Recently, I began taking a new prescription for my depression, Prozac (or fluoxetine), and I was wondering what other peoples opinions were on such medication (mood altering). For a long time, I have always believed that these types of drugs may have some negative effects on a person's health over a long period of time. I do realize that Prozac is FDA approved for adolescents, however this still doesn't make me feel that it is completely safe for me. I feel as if any medication that alters your state of mind may have some sort of unwanted effects in the long run. Another one of my concerns pertains to the fact that I don't feel like the same person I was before I had started taking the medication; not so much in a negative but more so in a way that feels foreign to me. I presume these feelings come from my unfamiliarity with feeling more positive as opposed to constantly depressed. Does anyone have any information that might put my mind at ease? I might just be feeling a bit paranoid. Thank you for your time.
Hi Let us be clear with one thing first, ALL DRUGS have the potential to cause negative effects on a person’s health. It doesn’t even need to be taken for a long period of time. Even something as common as an OTC Paracetamol can cause adverse effects to persons with sensitivity to it. Now regarding your concerns on taking Prozac (Fluoxetine), YES just like any other medication Prozac does come with its own unique set of potential side effects and adverse effects. However, taken just as how the doctor prescribed it then these side effects are usually temporary, that is these side effects will usually last for about a month or three at most. Since you are male one of the most noticeable side effects of Antidepressants is Anorgasmia, which is the inability to reach or experience orgasm. Again I reiterate that this is a temporary side effect and that you will eventually be able to return to normative sexual functions. Psychotropic medications by essence alters the levels of neurotransmitters present in the brain. In this case Prozac or Fluoxetine alters the levels of Serotonin. One thing we can note here is the long term use of Antidepressants creates a sort of dependence, because the medication creates a sort of “artificial” elevation in the neurotransmitter Serotonin. Abrupt withdrawal or reduction in dosage will cause a sudden deficiency in the neurotransmitter levels which will have various psychological and physical aide effects we term SSRI Discontinuation Syndrome. Again the important concept here is that this is again temporary and is usually immediately reversible with administration of the drug. And preventable by gradual tapering of the dosage. However, it can be noted that long term users of Antidepressants have higher levels of (Depression) relapse whence medication is discontinued. Other notable side effects or adverse effects noted in the long term use of Antidepressants is (1) Medication induced Bipolar Disorder. Bipolar Disorder just like Major Depressive Disorder is a Mood Disorder. The actual difference is wherein in Bipolar Disorder there are episodes of Mania where there is actual elevation of neurotransmitters, such as Dopamine. In some cases the use of Antidepressants causes an offshoot wherein instead of just elevating the neurotransmitters, and hence Mood from Depressive to Euthymic (normal mood), it elevates it to Mania. Another important issue concerning the long term use of Antidepressants, is the higher risk of Suicide on persons below the age of 25yo. It is not clear as to the relationship between the use of Antidepressants and Suicide Risk. And there are actual criticisms as to this claim, as some studies claim the contrary that Antidepressants help decrease suicidal ideations. However, Antidepressants such as Prozac or Fluoxetine carry a black box warning for Increased Suicide Risk. You are pretty smart at noting that yes the reason you don’t feel “the same” is because the general feeling of negativity is somewhat diminished. Having had Depression for so long (if I may presume) has created a sort of comfort zone for you. Your brain is subconsciously saying “this is what I’m used to, this is what is safe.” This new feeling, this foreign concept of positivity creates apprehension, fear of the unknown. How do I basically tread these new waters? This feeling of apprehension is generally shared by those new at taking psychotropic medications. The feeling of Positivity in Major Depressive Disorder, the feeling of Euthymic, being grounded and calm in Bipolar Disorder, the Feeling of blunt in Schizophrenics. Sometimes this new feeling proves to be too unfamiliar that some resort to discontinuing their medications, common in Bipolar Disorder Type II patients who miss the “rush, elation and hyper-functioning” of hypomania. True side effects and adverse effects can be scary, the mere thought makes you want to take a step back. However, I pose you this question--- Do you prefer taking a pill, having some side effect but ultimately living a normal life? Or don’t take a pill, suffer through your condition and all issues which come with it and have your family watch you be miserable. Because basically that’s how it’s going to play out. Ultimately I do hope you get better. ---------- Post added 15th Oct 2015 at 06:54 PM ---------- I had forgot to state that the above mentioned potential side effects and adverse effects have been observed on SOME, but not all long term users of Antidepressants. Please allay your fears that the above mentioned will happen to you. Just remember to follow your doctor's instructions as to your medications. Report any possible side effect or any deviation from the norm so as he or she can help you get the best out of your treatment.
Sigh. OK, once again, I think we need to take a step back and instead of getting a dissertation straight out of the Physician's Desk Reference, talk in sensible and practical terms that are actually helpful to the OP. First (OP), one of the questions to ask yourself is what's going on that caused the drug to be prescribed in the first place. Prozac, like all SSRIs, is not a magic bullet. What it does, when it works, is to basically take the edge off of of the lows. It won't make you not depressed, but it will help you if the depression is really insurmountable. The studies looking at its effectiveness show it is questionable at best... it's only about 20% better than placebo (sugar pills). The other major issue is that (at least in the US and UK), antidepressants are grossly overprescribed, and the psychiatrists who prescribe them, at least in the US, are rarely given enough time to do a really thorough intake and determine if psychotropic medication is appropriate. Often it's a 15 or 20 minute appointment (even less if you're prescribed by your general practitioner) which is enough time for a very basic overview and to write a prescription. Not really a good way to start. So it would help to know how you ended up on them. If you've been seeing a psychotherapist for a while, tried other options to deal with the depression, and it hasn't worked, and the psychotherapist referred you... or if you are so depressed that you simply have real difficulty functioning at all... then it's sensible to consider trying an SSRI. If, on the other hand, you mentioned to your general practitioner that you're feeling a bit down and s/he prescribed Prozac... then you might want to think more carefully. Prozac was never tested on teens, and when it first came out, there were a lot of issues with it actually causing mood swings in some people that could actually make people more depressed. And at best, its value is limited. But for some people it can be beneficial. That said, the overwhelming majority of teens that are prescribed an SSRI antidepressant probably don't actually need it, according to a number of studies, so your concerns are well placed. This isn't something that anyone at EC, with or without a professional credential, can tell you what to do or what not to do. What I can tell you is that Prozac does have a pretty severe impact on a very delicate neurotransmitter system, and the best clinicians generally don't recommend using any psychtropic drugs with teens unless other options (CBT or other psychotherapy) have been ineffective, or unless the depression is so severe that the person literally cannot function. If you don't fall into one of those categories, then... if it were me... I'd seek out a good psychotherapist and start there first, as there's no harm in trying the less invasive methods of dealing with the issue first. Less side effects, less long term effects, and a chance to learn about yourself and your own feelings and experiences and how they've affected you.
Wouldn't it be more prudent to assume that the perception of usefullness be made by the actual OP rather than another commentator who is basically doing the same thing and that is giving his own opinion on a matter. Our insight and advice is for a large matter influenced by our own expertise and training. One may be more adept at psychotherapy and psychology in general, while the other more adept at neuro-psychiatry and medications. Does it necessarily make the other's approach less valid or of less value than the other? I for one do not discount the validity of another commentator's insight or manner of answering a question just because it is a different approach from my own. Unless that is if one wants to blatantly display bias towards his own opinion.
Dude, EC is not a training ground for you to practice what you have learnt. And the way you write reflects as if that's exactly what your doing. If it's not what your doing, then your doing a horrible job of trying to help people by connecting with them. Good bedside manors is a useful practice, as a doctor, therapist or almost any given profession. Instead of helping, your actually creating distractions. If you really want to help, try and change your approach to be more thoughtful and sensitive to the specific topic at hand.
