While Prozac is only officially approved to treat panic disorders, it’s often prescribed for generalized anxiety as well. But, there are some serious possible side effects to be aware of.
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, anxiety disorders affect more than 40 million American adults. A majority of people don’t receive treatment.
There are several treatment options available to manage symptoms of anxiety disorders, including psychotherapy and medications such as Prozac.
In this article, we’ll discuss Prozac’s use in anxiety, its side effects, risks, and other key information.
What is Prozac?
Prozac (fluoxetine) is a popular antidepressant medication that’s been around since the 1980s. It’s approved to treat major depressive disorder (MDD), obsessive-compulsive disorder (OCD), bulimia, and panic disorder. Doctors and other healthcare professionals also prescribe Prozac off-label to manage other types of anxiety disorders.
Prozac is a brand-name medication that’s also available in generic versions of different strengths. Generic versions are generally less expensive than brand-name Prozac.
Prozac and other medications in this class — known as selective serotonin reuptake inhibitors (SSRIs) — are considered the first choice for the treatment of anxiety disorders.
Prozac and other SSRI medications are preferred by doctors over other medications such as alprazolam or diazepam because they’re not habit-forming and can be used long term to treat symptoms of anxiety.
Prozac is also generally thought to be safer than older antidepressants such as tricyclic antidepressants or monoamine oxidase (MAO) inhibitors, which are also used to treat anxiety symptoms. While the exact way SSRIs work isn’t known, one of the ways it’s thought to work is by regulating your mood by increasing the levels of serotonin in your brain.
What the science says
Advantages of Prozac for anxiety
- oral medication with convenient, once-daily dosing
- generic available, making it more affordable
- not habit-forming like benzodiazepine medications for anxiety
Disadvantages of Prozac for anxiety
- has a Food and Drug Administration (FDA) black box warning for suicidal thoughts and behavior
- not approved for generalized anxiety disorder
- may cause anxiety, trouble sleeping, and nervousness
Prozac and generic fluoxetine are available in several different strengths and dose forms (capsule, tablet, and liquid) for ease of dosing.
Your dosage of Prozac will depend on:
- the condition being treated
- your age
- your health
- other medications you may be taking
For panic disorder, the usual starting dosage is 10 milligrams per day and may be increased if needed. A doctor will decide the best dosage 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, as you could experience withdrawal symptoms.
Ask a doctor or pharmacist about the best way to take Prozac and how to manage side effects.
Prozac can be taken with or without food. For best absorption, don’t take it alongside a fiber or vitamin supplement. It’s also best to take it with water and avoid drinks high in vitamin C, such as grapefruit or orange juice.
Prozac has a “black box” warning. This is the most serious warning a medication can get from the FDA.
People with MDD may experience worsening of their depression or suicidal thoughts or behavior. The risk is higher for children and adolescents under 25 years of age.
Share your medical and family history with a doctor and ask about the risks of Prozac. A 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. A doctor will need to monitor your weight while you’re taking Prozac.
Zoloft vs. Prozac for anxiety
Zoloft and Prozac are both approved to treat panic disorders and are often used off-label to treat anxiety. But Zoloft can only be used to treat children with OCD and is otherwise only approved for use in adults.
In general, there’s not a significant difference between using one or the other for the purposes of anxiety treatment. Side effects may vary, but the overall outcomes are similar.
Prozac may cause side effects, and some may be serious. This isn’t a complete list of all the side effects of Prozac, just some of the most common. Ask a 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 a 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 a doctor what you should expect to experience with Prozac.
Common side effects
Some common side effects include:
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 your blood (symptoms include headache, confusion, and weakness)
If you experience a severe or life threatening reaction to Prozac, call 911 or local emergency services right away.
Prozac can interact with other medications — including over-the-counter (OTC) products — vitamins, herbs, and other supplements. Be sure to tell a doctor or pharmacist about all of the medications and OTC products you take.
Ask a doctor for more information, but you should avoid taking these medications with Prozac:
- MAO inhibitors: When taken with Prozac, MAO inhibitors can cause dangerous reactions, including high fever, changes in your blood pressure, changes in your heart rate, confusion, and loss of consciousness.
- Thioridazine: Thioridazine can increase heart rhythm problems.
- Pimozide: Pimozide can increase heart rhythm problems when taken with Prozac.
Drinking alcohol may worsen your symptoms of anxiety and increase some side effects of Prozac. Ask a doctor if it’s safe to drink alcohol 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
- nonsteroidal anti-inflammatory drugs (NSAIDs) (ibuprofen, acetaminophen)
- anticonvulsant medications (carbamazepine, phenytoin)
This isn’t a complete list of all the interactions with Prozac. Ask a pharmacist for a complete list of interactions. Read this for a list of other medications used to treat anxiety and helpful information about each.
Prozac may not be safe for you if you have certain health or medical conditions. Ask a doctor for more information about the risks and benefits of Prozac for you.
- Liver disease: If you have problems with your liver, a doctor may need to adjust your dosage of Prozac or consider other medications to manage your anxiety.
- Seizures: If you have a history of seizure disorder, a 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 such as warfarin to thin your blood, Prozac can increase your risk of bleeding.
- Pregnant or nursing: It isn’t known if Prozac is safe during pregnancy or while nursing. Ask a doctor about the benefits and risks of Prozac during this time.
Is it possible to overdose on Prozac?
Yes, it’s possible to overdose on Prozac. Always take the medication exactly as a 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 local emergency services or go to an emergency room to get help right away.
Symptoms of overdose can include:
Prozac is a well-known antidepressant that’s currently only approved to treat panic disorder. Talk with a doctor about the benefits versus risks of Prozac and other options to manage general anxiety symptoms.
Ask a healthcare professional 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 the healthcare professional find the best treatment course for you. Prozac carries a risk of serious and some life threatening side effects to be aware of.
If you’ve recently started taking Prozac, remember it can take time to work. Don’t stop taking Prozac without talking with a doctor to avoid unpleasant side effects such as withdrawal.