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What is Prozac (Fluoxetine)?

Fluoxetine is sold under the brand name- Prozac. It is an antidepressant medication used to treat depressive symptoms and other mental health conditions such as obsessive-compulsive disorder, panic attack, eating disorder, and premenstrual dysphoric disorder.

Prozac works by improving severe symptoms of mental health disorders such as mood changes, alcohol dependence, abnormal eating behaviors, suicidal thoughts, and even delirium tremens (DTs). 

The rate of antidepressant use among teenagers and adults in the U.S. increased by as much as 400 percent between 1988 and 1994 and between 2005 and 2008. Statistics report estimates that one in every 10 Americans takes an antidepressant. They aren't taking only Prozac. Rather, they are also taking other antidepressants.8

How is Prozac Used?

Fluoxetine (Prozac) is one of the most recognizable SSRIs. SSRIs are selective serotonin reuptake inhibitors. These are drugs used to treat depression and other mental illness symptoms. They act to prevent serotonin (a neurotransmitter present in the gut and brain) reuptake. 

There is a significant connection between low serotonin levels and depression, obsessive-compulsive disorders, anxiety, and panic disorders, among others. Prozac prevents serotonin from moving back into the nerve endings (reuptake), thus boosting the chemical's level in the brain.

In 1987 the US Food and Drug Administration (FDA) approved Prozac for treating mental illness and co-occurring disorders.5 Other medications have also been approved as prescribed depressants. 

Prozac can be taken by children aged eight years or older as well as adults for treating severe depression and related mental health disorder symptoms like suicidal tendencies.

According to the National Health Service, UK (NHS), Prozac should be taken once every day, with or without food. It is okay to take Prozac at any time of the day. However, it would be best to stick with a particular time of the day.4

If you mistakenly skip a dose of fluoxetine, don't worry. Go ahead and take the next dose at the usual time the following day (never take two doses at a time). 

Your doctor will tell you the right dose to take. However, the usual dose is typically 20mg daily for adults. Your doctor might suggest you start with a lower dose and then increase it gradually to a maximum of 60mg a day.

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Side Effects & Risks of Prozac 

Even if you experience signs and symptoms of mental illness, it is wrong for you to self-medicate. Even prescribed antidepressants like Prozac have side effects. 

Also, some individuals undergo harmful interactions with drugs they are using for treatment. So it is better to seek professional medical advice before taking any medication.

Common side effects of Prozac

Below are some common side effects you might experience when you start taking Prozac. Some of these side effects will improve gradually as your body starts getting used to the medication:

  • Difficulty sleeping
  • Nausea
  • Constipation
  • Nervousness
  • Heart palpitations
  • Weight changes
  • Diarrhea
  • Loss of appetite
  • Headache
  • Feeling of tiredness

Other more severe side effects of Prozac include:

  • Severe dizziness
  • Chest pain or shortness of breath
  • Nosebleeds that won’t stop within 10 minutes
  • Painful erections
  • Allergic reactions

Is it Safe to Drink Alcohol While Taking Prozac?

It is not safe to drink alcohol while taking Prozac as this may cause harmful effects, e.g., it may increase the adverse effects of Prozac. You should avoid alcohol when taking antidepressants. Also, consuming alcohol and Prozac may reduce the benefits of taking the antidepressant medication.6 

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What Happens to Your Body When You Take Prozac and Drink Alcohol?

When you take Prozac and drink alcohol, you might experience the following side effects:

  • Feeling of hopelessness
  • Fatigue and weakness
  • Dizziness
  • Impaired motor skills
  • Blurred vision
  • Suicidal thoughts
  • Agitation
  • Increased risk of Prozac overdose

Continuous use of Prozac and alcohol can cause long-term adverse effects such as:

  • Liver or kidney issues
  • Heart damage
  • Blood sugar problem

Dangers of Mixing Prozac and Alcohol

Combining alcohol and Prozac is dangerous. Combining the two substances can cause extreme drowsiness and fatigue, which can, in turn, predispose to other potentially dangerous situations.

The potentially dangerous situations might include a high risk of falls and injuries, impaired driving, and poor decision-making. 

When you mix alcohol and Prozac medication, it will affect your motor skills, coordination, concentration, and judgment more than alcohol alone. 

It is not only the combination of alcohol and Prozac that works this way; many antidepressants will have similar effects when combined with alcohol. For instance, taking alcohol with other antidepressants such as MAOIs can cause a drastic increase in blood pressure and can cause a stroke.

How Does Alcohol Affect Depression?

Alcoholism and depression usually co-occur, and one can make the other worse. When you are in a state of depression, you might be tempted to take a few glasses of wine or bottles of beer. This might seem to relax you and relieve you of anxiety. However, you must know that there is a strong link between excessive alcohol consumption and depression. 

Most people with depression also have alcohol issues, and in most cases, depression comes first.2 Alcohol intake will only make depression worse. People who are depressed and resort to drinking are at risk of having a major depressive episode. This increases suicidal thoughts.  

Alcohol might have a short-term positive effect on mood, but it can cause mental health problems in the long run. Alcohol consumption has been linked to mental health issues such as depression and memory loss.1

This means mixing alcohol and Prozac can increase the risk of anxiety, depression, and suicidal tendencies. These are the same symptoms that Prozac is supposed to treat.

Is Any Amount of Alcohol Safe to Drink on Antidepressants?

It is safer to avoid drinking alcohol when you are on antidepressants like Prozac medication to avoid making your depression worse and increasing the risk of side effects.

If you must drink alcohol when taking Prozac, drink only small amounts and pay attention to how you feel.7 Don’t stop taking your antidepressant just because you want to drink alcohol to avoid withdrawal effects like seizures.3

Whether you should take some amounts of alcohol or not would depend on the type of antidepressant you are taking. For instance, if you are taking Monoamine-oxidase inhibitors (MAOIs), it would be best to avoid drinking alcohol completely. While taking alcohol and other antidepressants like SSRIs and TCAs (tricyclic antidepressants) may not cause as much harm as MAOIs.

However, manufacturers generally advise against drinking alcohol while taking any antidepressant. 

What Else to Avoid While Taking Antidepressants 

Asides from alcohol intake, there are other things you might have to avoid when taking antidepressants. Doing any of these things could predispose you to danger, worsen your symptoms or increase the side effects of the medication. Note that there are other substances that can interact with your medication.

Here are some of the things you should avoid while taking antidepressants:

  • Avoid taking other medicines that can interact with your antidepressant medication e.g
  • Avoid taking two antidepressants at a time unless advised by your doctor
  • Avoid taking herbal remedies (e.g., St John’s Wort) while taking a prescribed antidepressant
  • Avoid the use of illegal drugs if you are taking antidepressants
  • Do not drive or operate certain machinery while taking antidepressants as the medication can cause drowsiness, dizziness, and blurred vision

Treatment for Alcohol Misuse & Addiction

Most people that are addicted to alcohol find it difficult to stop even when it hurts them and makes them feel more depressed and anxious. Symptoms of alcohol misuse and addiction include:

  • Always drinking much and longer than you plan to
  • Increased frequency of alcohol use
  • Wanting alcohol so bad that it affects your thinking
  • Increased depression, lethargy, anxiety, or other emotional issues
  • Having professional and legal problems associated with your drinking habit
  • Avoiding contact with loved ones and having relationship issues because of your drinking habit
  • Drinking at inappropriate times
  • High dependence on alcohol

Treatment options

Treatment options for alcohol addiction include:

  1. Going to rehab. For someone showing symptoms of alcohol addiction, a common initial option for seeking addiction treatment is going for a rehabilitation program. A rehab program could be inpatient or outpatient, full hospital admission and partial admission, respectively. Both provide you with the support needed to recover and handle alcohol withdrawal symptoms.
  2. Use of medications and behavioral therapies. Some medications help patients quit drinking and can help treat their withdrawal symptoms (your doctor will prescribe one for you). Also, behavioral therapies like cognitive behavioral therapy (CBT), counseling, family therapy, and motivational enhancement therapy are always helpful when treating alcohol addiction.
  3. Support programs. Some alcohol addicts use 12-step programs like Alcoholics Anonymous (AA) to treat alcoholism. AA is an internationally recognized mutual aid group that focuses on helping alcoholics achieve sobriety.

Other support groups. There are other addiction support groups that don’t follow a 12-step program model like the AA that you can join. These communities will help you deal with the challenges of quitting alcohol and make your recovery journey easier.

Resources

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(1) “Alcohol and mental health.” Drinkaware.

(2) Boden, Joseph M, and David, M Fergusson. “Alcohol and Depression.” Addiction (Abingdon, England) vol. 106,5 (2011): 906-4. DOI: 10.1111/j.1360-0443.2010.03351.x.

(3) “Can I Drink Alcohol If I’m Taking Antidepressants?National Health Service, NHS, 2 April 2019. 

(4) "Fluoxetine (including Prozac)." National Health Service, NHS, 10 December 2018.

(5) “FDA Approved Drug Products.” US Food and Drug Administration. 

(6) “Fluoxetine (Prozac).” National Alliance on Mental Illness, Dec. 2020.

(7) Ponen, Sandra. “Fluoxetine.” Health navigator, New Zealand, 22 March 2021.(8) Wehrwein, Peter. “Astounding Increase In Antidepressant Use By Americans.” Harvard Health Publishing, 20 October 2011.

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