Does Prozac help with OCD? (3 research findings)
By
Dr Milena Locci de Oliveira (PhD)
Author bio
Dr Milena Locci de Oliveira is a Pharmacist and Doctor of Philosophy in Sciences from the University of São Paulo (USP). She has experience in microbiology, analytical toxicology, and clinical pharmacokinetics. She writes and reviews content on these topics.
Dr Milena’s Highlights:
-PhD in Sciences, University of São Paulo, Brazil, 2019.
-University College London (UCL) – Semester of remote collaboration in the areas of Pharmacometrics and Population Pharmacokinetics, 2018.
-Bachelor in Biochemical Pharmacy, University of São Paulo, Brazil, 2013.
“Science can be translated, and it is essential that everyone has access to quality information to make informed decisions” – Dr Milena Oliveira, PhD.
Professional Experience:
With a decade-long career as a researcher, Dr Milena has amassed extensive experience in conducting research projects in microbiology, analytical toxicology, and clinical pharmacokinetics.
Her expertise also extends to the preparation of technical and scientific reports, literature reviews, data analysis, and scientific communication, both oral and written.
Dr Milena has served as a Clinical Pharmacist, providing expert supervision and guidance to teams during the challenging times of the COVID-19 pandemic, particularly in the ICUs of two reference hospitals for patient hospitalization.
In her most recent role, Dr Milena worked on the implementation of the deliberatives of the São Paulo State Government Pharmaceutical Assistance Coordination. These decisions were aimed at ensuring medication access within the Unified Health System.
A widely multidisciplinary background enabled Dr Milena to become a professional capable of integrating scientific knowledge into private initiatives, education, and healthcare, delivering consistent services in patient safety and population health.
Professional Memberships & Affiliations:
Dr Milena Oliveira is a member of the Regional Council of Pharmacy of the State of São Paulo, Brazil.
Education:
-PhD in Sciences, University of São Paulo, Brazil, 2019.
-University College London (UCL) – Semester of remote collaboration, 2018.
-Bachelor in Biochemical Pharmacy, University of São Paulo, Brazil, 2013.
Relevant Published Work & Citations:
Oliveira ML de, Rocha A, Nardotto GHB, Pippa LF, Simões BP, Lanchote VL. Analysis of daunorubicin and its metabolite daunorubicinol in plasma and urine with application in the evaluation of total, renal and metabolic formation clearances in patients with acute myeloid leukemia. Journal of Pharmaceutical and Biomedical Analysis. Nov 2020. 191:113-124.
Abstracts. CPT: Pharmacometrics & Systems Pharmacology. 2020 Nov; 9 (S1).
Pippa LF, Oliveira ML de, Rocha A, de Andrade JM, Lanchote VL. Total, renal and hepatic clearances of doxorubicin and formation clearance of doxorubicinol in patients with breast cancer: Estimation of doxorubicin hepatic extraction ratio. Journal of Pharmaceutical and Biomedical Analysis. 2020 Jun 5; 185:113-231.
Godoy ALPC, De Jesus C, De Oliveira ML, Rocha A, Pereira MPM, Larangeira DF, Lanchote VL, Barrouin-Melo SM. Determination of Allopurinol and Oxypurinol in Dogs Plasma by High-Performance Liquid Chromatography with an Ultraviolet Detector: Application for Pharmacokinetic Studies. J Chromatogr Sep Tech. 2017; 8 (4).
Clímaco EC, Oliveira ML de, Pitondo-Silva A, Oliveira MG, Medeiros M, Lincopan N, et al. Clonal complexes 104, 109 and 113 playing a major role in the dissemination of OXA-carbapenemase-producing Acinetobacter baumannii in Southeast Brazil. Infection, Genetics and Evolution. 2013 Oct;19:127–33.
Conference Papers:
Oliveira, M. L.; NARDOTTO, G. H. B.; PIPPA, L. F.; ROCHA, A.; SIMOES, B. P.; LANCHOTE, V. L. . Daunorubicin metabolism and urinary excretion in patients with acute myeloid leukemia. In: 84th Annual Meeting of the German Society for Experimental and Clinical Pharmacology and Toxicology (DGPT) and the 20th Annual Meeting of the Association of the Clinical Pharmacology Germany (VKliPha), 2018, Göttingen. Naunyn-Schmiedeberg’s Arch Pharmacol, 2018. v. 391. p. S76-S76.
Oliveira, M. L.; NARDOTTO, G. H. B. ; ROCHA, A. ; SIMOES, B. P. ; LANCHOTE, V. L. . The low contribution of urinary excretion in the elimination of daunorubicin and its metabolite daunorubicinol in patients with acute myeloid leukemia. In: 49th Brazilian Congress of Pharmacology and Experimental Therapeutics., 2017, Ribeirão Preto. Livro de Resumos, 2017. p. 64-64.
Oliveira, M. L.; PIPPA, L. F. ; ROCHA, A. ; SIMOES, B. P. ; LANCHOTE, V. L. . Quantification of daunorubicin and its metabolite daunorubicinol in human plasma by LC-MS/MS. In: I International Meeting of Environmental Health and Toxicology (IMEHTOX), 2016, Ribeirão Preto. Livro de Resumos, 2016.
Oliveira, M. L.; Clímaco, E.C. ; OLIVEIRA, M. G. ; Lincopan, N. ; Darini A.L.C. . PFGE typing of Carbapenem-Resistant Acinetobacter baumannii isolated from different University Hospitals. In: V International Postgraduate and Research Symposium, 2012.
Clímaco, E.C. ; SILVA, A. P. ; Oliveira, M. L. ; OLIVEIRA, M. G. ; Lincopan, N. ; Darini A.L.C. Relação clonal entre linhagens de Acinetobacter baumannii produtoras de carbapenemases da família OXA em quatro hospitais no Brasil. In: XXI Latin American Congress of Microbiology, 2012, Santos. XXI Latin American Congress of Microbiology, 2012.
Oliveira, M. L.; Clímaco, E.C. ; OLIVEIRA, M. G. ; Darini A.L.C. . Dissemintion of OXA carbapenemases genes in carbapenem-resistant Acinetobacter baumannii in University Hospital of Juiz de Fora, MG. In: 8th CIFARP – International Congress of Pharmaceutical Sciences, 2011, Ribeirão Preto.
Clímaco, E.C. ; Oliveira, M. L. ; OLIVEIRA, M. G. ; Darini A.L.C. . Avaliação do sequenciamento parcial do gene rpoB e de seus flanqueadores para identificação de espécies de Acinetobacter na rotina laroratorial. In: 2° International Symposium on Clinical Microbiology, 2010, Florianópolis.
You can view some of Dr Milena’s work below and links to her professional profile.
Linkedin: https://www.linkedin.com/in/dra-milena-locci-de-oliveira-28986042/?locale=en_US
ResearchGate: https://www.researchgate.net/profile/Milena-Oliveira-6
Escavador: https://www.escavador.com/sobre/5394254/milena-locci-de-oliveira
Lattes: https://buscatextual.cnpq.br/buscatextual/busca.do
Scopus: https://www.scopus.com/authid/detail.uri?authorId=57199779361
Scholar: https://scholar.google.com/citations?view_op=list_works&hl=pt-BR&user=1YUBDIQAAAAJ
In this article, we will discuss whether Prozac (Fluoxetine) can be used in the treatment of obsessive-compulsive disorder (OCD). We will explain various research findings, dosage recommendations of Prozac for OCD, and side effects. We will also discuss what other alternative treatment options for OCD are available if Prozac fails.
Does Prozac help with OCD?
Yes, Prozac (also known as Fluoxetine), helps with obsessive-compulsive disorder (OCD) treatment. Prozac is a selective serotonin reuptake inhibitor (SSRI) and has been approved by the FDA for the treatment of OCD and many other depressive disorders (1). Prozac can be used as a monotherapy as well as adjunctive therapy with other approved medications for OCD, to achieve the desired effect.
Serotonin, the neurotransmitter for happiness and optimism, decreases in depression. Prozac and other SSRIs, work by increasing the amount of serotonin in the brain. This increased activity of serotonin regulates your mood. OCD can be characterised by the presence of obsessions, compulsions, or both in individuals. Prozac can help reduce obsessions and compulsions in individuals and improve symptoms of OCD (2,3,4).
What does research suggest?
SSRIs are effective in treating OCD and are considered the treatment of choice because they have better tolerability than other medications. SSRIs, including Prozac, have better efficacy for both short and long-term therapy. Research comparing SSRIs with clomipramine, a tricyclic anti-depressant, also used for OCD, has provided evidence of similar efficacy, but states that SSRIs show fewer side effects and better tolerance profile in individuals with OCD (5).
Another research study has also given the same results, with SSRIs proving to be more tolerable in patients with OCD when compared with other anti-depressant medications. In another study, patients were checked for their response to SSRIs and clomipramine for the treatment of OCD. A combination of both medications proved to be effective in patients who did not respond to SSRI monotherapy (6,7).
One clinical study assessed the efficacy of fluoxetine for OCD in children and adolescents. This study reported that 20mg to 60mg/day dosing of the medication was effective and well-tolerated in this population (8).
Another study also reported the safety and efficacy of fluoxetine in children and adolescents with OCD. This study found fluoxetine to be safe and effective for OCD, but the complete development of fluoxetine’s effect took more than 8 weeks (9).
Research of literature has established fluoxetine to be safe, effective and well-tolerated for the treatment of OCD in adults. Fluoxetine tends to reduce impulsiveness and suicidal ideation in OCD patients. Fluoxetine is found to have a good safety profile and any side effects experienced hardly led to discontinuation of the medication (10).
What is the dosage recommendation of Prozac for OCD?
In adults with OCD, the starting dose of Fluoxetine is 20mg/day, with the maximum recommended daily dosage of 80mg. In adolescents, a starting dose of 10mg/day is recommended. Most patients respond well to the given dosages (1).
Your healthcare provider may also prescribe you Prozac in these dosages if you do not have any other underlying condition which requires a change in dosing. Please keep in mind to use Prozac only on prescription, and do not make dose adjustments without consulting your doctor.
What are the side effects of Prozac when used for OCD?
The most common side effects reported by patients using Prozac include the following (2):
Not everyone taking Prozac will experience these side effects; but if they do occur, you should contact your healthcare provider.
What other treatment options are available for OCD?
If Prozac is not helping with your OCD, please consider reaching out to your healthcare provider. Your doctor may start another medicine with Prozac, or change the medication altogether. The FDA has approved many other medicines for OCD some of which include:
- Clomipramine-for adults, and children above 10 years
- Paroxetine-for adults only
- Sertraline-for adults, and children above 6 years
- Fluvoxamine-for adults, and children above 7 years
Your doctor may prescribe any of these medications, or may also prescribe medications like Citalopram (also known as Celexa), or Mirtazapine which are not FDA-approved for the treatment of OCD but still help manage its symptoms.
Conclusion
In this article, we have discussed the use of Prozac in the treatment of OCD. Prozac has been approved by the FDA as a first-line treatment for OCD, and many research studies prove its effectiveness. Prozac is generally used as monotherapy in individuals with OCD, but can also be used in adjunct with other medications to enhance its effect.
Keep in mind that your healthcare provider will prescribe the most appropriate medication based on your case evaluation and response.
Was this helpful?
References
1.-
The Food and Drug Administration (FDA). HIGHLIGHTS OF PRESCRIBING INFORMATION. PROZAC (fluoxetine capsules) for oral use. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/018936s108lbl.pdf
2.-
Sohel AJ, Shutter MC, Molla M. Fluoxetine. In: StatPearls. StatPearls Publishing, Treasure Island (FL); 2022. PMID: 29083803. https://europepmc.org/article/nbk/nbk459223
3.-
Dfarhud D, Malmir M, Khanahmadi M. Happiness & Health: The Biological Factors- Systematic Review Article. Iran J Public Health. 2014 Nov;43(11):1468-77. PMID: 26060713; PMCID: PMC4449495. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4449495/
4.-
Veale D, Roberts A. Obsessive-compulsive disorder. Bmj. 2014 Apr 7;348:g2183. https://www.bmj.com/content/348/bmj.g2183
5.-
Pigott TA, Seay SM. A review of the efficacy of selective serotonin reuptake inhibitors in obsessive-compulsive disorder. Journal of Clinical Psychiatry. 1999 Feb 15;60(2):101-6. https://www.psychiatrist.com/jcp/review-efficacy-selective-serotonin-reuptake-inhibitors/
6.-
Cartwright C, Hollander E. SSRIs in the treatment of obsessive-compulsive disorder. Depress Anxiety. 1998;8 Suppl 1:105-13. doi: 10.1002/(sici)1520-6394(1998)8:1+<105::aid-da16>3.0.co;2-t. PMID: 9809222. https://pubmed.ncbi.nlm.nih.gov/9809222/
7.-
Andrade C. Augmenting selective serotonin reuptake inhibitors with clomipramine in obsessive-compulsive disorder: benefits and risks. The Journal of clinical psychiatry. 2013 Dec 15;74(12):1707. https://www.psychiatrist.com/jcp/augmenting-selective-serotonin-reuptake-inhibitors/
8.-
Geller DA, Hoog SL, Heiligenstein JH, Ricardi RK, Tamura RO, Kluszynski S, Jacobson JG, Fluoxetine Pediatric OCD Study Team. Fluoxetine treatment for obsessive-compulsive disorder in children and adolescents: a placebo-controlled clinical trial. Journal of the American Academy of Child & Adolescent Psychiatry. 2001 Jul 1;40(7):773-9. https://www.sciencedirect.com/science/article/abs/pii/S0890856709603105
9.-
Liebowitz MR, Turner SM, Piacentini J, Beidel DC, Clarvit SR, Davies SO, Graae F, Jaffer M, Lin SH, Sallee FR, Schmidt AB. Fluoxetine in children and adolescents with OCD: a placebo-controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry. 2002 Dec 1;41(12):1431-8. https://www.sciencedirect.com/science/article/abs/pii/S0890856709607371
10.-
Etain B, Bonnet-Perrin E. Value of fluoxetine in obsessive-compulsive disorder in the adult: review of the literature. L’encephale. 2001 May 1;27(3):280-9. https://europepmc.org/article/med/11488259
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