How Prozac Is Used to Treat Bipolar Depression

How Prozac Is Used to Treat Bipolar Depression Bipolar Disorder Treatment Medications Print How Prozac (Fluoxetine) Is Used to Treat Bipolar Disorder By Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. Learn about our editorial policy Marcia Purse Medically reviewed by Medically reviewed by Steven Gans, MD on January 31, 2020 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on February 24, 2020 Bipolar Disorder Overview Symptoms & Diagnosis Causes Treatment Living With In Children Your Rights Jonathan Nourok Collection / The Image Bank / Getty Images In This Article Table of Contents Expand Use in Treating Anxiety Disorder Recommended Dosages Common Side Effects Drug Hypersensitivity Black Box Warning Withdrawal Symptoms View All Prozac (fluoxetine) is a type of antidepressant known as a  selective serotonin reuptake inhibitor (SSRI)  which is often used for the treatment of depression, bipolar disorder, and other mental illnesses. As useful as Prozac can be in treating these conditions, the drug may cause side effects ranging in severity from mild to life-threatening. Moreover, people who take Prozac may experience withdrawal symptoms if the treatment is not tapered off appropriately. Use in Treating Anxiety Disorder Prozac is commonly used to treat anxiety disorders, many of which can co-exist with bipolar disorder. These include generalized anxiety disorder (GAD), social anxiety disorder (SAD), panic disorder (PD), and post-traumatic stress disorder (PTSD) In fact, a 2015 review of studies published in EBioMedicine concluded that the lifetime risk of an anxiety disorder co-occurring with bipolar disorder was 42.7%. Within the context of bipolar disorder, Prozac is considered the only antidepressant with a formal indication in treating bipolar depression but only when used in combination with the antipsychotic drug Zyprexa (olanzapine). Antidepressants need to be used with caution in bipolar disorder, as there is some evidence that they can trigger mania and worsen cycling of the disorder. On the downside, the concomitant use of Prozac and Zyprexa also increases the risk of side effects. Recommended Dosages There is a fixed-dose combination drug called Symbyax  which combines Prozac and Zyprexa in a convenient capsule formulation. Approved for adults in 2009 and children in 2013, Symbyax is usually prescribed at a lower dose and gradually increased until the depression symptoms resolve. Ultimately, the aim of bipolar depression treatment is to alleviate symptoms at the lowest possible dose to reduce the risk of side effects. Common Side Effects Side effects are not uncommon when taking Prozac. Some are mild and transient and will often resolve as your body gradually adapts to the medication.   Side effects of Prozac may include: Abdominal cramps and bloatingAbnormal dreamsAnxietyConstipationDiarrheaDizziness or lightheadednessDrowsinessDry mouthSexual side effectsHeadachesIncreased sweatingInsomniaLoss of appetiteLow libidoNausea and vomitingTremorsWeakness Call your doctor if any of these side effects persist or worsen. Drug Hypersensitivity Some adverse reactions to Prozac may be serious and require emergency medical treatment. This is especially true if there are signs of a potentially life-threatening allergic response known as anaphylaxis. Call 911 or seek immediate emergency care if you experience some or all of the following symptoms: Rash or hivesFeverFacial swellingSwelling of the tongue and/or throatTrouble breathingDifficulty swallowingDisorientation and confusionNausea and vomitingRapid heart rateFaintingA feeling of impending doom If left untreated, anaphylaxis can lead to shock, coma, respiratory or heart failure, and death. Black Box Warning Prozac and other antidepressants have been found to potentially increase suicidal thoughts or actions in some children, teenagers, or young adults. This usually occurs within the first few months of starting treatment or when the dose is changed. Call your doctor immediately if you notice any sudden or severe changes in mood, behavior, thoughts, or feelings. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. Withdrawal Symptoms It is important to never stop taking Prozac without first speaking with your doctor and working out a dosage reduction plan. Stopping treatment abruptly can lead to a form of drug withdrawal known as SSRI discontinuation syndrome. While withdrawal is more common with shorter half-life antidepressants like Paxil (paroxetine) or Zoloft (sertraline), it can occasionally happen with the longer half-life Prozac, especially if you have been on treatment for a long time. SSRI withdrawal is rarely dangerous, but it can be extremely uncomfortable and distressing. Symptoms typically include: DizzinessExtreme anxietyFatigueHeadachesMalaiseNausea and vomitingProfuse sweatingVertigoHeadachesWeakness If the decision is made to stop Prozac, you would need to taper down slowly. Your doctor can provide specific instructions as well as the appropriate dosage pills.