Prozac (fluoxetine) is a safe, effective treatment for depression, obsessive-compulsive disorder (OCD), eating disorders, and a range of anxiety disorders. The medication carries some risks, though, including unwanted side effects that emerge when treatment begins and withdrawal symptoms that may emerge when treatment ends. These rare symptoms may be uncomfortable, but they’re not life-threatening.
Increased Risk of Suicidal Thoughts and Behaviors Prozac has a boxed warning for increased risks of suicidal thoughts and behaviors. This is a warning from the Food and Drug Administration (FDA); therefore, a qualified doctor should prescribe the medication.
What Is Prozac?
Prozac is an antidepressant prescription medication that helps reduce mental health symptoms by increasing levels of a wanted neurotransmitter in the brain. As a selective serotonin reuptake inhibitor (SSRI), Prozac blocks neurons from reabsorbing serotonin– which contributes to sleep and mood–and allows more of the chemical to be available in the system.1
Prozac is a brand-name medication for its active ingredient, fluoxetine. Fluoxetine also comes in a generic form that does not have a brand name.
For a person who is working to manage their mental health symptoms, Prozac can be an effective option. It can successfully treat a number of conditions.
Prozac is FDA approved to treat the following conditions:2
- Major Depression Disorder (MDD)
- OCD
- Bulimia nervosa
- Panic disorder
Prozac is also sometimes prescribed off-label for other disorders like social anxiety and premenstrual dysphoric disorder (PMDD). An off-label use is when a doctor uses their judgment to prescribe a medication for an indication that is not FDA approved.
When used alone or combined with other psychiatric medications, Prozac is also approved to treat:1,2
- Bipolar disorders
- Major depression disorder that has not responded to previous treatments
Prozac Withdrawal Symptoms
Prozac withdrawal symptoms are the physical and emotional symptoms a person can experience if they quickly reduce or end their use of the drug; however, not everyone will experience Prozac withdrawal. Depending on the individual and their specific situation, these symptoms (e.g., mood swings, irritability, anxiety, etc.) could range from mildly uncomfortable to highly distressing.
Common Prozac (fluoxetine) withdrawal symptoms can include:2
- Mood changes
- Irritability and agitation
- Dizziness
- Numbness or tingling
- Anxiety
- Sweating
- Confusion
- Headaches
- Feeling tired by having a hard time sleeping
If starting or stopping a medication creates unwanted mood changes, people should look for signs of suicidal ideation and thoughts of self-harm. These could be fleeting or intense with plans and intent, so active assessment and appropriate treatment are critically important.
It’s important to talk with your doctor before stopping or changing your Prozac dose. They will help to decide the correct dose of medication for you or develop a plan to stop taking Prozac.
When to Speak With Your Doctor
It’s never too early to speak to your doctor about the risks of Prozac withdrawal. With a plan in place, you can work to avoid any withdrawal symptoms and maintain your mental health along the way.
When being prescribed any new medication, considering asking these questions:
- When should I take this medication?
- What happens if I miss a dose?
- What should I do if side effects appear?
- How should I proceed if I want to stop taking this medication?
- Do any of the other medications, herbs, or supplements I take interact with this medication?
Prozac Withdrawal Timeline
People who stopped taking Prozac usually have no withdrawal symptoms within the first week. This result occurs because it usually takes at least three half-lives for withdrawal symptoms to present.4
Prozac’s half-life is between four and six days. By contrast, antidepressants like Effexor (venlafaxine) and Paxil (paroxetine) have shorter half-lives (14 and 12 hours respectively).4 So, fluoxetine withdrawal symptoms may not appear for 12 days after last use.4
If someone has not experienced any withdrawal symptoms after three or four weeks, there is little chance of symptoms emerging. It would be very unlikely to find withdrawal symptoms that appear past this window.
Coping With Prozac Withdrawal Symptoms
Strategies to help relieve and minimize symptoms of Prozac withdrawal include tapering the dose over time, switching to another medication, attending or increasing therapy, paying attention to your physical health, and practicing self-care.
Here are five ways to relieve and minimize symptoms of Prozac withdrawal:
1. Taper the Dose
Generally, stopping medications abruptly is not recommended, so prescribers will offer a simple taper schedule that allows you to take smaller amounts over the course of days or weeks. This method helps the medication slowly leave the body to reduce the risk of withdrawal symptoms.
2. Switch to Another Antidepressant
Ending one medication can be hazardous, so some prescribers will start another medication during the process. By switching to another antidepressant, the targeted mental health symptoms can still receive treatment.
3. Attend to Physical Health
As Prozac leaves your body, your serotonin levels could be disrupted in the short-term. To help maintain balance, it is valuable to engage in healthy behaviors that regulate serotonin. Exercise, healthy eating, and restful sleep can assist in managing your Prozac withdrawal.
4. Practice Increased Self-Care
Different forms of self-care are unique to the individual but often include tracking symptoms, being with loved ones, and doing things you enjoy. Take action before symptoms appear to minimize their impact.
5. Increase Therapy
The change in medication could put your mental health at increased risk. Seek out the additional support of speaking with a therapist. If you aren’t already in therapy, consider starting, and if you already attend, speak to your therapist about increasing your sessions temporarily
You should talk with your doctor about changing your medication before changing your dose in any way. They will help to determine the most effective way for you to change or stop your medication.
Discontinuation vs. Relapse of Depression Symptoms
When medication is stopped, people wonder if they’re experiencing withdrawal, rebound, relapse, or something new.4 Depressive relapse and recurrence will look like standard depressive disorders that a person may have experienced previously. Rebound, on the other hand, will present as a return of depression symptoms to a greater extent than before treatment. These intense symptoms will usually be shorter in duration.4
Discontinuation of Prozac After Long-Term Treatment
Whether a person has been using Prozac for six months or six years, the discontinuation process should be similar.
Discontinuation of Prozac While Pregnant or Breastfeeding
Anyone who is pregnant, breastfeeding, or plans to become pregnant in the near future should talk to their prescriber about their Prozac use. Prozac may cause problems in newborns, especially if taken in the last months of pregnancy. Prozac also shows up in breast milk and has caused side effects in breastfeeding children. Your doctor will talk with you about the risks and benefits of taking Prozac while pregnant or breastfeeding.
Questions to Ask Your Health Team About Stopping Prozac
Being a curious, informed patient is a great way to avoid the risks of medications and minimize potential harms. Whenever planning to start or stop a medication, be sure to have a discussion with your treatment team about the risks and benefits to the process.
Questions to ask your health care team about discontinuing Prozac include:2
- Why do you think I should stop this medication?
- Is it going to be dangerous to stop taking Prozac?
- Should I stop taking Prozac all at once or over a period of time?
- What are the risks of stopping Prozac?
- When should I expect to notice the influence of Prozac withdrawal?
- What should I do if something feels off during my withdrawal process?
- Who should I call and what should I do if I get really sick?
- Would starting a new medication help limit the withdrawal symptoms?
- Could my depression get worse after I stop taking Prozac?
Ideally, your treatment team will be honest and straightforward about the risks of Prozac withdrawal. Although there is a chance you could experience some unwanted side effects of Prozac discontinuation, the risk is minor. Most people can end their use of the medication with very minimal symptoms. Other people may note nothing more than mild discomfort.
Final Thoughts
With any medication, the side effects from starting or stopping vary based on individual differences. It’s important to discuss discontinuation of Prozac with your doctor and care team before changing dose or stopping. This way, you can plan and prepare for issues before they present.
Prozac Withdrawal Infographics
