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When we talk about antidepressants, Prozac® and the other drugs in the SSRI class of medications have made incredible changes for people affected by mood disorders like anxiety, depression and more.Â
But there are downsides to these medications, including an array of side effects — both minor and serious. Naturally, some people may be concerned for their health when offered a new medication like Prozac, and it’s normal to wonder, “is Prozac addictive?”
Addictive drugs are a more confusing concept than we typically acknowledge. We picture people at the extremes, experiencing severe symptoms of withdrawal, experiencing social fallout as a result of behaviors that are due to psychological dependence on a steady flow of medication.Â
That won’t happen to people on Prozac, regardless of their history of substance abuse. But Prozac users still have to tread lightly should they need to or choose to go off of this medication, because there can be unwanted effects. Before stopping the use of medication, talking to a healthcare professional is highly recommended to avoid a Prozac withdrawal.
To understand why Prozac and antidepressant withdrawal happen and how they might affect you, we need to unpack what Prozac actually is.
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As treatment options for depression go, Prozac is pretty well known.Â
Prozac, or fluoxetine, is an antidepressant medication approved by the U.S. Food and Drug Administration (FDA) to treat depression symptoms.Â
It’s part of a class of drugs called SSRIs, short for selective serotonin reuptake inhibitors.Â
These medications regulate your brain’s ability to reabsorb the serotonin molecules that it produces, with the goal being to regulate your mood.
When your brain has what it considers to be an excess supply of serotonin levels, it tends to vacuum those up and start anew.Â
The problem with this is, for people who have mood disorders like major depression, bipolar disorder, dysphoric disorder, panic disorders, obsessive-compulsive disorder, depression and anxiety, the vacuuming leaves you without the necessary supply to regulate your moods.Â
That results in crashes — the low-lows you feel at the bottom of a major depressive episode.Â
SSRIs like Prozac prevent that absorption, so there’s always a supply on hand. Generally, this is how most antidepressants work, though others may moderate the levels of norepinephrine, dopamine or other neurotransmitters to achieve the desired effects.
If it sounds worrisome that your brain could be flooded with a chemical that affects your mood so deeply, well, you’d be right — excessive serotonin can lead to some nasty side effects, from nausea, headache and insomnia, to more serious things like weight gain (or weight loss), sexual dysfunction, tremors or a condition called serotonin syndrome, which can be potentially fatal.
People who take Prozac or other SSRIs tend to need to have a regular dose to keep balance in their levels of serotonin and in the levels of the medication itself, which can lead to some pretty fair questions about whether Prozac and other antidepressants are addictive.
Addictive is a strong word. When we talk about addiction, we’re actually talking about a chemical dependency — changes to the brain, and a compulsive seeking out of the effects of that source of addiction.Â
With Prozac, it may affect the way your brain works. You may, to a certain extent, “depend” on that change to function properly, but you’re not compelled to seek out the effect.
In other words — and to be blunt — no, Prozac is a non-addictive medication.Â
Prozac is not something that you’ll want to take handfuls of at a time, but it won’t be difficult to go the recommended amount of time between doses and it won’t cause you to salivate at the idea of another hit of antidepressant bliss.Â
What Prozac will do, however, is induce some withdrawal symptoms if and when your dosage is decreased or you cease taking the medication.Â
Let’s take a look at those.
Going off Prozac might happen for a variety of reasons, including an adjustment in dosage, a plan to switch to another medication, or a decision made with the guidance of a medical professional to quit using the medication as part of your treatment plan.Â
When this happens, you will likely experience some forms of withdrawal and the symptoms that are associated with withdrawal.
Withdrawal symptoms can range from mild to severe. Often, this is a result of how much of a reduction in the medication you’re getting.Â
Someone who goes from a maximum recommended dosage to nothing will experience the most extreme withdrawal symptoms, while someone making an incremental reduction (which is what your healthcare provider will recommend and oversee) may see far more mild adverse effects.Â
Of course, it’s not always the case — someone going off fluoxetine may see no symptoms, and this does happen on a case-by-case basis.Â
Typically, though, you will react to withdrawal, and you’ll see this reaction play out in the form of the following common side effects:
Mood changes
Irritability
Dizziness
Tingling or numbness in extremities
Anxiety
Confusion
Headache
Lethargy
Agitation
Sleep problems and insomnia
Oh, and it’s possible that your symptoms of depression and other mood disorders might return, from panic attacks to a loss of stable moods and even suicidal tendencies.
You might stop taking Prozac for a variety of reasons, from issues with resistant depression that could be treated by other antidepressant drugs, to the side effects we mentioned above.
To mitigate these symptoms of withdrawal, your healthcare provider will likely reduce your dosage gradually, over a period of time, so that the transition is as smooth as possible, and the symptoms of withdrawal are minimal.
That may mean a very gradual decrease in your dosage over time, especially if you’re on a high dose of fluoxetine. A higher dose may also mean it’ll take a more significant amount of time to safely wean off of it than it would with a lesser dosage.
Keep in mind that Prozac can take more than a month to begin showing its effects when you first start taking it, so the opposite can be true as you’re going off of it.Â
If you’re treating generalized anxiety disorder or depressive disorder, chances are that the furthest thing from your mind is going to be going off of prescription drugs designed to help you treat those mood disorders.Â
And yet, many people worry about the end game of these medications: whether they’ll ever stop taking them, what will happen if they do and if they should prepare for the worst.Â
These are all intelligent, normal and frequent questions — and they should be brought to the attention of a healthcare professional.
Whether you’re about to begin taking antidepressants or have already started a course of Prozac, take these questions to a mental health professional.Â
They’ll be able to help you understand the details as they apply to your unique circumstances, and help you tailor a treatment program to meet your needs.Â
That treatment program might include more than medication, in which case you might consider using hers online therapy.Â
Whether you use us or someone else, the next step should be talking to an expert, because the worries you have aren’t going to be solved alone.
Dr. Vicky Davis is a board-certified Family Nurse Practitioner with over 20 years of experience in clinical practice, leadership and education.Â
Dr. Davis' expertise include direct patient care and many years working in clinical research to bring evidence-based care to patients and their families.Â
She is a Florida native who obtained her master’s degree from the University of Florida and completed her Doctor of Nursing Practice in 2020 from Chamberlain College of Nursing.Â
She is also an active member of the American Academy of Nurse Practitioners.