*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.
Prozac, with the active ingredient fluoxetine, belongs to the selective serotonin reuptake inhibitor (SSRI) drug class. It is FDA-approved to treat depression and OCD in children, and adults and bulimia nervosa and panic disorder in adults only.
Common side effects such as nausea and diarrhea may appear in the first few weeks and fade over time. While it is considered a safe and effective treatment, there is risk for serious side effects as well.
If you’re considering Prozac, online psychiatry platforms such as Talkiatry and Brightside Health can connect you with a provider quickly. They offer assessments and can provide a prescription if they determine Prozac or another medication may help your symptoms.
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.
Key Takeaways
Prozac is a prescription antidepressant medication used to treat depression, OCD, bulimia nervosa, panic disorder, and several other mental health disorders.
Prozac, with the active ingredient fluoxetine, is a selective serotonin reuptake inhibitor (SSRI).
If you are considering Prozac, a good place to start is with an evaluation from a medical provider. Many online psychiatry platforms offer online assessments and medication management, such as Talkiatry or Circle Medical.
Online Psychiatry and Medication Management Covered by Insurance
Talkiatry can match you with a real psychiatrist who takes your insurance and is seeing new patients. They’re in-network with major insurers and offer medication management. Get started with a short online assessment
What Is Prozac (Fluoxetine)?
Prozac is a brand name FDA-approved SSRI antidepressant used to treat several mental health conditions.1 This medication for depression is approved for use in adults and children 8 and older. Prozac is available as the generic medication fluoxetine with the same risks and treatment benefits as the branded form.
Fluoxetine is also used with olanzapine in a combination medication called Symbyax, which is FDA-approved to treat bipolar disorder. This article will focus on Prozac.
How Does Prozac Work?
Prozac is thought to work by increasing serotonin levels in the brain. Serotonin is a body chemical involved in mood regulation, and for some who take it, Prozac’s effects may improve mood and diminish anxiety.
What Is Prozac Used to Treat?
Prozac is used to treat several mental health conditions and is shown to be effective for both acute and chronic symptoms. This means that people can safely use Prozac at different phases of their treatment with effective results.
Prozac is FDA-approved to treat the following conditions:1
- Major depression
- Obsessive compulsive disorder (OCD)
- Bulimia nervosa
- Panic disorder with and without agoraphobia
One form of fluoxetine is FDA-approved to treat:
- Premenstrual dysphoric disorder (PMDD)*
It is important to note that the generic form of Prozac, known as fluoxetine, also comes in tablets. The generic fluoxetine is the only form of fluoxetine or Prozac that is FDA approved to treat PMDD. If your doctor prescribes you fluoxetine to treat PMDD be sure to check with your provider about which form you can expect. Once prescribed, follow their directions exactly.7
Prozac is not used to treat bipolar disorder because of the risk of triggering manic episodes. Fluoxetine is only approved to treat bipolar disorder in combination with olanzapine as the brand-name medication Symbyax.
Off-Label (Non-FDA-Approved) Uses of Prozac
Providers may offer prescriptions for Prozac for non-FDA-approved uses. This is called an off-label use. Providers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.
Off-label (non-FDA-approved) uses of Prozac include:
- Binge eating disorder
- Social anxiety disorder
- Post-traumatic stress disorder (PTSD)
- Premenstrual dysphoric disorder (PMDD)
How Effective Is Prozac?
Prozac has been shown to be effective for treatment of depression and OCD in adults and adolescents, as well as other mental health conditions. Studies of Prozac against a placebo as a treatment for depression found that Prozac significantly reduced several symptoms including depressed mood, sleep disturbances, and anxiety. Prozac also significantly increased the rate of response and remission.1
When studied as a treatment for OCD, more than half of patients taking Prozac reported an improvement of some kind at all doses, compared to more than 70% of placebo patients, not improving or worsening.1
When compared to other antidepressants, Prozac is right in the middle. It is more effective than older antidepressants but not considered the most effective agent. Additionally, it is well tolerated, having one of the least amount of reported side effects when compared to other antidepressants.2
How Long Does it Take for Prozac to Work?
Prozac can take about 4-8 weeks to become fully effective, but some individuals may start to feel better after the first week or two. Each person may have a different response time based on how their body absorbs and processes the medication.
How Long Do I Need to Keep Taking Prozac?
Each person will require a different length of treatment with Prozac that is specific to their condition, overall health, and response to the medication. Most patients will take Prozac for at least 8 weeks to allow for the medicine to take its full effect. Of course, if side effects that are severe arise, treatment may stop sooner.
Depending on your goals of treatment, your provider may direct you to take the medication for months to years. Be sure to always keep follow up appointments and be aware of changes in your health that may be due to Prozac. If you are directed to stop treatment, follow your prescriber’s direction exactly to avoid unpleasant withdrawal side effects.1
Common Prozac Side Effects
Common side effects of Prozac may include nausea, headaches, and diarrhea. However, not everyone will experience these side effects, and may decide the benefits of Prozac outweigh the risks.
Some side effects may appear soon after your first dose, while others may take more time to emerge. If side effects do appear, many of them will gradually disappear as your body adjusts to the medication. If any side effects worsen or persist, contact your provider as soon as possible.
Common Prozac side effects may include:1
- Nausea
- Diarrhea
- Dry mouth
- Loss of appetite
- Increased sweating
- Flu symptoms
- Sexual dysfunction
- Reduced sex drive
- Sleep changes
- Tremor
- Yawning
- Fatigue
- Anxiety
Side effects in children and adolescents may include:
- Increased thirst
- Agitation
- More frequent urination
- Slowed growth rate and weight change
*All medications, including Prozac, can cause side effects that can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and understand the potential side effects and benefits of any medication.
Serious Prozac Side Effects
There is a risk for Prozac side effects to be severe or persistent. Also, abruptly stopping or mixing other substances with Prozac can worsen side effects. If serious side effects appear, it is important to seek immediate medical attention.
Serious side effects of Prozac for adults include:1
- Serotonin syndrome
- Abnormal bleeding
- Seizures
- Vision changes
- Manic episodes
- Low salt levels (hyponatremia)
- Suicidal thoughts
- Allergic reactions
- Irregular heartbeat
- Muscle rigidity, tremors, fever, and/or seizures (Could be a sign of serotonin syndrome)
*All medications, including Prozac, can cause side effects that can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and understand the potential side effects and benefits of any medication.
What Are The Long-term Effects of Taking Prozac?
Many patients are prescribed Prozac long term for continual treatment and this can bring about both new and recurring side effects. There are reports of sexual side effects, weight gain, and poor sleep in patients taking Prozac long term.5 Additionally, longer treatment times can lead to more severe discontinuation syndrome, or withdrawal symptoms when stopping treatment. Always be looking for changes in health to identify side effects even if you have been taking Prozac for months or years.
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What Are the Risks & Warnings for Prozac?
Suicidal Thoughts & Behaviors
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.
Allergic Reactions
For some people, Prozac may cause an allergic reaction, which includes symptoms such as reaction, rash, and swelling of the face, hands, or feet. If you experience trouble breathing as part of an allergic reaction, seek immediate medical care.
Severe allergic reactions to Prozac can include breathing problems, swelling, and rash or hives.
Triggering Manic Episodes
For some people with bipolar disorder, taking Prozac can increase the risk of triggering manic episodes. Prior to starting treatment with an antidepressant like Prozac, patients with depressive symptoms should be screened to determine if they are at risk for bipolar disorder.
Serotonin Syndrome
Taking Prozac can increase the risk of serotonin syndrome, a potentially life-threatening condition resulting from high levels of serotonin in the body. Symptoms include by agitation, shakiness, vomiting, and hallucinations.
Seizures
For some people, taking Prozac can increase the risk of seizures occurring. Anyone with a history of seizure disorders should take extra care when considering taking Prozac.
Hyponatremia
A rare but serious side effect, hyponatremia (low sodium levels), has been associated with the use of antidepressants such as Prozac. Low sodium levels in your blood may be serious and may cause death. Elderly people may be at greater risk for this.
Abnormal Bleeding
Taking Prozac may increase the risk of abnormal bleeding, especially when taking the medication with NSAIDs, aspirin, warfarin, or other drugs that affect blood clotting. Signs of abnormal bleeding can include bruising under the skin, a cut that does not stop bleeding, discolored stool, nose bleedings, or vomiting blood.
Pregnancy Risks
Taking Prozac during pregnancy can come with risk. When a pregnant parent takes fluoxetine during the third trimester, there is an increased risk of newborns showing withdrawal symptoms.
Breastfeeding Risks
Fluoxetine has been shown to cross the placenta during pregnancy and be present in breast milk.
Risk of Angle-closure Glaucoma
For some people, Prozac may increase the risk of angle-closure glaucoma, a rare but serious eye condition.
Abnormal Heart Rhythm
For some people, Prozac may increase the risk of an abnormal heart rhythm developing called QT prolongation.
Antidepressant Discontinuation Syndrome
Stopping Prozac abruptly can lead to symptoms of Prozac withdrawal, known as antidepressant discontinuation syndrome. Because of this, it is always recommended to taper the dose of medication as instructed by your provider. Do not stop taking Prozac or adjust your dosage on your own.
Common symptoms of Prozac withdrawal include dizziness, nausea, shaking, sweating, agitation, sleep problems, seizures, and electric shock sensations.
Drug Interactions
Taking certain medications, herbs, or supplements alongside Prozac can change how Prozac works in your body or increase the risk for serious side effects. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
Substances you should avoid using while taking Prozac include:
- Additional SSRI or SNRI medications
- Monoamine oxidase inhibitors (MAOIs)
- Tricyclic antidepressants (TCAs)
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Buspirone
- Alcohol
This is not a comprehensive list of all possible drug interactions for Prozac. Be sure to talk with your doctor or pharmacist about any prescription or over the counter medications you take, as well as supplements, herbs, and teas.
Who Should Not Take Prozac?
Some patients may experience side effects from Prozac more than others. While side effects can occur for anyone, specific patient populations should be cautious with Prozac. They may have an elevated risk for serious interactions and side effects.
For example, patients taking other SSRIs, SNRIs, or medications that affect serotonin in the brain are at risk of developing serotonin syndrome. Adolescent patients and their parents should be aware of the chance of increased suicidal thoughts and behaviors when starting Prozac. Due to these and other risks, it is essential to discuss your health conditions with your provider. They can help you select the medication that is the most suitable for you.
Populations who are at an increased risk of side effects include those who are or have:1
- Kidney problems
- Liver problems
- Heart problems
- Bipolar disorder or mania
- Prior allergic reactions to fluoxetine
- Prior vision issues such as glaucoma
- A history of seizures
- A history of stroke
- Low sodium levels in the blood
- Bleeding problems
Drug Interactions With Prozac
Many medications, including Prozac, can interact with other substances in the body. Mixing other medicines, substances, or alcohol with Prozac could either reduce or amplify its effects to dangerous levels. Always talk with your prescriber about the foods, supplements, and substances to avoid while using Prozac.
Substances you should avoid while taking Prozac include:1
- Additional SSRI or SNRI medications
- Monoamine oxidase inhibitors (MAOIs)
- Tricyclic antidepressants (TCAs)
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Buspirone
- Antipsychotics
- Triptans, which may be used to treat migraines
- St. John’s wort
- Alcohol
This is not a comprehensive list of the possible interactions with Prozac. You should talk with your provider and your pharmacist about all prescription and over-the-counter medications, herbs, and supplements you take before starting Prozac.
Prozac Withdrawal
The withdrawal effects of Prozac are not well-understood. But if you abruptly stop taking your medication, you may experience some unwanted effects. For this reason, a person should always take the medication as prescribed and speak to their provider before ending treatment.1 Do not stop taking Prozac or adjust your dosage on your own.
When someone stops taking Prozac, they could experience withdrawal symptoms like:2
- Mood changes
- Irritability and agitation
- Anxiety
- Dizziness
- Feeling tired but trouble sleeping
- Numbness or tingling in hand or feet
- Confusion
- Headaches
Prozac Dosages for FDA-Approved Treatment
In many cases, a Prozac dosage of 10 mg or 20 mg is recommended to limit the risk of harmful side effects or allergic relationships.3
If your provider determines that you are tolerating Prozac well, they may increase the daily dosage up to 80 mg. Not everyone benefits from the highest dose of Prozac. Some people may find the best results are somewhere in the middle.
How Should I Take Prozac?
Take your Prozac dosage exactly as prescribed by your provider. Do not change dose, frequency, or how you take it unless you are instructed to do so. Usually, Prozac is taken once a day with or without food. It’s an oral medication available as a tablet or capsule.2 Like with other medications, it’s important to not chew or crush the medication before swallowing.
Remember that Prozac takes time to become fully effective and can take several weeks of consistent use to see results.
What Happens If I Miss a Dose of Prozac?
If you forget to take your Prozac dose, take it as soon as you remember. If your next dose is due soon, skip the missed one and take your next scheduled dose. Never take two doses at once, and continue taking your medication as prescribed unless your prescriber directs you to do otherwise.1
Can You Overdose on Prozac?
Accidental overdoses of Prozac are rare, but people can intentionally take too much and put themselves at risk of serious complications. An overdose of Prozac is a serious medical event. Due to this risk, prescribers often prescribe the smallest quantity of Prozac available.1
Someone who has overdosed on Prozac may have the following symptoms:1
- Being confused and unresponsive
- Unsteadiness
- Feeling nervous, shaky, and dizzy
- Abnormal heart rate
- Fever
- Fainting or loss of consciousness
- Seizure
What Should You Do If You Take Too Much Prozac?
Anyone who suspects an overdose of Prozac should seek emergency medical attention by calling 9-1-1 or going to an emergency department. There is no special treatment to reverse overdose symptoms, but the medical team can monitor vitals and ensure safety.
Additionally, someone prescribed Prozac should keep their medication in a secure location where the odds of accidental ingestion are unlikely.
How to Get a Prescription for Prozac
To get a prescription for Prozac in person, start with an evaluation for your symptoms. Your primary care provider, who may be a physician, nurse practitioner, or physician assistant, can help you get the process started. They may make a referral to a psychiatrist or specialist to determine if a prescription for Prozac should be included in your treatment plan.
Can I Get Prozac Prescribed Online?
To get an online prescription for Prozac, you will also start by getting evaluated by an online psychiatric provider. We have thoroughly reviewed platforms like Talkiatry or Circle Medical that prescribe non-controlled substances such as antidepressants and some anti-anxiety medications.
Online Psychiatry and Medication Management Covered by Insurance
Talkiatry can match you with a real psychiatrist who takes your insurance and is seeing new patients. They’re in-network with major insurers and offer medication management. Get started with a short online assessment
Questions to Ask Your Provider
It is important to discuss the potential risks and benefits of Prozac with your doctor, psychiatrist, or therapist. Ask them whether side effects will go away on their own or if any intervention is needed.
Also, many online psychiatry services are available with convenient access to mental health care for depression and anxiety problems. Individuals may even change prescribers and get a mental health evaluation, diagnosis, and personalized treatment plan.
Questions to ask your care team about Prozac include:
- What is Prozac? Why do you think it’s right for me?
- What side effects should I expect, and how long do you think they will last?
- What do SSRIs do in my body?
- How long will I have to take these, and will I get addicted to them?
- Other medications didn’t work for me, so what makes you think Prozac will help?
- I’m planning to become pregnant; is Prozac still right for me or is another antidepressant recommended during pregnancy?
- Is there a chance that this medication could make me feel worse instead of better?
- If I’m having a bad day, should I take more Prozac?
- Will Prozac take away my emotions or change my personality?
- How does Prozac compare to Paxil as an antidepressant?
Provider’s Tips
Your prescriber will share important information about your Prozac prescription. They will explain how to take and store your medication, what to avoid when taking it, and what to do about side effects. Follow these tips for safe and effective use of Prozac.
- Take your medication as prescribed, do not change your dose or stop taking it unless your prescriber tells you to. Keeping a consistent dosing schedule reduces the chance of unwanted side effects. When taking antidepressants, this approach can prevent withdrawal symptoms such as dizziness, brain zaps, and flu-like symptoms.1
- Take your medication at the same time each day. Doing so can help you remember to take it, making it as effective as possible. Your healthcare provider can help determine the optimal timing based on your sleep patterns and initial medication response.
- Tell your prescriber right away if you or your child have any worsening mental health symptoms. Antidepressants have a boxed warning for increased risk of suicidal thoughts and behaviors in children under age 18 and young adults.
- You should take your first dose while you are home and not needing to drive. Prozac has been known to cause drowsiness in some patients, and you should avoid driving after taking Prozac until you know how it affects you.1
- Ask your doctor whether it is safe to drink alcohol while taking Prozac.
- Tell your prescriber about all medications and supplements you take, including over-the-counter treatments. Many over-the-counter medications and supplements can interact with prescription medications.
Frequently Asked Questions
What Is Prozac (Fluoxetine) & What Is It Used to Treat?
Prozac (fluoxetine) is an antidepressant in the selective serotonin reuptake inhibitors (SSRI) drug class.1 It is FDA-approved to treat major depression and OCD in adults and children. Prozac is also approved to treat panic disorder and bulimia nervosa in adults only.
What Are Common Side Effects of Prozac?
Common Prozac side effects include nausea, fatigue, changes in sleep and appetite, and sexual dysfunction.
How Long Will Prozac Side Effects Last?
Side effects are one of the most common reasons people choose to stop taking Prozac. While some effects can be managed and may fade away after the first few weeks, some do not go away unless a person stops taking the medication.
Should I Stop Taking Prozac If I Experience Side Effects?
Do not stop taking Prozac unless you have been advised to do so by your provider. Doing so can lead to antidepressant discontinuation syndrome, also known as antidepressant withdrawal. This can cause uncomfortable symptoms, including dizziness, fatigue, irritability, and nausea.
How Does Prozac Make You Feel During the First Week?
During the first week of taking Prozac, the medication is building up in your body. This may trigger side effects for some people. It takes several weeks for Prozac to start working and you may not notice any difference in your symptoms yet.
Does Prozac Affect Sex Drive?
Increased serotonin levels may impact hormones such as testosterone and dopamine. While this process is not completely understood, these hormonal effects may inhibit sex drive for some who take Prozac.6
Can Prozac Be Used During Pregnancy?
Taking Prozac during pregnancy can come with risk. When a pregnant parent takes fluoxetine during the third trimester, there is an increased risk of newborns showing withdrawal symptoms.
Can Prozac Be Used While Breastfeeding?
Fluoxetine has been shown to cross the placenta during pregnancy and be present in breast milk. Talk to your provider about the benefits and risks of taking Prozac while breastfeeding.
Is it Safe to Drive While Taking Prozac?
Prozac can make you sleepy. Avoid driving or operating dangerous equipment, at least until you find out how the medication affects your judgment or reaction times.
Is It OK to Drink Alcohol While Taking Prozac?
No, drinking alcohol while taking Prozac is not recommended. Alcohol significantly affects the brain and can worsen side effects, such as drowsiness, dizziness and other possible dangerous health complications.
ChoosingTherapy.com 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.
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Prozac – fluoxetine hydrochloride capsule. (November 13, 2024). DailyMed.nlm.nih.gov. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm
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Magni, L. R., Purgato, M., Gastaldon, C., Papola, D., Furukawa, T. A., Cipriani, A., & Barbui, C. (2013). Fluoxetine versus other types of pharmacotherapy for depression. The Cochrane database of systematic reviews, 2013(7), CD004185. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24353997/
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Santarsieri, D., & Schwartz, T. L. (2015). Antidepressant efficacy and side-effect burden: a quick guide for clinicians. Drugs in context, 4, 212290. Retrieved from https://doi.org/10.7573/dic.212290
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Buchman, N., Strous, R. D., & Baruch, Y. (2002). Side effects of long-term treatment with fluoxetine. Clinical neuropharmacology, 25(1), 55–57. Retrieved from https://pubmed.ncbi.nlm.nih.gov/11852298/
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Ferguson J. M. (2001). SSRI Antidepressant Medications: Adverse Effects and Tolerability. Primary care companion to the Journal of clinical psychiatry, 3(1), 22–27. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC181155/
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Jing, E., & Straw-Wilson, K. (2016). Sexual dysfunction in selective serotonin reuptake inhibitors (SSRIs) and potential solutions: A narrative literature review. The mental health clinician, 6(4), 191–196. Retrieved from https://doi.org/10.9740/mhc.2016.07.191
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Fluoxetine tablet. (December 11, 2024). DailyMed.nlm.nih.gov. Retrieved from https://dailymed.nlm.nih.gov/dailymed/lookup.cfm
We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.
Author: No Change
Reviewer: No Change
Primary updates: Added “Key Takeaways” feature. Edited for clarity and reorganized. Revised and retitled section titled “Prozac Dosage” to “Prozac Dosages for FDA-Approved Treatment”. Added new sections “How Does Prozac Work?”, “How Effective Is Prozac?”, “How Long Does it Take Prozac to Work?” “How Long Do I Need to Keep Taking Prozac?”, “What Are the Long-term Effects of Prozac?”. Consolidated “Fluoxetine Warnings” into new “Risks” feature. Added “Who Should Not Take Prozac?”, “How to Get a Prescription for Prozac”. Retitled “What to Avoid While Taking Prozac” to “Drug Interactions With Prozac”. Retitled “Questions to Ask Your Health Team About Prozac (Fluoxetine)” to “Questions to Ask Your Provider”. Removed “For Further Reading” section, added FAQs. Replaced “Final Thoughts on Prozac” with “Prescriber’s Tips” feature.
Author: Eric Patterson, LPC
Medical Reviewer: Benjamin Troy, MD
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