Prozac Vs. Trazodone: Drug Comparison

Prozac^® (fluoxetine) is a selective serotonin reuptake inhibitor (SSRI) used to treat depression, anxiety, and other mood disorders by increasing available serotonin levels in the brain, which helps improve mood and reduce anxiety. Its FDA-approved indications include major depressive disorder (MDD), obsessive-compulsive disorder (OCD), bulimia nervosa, panic disorder, and premenstrual dysphoric disorder (PMDD). Off-label uses may include managing post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), and borderline personality disorder. Prozac is available in capsule, tablet, and liquid form, typically taken once daily. Common side effects include nausea, insomnia, headache, and sexual dysfunction. It has a boxed warning for an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults during the early stages of treatment.

Trazodone is an antidepressant that works by inhibiting serotonin reuptake and blocking certain serotonin receptors, helping to improve mood and alleviate symptoms of depression. Its FDA-approved indication is for the treatment of major depressive disorder (MDD) in adults. Off-label uses include treating insomnia, anxiety, and chronic pain. Trazodone is available in tablet form, typically taken once or twice daily, often at bedtime due to its sedating effects. Common side effects include swelling, drowsiness, nasal congestion, dizziness, and dry mouth. There is a risk of increased suicidal thoughts and behaviors in children, adolescents, and young adults, similar to other antidepressants.

Selective serotonin reuptake inhibitor (SSRI)

Selective serotonin reuptake inhibitor (SSRI)

Prozac (fluoxetine hydrochloride) is a indicated for:

• Acute and maintenance treatment of major depressive disorder (MDD)

• Acute and maintenance treatment of obsessive compulsive disorder (OCD)

• Acute and maintenance treatment of bulimia nervosa

• Acute treatment of panic disorder, with or without agoraphobia

Prozac and olanzapine in combination for treatment of:

• Acute depressive episodes associated with bipolar I disorder

• Treatment resistant depression

Trazodone is indicated:

• For the treatment of major depressive disorder (MDD)

• Typically taken orally once daily

• Comes in 10 mg, 20 mg, and 40 mg Pulvules^®

• Typically taken orally in divided doses per day

• Comes in 50 mg, 100 mg, 150 mg, and 300 mg tablets

Most common adverse reactions (≥5% and at least twice that for placebo) associated with:

Major depressive disorder, obsessive compulsive disorder, bulimia, and panic disorder:

• Abnormal dreams

• Abnormal ejaculation

• Anorexia

• Anxiety

• Weakness

• Diarrhea

• Dry mouth

• Indigestion

• Flu syndrome

• Impotence

• Insomnia

• Libido decreased

• Nausea

• Nervousness

• Inflammation of the throat

• Rash

• Inflammation of the sinuses

• Sleepiness

• Sweating

• Tremor

• Vasodilatation

• Yawn

Prozac and olanzapine in combination:

• Also refer to the adverse reactions section of the package insert for Symbyax

Most common adverse reactions (incidence ≥ 5% and twice that of placebo) are:

• Swelling

• Blurred vision

• Fainting

• Drowsiness

• Fatigue

• Diarrhea

• Nasal congestion

• Weight loss

• Serotonin syndrome and MAOIs

• Pimozide

• Thioridazine

• When using Prozac and olanzapine in combination, also refer to the contraindications section of the package insert for Symbyax

• Drug interactions: monoamine oxidase inhibitors (MAOIs), drugs metabolized by CYP2D6, tricyclic antidepressants (TCAs), CNS acting drugs, benzodiazepines, antipsychotics, anticonvulsants, serotonergic drugs, drugs that interfere with hemostasis (e.g., NSAIDs, aspirin, warfarin), drugs tightly bound to plasma proteins, olanzapine, drugs that prolong the QT interval

• Concomitant use of monoamine oxidase inhibitors (MAOIs), or use within 14 days of stopping MAOIs

• Drug interactions: CNS depressants, CYP3A4 inhibitors, CYP3A4 inducers, digoxin, phenytoin, warfarin

• Suicidal thoughts and behaviors in children, adolescents, and young adults

• Serotonin syndrome

• Allergic reactions and rash

• Activation of mania/hypomania

• Seizures

• Altered appetite and weight

• Increased risk of bleeding

• Angle-closure glaucoma

• Low blood sodium

• Anxiety and insomnia

• QT prolongation

• Potential for cognitive and motor impairment

• Long half-life

• Prozac and olanzapine in combination: When using Prozac and olanzapine in combination, also refer to the warnings and precautions section of the package insert for Symbyax

• Sexual dysfunction

• Pregnancy: SSRI use, particularly later in pregnancy, may increase risk for persistent pulmonary hypertension and symptoms of poor adaptation (respiratory distress, temperature instability, feeding difficulty, hypotonia, tremor, irritability) in the neonate

• Serotonin syndrome

• Cardiac arrhythmias

• Positional low blood pressure and fainting

• Increased risk of bleeding

• Prolonged erection

• Activation of mania or hypomania

• Potential for cognitive and motor impairment

• Angle-closure glaucoma

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

Increased risk of suicidal thinking and behavior in children, adolescents, and young adults taking antidepressants.

Monitor for worsening and emergence of suicidal thoughts and behaviors.

When using Prozac and olanzapine in combination, also refer to Boxed Warning section of the package insert for Symbyax.

WARNING: SUICIDAL THOUGHTS and BEHAVIORS

Antidepresants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients.

Closely monitor for clinical worsening and emergence of suicidal thoughts and behaviors.

Trazodone hydrochloride tablet is not approved for use in pediatric patients.

*This information is from the label for brand name Prozac^®. See the Full Prescribing Information for more complete information. Fluoxetine, the active ingredient in Prozac, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient fluoxetine.

*This information is from the trazodone hydrochloride label used by Accord Healthcare, Inc. See the Full Prescribing Information for more complete information. This information may not be accurate for all medications that include the active ingredient trazodone.