IRFANA PARVEEN
By Irfana Parveen

B.Sc (Psychiatry Ward)

01 December 2021
Medically reviewed by
Kajal Jain
M. Pharm
Efficacy and Safety of Prozac in the Treatment of Bipolar Disorder
Table of Contents

Bipolar is a mental health illness that causes extreme mood changes to emotional distress, manic episodes and low moods like depression. These are the main two involved in bipolar; the study showed the results of 50%.

People have undergone at least three depression episodes before mania; you might see people with high energy levels, over-talkative and self-importance, and they quickly get distracted. In the US, an estimated population of 4.4% of adults are experiencing bipolar disorder in their lives. 

Prozac is considered an effective drug to treat bipolar disorder; let us see about more in detail given below, 

What is Prozac?

Prozac is a medication used to treat mental health problems such as anxiety, depression, and panic disorders. But before taking Prozac for bipolar disorder, it eliminates the chance of risk and negative consequences. 

Prozac is widely used as an antidepressant. It can also be used for treating bipolar disorder along with Olanzapine. Prozac is a medication for bipolar disorder and has provided better results. 

The effects may vary from person to person depending upon the medical history, condition, and response to the treatment.

Thus, it is necessary to consult a medical practitioner before taking Prozac. It is also used for treating bipolar disorder in combination with Olanzapine. 

How Does Prozac Work?

Prozac belongs to an SSRI group of drugs, which works by preventing the reabsorption of natural substances in the brain called serotonin. Usually, serotonin works in the regulation of mood.

Prozac works in the brain to help to maintain a sufficient amount of serotonin, so it will be helpful in the positive feeling of well-being, improving communication between your brain cells.

Though your doctor will prescribe this drug to treat symptoms of mood-related disorders like anxiety, an antidepressant medication like Prozac will be adequate to treat mental health illnesses like depression with anxiety.  

Study To Check The Efficacy Of Prozac For Bipolar disorder:

Jay D Amsterdam and Justine Shults conducted a study to compare the efficacy of Prozac (Fluoxetine monotherapy) and Lithium therapy on people suffering from Bipolar disorder II.

The study was conducted on people recovering from a major depressive episode and was medicated with 10-40 mg Prozac, 300-1200 mg Lithium, and Placebo daily for 50 weeks. This procedure aimed to measure the time to relapse and frequency of hypomanic symptoms.

The number of people assigned Prozac, Lithium, and Placebo was 28,26 and 27, respectively. 
After conducting the study, it was observed that the meantime of relapse for the medications was as follows:

  • Prozac/ Fluoxetine: 249.9 days
  • Lithium: 156.4 days
  • Placebo: 186.9 days.

Also, the hazard of relapse due to Lithium was about 2.5 times greater than that of Prozac. 
Thus, the result of the study showed that long-term Prozac monotherapy could be beneficial and provide better relapse prevention than other lithium monotherapy after bipolar disorder.

While taking Prozac, you may feel more relaxed and less anxious, feel fewer symptoms, sleep well, and maintain regular energy. If you are taking Prozac, consult about how long it will take and work in your system.
Avoid drinking alcohol because it contains antidepressant properties. Combining it with alcohol will lead to a decrease in your drug working state and develop adverse reactions.
The negative effect is drowsiness, Anxiety, insomnia, headache, sexual problem, and risk of bleeding etc.

Dosage Of Prozac For Bipolar Disorder:

Prozac is used to treat bipolar disorder in combination with Olanzapine.

For adult dosage

  • The initial dose of Prozac can be 25 mg daily with 6 mg of Olanzapine.
  • The maximum daily dose can be increased up to 50 mg with 12 mg Olanzapine depending upon the treatment's response and efficacy.
  • The maintenance dose can range from 25-50 mg with 3-12 mg of Olanzapine. 

For pediatric dosage

  • The initial dose of Prozac can be 25 mg per day with 3 mg of Olanzapine.
  • The maintenance and maximum amount are similar for children and adults. 

Side Effects Of Prozac For Bipolar Disorder:

Following are the common side effects associated with the medication of Prozac for Bipolar disorder

Common Side Effects Severe Side Effects
Dry mouth Agitation
Dizziness Irregular heartbeats
Weakness Hallucinations
Flu symptoms Severe weakness
Loss of sexual interest Suicidal thoughts

Some severe side effects can happen after the medication of Prozac that may require emergency medical assistance or even termination of drugs

Who should not take Prozac?      

Before consuming the drug, Prozac informs your doctor if you are allergic to any other medicines because it may cause some allergic reactions due to the presence of inactive ingredients leading to serious side effects.

Consult your doctor before taking medication if you have any history of health issues like liver problems, heart problems, mental illness or seizure attacks.

Pregnancy

People planning or being pregnant should avoid taking drugs like antidepressants. It may be linked to an increased risk of neonatal malfunction syndrome. 

Breastfeeding

You should not take Prozac while breastfeeding your baby; it will pass into the milk and have a high risk of developing side effects for both the mother and neonate. Before taking the drug, consult your doctor. 

Drug interaction

Drugs can interact with one or two medications, including over-the-counter products, Herbal supplements, and vitamins. Inform your doctor about all the medicines you currently use before taking Prozac.

Ask your doctor before taking the drug, such as, 

  • Avoid taking MAO inhibitors (MAOIs) with Prozac; it can lead to side effects like changes in blood pressure, heart rate, confusion, and tiredness. 
  • Thioridazine leads to increased heart rate.
  • Avoiding taking Pimozide leads to heart rhythm while taking Prozac.

Avoid taking the drug with other medications, such as,  

  • Antidepressant drugs
  • CNS depressant drugs like opioids and benzodiazepines.
  • warfarin
  • aspirin 
  • NSAIDs drugs. 

Bottom Line From Practical Anxiety Solutions     

Bipolar disorder is a widespread mental illness that should need medical attention immediately; it is considered two episodes of manic and depression; people will continue ongoing both in different periods; the drug Prozac will be effective in treating bipolar disorder.

It belongs to the antidepressant medication. It has the properties of reabsorbing the natural substance and allowing you to feel calm and relaxed.

Before taking medicine, consult your doctor about any other medications you currently use; inform your doctor about your health history. To avoid prior side effects. 

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