PROZAC SUMMARY
Prozac® (fluoxetine hydrochloride) is a psychotropic drug for oral administration. It is also marketed for the treatment of premenstrual dysphoric disorder (Sarafem®, fluoxetine hydrochloride).
Prozac is indicated for the following:
MAJOR DEPRESSIVE DISORDER
Prozac is indicated for the treatment of major depressive disorder.
OBSESSIVE-COMPULSIVE DISORDER
Prozac is indicated for the treatment of obsessions and compulsions in patients with obsessive-compulsive disorder (OCD), as defined in the DSM-III-R; i.e., the obsessions or compulsions cause marked distress, are time-consuming, or significantly interfere with social or occupational functioning.
BULIMIA NERVOSA
Prozac is indicated for the treatment of binge-eating and vomiting behaviors in patients with moderate to severe bulimia nervosa.
PANIC DISORDER
Prozac is indicated for the treatment of panic disorder, with or without agoraphobia, as defined in DSM-IV. Panic disorder is characterized by the occurrence of unexpected panic attacks, and associated concern about having additional attacks, worry about the implications or consequences of the attacks, and/or a significant change in behavior related to the attacks.
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NEWS HIGHLIGHTS
Published Studies Related to Prozac (Fluoxetine)
Simvastatin as an adjuvant therapy to fluoxetine in patients with moderate to
severe major depression: A double-blind placebo-controlled trial. [2015] Statins have been shown to decrease depressive symptoms in certain groups of
patients, an effect that is mostly attributed to their anti-inflammatory and
neurotransmitter modulatory potentials. We aimed to investigate the
antidepressant effects of simvastatin as an adjuvant therapy in patients with
moderate to severe depression...
Comparable efficacy and safety of 8 weeks treatment with agomelatine 25-50mg or
fluoxetine 20-40mg in Asian out-patients with major depressive disorder. [2014] CONCLUSIONS: Agomelatine and fluoxetine are equally effective in the treatment of
Fluoxetine in progressive multiple sclerosis (FLUOX-PMS): study protocol for a
randomized controlled trial. [2014] BACKGROUND: Currently available disease-modifying treatments acting by modifying
the immune response are ineffective in progressive multiple sclerosis (MS), which
is caused by a widespread axonal degeneration. Mechanisms suspected to be
involved in this widespread axonal degeneration are reduced axonal energy
metabolism, axonal glutamate toxicity, and reduced cerebral blood flow...
A randomized, double-blind, clinical trial comparing the efficacy and safety of
Crocus sativus L. with fluoxetine for improving mild to moderate depression in
post percutaneous coronary intervention patients. [2014] (PCI)... CONCLUSION: Short-term therapy with saffron capsules showed the same
Fluoxetine for Autistic Behaviors (FAB trial): study protocol for a randomized
controlled trial in children and adolescents with autism. [2014] BACKGROUND: Serotonin reuptake inhibitors (SSRIs) are commonly prescribed
off-label for children with autism... The outcomes of this study will contribute to evidence-based
interventions used in clinical practice to assist children with ASD.
Clinical Trials Related to Prozac (Fluoxetine)
The Effects of Multiple Dose Fluoxetine and Metabolites on CYP1A2, CYP2C19, CYP2D6 and CYP3A4 Activity [Completed]
Inhibitory drug-drug interactions (DDIs) are a considerable concern as inhibition of drug's
clearance can lead to increased plasma concentrations and subsequent adverse events and
toxicities. Fluoxetine (Prozac®) is a widely prescribed antidepressant, but is also a potent
inhibitor of cytochrome P450 (CYP) enzymes. Fluoxetine was chosen as the model inhibitor for
this study because it is a clinically important inhibitor of multiple CYP enzymes with
varying potencies for each isoform. From in vitro data, fluoxetine is predicted to be a
moderate inhibitor of CYP2D6, but a strong inhibitor of CYP2C19 and CYP3A4. However, in vivo
fluoxetine causes a potent interaction with CYP2D6 and a weak-to-no interaction with CYP3A4.
The magnitude of the in vivo interaction of fluoxetine with CYP2C19 is not known. This in
vitro-to-in vivo discrepancy is of concern for two reasons: 1) In clinical drug development,
in vivo drug-drug interactions are tested only when in vitro experiments predict a risk for
in vivo DDIs and 2) Because in vivo DDI's are tested using a rank order approach of going
from the most potent in vitro interaction to the least potent until no interaction in vivo
is observed. In this study the interaction between fluoxetine and CYP3A4, CYP2C19 and CYP2D6
will be quantified simultaneously and the quantitative in vitro-to-in vivo predictions
tested. Fluoxetine will be orally administered daily for 14 days and CYP1A2, CYP3A4, CYP2C19
and CYP2D6 activity will be tested in the end of fluoxetine dosing using a cocktail of CYP
probes including caffeine, midazolam, omeprazole and dextromethorphan. Lovastatin will be
administered on a separate day and used as a second CYP3A4 probe to test whether CYP3A4
inhibition by fluoxetine depends on the contribution of intestinal CYP3A4 to the probe
clearance. Plasma and urine samples will be collected for 12 and 24 hrs, respectively,
during the control sessions (before fluoxetine administration) and for 24 hrs during the
treatment sessions (fluoxetine multiple dose). The concentrations of each of the probe drugs
and their metabolites (when applicable) as well as fluoxetine and its metabolites will be
measured in the collected samples and pharmacokinetic analysis will be performed. The
primary outcome measures for CYP inhibition will be the increase in the area under plasma
concentrations time curve (AUC) of each of the probes. The null hypothesis of this study is
that the area under plasma concentrations time curves (AUCs) of caffeine, dextromethorphan,
omeprazole, midazolam or lovastatin are the same between the control session and the
fluoxetine session. Because lovastatin has the greatest variability in its baseline
pharmacokinetics the study was powered based on the specific null hypothesis for lovastatin.
The alternative hypothesis is that fluoxetine decreases the clearance of the probe drugs
resulting in a significant increase in the AUCs between the control and study sessions.
Efficacy of Fluoxetine in Reducing Ictal Hypoventilation in Patients With Partial Epilepsy [Completed]
The purpose of this study is to determine the effects of fluoxetine on breathing mechanisms
during seizures. Patients with partial epilepsy commonly have changes in their breathing
mechanisms during seizures. These changes may increase the risk of serious side effects
from seizures, including sudden unexplained death in epilepsy (SUDEP), which affects 2-10
per 1000 patients with epilepsy each year. Fluoxetine (Prozac) may help to stimulate
breathing through its actions in the brain and has been shown to improve breathing changes
seen with seizures in certain animals. Fluoxetine is in a class of medications called
selective serotonin reuptake inhibitors (SSRIs). It works by increasing the amount of
serotonin, a natural substance in the brain, at synapses, the junctions at which nerve cells
in the brain communicate. Fluoxetine is currently approved by the United States Food and
Drug Administration (FDA) for the treatment of patients with Major Depressive Disorder,
Obsessive Compulsive Disorder, Bulimia Nervosa, Panic Disorder and Premenstrual Dysphoric
Disorder.
90 mg Fluoxetine Hydrochloride Capsules Under Fasting Conditions [Completed]
This study compared the relative bioavailability (rate and extent of absorption) of 90 mg
Fluoxetine Hydrochloride Capsules by Teva Pharmaceuticals, USA with that of 90 mg PROZAC
WEEKLY® Capsules by Eli Lilly and Company following a single oral dose (1 x 90 mg) in
healthy adult volunteers under fasting conditions.
90 mg Fluoxetine Hydrochloride Capsules Under Non-Fasting Conditions [Completed]
This study compared the relative bioavailability (rate and extent of absorption) of 90 mg
Fluoxetine Hydrochloride Capsules by Teva Pharmaceuticals, USA with that of 90 mg PROZAC
WEEKLY® Capsules by Eli Lilly and Company following a single oral dose (1 x 90 mg) in
healthy adult volunteers under non-fasting conditions.
Effects rTMS Combined With Fluoxetine on Motor Recovery in Stroke Patients [Recruiting]
In this study investigator's aim to assess the effect of a type of non-invasive brain
stimulation technique called repetitive transcranial magnetic stimulation (rTMS) in
conjunction with fluoxetine on motor recovery after stroke.
Reports of Suspected Prozac (Fluoxetine) Side Effects
Foetal Exposure During Pregnancy (402),
Drug Ineffective (74),
Talipes (55),
Ventricular Septal Defect (46),
Atrial Septal Defect (44),
Anxiety (42),
Depression (40),
Cleft Palate (35),
Suicidal Ideation (33),
Weight Increased (32), more >>
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PATIENT REVIEWS / RATINGS / COMMENTSBased on a total of 51 ratings/reviews, Prozac has an overall score of 7.25. The effectiveness score is 7.88 and the side effect score is 7.25. The scores are on ten point scale: 10 - best, 1 - worst. Below are selected reviews: the highest, the median and the lowest rated.
| Prozac review by 35 year old female patient | | Rating |
Overall rating: | | |
Effectiveness: | | Highly Effective |
Side effects: | | No Side Effects | | Treatment Info |
Condition / reason: | | Depression |
Dosage & duration: | | 20mg. taken once a day for the period of past 3 years |
Other conditions: | | High cholesterol |
Other drugs taken: | | Lovastatin | | Reported Results |
Benefits: | | Within a few days, my mood, self-esteem, attitude and over-all well-being improved tremendously! I went from feeling suicidal and not being able to funtion properly in order to take care of myself or my family, to feeling better than I had since I was in my teens. I began to lose some of the weight I had gained from being depressed. I was in a wonderful mood and I had so much more energy than I had in years. My overall experience with Prozac has been perfect! |
Side effects: | | I have had no known side effects to this date. I do watch out for muscle cramps that last more than a week and I have blood work done once a year to ensure that my kidneys are not being affected. |
Comments: | | I started on 10 mgs. once a day and when that was tolerated well I went up to 40 mgs. This caused some insomnia and nervousness so my Dr. lowered it to 20 mgs. a day. There are still times I get depressed for a few days but that only happens once or twice a year and it is mild. I am looking at being on Prozac as long as my body toleates it, due to once being taken off I went into a fast downward spiral and had to begin again. |
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| Prozac review by 17 year old female patient | | Rating |
Overall rating: | | |
Effectiveness: | | Moderately Effective |
Side effects: | | Mild Side Effects | | Treatment Info |
Condition / reason: | | depression |
Dosage & duration: | | 80mg taken trice a day for the period of 3 years |
Other conditions: | | anorexia |
Other drugs taken: | | zyprexa, motilium, pharmaton, letter, etc. | | Reported Results |
Benefits: | | I felt better mood, optimism towards life in general, greater control of portion sizes. My recovery from anorexia was not easy, so I had a few months of moderate bulimia. It was then that my dosage grew bigger: 3 pills of 20 mg per day, though some days I would have 4 pills. |
Side effects: | | don't recall |
Comments: | | it takes very long, and requires a very large amount of patience. |
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| Prozac review by 31 year old female patient | | Rating |
Overall rating: | | |
Effectiveness: | | Ineffective |
Side effects: | | Extremely Severe Side Effects | | Treatment Info |
Condition / reason: | | Severe Anxiety |
Dosage & duration: | | 20 mg per day taken once per day for the period of one week |
Other conditions: | | none |
Other drugs taken: | | Diazepam | | Reported Results |
Benefits: | | This medication did not make me sedated or cause constipation like the last one I tried and I had no trouble getting to sleep at night. |
Side effects: | | On the first day of taking this medication, I became extremely high and anxious within an hour of taking it. I then went on a major shopping spree, had major increased energy and talked a lot more then I usually do. By the second night, I started crying and could not stop and my teeth would not stop chattering. Over the next few days I became like a zombie during the day, but by night I would be a crying shaking mess. On the last day of taking this medication I was truly suicidal and I was not even depressed when I started this medication a week earlier. This medication was to treat severe anxiety only, and it did help for this, but made me severely depressed as a consequence. This medication may be very beneficial for some people, but it did not work for me. |
Comments: | | I started taking one 10mg tablet of Fluoxetine in the morning for three days and then changed to one 20mg tablet in the morning |
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Page last updated: 2015-08-10
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