Can you stay on Prozac forever? (+3 side effects)

In this article we will discuss the long-term benefits of Prozac and whether it can be taken for a lifetime. Prozac is a brand name of fluoxetine that is used in the treatment of various mental health conditions. 

Can you stay on Prozac forever?

It may or may not be necessary to take Prozac forever. Depending on the severity of the disease, long-term use of Prozac may be necessary for those with chronic depression. Antidepressants are frequently taken indefinitely in these situations. This is partially because depression is an incurable condition.

The aim of the treatment is not to cure depression but rather to achieve symptom remission (disappearance of symptoms). However, remission might not be achievable for some individuals. 

Prozac is often administered daily because of its relatively long half-life. An enteric-coated extended-release form of Prozac is prescribed every seven days of maintenance therapy. The treatment can continue for a few months to many years depending on the condition of the patient. 

How long-term use of Prozac affect its safety profile?

Doctors usually start the treatment on a low dose of Prozac. They will then gradually modify it to get the appropriate dose for the patient. In the end, the doctor will recommend the lowest necessary dose to get the desired result. 

Over 60% of patients 12 years of age and older who were prescribed antidepressants have been taking them for two years or longer. About 14% of that group has been taking these drugs for more than 10 years (1).

Researchers suggest that less than 1% of Prozac users may be at risk for abrupt liver damage. These hepatic side effects usually manifest two to twelve weeks after initiating Prozac. Your doctor might advise keeping an eye on your liver enzyme levels to find any problem with liver activity due to long-term use of Prozac (2).

What are the side effects of long-term use of Prozac?

According to current research, long-term antidepressant use may have identified negative effects. Among these risks, especially for Prozac users, is an elevated risk of gastrointestinal bleeding. 

Long-term Prozac use can cause mild to serious side effects. 

  1. Mild side effects: These may include insomnia, headache, weakness, weight loss, reduced appetite, sexual dysfunction, dry mouth, dizziness, and tremors amongst others. 
  2. Serious side effects: These side effects are not very common but can be triggered by the long-term use of Prozac.
  • Hyponatremia: This can lead to low levels of sodium in your body which can cause confusion, memory problems, trouble concentrating and weakness.
  • Serotonin syndrome: This occurs due to an abnormal buildup of serotonin in the body. Symptoms can include increased heart rate, muscle stiffness, nausea, seizures, agitation, and sweating.
  • Closed-angle glaucoma: This can cause a sudden buildup of pressure inside your eye. The symptoms might include blurred vision, redness, severe headache and seeing haloes around light. 
  • Mania: You can experience unusual energy which can affect your mood and behaviour. You will talk more and faster than before, and experience extreme happiness, impulsive behaviour and drifting thoughts.
  • Bleeding more easily: It will take longer for you to stop bleeding after an injury. You will experience frequent nose bleeds, and easy bruising, with blood in vomit and black stool.
  • Suicidal thoughts and seizures.

When to consult the physician for personalized advice?

If you plan on taking Prozac for a long time then you should consult your physician or health care provider if you feel any off-set behavioral changes like:

  • Suicidal thought,
  • Any side effect or adverse effect,
  • Any additional mental health issues or physical conditions you may have.

You should also inform your healthcare provider of the following things:

  • Any drug allergy, or other medications you have added to your dosage regimen, including over-the-counter herbal, and nutritional supplements,
  • Pregnancy,
  • Use of alcohol or prohibited drugs.

What does the clinical data suggest?

According to recent research conducted by the National Insitute of Health and Care Research, up to 40% of patients who used antidepressants for at least nine months were able to quit taking them without experiencing a relapse in the depressive symptoms. Some of the people whose symptoms did recur were able to control them without needing to take medication. 

This does not imply that long-term antidepressant use is beneficial to everyone or that antidepressants are never needed, but it does imply that some people who are currently on Prozac could safely stop. If Prozac is working for the patient but he doesn’t want to take them forever, then it should be discussed with the doctor.

Conclusion

In this article, we discussed if Prozac can be used indefinitely. We also discussed the side effects you might experience due to prolonged use of Prozac.

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References

1.-

Pratt LA, Brody DJ, Gu Q. Antidepressant Use among Persons Aged 12 and Over: United States, 2011-2014. NCHS Data Brief. Number 283. National Center for Health Statistics. 2017 Aug. https://www.cdc.gov/nchs/products/databriefs/db283.htm?mod=article_inline

2.-

LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Fluoxetine. [Updated 2018 Feb 2]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK548010/

3.-

Opatrny L, Delaney JC, Suissa S. Gastro‐intestinal haemorrhage risks of selective serotonin receptor antagonist therapy: a new look. British journal of clinical pharmacology. 2008 Jul;66(1):76-81. https://bpspubs.onlinelibrary.wiley.com/doi/10.1111/j.1365-2125.2008.03154.x

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