How Prozac (Fluoxetine) Is Used to Treat Bipolar Disorder

Table of ContentsView AllTable of ContentsFor Anxiety DisordersRecommended DosagesCommon Side EffectsDrug HypersensitivityBlack Box WarningWithdrawal Symptoms

Table of ContentsView All

View All

Table of Contents

For Anxiety Disorders

Recommended Dosages

Common Side Effects

Drug Hypersensitivity

Black Box Warning

Withdrawal Symptoms

Close

What is Prozac (fluoxetine)?Prozac is a type of antidepressant known as aselective serotonin reuptake inhibitor (SSRI), which is often used to treatdepression,bipolar disorder, and other mental illnesses.

What is Prozac (fluoxetine)?

Prozac is a type of antidepressant known as aselective serotonin reuptake inhibitor (SSRI), which is often used to treatdepression,bipolar disorder, and other mental illnesses.

As useful as Prozac can be in treating these conditions, the drug may cause side effects ranging in severity from mild to life-threatening. Moreover, people who take Prozac may experience withdrawal symptoms if the treatment is not tapered off appropriately.

Prozac is commonly used to treatanxiety disorders, many of which can co-exist with bipolar disorder. These include generalized anxiety disorder (GAD), social anxiety disorder (SAD), panic disorder (PD), and post-traumatic stress disorder (PTSD)

In fact, a 2015 review of studies published inEBioMedicineconcluded that the lifetime risk of an anxiety disorder co-occurring with bipolar disorder was 42.7%.

Within the context of bipolar disorder, Prozac is considered the only antidepressant with a formal indication in treatingbipolar depressionbut only when used in combination with theantipsychoticdrug Zyprexa (olanzapine).

Antidepressants need to be used with caution in bipolar disorder, as there is some evidence that they can trigger mania and worsen cycling of the disorder.

On the downside, the concomitant use of Prozac and Zyprexa also increases the risk of side effects.

Ultimately, the aim of bipolar depression treatment is to alleviate symptoms at the lowest possible dose to reduce the risk of side effects.

Side effects are not uncommon when taking Prozac. Some are mild and transient and will often resolve as your body gradually adapts to the medication.

Side effects of Prozac may include:

Call your doctor if any of these side effects persist or worsen.

Some adverse reactions to Prozac may be serious and require emergency medical treatment. This is especially true if there are signs of a potentially life-threatening allergic response known as anaphylaxis.

Call 911 or seek immediate emergency care if you experience some or all of the following symptoms:

If left untreated, anaphylaxis can lead to shock, coma, respiratory or heart failure, and death.

Prozac and other antidepressants can increase suicidal thoughts or actions in some children, teenagers, or young adults. This usually occurs within the first few months of starting treatment or when the dose is changed. Call your doctor immediately if you notice any sudden or severe changes in mood, behavior, thoughts, or feelings.

If your child is having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see ourNational Helpline Database.

If your child is having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see ourNational Helpline Database.

Although withdrawal is more common with shorter half-life antidepressants like Paxil (paroxetine) or Zoloft (sertraline), it can occasionally happen with the longer half-life Prozac, especially if you have been on treatment for a long time. SSRI withdrawal is rarely dangerous, but it can be extremely uncomfortable and distressing.

Symptoms typically include:

If the decision is made to stop Prozac, you would need to taper down slowly. Your doctor can provide specific instructions as well as the appropriate dosage pills.

Never stop taking Prozac without first speaking with your doctor and working out a dosage reduction plan.Stopping treatment abruptly can lead to a form of drug withdrawal known asSSRI discontinuation syndrome.

6 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Nabavi B, Mitchell AJ, Nutt D.A Lifetime Prevalence of Comorbidity Between Bipolar Affective Disorder and Anxiety Disorders: A Meta-analysis of 52 Interview-based Studies of Psychiatric Population.EBioMedicine. 2015;2(10):1405-19.  doi:10.1016/j.ebiom.2015.09.006US Food & Drug Administration.Highlights of prescribing information: Symbax.US Food & Drug Administration.Medication Guide: Prozac.US National Library of Medicine.Fluoxetine.US Food & Drug Administration.Highlights of prescribing information: Prozac.Fava GA, Gatti A, Belaise C, Guidi J, Offidani E.Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review.Psychother Psychosom. 2015;84(2):72-81.  doi:10.1159/000370338Additional ReadingSharma T, Guski LS, Freund N, Gøtzsche PC.Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports.BMJ. 2016;352:i65. doi:10.1136/bmj.i65Silva MT, Zimmermann IR, Galvao TF, Pereira MG.Olanzapine plus fluoxetine for bipolar disorder: a systematic review and meta-analysis.J Affect Disord. 2013;146(3):310-8. doi:10.1016/j.jad.2012.11.001

6 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Nabavi B, Mitchell AJ, Nutt D.A Lifetime Prevalence of Comorbidity Between Bipolar Affective Disorder and Anxiety Disorders: A Meta-analysis of 52 Interview-based Studies of Psychiatric Population.EBioMedicine. 2015;2(10):1405-19.  doi:10.1016/j.ebiom.2015.09.006US Food & Drug Administration.Highlights of prescribing information: Symbax.US Food & Drug Administration.Medication Guide: Prozac.US National Library of Medicine.Fluoxetine.US Food & Drug Administration.Highlights of prescribing information: Prozac.Fava GA, Gatti A, Belaise C, Guidi J, Offidani E.Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review.Psychother Psychosom. 2015;84(2):72-81.  doi:10.1159/000370338Additional ReadingSharma T, Guski LS, Freund N, Gøtzsche PC.Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports.BMJ. 2016;352:i65. doi:10.1136/bmj.i65Silva MT, Zimmermann IR, Galvao TF, Pereira MG.Olanzapine plus fluoxetine for bipolar disorder: a systematic review and meta-analysis.J Affect Disord. 2013;146(3):310-8. doi:10.1016/j.jad.2012.11.001

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Nabavi B, Mitchell AJ, Nutt D.A Lifetime Prevalence of Comorbidity Between Bipolar Affective Disorder and Anxiety Disorders: A Meta-analysis of 52 Interview-based Studies of Psychiatric Population.EBioMedicine. 2015;2(10):1405-19.  doi:10.1016/j.ebiom.2015.09.006US Food & Drug Administration.Highlights of prescribing information: Symbax.US Food & Drug Administration.Medication Guide: Prozac.US National Library of Medicine.Fluoxetine.US Food & Drug Administration.Highlights of prescribing information: Prozac.Fava GA, Gatti A, Belaise C, Guidi J, Offidani E.Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review.Psychother Psychosom. 2015;84(2):72-81.  doi:10.1159/000370338

Nabavi B, Mitchell AJ, Nutt D.A Lifetime Prevalence of Comorbidity Between Bipolar Affective Disorder and Anxiety Disorders: A Meta-analysis of 52 Interview-based Studies of Psychiatric Population.EBioMedicine. 2015;2(10):1405-19.  doi:10.1016/j.ebiom.2015.09.006

US Food & Drug Administration.Highlights of prescribing information: Symbax.

US Food & Drug Administration.Medication Guide: Prozac.

US National Library of Medicine.Fluoxetine.

US Food & Drug Administration.Highlights of prescribing information: Prozac.

Fava GA, Gatti A, Belaise C, Guidi J, Offidani E.Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review.Psychother Psychosom. 2015;84(2):72-81.  doi:10.1159/000370338

Sharma T, Guski LS, Freund N, Gøtzsche PC.Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports.BMJ. 2016;352:i65. doi:10.1136/bmj.i65Silva MT, Zimmermann IR, Galvao TF, Pereira MG.Olanzapine plus fluoxetine for bipolar disorder: a systematic review and meta-analysis.J Affect Disord. 2013;146(3):310-8. doi:10.1016/j.jad.2012.11.001

Sharma T, Guski LS, Freund N, Gøtzsche PC.Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports.BMJ. 2016;352:i65. doi:10.1136/bmj.i65

Silva MT, Zimmermann IR, Galvao TF, Pereira MG.Olanzapine plus fluoxetine for bipolar disorder: a systematic review and meta-analysis.J Affect Disord. 2013;146(3):310-8. doi:10.1016/j.jad.2012.11.001

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