Occasional anxiety is common and happens to all of us, but anxiety disorders are more than brief anxiety.
People with anxiety disorders deal with excessive fear and worry that interferes with daily life, with these feelings lasting longer than 6 months.
According to the Anxiety and Depression Association of America (ADAA), anxiety disorders affect over 40 million American adults, though a majority of people don’t receive treatment.
There are several treatment options available to manage symptoms of anxiety disorders, including psychotherapy and medications like Prozac.
In this article, we’ll discuss Prozac’s use in anxiety, side effects, risks, and other key information.
Prozac (fluoxetine) is a popular antidepressant medication that’s been around since the 1980s. It is approved to treat panic disorders — a type of anxiety disorder, but doctors also often prescribe Prozac to treat other types of anxiety as well.
Prozac is a brand-name medication that is also available in generic versions in different strengths. Generic versions are generally less expensive than brand-name Prozac.
It’s approved by the Food and Drug Administration (FDA) to treat major depressive disorder, obsessive compulsive disorder (OCD), bulimia, and panic disorder, but doctors also prescribe Prozac off-label to manage other types of anxiety disorders.
Prozac and other medications in this class — known as selective serotonin reuptake inhibitors (SSRIs) — are considered the first choice for treatment of anxiety disorders.
What the science says
Prozac belongs to a class of medications called SSRIs. While the exact way SSRIs work isn’t known, one of the ways it’s thought to work is by regulating mood by increasing serotonin in your brain.
This is one of the reasons doctors often prescribe SSRIs like Prozac to ease symptoms of mood-related conditions like anxiety.
Prozac and other antidepressant-type medications can also be effective when someone has other mental health conditions, like depression, along with anxiety.
Prozac and generic fluoxetine are available in several different strengths and dosage forms (capsule, tablet, liquid) for ease of dosing.
The dosage for Prozac depends on
- the condition being treated
- your age
- your health
- other medications you may be taking
For panic disorder, the usual starting dose is 10mg per day and may be increased if needed. Your doctor will decide the best dose of Prozac for you based on your condition and how you respond to treatment.
Take Prozac exactly as prescribed. Keep in mind, it may take several weeks to see the full effects of Prozac. Do not suddenly stop taking Prozac, you could experience withdrawal symptoms.
Prozac can be taken with or without food.
Ask your doctor or pharmacist about the best way to take Prozac and how to manage side effects.
Prozac may cause side effects, and some may be serious. This isn’t a complete list of all side effects of Prozac. Ask your pharmacist or doctor for a full list of side effects.
Side effects generally go away after a few days or a few weeks, but if they’re bothersome or serious, call your doctor to discuss your treatment options.
Prozac can also cause anxiety as a side effect. This may happen when you first start taking Prozac. Ask your doctor what to expect with Prozac.
Common side effects
Some common side effects include:
- anxiety, nervousness
- dry mouth
- trouble sleeping
Serious side effects
Serious side effects include:
- serotonin syndrome (too much serotonin builds up and can be dangerous)
- allergic reactions
- unusual bruising or bleeding
- mania symptoms (intense mood shifts)
- low salt levels in the blood (symptoms include headache, confusion, weakness)
If you experience a severe or life-threatening reaction to Prozac, call 911 right away.
Prozac can interact with other medications (including over-the-counter products), vitamins, herbs, and other supplements. Be sure to tell your doctor and pharmacist about all of the medications and OTC products you take.
Ask your doctor for more information, but you should avoid taking these medications with Prozac:
- MAO inhibitors (MAOIs), when taken with Prozac, can cause dangerous reactions, including high fever, changes in blood pressure, heart rate, confusion, and loss of consciousness.
- Thioridazine can increase heart rhythm problems.
- Pimozide can increase heart rhythm problems taken with Prozac.
Other medications that may interact with Prozac and increase side effects include:
- other antidepressant medications
- central nervous system depressant medications (opioids, benzodiazepines)
- St. John’s wort
- NSAIDs (ibuprofen, acetaminophen)
- anticonvulsant medications (carbamazepine, phenytoin)
This isn’t a complete list of all the interactions with Prozac. Ask your pharmacist for a complete list of interactions.
Prozac has a black box warning. This is the most serious warning about a medication from the FDA.
People with major depressive disorder (MDD) may experience worsening of their depression, suicidal thoughts, or behavior. The risk is higher for children and adolescents under age 25.
Share your medical and family history with your doctor and ask about the risks of Prozac. Your doctor will monitor you carefully while you take Prozac.
Prozac may cause loss of appetite and weight loss. This may be serious in some people. Your doctor will need to monitor your weight while you’re taking Prozac.
Yes, it’s possible to overdose on Prozac. Always take the medication exactly as your doctor has prescribed. Taking too much Prozac can be dangerous and even life-threatening.
If you think you’ve taken too much Prozac, call 911 (or your local emergency number) or go to an emergency room to get help right away.
Symptoms of overdose can include:
- high blood pressure
- fast heart rate
- trouble walking
- nausea, vomiting
Don’t suddenly stop taking Prozac without talking to your doctor.
You may experience withdrawal symptoms including
- insomnia (trouble sleeping)
Prozac may not be safe for you if you have certain health or medical conditions. Ask your doctor for more information about the risks and benefits of Prozac for you.
- Liver disease. If you have problems with your liver, your doctor may need to adjust your dose of Prozac or consider other medications to manage your anxiety.
- Seizures. If you have a history of seizure disorder, your doctor will discuss your risks if you choose to take Prozac.
- Bipolar 1 disorder. Prozac can increase the risk of manic episodes when used alone in people with bipolar disorder.
- Blood clotting disorders. If you’re taking medications like warfarin to thin your blood, Prozac can increase your risk of bleeding.
- Pregnant or breastfeeding. It isn’t known if Prozac is safe during pregnancy or while breastfeeding. Ask your doctor about the benefits and risks of Prozac if you’re pregnant or breastfeeding.
Anxiety disorders are complex, chronic conditions that can be long-lasting with many causes. But there are lots of treatment options available including medications and psychotherapy like cognitive behavioral therapy (CBT) that can help regulate symptoms.
Prozac is a well-known antidepressant that’s currently only approved to treat panic disorder. Talk to your doctor about the benefits versus risks of Prozac and other options to manage anxiety symptoms.
Ask your healthcare provider for more information about Prozac and if it’s the best medication for you. Be sure to discuss your health and medical history to help your doctor find the best treatment course.
Learn about anxiety triggers and consider these positive steps to help manage anxiety
- regular exercise
- focused breathing techniques
- proper sleep
- stress management skills
If you’ve recently started taking Prozac, remember it can take time to work. Don’t stop taking Prozac without talking to your doctor to avoid unpleasant side effects like withdrawal.