. I drew on previously sequestered FDA premarketing data on Prozac, the scientific literature, and my own clinical and forensic cases. 

Tricyclic drugs have, as the name implies, a three-ring structure, and interfere with reuptake of norepinephrine and/or serotonin into axon terminals. Tricyclic drugs include imipramine (Tofranil), amitriptyline (Elavil), clomipramine (Anafranil), and nortriptyline (Pamelor, Aventil). Tricyclics have the occasional but unfortunate cardiovascular side effects of arrhythmia and postural hypotension. Newer, nontricyclic antidepressants have been developed that are collectively referred to as SSRIs. These have a potent and selective action on serotonin, and lack the cardiovascular side effects of the tricyclics. These include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), and fluvoxamine (Luvox). A fifth SSRI, citalopram (Celexa) has been used in Europe and has recently been approved in the United States. Venlafaxine (Effexor) blocks reuptake of norepinephrine and serotonin, while bupropion (Wellbutrin) acts on both dopamine and norepinephrine. 

Other Antidepressants. Antidepressant refinements for the next 30 years primarily consisted of the development of new TCAs. However, in 1988, a novel antidepressant class, the selective serotonin reuptake inhibitors (SSRIs), was introduced in the United States. The chief innovation of the SSRIs was that they afforded the comparable effectiveness of the TCAs with fewer side effects and minimal toxicity. The debut of the SSRIs coincided with the reworking of the nosology of the anxiety disorders in DSM-III and DSM-IV. As a result, the SSRIs have been studied extensively in each of the respective anxiety disorders and in many cases have obtained FDA approval for the treatment of one or more of these anxiety syndromes. The SSRIs currently available in the United States include citalopram (Celexa), escitalo-pram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft). 

Specific Serotonin Reuptake inhibitors (SSRis). To date, the only SSRI studied in AN is fluoxetine (Prozac). During the acute refeeding phase of treatment, fluoxetine shows modest improvement in weight gain while a larger controlled study during the maintenance phase of treatment demonstrated effectiveness in the prevention of relapse. From the standpoint of side effects and toxicity, the SSRIs are clearly... 

The efficacy of fluoxetine in treating patients with moderate depression is comparable to the efficacy of tricyclic antidepressants. It is capable of elevating mood and removing feelings of fear and stress. It does not have a sedative effect. Fluoxetine is used in depression as well as in bulemic neuroses. Use of fluoxetine is preferred in cases when sedative, hypotensive, and anticholinergic side effects caused by other antidepressants are con-traindicative to patients. Prozac is a synonym for fluoxetine. 

Tricyclic antidepressants are still prescribed today, but some patients experience side effects such as dry mouth, blurry vision, constipation, and other uncomfortable conditions. Other antidepressants have since been found that induce fewer side effects. One of the most popular is fluoxetine, which is marketed under the trade name Prozac. This drug, along with Zoloft and other antidepressants, are known to inhibit reuptake proteins specifically for serotonin. As a result, these drugs are called selective serotonin reuptake inhibitors, or SSRIs. Although some concerns have appeared because of a possible risk of suicide in young patients who take Prozac, these drugs are commonly prescribed and have proved highly effective in millions of patients. 

The problem is that all drugs exert a number of different effects, some of which are wanted and some of which are not (the side effects). In researching the activity of fluoxetine (Prozac), scientists noticed a discrepancy between the time the drug acts on serotonin transporters and the time at which the patient s symptoms are relieved. Many patients do... 

Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac) begin to be used as antidepressants. These medications are generally effective and have fewer side effects than earlier drugs. 

The most widely known SSRIs are fluoxetine hydrochloride (4, Prozac , Lilly), sertraline hydrochloride (5, Zoloft , Pfizer) and paroxetine hydrochloride (6, Paxil , GSK). Fluoxetine (4, Prozac ) was the first SSRl approved and effected a revolutionary change in the treatment of depression. In 2000, it was the most widely prescribed antidepressant drug in the United States with worldwide sales of 2.58B. Sertraline (5, Zoloft ) has been available in the United States since 1992 and had worldwide sales of 2.14B in 2000. Compared to fluoxetine (4), it has a shorter duration of action and fewer CNS activating side-effects such as nervousness and anxiety. Paroxetine (6, Paxil ) generated worldwide sales of 2.35B in 2000 and has a relatively benign side-effect profile, which favors its use with elderly patients. 

Fluoxetine (Prozac] Moderate, selective inhibition of serotonin reuptake No sedative, anticholinergic, or cardiovascular side effects helpful in obsessive-compulsive disorder May cause anxiety, nausea, insomnia long half-life can lead to accumulation... 

Fisher et al. (1993) conducted a phone survey of pharmacy patients taking various antidepressants and compared fluoxetine to trazodone. They concluded that fluoxetine caused a higher incidence of psychologic/ psychiatric adverse clinical events, including delusions and hallucinations, aggression, and suicidal ideation (p. 235, emphasis added). In a followup study, Fisher et al. (1995) found that many of the same side effects reported in regard to Prozac were also reported for Zoloft. Both drugs... 

The new wave of safer antidepressants introduced in the 1990s, led by fluoxetine (Prozac),is dominated by drugs that are serotonin-selective reuptake inhibitors (SSRIs). The SSRIs exhibit some adverse side effects, notably in impaired sexual function in both men and women, but because they are relatively safe physicians have been less inhibited about using them. This has extended the clin-... 

Fluoxetine hydrochloride (brand name Prozac) An antidepressant that functions as an SSRI and is prescribed for depression that is severe enough to impair daily functioning. This medication is also used to treat obsessive-compulsive disorder (OCD). It should not be used with an MAO inhibitor. Some common side effects include abnormal dreams, abnonnal ejaculation, decreased orgasmic functioning, agitation, and headaches. 

These include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), escitalopram (Lexapro), and citalopram (Celexa). Prozac has become a household word. It was the first to be approved by the FDA, in 1987.3 SSRIs increase the level of serotonin in the synapse, at least initially, and ultimately contribute to regaining a sense of well-being. Side effects may include sexual dysfunction, nausea. 

S)-(+) Dexfenfluramine (Redux ) 21, a serotonin reuptake inhibitor, has been marketed in Europe and the United States as a very effective anti-obesity drug. This isomer, obtained by resolution of racemic fenfluramine using d-camphoric acid, exhibits a greater anorectic effect than die (R)-(-) and racemic forms, since it is more selective on serotonin as a 5-HT agonist (22). As a result of reports of imdesirable side effects, e.g., valvular heart disease, Redux has been wididrawn from the market, while further studies continue. Racemic fluoxetine (Prozac ) (22) is widely used for treatment of major depression and is one of the most commonly prescribed medications. It is also approved for treatment of obsessive compulsive disorder and bulimia. Non-racemic fluoxetine and its intermediates have been prepared by chemical, enzymatic. 

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