Is Prozac(Fluoxetine) good for social anxiety?

Prozac, the trade name for Fluoxetine, is an antidepressant included in the class of selective serotonin reuptake inhibitors (SSRIs). FDA approved the use of Prozac in the treatment of bulimia nervosa, obsessive compulsive disorder, depression and panic disorders. Recent medical studies reported that this drug also is beneficial for patients suffering from social anxiety.

Other SSRIs used for treating social anxiety:

  • Zoloft (Sertraline)
  • Luvox (Fluvoxamine)
  • Paxil (Paroxetine)
  • Celexa (Citalopram)
  • Lexapro (Escitalopram Oxalate)

Things to know about Prozac

  1. How does Prozac work?

The nerve cells release the neurotransmitter serotonin in the brain. It is thought that the level of this chemical is responsible for:

  • mood balance
  • appetite
  • sex drive
  • sleep
  • social conduct

A lower amount of serotonin leads to symptoms of anxiety and depression. Here steps in Prozac, which role is to prevent this situation by keeping serotonin from being absorbed again in the brain.

  1. Reasons to prescribe Prozac

Doctors go for prescribing Prozac off-label in the treatment of social anxiety because:

  • is relatively safe in overdose
  • does not cause significant weight gain
  • produces moderate withdrawal symptoms
  • missing dose does not lead to serious problems
  • has low risk to develop suicidal thoughts
  • does not affect insulin action in patients with type 2 diabetes
  • is well tolerated in most cases

Prozac is available in capsules and oral solution that in general should be administered in the morning to prevent sleep dysfunction. Patients, who deal with stomach discomfort, need to take the medication with food.

  1. Common side effects of Prozac
  • insomnia
  • impotence
  • decreased libido
  • excessive sweating
  • fatigue
  • tremor
  • crisis of anger
  • dry mouth
  • vomiting, diarrhea
  • loss of appetite
  1. Possible risks related to using Prozac
  • development of tics that persist a long time after ceasing the treatment

There are reports about several types of tics induced by Prozac such as: darting motions of the tongue, lip pursing, grimacing, and lip smacking.

  • occurrence of different forms of sexual dysfunctions
  • muscle spasms and severe agitation have been noticed in about 10 percent of patients
  • low quality of sleep
  • slow onset of action

It takes between 4 and 6 weeks until the results of the therapy become visible, so that Prozac is not an appropriate solution for patients who require quick antidepressant help.

  • increased violent tendencies

The case of the press operator from Louisville, who killed 8 people and hurt another 12 with an AK-47 in 1989, a few weeks later after he started to take Prozac is often mentioned when it comes to talking about possible risks associated with Prozac.

  • Prozac has a long wash out period

The human body eliminates Prozac at a very slow pace and for the time being, there are no methods that could speed up this process. It takes weeks before the patient is allowed to switch to another antidepressant.

  • stressful gastrointestinal discomfort
  • negative impact on keeping the control of blood glucose in diabetics
  • inability to stand still

The need to move all the time might appear within the first weeks of treatment. You have to inform your doctor about this right away.

  • low level of sodium in the blood

This condition is likely to occur in elderly people and causes confusion, muscle spasms, drowsy feeling, and convulsions.

  1. Evidence of Prozac efficacy in social phobia

There is a medical study published in the Archives of General Psychiatry by the psychiatrist and behavioral researcher Jonathan R.T. Davidson, who studied the effect of Prozac along the length of 14 weeks of treatment in 295 patients diagnosed with social anxiety.

The results showed that more than half of the patients, who received Prozac, felt much improvement in controlling the symptoms of anxiety. Moreover, the study revealed that when Prozac is combined with cognitive behavioral therapy, the improvement is even better.

  1. Conclusion

People, who take Prozac to relieve their anxiety symptoms, claim that their ability of learning is considerably improved, they feel more self-confident and less shy, and acquire social skills much easily.

The doctors’ point of view is that patients need to be educated that the risks of using this drug cannot be ignored. A long term treatment with Prozac is not a cost-free decision. In addition, there are reports about situations when once the patient stopped taking his medication, the social anxiety returned forcefully.

The best approach is to aim the roots of the disorder and go for a combination between Prozac, psychotherapy, herbal remedies, workouts, and a balanced diet.