Approximately 280 million people around the world have depression, according to the World Health Organization.
That doesn’t mean they’re just experiencing fluctuations in mood.
Depression is a serious medical condition that can impact your ability to perform daily tasks, and cause relationships at work, school, and at home to suffer.
It can even lead to suicidal thoughts and actions.
About 13 percent of Americans were prescribed antidepressants between 2015-2018, according to the Centers for Disease Control and Prevention.
One of the best-known antidepressants is Prozac, the brand name version of a medication called fluoxetine.
When a patient needs to stop taking Prozac or another antidepressant, they should only do so under the supervision and instruction of their healthcare provider.
That’s because antidepressants may cause withdrawal symptoms as the body adjusts to their absence.
In this article, I’ll talk more about Prozac, and what withdrawal from the medication involves—including symptoms, side effects, and ways to cope.
I’ll also provide some precautions about interactions with other substances.
And I’ll tell you when it’s best to talk to your doctor.
What is Prozac?
It is used for the treatment of depression and other mood disorders.
Serotonin is a neurotransmitter, a type of molecule used by your nervous system to carry messages between your brain and body.
Serotonin promotes feelings of calm, positivity, and balance.
Under normal circumstances, serotonin is recycled once it’s delivered its message—a process called “reuptake.”
People who experience depression and other mood disorders may clear serotonin too quickly.
Prozac and other SSRIs work to slow the rate at which the brain reuptakes serotonin, so there’s more available in the brain.
By allowing the brain to retain more serotonin, Prozac can treat symptoms of depression and other mood imbalances.
Prozac, and its generic version, fluoxetine, are approved by the U.S. Food and Drug Administration (FDA) for the treatment of the following conditions:
- Major depressive disorder (MDD)
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Binge eating disorder
- Premenstrual dysphoric disorder (PMDD)
- Bipolar disorder (along with olanzapine)
- Treatment-resistant depression (along with olanzapine)
Prozac may also be used off-label for other purposes at the discretion of prescribing physicians. “Off-label” means that the medication has not been approved by the FDA for the specific condition the doctor is prescribing it for.
But don’t worry, the doctor can still do so ethically—they provide justification for why the medication can help manage symptoms.
Some common off-label uses of Prozac include:
- Social anxiety disorder (also known as social phobia)
- Post-traumatic stress disorder (PTSD)
- Borderline personality disorder
- Raynaud phenomenon
- Selective mutism
The typical daily dose ranges from 20-60 mg.
Prozac Withdrawal Symptoms
The symptoms associated with Prozac withdrawal can depend on many factors, such as:
- The dosage you were taking
- How long you had been taking Prozac
- Your age
- Your weight
- Your liver and kidney function
- Other health conditions
- Other medications you take
Prozac is metabolized by the liver and excreted from the body by the kidneys.
How quickly your body detoxes from the medication will depend on how efficiently it clears the medication.
If you also take other medications that are processed by your liver and kidneys, or if you have problems with liver or kidney function, the clearance process may take longer.
Symptoms that may occur with Prozac withdrawal can include:
- Motor: Loss of balance, dizziness, problems walking, muscle tension, tremoring, restless legs
- Sleep: Insomnia, vivid or strange dreams
- Mood: Anxiety, agitation, depression, irritability, mood swings, mania, and suicidal ideation
If you experience thoughts of self-harm or suicide, talk to your healthcare provider immediately, seek emergency care, or call 9-1-1.
Prozac stays in your body longer than other SSRIs when you stop taking it.
The half-life of Prozac is 1-3 days if you have not been taking it for long, and 4-6 days if you have been taking the medication for a while.
This means that it takes that much time for the dosage in circulation in your body to be reduced by half.
For people with liver or kidney problems, the half-life is higher.
At these rates, it can take about a month before Prozac is out of your system.
Withdrawal symptoms may appear as you are tapering off the medication, or after the medication is fully out of your system.
Always keep your doctor informed about how you are feeling to avoid serious complications or side effects.
Prozac Side Effects
Common side effects of Prozac include:
- Nervousness or anxiety
- Problems falling or staying asleep
- Dry mouth
- Loss of appetite
- Changes in sex drive or sexual ability
Prozac carries a black box warning, which is relevant whether you are starting to take the drug or are tapering off of it. Serious complications to watch out for include:
- Suicidal thoughts or actions: Changes in behavior, mood, actions, thoughts, or feelings (especially if sudden or severe). If you notice these signs or symptoms, seek emergency medical care immediately.
- Serotonin syndrome: A life-threatening condition where your serotonin levels are too high. Serotonin syndrome includes symptoms like agitation, hallucinations, coma, or severe changes to mental status. It can also include muscular coordination problems, twitching, racing heartbeat, sudden changes in blood pressure, fever, nausea, vomiting, or diarrhea. Seek emergency medical help if you notice these signs. Serotonin syndrome requires emergency room care and monitoring.
- Severe allergic reactions: Trouble breathing, hives, or swelling of the face, tongue, eyes, or mouth. Discontinue if these symptoms occur, seek medical care, and let your healthcare provider know immediately.
- Bleeding problems: Prozac may increase the risk of bleeding, especially if you take blood-thinning medication, nonsteroidal anti-inflammatory drugs (NSAIDs, including ibuprofen), or aspirin.
Managing Prozac side effects
If you experience side effects that are overwhelming or affect your quality of life, let your doctor know.
They may be able to adjust your dose or provide other ways to help manage side effects.
Do not suddenly stop taking Prozac.
If you do, you could experience withdrawal symptoms or serious side effects.
If you cannot manage Prozac’s side effects, your doctor will create a safe tapering plan to help you switch medications or discontinue antidepressants entirely.
Precautions and Warnings
If you are taking Prozac or other antidepressants, never stop taking the medication suddenly without working with your doctor.
Antidepressants take time to build up in your system, but also stay at higher concentrations for weeks even after you start to taper your dose.
Stopping suddenly can result in serious side effects or symptom relapses.
Pay close attention to your dosage.
Taking too much Prozac increases the risk of overdose and serious complications.
Taking too little Prozac when you are weaning off can lead to withdrawal symptoms.
Changing the dosage of Prozac may increase the risk for suicidal thoughts and behaviors.
Anyone taking Prozac or other antidepressants should be monitored closely for changes in behavior, worsening symptoms, or thoughts of self-harm.
Any signs should be immediately reported to a healthcare provider.
Prozac lasts for a long time in your body, even as you start to take less.
It can take several weeks for changes to be reflected in your body.
Do not to suddenly discontinue Prozac or any other antidepressant, unless an allergic reaction occurs.
Prozac has many potential food and drug interactions, complications that occur when the medication is taken at the same time as other medications or foods.
Interactions may also occur with herbal supplements, vitamins, and minerals.
Always tell your doctor about everything that you take, even occasionally, such as over-the-counter medications, multivitamins, illicit drugs, alcohol, or other supplements or natural health products.
Medicines, foods, and supplements that can interact with Prozac include:
- MAOIs (monoamine oxidase inhibitors)
- Other SSRIs
- St. John’s wort
Prozac may be riskier for certain populations:
- People who are pregnant: Prozac is a Class C pregnancy drug. It should only be used if the benefit outweighs the potential risk. No studies exist that have assessed the safety of Prozac in the first trimester and it is not fully understood how it impacts labor and delivery. In some cases, your doctor may feel that continuing Prozac represents the safest scenario for the pregnant person’s health. Tell your doctor if you are pregnant or plan to become pregnant.
- People who are breastfeeding: Nursing people should not take Prozac because it is excreted in breastmilk.
- Older adults: Prozac has a longer half-life, and higher concentrations of the drug may increase the risk for low sodium, which is a serious electrolyte imbalance.
- People with liver problems: People who have cirrhosis should not take Prozac or should be treated with lower, less frequent doses. Prozac is metabolized in the liver. Decreased liver function increases the half-life, leading to longer plasma concentrations of the drug.
Coping and Relief
Withdrawal from Prozac can be uncomfortable and unsettling.
The best way to manage the process is to follow your doctor’s instructions.
The following may help provide relief:
- Closely follow the taper dosage: Your doctor will gradually reduce your dosage over weeks until you eventually stop. This is called tapering. The longer the taper, the less likely you will be to have pronounced symptoms and a potential relapse.
- Psychotherapy: If your feelings of depression come back as you taper off of Prozac, psychotherapy can be helpful. It may not always resolve your depression, but therapists are trained to help you find proactive ways to manage your mood. You could also try cognitive behavioral therapy (CBT) or eye movement desensitization and reprocessing (EMDR). Both of these specific types of therapy have been found to be supportive of people dealing with depression.
- Lifestyle: Don’t smoke, reduce your alcohol intake, and don’t rely too heavily on caffeine. Get daily physical activity and adequate sleep. Eat a nutritious diet, stay hydrated, and try to engage in hobbies or activities that bring you joy. You don’t have to do all of these things at once. Even small changes to lifestyle can improve well-being and quality of life.
Your doctor will want to know if you start to feel noticeably worse or experience side effects or symptoms that you were not expecting.
If you feel overwhelmed or scared, check in with your doctor.
When to See a Doctor
If you are tapering off Prozac and are concerned about symptoms, how you are feeling, or side effects, talk to your doctor.
If you take Prozac but want to stop taking it or switch to a different medication, let your doctor know.
They will talk through available options and help create a safe plan for discontinuing Prozac while minimizing the potential for serious withdrawal symptoms.
Never stop taking Prozac without your doctor’s help.
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Frequently Asked Questions
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
Label for Prozac (fluoxetine). (2017).
Cognitive behavioral therapy for depression. (2020).
The efficacy of EMDR in the treatment of depression. (2016).