Does Prozac Cause Anxiety at First? (3+side management tips)

Prozac (Fluoxetine) is associated with acute anxiety in the initial phase of treatment and when the drug’s dosage is increased. In this article, we will discuss why this phenomenon occurs, how its side effects present, and some of the ways we can manage its presentation.

Does Prozac Cause Anxiety at First?

Yes, Prozac is known to cause anxiety in the initial phases of treatment. Prozac (Fluoxetine) is a well-known antidepressant medication commonly prescribed for the management of; depression, obsessive-compulsive disorder (OCD), panic disorders, eating disorders (bulimia, binge eating disorders) and premenstrual dysphoric disorder (1).

Like all medications, Prozac may cause unwanted negative side effects. These may include (1):

• Anxiety and nervousness
• Weight loss
• Insomnia
• Dry mouth (xerostomia)
• Excessive sweating (hyperhidrosis)
• Metallic taste
• Diarrhoea
• Nausea
• Fatigue
• Restlessness
• Mood disturbances
• Gastrointestinal Reflux disorder and heartburn 
• Severe headaches
• Bruising
• Bleeding
• Serotonin Syndrome

In this article, we will focus on Prozac-induced anxiety. Acute Prozac-induced anxiety often occurs in the first few weeks when a patient starts the medication or when the patient’s dose is increased (2). In this article, we will focus on this side effect.

What does research suggest?

Plenty of research has been conducted to determine the mechanism associated with acute Prozac-induced anxiety in the initial phases of treatment. The most common finding is attributable to the way Prozac exerts its effects on the body.

Prozac is an antidepressant of the Selective Serotonin Receptor Inhibitor class. As such, it blocks the binding of Serotonin Neurotransmitters to receptors, causing an increase in Serotonin levels (2).

Serotonin is a neurotransmitter that also acts as a hormone. It plays a role in regulating mood, memory, and gastrointestinal regulation (3).

In the management of mental health disorders such as depression and Obsessive-compulsive disorder, this mechanism promotes a feeling of well-being and emotional stability. This is why it is a well-prescribed first-line antidepressant.

Its mechanism also influences gastric motility, affecting gastric emptying and acid secretions (3).

The mechanism in which Prozac exerts its effects explains the associated side effects such as anxiety. The increased level of Serotonin in the Central Nervous System is responsible for anxiety-like symptoms that you may experience with Prozac at the beginning of treatment (2).

What are the symptoms associated with Prozac-induced anxiety?

Prozac-induced anxiety can cause the following signs and symptoms: (2)

• Nervousness
• Increased heart rate
• Hyperventilation
• Sweating
• Tremors
• Concentration problems

It is important to note that these symptoms usually resolve as the body adjusts to the medication or dose increment of the medication.

Management tips for Prozac-induced anxiety

If you feel like you are experiencing any of the anxiety symptoms, you should do the following:

Consult with your healthcare practitioner:

Experiencing acute anxiety shortly after starting your treatment with this medication or after a dose adjustment is quite an uncomfortable experience. Therefore, it is important to consult with your doctor. Your doctor will examine your symptoms and tailor your treatment plan based on your needs.

Your doctor may adjust your treatment plan by making medication adjustments. They may recommend dose titrations, beginning treatment with low doses of Prozac and titrating upwards as per the treatment needs. Additionally, your doctor may also prescribe additional medications to help manage anxiety (1,2).

Be patient:

In most cases, the anxiety experienced while starting Prozac subsides over time as the body adjusts to the medication. It may take a few weeks before the symptoms subside, and you start feeling the beneficial effects of the medication. Employing this technique requires patience and reaching out to your family and friends for support and reassurance.

Lifestyle modifications:

This technique involves employing behaviour modifications that may help you self-regulate and ground your emotions. Utilizing this technique involves the use of alternative and complementary relaxation therapies such as: (5)

• Meditation and deep breathing exercises
• Exercise (running, gyming, walking)
• Practising yoga
• Massage therapy
• Relaxation techniques such as music

Having a proper diet may also help alleviate anxiety-like symptoms. Key nutrients in the diet such as magnesium and vitamin B help lower the risk of anxiety (4).

Conclusion:

While you may experience acute anxiety at the beginning of treatment with Prozac, this side effect is generally temporary and subsides as your body adjusts and time goes by. It is important to contact your healthcare provider for personalized guidance so that they can advise you on strategies that will help you manage these symptoms during treatment.

References