PROZAC
Prozac, a member of the family of drugs called
“selective serotonin re-uptake inhibitors”
and is prescribed when depressive illness interferes
with daily functioning. Drugs in this class slow
the dissipation of serotonin, which is the body’s
medium for transmission of signals between nerves
in the brain. This effectively increases the bio-availability
of serotonin to the brain. This brings relief from
symptoms as serotonin levels are believed to govern
our state of well-being. Patients talk of relief
from prolonged sadness, overwhelming feelings of
hopelessness, difficulties with concentration and
thoughts of death and suicide that often plague
those who suffer from depression.
Prozac is now used in the treatment of a wide range
of depressive illnesses. Other symptoms associated
with depression include loss of sleep, loss of appetite,
some motor function disabilities, loss of sex drive,
apathy, feelings of guilt and worthlessness, loss
of concentration, impaired mental functioning and
suicidal thoughts.
There is no definitive way of identifying mental
disorders, but they can be divided into the three
loose, overlapping categories of emotional, personality
and thought disorders.
Emotional
The most prevalent category, broadly defined as
emotional disorders, is characterized by depression
and anxiety and afflicts many millions of Americans
each year. Mental symptoms of depression include
persistent feelings of sadness, fear, pessimism,
worthlessness, hopelessness and suicidal despair.
Physiological symptoms can include sleep disorders,
digestive disorders, increased or decreased appetite,
and skin disorders. Anxiety disorders alone affect
over 10 million people annually (U.S.A.) and the
symptoms can range from a sense of unease to disabling
panic attacks. Physiological manifestations can
include chest tightness, hyperventilation, heart
arrhythmia, digestive disorders and isolation and
reclussiveness.
Personality Disorders
Personality disorders are expressed in many ways,
but usually include an inability to interact with
others in a variety of settings. Feelings of paranoia
prevent sufferers from relating socially, while
narcissistic people tend to have troubled relationships
because of self-centered behavior. Antisocial people
find it difficult to adhere to rules and follow
appropriate patterns of behavior when relating to
others. Sufferers can also be over-dependent, compulsive,
aggressive, and highly insecure, making relationships
difficult. Many people addicted to drugs, alcohol
or gambling are also considered to be suffering
from personality disorders and often benefit from
treatment with Prozac.
Thought Disorders
Again, these have wide-ranging symptoms that can
include manic and depressive behaviors, schizophrenia,
dementia, learning problems, behavioral difficulties,
and delusional thinking.
Causes of Mental Disorder
It was long thought that the sole cause of depression
was psychological in nature and was more prevalent
in those genetically predisposed. Current research,
however, suggests that many other factors can be
a precursor to the onset of many of these depressive
symptoms. These include nutritional deficiencies,
allergies, food sensitivities, dependence on drugs
and alcohol, ageing, untenable social situations
coupled with poor conflict resolution skills, and
biochemical imbalances. Illness is another precursor
that has been statistically established as a cause
of depression, along with physical and emotional
stress. Recent research has suggested that environmental
stressors from chemicals, toxins and even living
in proximity to electromagnetic (prevalent under
power lines) fields can contribute.
Additional Therapies
It has been established that dietary deficiencies
can lead to depression; it therefore follows that
nutrition can play a role in the restoration of
good mental health. Virtually any nutritional deficiency
can lead to depression, but a lack of B vitamins,
vitamin C and folic acid, has been linked to mental
illness. Simple deficiencies in the trace element
lithium, was identified as statistically prevalent
in Texas prison populations.
Diet and Nutrition
Dietary considerations for good mental health are
as much about what you don’t eat as what you
do eat. You should certainly avoid or limit intake
of alcohol, and avoid excessive consumption of cheese,
yeast, and as much as possible, preserved and refined
junk foods. Also limit sugary foods and caffeine
and try and identify foods that trigger bouts of
depression. For example, recent research in England
has established a strong statistical causal link
between excessive consumption of aspartame, the
sugar substitute used in diet foods, and depression.
Conversely, well-being is helped by good nutrition
You should try and make vegetable protein 15 to
25 percent of your total caloric intake and include
fish and other foods with plenty of fatty acids
in your diet. Also try and drink at least one half
gallon of water per day and never overeat or binge.
Avoid foods grown with pesticides or processed with
additives whenever possible. Include as many fresh
whole foods in your diet as possible. Try and eat
foods rich in magnesium, calcium and B vitamins
every day.
Exercise
As one researcher said recently, a moderate exercise
program helps almost any condition, and that includes
depression. However the emphasis here is on moderate.
Excessive exercise can have a deleterious effect
on your well-being and it will not necessarily improve
your overall health or mental state. If you are
a type A personality, do not “attack”
exercise as though it is an enemy to be beaten.
Repetitive, low impact activities, such as walking
or light workout routines will improve your cardiovascular
health and sense of well-being.
Indications and Dosages
Depression and Obsessive Compulsive Disorder
Adults: Commence with 20mg taken orally in the
morning and increase dosage as necessary up to a
maximum of 80mg
Children: Commence oral dosage for children 7 to
17 at 10 mg per day and increase if necessary to
20 mg after two weeks. Maximum daily dosage is 60
mg. For children 8 to 18 suffering from depression,
10 mg per day for 7 days increasing to 20 mg daily
if necessary.
Depression in Elderly Patients
For adults age 65 and over, an initial dosage taken
orally each morning of 20 mg is recommended. Dosage
may be increased if necessary, up to a maximum of
80 mg, but caution should, and dosages reduced,
for those with systemic illness or those receiving
multiple drug therapies.
Bulimia Nervosa Treatment Short Term and Long Term
Oral dosage each morning of 60 mg is recommended.
Adult Panic Disorder or Agoraphobia
An oral daily dosage of 10 mg for one week is recommended,
increasing if needed to 20 mg daily, with the maximum
dosage being 60 mg per day.
Bipolar Disorder Depression
Adult: Start with a 20 mg oral dosage each morning
and increase to 60 mg per day if necessary.
Important Note: For those on multiple drug therapies
or patients with renal or hepatic impairment, it
may be necessary to reduce dosages or increase dosing
intervals.
Contraindications and Cautions
Contraindicated for patients with sensitivity to
this drug and for those taking monoamine oxidase
(MAO inhibitors) within 14 days of starting Prozac
therapy. Caution should be exercised by patients
in the high-risk category for suicide and those
with a history of diabetes mellitus, renal disease,
hepatic or renal disease, mania or seizures.
Patient Advice
Wherever possible you should avoid taking Prozac
(fluoxetine hydrochloride) in the afternoon wherever
possible, because fluoxetine can cause nervousness
and insomnia. Prozac may also impair psychomotor
coordination, so activities requiring these skills,
such as driving and operating machinery, should
be avoided until the personal effects of this drug
are known.
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Allergies
