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Prozac for Anxiety Disorders: Effectiveness, Side Effects, & Interactions

Published: April 26, 2022 Updated: August 8, 2022
Published: 04/26/2022 Updated: 08/08/2022
Headshot of Dianne Grande, Ph.D.
Written by:

Dianne Grande

Ph.D.
Headshot of Dena Westphalen, Pharm. D.
Reviewed by:

Dena Westphalen

Pharm. D.
  • What Is Prozac?Prozac
  • Does Prozac Help With Anxiety Disorders?Prozac for Anxiety
  • How Does Prozac Help With Anxiety Disorders?How It Helps
  • How to Take ProzacInstructions
  • Prozac Dosage For Anxiety DisordersDosage
  • Can You Overdose On Prozac?Overdose?
  • How Quickly Does Prozac Work For Anxiety Disorders?Time
  • Side Effects of ProzacEffects
  • Medications to Avoid if You’re Taking ProzacMeds to Avoid
  • Risks & Precautions of Taking ProzacRisks
  • Questions to Ask Your Doctor About Taking Prozac For Anxiety DisordersQuestions
  • Final ThoughtsConclusion
  • Additional ResourcesResources
  • Prozac for Anxiety InfographicsInfographics
Headshot of Dianne Grande, Ph.D.
Written by:

Dianne Grande

Ph.D.
Headshot of Dena Westphalen, Pharm. D.
Reviewed by:

Dena Westphalen

Pharm. D.

Prozac is an antidepressant that has been demonstrated to work well as treatment for several types of anxiety disorders. It’s FDA approved for obsessive-compulsive disorder (OCD) and panic disorder. It’s also prescribed off-label for social anxiety and post-traumatic stress disorder (PTSD). There are some risks, possible side effects, and certain medications to avoid if you’re taking Prozac.

Boxed Warning: Fluoxetine (Prozac)

Risk of Suicidal Thoughts and Behaviors in Certain People
Fluoxetine, the active ingredient in Prozac, has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA). Fluoxetine can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. Regardless of your age, you should talk with your doctor about serious risks with fluoxetine and any other medications before starting treatment.

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What Is Prozac?

Although Prozac (fluoxetine) is typically a medication for depression, it’s also used as a medication for anxiety disorders, OCD, and panic disorder. It’s in a class of medications known as selective serotonin reuptake inhibitors (SSRIs). It affects the level of the neurotransmitter serotonin, which naturally exists in the brain. It has been safely used with adults, seniors, and children ages 8 and older.1

Prozac can, however, create problems during pregnancy and after the birth, and is generally not advised for use in late term pregnancy.

Does Prozac Help With Anxiety Disorders?

Prozac doesn’t cure these disorders, but it can help reduce specific anxiety symptoms. For OCD, it is approved to treat obsessions and compulsions. Along with other SSRI medications, Prozac has the benefit of not being habit-forming, so it can be used long term to treat anxiety disorders. It is usually taken once daily, and there is a generic option available.

Types of anxiety disorders Prozac is approved to treat include:

  • Prozac for OCD: Prozac is approved by the FDA for the relief of symptoms of OCD. It has been moderately effective in reducing repetitive or ritualized behaviors and obsessive thoughts.2
  • Prozac for Panic Attacks: Prozac is approved by the FDA for the treatment of panic attacks and can help treat panic disorders. It has been effective in reducing the occurrence of sudden attacks of extreme fear and worries about having these attacks.3

Prozac is also used off-label to treat other anxiety disorders. Off-label treatment is when a medication is prescribed by a physician for a reason other than it is approved for.

Anxiety disorders that Prozac is used to treat off-label include:

  • Prozac for Social Anxiety: Prozac is used off-label for relief of symptoms of social anxiety. It helps reduce anxiety and increase feelings of relaxation and focus.
  • Prozac for PTSD: Prozac is used off-label in the treatment of PTSD. It has been known to improve sleep and help the person return to their normal activities without feeling the need to avoid places or situations.4

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How Does Prozac Help With Anxiety Disorders?

Prozac is one of several medications known as SSRIs. Serotonin is one of the neurotransmitters that normally carry signals between neurons. The SSRIs block the reabsorption (reuptake) of serotonin into the neurons, leaving more serotonin available to enable messages to travel between neurons.5 Increased levels of serotonin have been associated with an overall calming of the nervous system, improved mood, and better sleep quality.6

Another way the SSRIs help is through their effect on the brain’s structure over a period of time. Higher levels of serotonin are believed to increase the brain’s ability to restructure parts of itself, in effect, becoming more adaptable. After weeks of use of an SSRI, the brain becomes more able to adapt to new learning.7

How to Take Prozac

Prozac contains the active medication fluoxetine and is available in a variety of forms: tablet, capsule, extended release capsule, and liquid solution.8 It is usually taken only once daily, in the morning.  As for any prescription medication, it should be taken according to the instructions of a physician. You should not stop taking Prozac except under the advice and guidance of your physician. Stopping suddenly can cause unpleasant withdrawal symptoms.

Prozac Dosage For Anxiety Disorders

The effective dosage of Prozac varies with age, disorder, and individual response. You should always consult with your doctor about dosage before taking Prozac, and should never adjust dosage without consulting your physician first.

Obsessive-Compulsive Disorder

Adults with OCD are started at 20 mg per day, with gradual increase as needed based on symptoms. The typical range for adults with OCD is between 20 to 60 mg per day. Your doctor will work with you on your dosage and you should only take the amount of Prozac your doctor has instructed you to take.

Children and teens with OCD are started at 10 mg per day for 2 weeks then have their dose increased to 20 mg per day. The typical range for children with OCD is between 20 and 60 mg per day.9

Panic Disorder

For both adults and children/teens with panic disorder, the starting dose is 10 mg per day for 1 week. Then the dose is increased to 20 mg per day. If needed, the dosage can continue to be increased up to 60 mg per day. Your doctor will work with you on your dosage and you should only take the amount of Prozac your doctor has instructed you to take.

Can You Overdose On Prozac?

It is possible to overdose on Prozac, which can cause dangerous and possibly life-threatening symptoms. In the event of an overdose, call 9-1-1 for emergency assistance. Consider also calling your doctor as soon as possible. Depending on the severity of your symptoms, it might be necessary to go to an emergency room.

Possible symptoms of a Prozac overdose include:10

  • Agitation, confusion, or nervousness
  • Dizziness
  • High blood pressure or fast heart rate
  • Poor coordination or trouble walking
  • Seizures, possibly delayed onset
  • Gastrointestinal symptoms such as nausea or vomiting
  • Tremors

How Quickly Does Prozac Work For Anxiety Disorders?

For most people, it takes at least 2 weeks after starting Prozac to begin to feel better. Symptoms such as better sleep, energy level, and appetite are usually the first signs of improvement. It may take 6 to 8 weeks to experience the full benefit of Prozac.6 Since it is an SSRI, the time required can be compared to how long it takes for antidepressants to work.

Side Effects of Prozac

As for any medication, there are numerous possible side effects of taking Prozac. However, many people have minimal side effects or none at all. Most of the common side effects of Prozac will improve over the first 2 weeks of taking the medication. The sexual side effects usually do not lessen over time.

Common Prozac side effects include:11

  • Headache
  • Nausea
  • Diarrhea
  • Dry mouth
  • Increased sweating
  • Feeling nervous
  • Restlessness
  • Fatigue
  • Difficulty sleeping
  • Problems with orgasm, ejaculatory delay, or loss of libido

More serious side effects may also occur when taking Prozac. A doctor should be notified immediately in these circumstances.

Serious fluoxetine side effects that need immediate attention include:6

  • Mood shifts, very high energy, agitation
  • Thoughts or behaviors of suicide*
  • Unusual bruising or bleeding
  • Muscle weakness or spasm
  • Unusual weight loss
  • Shaking or tremors

There are some additional rare but serious possible side effects of taking Prozac. A doctor should be notified immediately if any of these symptoms occur. You may also need to seek emergency care with the onset of any of these symptoms.

Rare and serious side effects of Prozac may include:6

  • Seizures
  • Kidney problems, possibly seen as changes in urination
  • Eye pain, swelling, or redness
  • Changes in vision, blurred vision
  • Serotonin syndrome, particularly if other drugs that increase serotonin are being taken along with fluoxetine
  • Allergic reactions, such as rash, itching, or trouble breathing

Medications to Avoid if You’re Taking Prozac

It’s important to discuss the use of any other drugs with your doctor before starting Prozac. There are numerous medications that might interact, resulting in possibly serious side effects. Some of the more commonly used medications that might interact include: aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), warfarin, and other blood thinners. Use of these drugs while taking fluoxetine increases the risk of bleeding.5

Prozac might also interact with other antidepressants, amphetamines, pain medications, or St. John’s Wort, presenting the risk of serotonin syndrome.,11

Symptoms of serotonin syndrome include:

  • Anxiety
  • Agitation
  • Fever
  • Sweating
  • Confusion
  • Tremors
  • Restlessness
  • Poor coordination
  • Large changes in blood pressure
  • Rapid heart rate

You should talk with your doctor before starting any prescription medication, over-the-counter medication, herb, or supplement while taking Prozac.

Risks & Precautions of Taking Prozac

Note that drinking alcohol or using illegal drugs might decrease the benefits or increase the adverse effects of Prozac, such as sedation.11 There are also several risks associated with taking Prozac and other anxiety medication during pregnancy, or during the course of breastfeeding.11 The risks and benefits of using an antidepressant at these times should be discussed with your doctor, as well as the alternative ways to manage anxiety while pregnant.

It’s very important not to abruptly stop taking Prozac due to the risk of prozac withdrawal. Stopping suddenly can result in one or more withdrawal symptoms, including: nausea, dizziness, vomiting, irritability, headache, nightmares, or prickling/tingling sensation on the skin.11 Talk with your doctor if you are considering discontinuing Prozac.

The FDA has placed a black box warning for the use of antidepressants. Studies have shown an increased risk of suicidal thoughts and behaviors among children, teens, and adults under age 24 while using antidepressants. To manage this risk, families and caregivers should remain alert to signs of increased anxiety, restlessness, irritability, aggressiveness, or insomnia.

If any of these changes are noticed, they should be reported to the health-care professional immediately. This risk is especially high during the first few months of treatment, or when the dosage is changed.11

Questions to Ask Your Doctor About Taking Prozac For Anxiety Disorders

If you’re considering taking Prozac for an anxiety disorder, have a thorough discussion with your health care team. The physician or psychiatrist who is prescribing it will need to assess your possible benefits and risks of using this medication. You shouldn’t feel uncomfortable asking questions or addressing concerns.

Here are questions to ask your care team about Prozac:12

  1. How well might Prozac work to relieve my symptoms?
  2. What are the benefits of fluoxetine (Prozac)?
  3. What side effects should I watch for?
  4. What is my risk for serious side effects, given my medical history and health condition?
  5. What lifestyle changes would I need to make if I started taking this medication? For example, do I need to give up alcohol or any other drug that I am currently using?
  6. What is the cost for this medication? Are there any less costly but equally effective alternatives?
  7. How might the medication interact with what I am taking now? Tell your team about  other medicines, vitamins, or supplements.
  8. Would I benefit more if I participate in psychotherapy while taking Prozac (fluoxetine)?
  9. If I cannot tolerate side effects, how would I stop taking Prozac?
  10.  Are there other SSRIs or other types of medication that might be better for me?

Final Thoughts

Prozac for anxiety disorders can be effective, especially when combined with psychotherapy. As with other medications, there are possible side effects to be considered as well as certain risks and precautions. Before taking fluoxetine for an anxiety disorder, discuss a treatment plan with your doctor and care team to see if it’s the right option for you.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for referrals by the companies mentioned below.

Brightside Health (Online Psychiatry) – If you’re struggling with serious mental health issues, finding the right medication can make a difference. Brightside Health treatment plans start at $95 per month. Cigna and Aetna accepted. Following a free online evaluation and receiving a prescription, you can get FDA approved medications delivered to your door. Free Assessment

Hims / Hers (Online Psychiatry) – If you’re living with anxiety, depression, OCD, or PTSD finding the right medication match may make all the difference. Get FDA approved medication prescribed by your dedicated Hims / Hers Healthcare Provider and delivered right to your door. Plans start at $25 per month (first month). Get Started

BetterHelp (Online Therapy) – BetterHelp has over 20,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $60 per week. Complete a brief questionnaire and get matched with the right therapist for you. Get Started

Choosing Therapy partners with leading mental health companies and is compensated for referrals by Brightside, Hims / Hers, and BetterHelp

For Further Reading

  • Anxiety & Depression Association of American (ADAA) online support group
  • The Tribe: Peer to peer online support groups
  • Daily Strength: Anxiety support group
  • Mayo Clinic

Prozac for Anxiety Infographics

What is Prozac (Fluoxetine)? What is Prozac Used for? Prozac (Fluoxetine) Warnings

What to Avoid While Taking Prozac Prozac Side Effects

11 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • (April 2017). Safest SSRI Antidepressants for Anxiety in Children: Is Prozac (Fluoxetine) your best bet? Steadyhealth.com. Retrieved from: https://www.steadyhealth.com/articles/safest-ssri-antidepressants-for-anxiety-in-children-is-prozac-fluoxetine-your-best-bet

  • (2021). Prozac for OCD: How the Medication Treats the Symptoms of Obsessive Compulsive Disorder. HealthGuideInfo.com. Retrieved from: https://www.healthguideinfo.com/ocd-treatment/p85586/

  • (January 2022) Fluoxetine. National Institute of Health: National Library of Medicine. Retrieved from: https://medlineplus.gov/druginfo/meds/a689006.html

  • (March 2022). Medications for PTSD. National Center for PTSD. Retrieved from: https://www.ptsd.va.gov/understand_tx/meds_for_ptsd.asp

  • (September 2019). Selective serotonin reuptake inhibitors (SSRIs)  Mayo Clinic. Retrieved from: https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825

  • (2022). Prozac capsule – Uses, Side Effects, and More. WEBMD. Retrieved from: https://www.webmd.com/drugs/2/drug-6997/prozac-oral/details

  • (September 2019). What you need to know about SSRIs. Anxiety.org. Retrieved from: https://www.anxiety.org/selective-serotonin-reuptake-inhibitor-ssri

  • (March 2022). Generic Prozac Availability. Drugs.com. Retrieved from: https://www.drugs.com/availability/generic-prozac.html

  • (December 2021). Prozac. National Institute of Health: National Library of Medicine. Retrieved from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm

  • (December 2020). Fluoxetine (Prozac). National Alliance on Mental Illness. Retrieved from: https://nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Fluoxetine-(Prozac)

  • (July 2018). Anxiety Disorders: Treatments and Therapy – Medication. National Institute of Mental Health. Retrieved from: https://www.nimh.nih.gov/health/topics/anxiety-disorders

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Headshot of Dianne Grande, Ph.D.
Written by:

Dianne Grande

Ph.D.
Headshot of Dena Westphalen, Pharm. D.
Reviewed by:

Dena Westphalen

Pharm. D.
  • What Is Prozac?Prozac
  • Does Prozac Help With Anxiety Disorders?Prozac for Anxiety
  • How Does Prozac Help With Anxiety Disorders?How It Helps
  • How to Take ProzacInstructions
  • Prozac Dosage For Anxiety DisordersDosage
  • Can You Overdose On Prozac?Overdose?
  • How Quickly Does Prozac Work For Anxiety Disorders?Time
  • Side Effects of ProzacEffects
  • Medications to Avoid if You’re Taking ProzacMeds to Avoid
  • Risks & Precautions of Taking ProzacRisks
  • Questions to Ask Your Doctor About Taking Prozac For Anxiety DisordersQuestions
  • Final ThoughtsConclusion
  • Additional ResourcesResources
  • Prozac for Anxiety InfographicsInfographics
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