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Prozac Withdrawal Symptoms

prozac withdrawal symptomsProzac withdrawal should be done slowly, not all at once due to the overwhelming reactions that may ensue. Prozac or fluoxetine has a relatively long half-life, and this may allow for easier withdrawal than other antidepressants with a shorter half-life. However, each person has a unique health profile, and reactions differ from person to person.3,19 Prozac addiction or abuse has been reported as a small but growing concern in the medical literature.8 However, dependence is much more frequently observed, resulting in adverse withdrawal effects. A 2017 review of prescriptions in Germany found SSRIs to be the most commonly prescribed psychiatric drug across the country.10 And, a study out of Denmark showed that the majority of medical advice hotline calls had to do with questions relating to antidepressant withdrawal symptoms.11

Some persons will experience mild symptoms, while others may find the withdrawals compare to or surpass the level of discomfort associated with coming off benzodiazepines, according to a massive review of medical literature by Offidani and associates, published in the 2013 Journal of Psychotherapy and Psychosomatics.12 A set of 53 withdrawal symptoms associated with antidepressant withdrawal was compiled by Black et al, published in the 2000 Journal of Psychiatry and Neuroscience.13 The most common Prozac withdrawals are listed below. Always seek medical oversight for Prozac withdrawal for your health and safety.

Common symptoms of Prozac withdrawal include:
  • Insomnia, vivid dreams or nightmares, disturbed sleep 10,13
  • Imbalance, unsteady gait, vertigo, dizziness, lightheadedness 13,28
  • Nausea, vomiting 7,10,28,29
  • Brain zaps (electrical jolts through the head) associated with bilateral eye movement 13,20,21
  • Hyperarousal, anxiety, aggression, irritability, restlessness 7,13,14,29
  • Flu-like symptoms, sweating, lethargy, fatigue, myalgia, headache 7,10,13,29
  • Visual or audio hallucinations 13,18,28
  • Burning, tingling, prickling sensations 13,20,21
  • Akathisia, jerking motions, psycho-motor disturbances 14,30

Despite overwhelming evidence and even FDA black-box warnings, Prozac withdrawal symptoms tend to get blamed on the patient rather than the drug itself.

Prozac can have extraordinary side effects and debilitating withdrawal characteristics for certain persons. Disturbingly, these patients tend to get disregarded and minimized for their very real suffering.

Do Your Symptoms Require Prozac?

successful prozac withdrawal
Alternative to Meds Center been tackling antidepressant withdrawal for over 17 years. We have published evidence regarding our success. Our staff, including licensed professionals and founding members, have overcome similar struggles, which is why we do this work. After working with over 20,000 cases, we have found that each person needs a unique combination of support. Some people are neurotoxic in a way that debilitates neurochemical balance, some require lifestyle modification including diet changes, exercise, and supplementation, and some people have genetic polymorphisms or even medical conditions that can be identified and improved.
Watch this video of a woman who came to Alternative to Meds in a truly disabled state. She was on benzodiazepines and antidepressants and was still highly anxious and highly depressed. She was unable to work and barely able to walk. After completing the program, she was off both medications, was able to walk 1½ hours a day, and has since regained her profession of being a professional counselor.

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About Prozac

antidepressant drugsAccording to recent statistics, Prozac is once again poised among the top three most prescribed antidepressant drugs in the world. Statista reported 24,961,000 Prozac prescriptions were written in the US alone in 2011-2012.1 Despite sagging sales pre-pandemic, the numbers have again spiked for antidepressants and other pharmaceutical drugs at an astounding 34% rise according to 2020 statistics.26 Prozac is an antidepressant drug in the class called selective serotonin reuptake inhibitors or SSRIs. Prozac affects certain natural chemicals that are designed to regulate brain function, the digestive system, hormone activation or suppression, body temperature, mood and emotional response, and a million other components of the human body. A theory was launched that depressed persons have a deficiency in serotonin and a new era of drugs was born to respond to this condition. However, the “serotonin theory” has been subject to debate,15,16,17 despite the successful marketing of SSRI drugs, capturing billions of dollars each year for the ongoing sales campaign.

In 2018 the National Center for Health Statistics reported that 48% of all US citizens took at least one prescription drug in the previous 30 days and that the third most prescribed drug was antidepressant medication.4 Just as alarming, teen suicides have also risen by 50% in the last decade.27 Many such antidepressants were originally approved only after short-term studies that did not include long-term efficacy or safety. According to a comprehensive review of clinical data by Danborg et al, the benefits of SSRI use have been exaggerated by short-term trials, and the harms of long-term SSRIs have been underestimated and are largely unknown. All authors in the review concluded there were no documented long-term beneficial outcomes after long-term use of SSRIs.16

SSRIs are prescribed to children 8 and older and adults for major depressive disorder, for children age 7 and older, and adults diagnosed with obsessive-compulsive disorder, and panic disorder in the adult population.7 With surprising clarity, the DSM-5 clearly delineates the critical importance of assessment in carefully selecting persons who may or may not be good candidates for SSRI drugs.2

Seek Medical Help for Prozac Withdrawal

While an ever-growing number of doctors and nurse practitioners are legally able to prescribe medications, it remains essential for consumers to practice due diligence in fully researching a drug and possible useful adjunctive therapies for treating depression in all age categories, before either beginning or ending a prescription drug. For those who have decided to stop taking Prozac, medical oversight is strongly advised. Alternative to Meds Center has designed programs using non-harmful, effective techniques and implements educational components that teach clients and practitioners alike how to get off Prozac safely and as comfortably as possible.

Below you will find some information that may be useful for such research, covering frequently asked questions, concerns, side effects, and additional data. Also below is more information on Prozac alternative treatment, safe Prozac withdrawal strategies, and more. Please contact us to provide more information on these or other topics by request.

When to Consider Prozac Withdrawal

When Prozac side effects become hard to tolerate or seem to outweigh the benefits of the drug, a person may decide to discontinue Prozac.

Prozac withdrawal can be safely done but must be done gradually and can be greatly eased with adequate support during the process. There are strategic ways to build the neurochemistry naturally so as to properly brace for the withdrawal process

Always seek medical assistance from your doctor, or a competent and licensed health practitioner to get guidance on how to get off Prozac safely. Alternative to Meds Center specializes in Prozac withdrawal treatment and other programs to achieve mental health naturally. Stopping Prozac can be done surprisingly gently and comfortably with the correct protocols and support in place.

Testimonial
Prozac Withdrawal
Success

At ATMC I was always supported. The staff was great at providing opportunities for me to work towards stability. What helped me here was always keeping a positive outlook and the constant encouragement and reminders to keep faith in myself.

~Jackie

 

What Is Prozac Used For?

SSRI drugs such as Prozac are used in treating MDD (major depressive disorder). There are about half a dozen SSRIs that the FDA has approved for treating depression, each having similar characteristics and efficacy. Prozac is the one that remains approved for prescribing to young people, and that is possibly why the number of Prozac prescriptions tends to outweigh the other drugs in this class. Prozac alternative treatments are available but sadly ignored in the main by doctors and others who may not have been trained in such methods, using non-drug-based protocols. Alternative to Meds Center specializes in alternative treatments for Prozac withdrawal, and for recovering natural mental health without prescription drugs.

According to various psychiatric associations around the world, pharmacological solutions are not always the recommended first line of defense. For example, often the recommendation of psychotherapy is shown to work whereas prescribed antidepressants are much less effective. For example, two-thirds of adolescents who were prescribed antidepressants reported relapse phenomena after completing a course of SSRI treatment in the absence of psychotherapy.3

One type of “talk therapy” found effective for the treatment of depression is called CBT, cognitive behavioral therapy. There are many forms of CBT that can be explored, including these:

Cognitive restructuring:  involves identifying irrational beliefs or negative automatic thoughts or assumptions and replacing those with more positive and realistic thoughts and conclusions.

Behavioral Activation:  creating strategies that support and explore pleasurable experiences; this may motivate and overcome those aspects of inertia or avoidance that are often associated with depression.

Problem-solving collaboration:  engaging with a skillful therapist can foster new ways to solve old problems.

Between therapy sessions:  assigned “homework” to be done between sessions can provide meaningful opportunities to put into practice newly discovered ways of addressing challenges that may instill a sense of tangible and demonstrated progress.

Prozac Alternative Names and Slang

Prozac is the brand name for fluoxetine hydrochloride, the active main ingredient. Slang or street names for Prozac are:

  • Wonder drug
  • Bottled smiles
  • Miracle drug
  • Happy pills

Prozac has become a slang word itself, according to the Cambridge Advanced Learner’s Dictionary, where the definition for Prozac is used as an adjective to describe “someone lively and excited.”

Prozac Side Effects

The most troubling side effect of Prozac is the increased risk of suicide, and unexpected episodes of rage or violence, especially in the initial period of starting to take the drug.20-25

Some people do not report any Prozac side effects or report only mild reactions. Others experience a range of adverse effects from mild to moderate to severe. Such reactions may lead to a decision to begin a program of getting off Prozac. For those considering Prozac cessation, a Prozac taper should only be attempted with medical help and guidance.

Some Prozac side effects include:
  • Thoughts of suicide, harming self or others, especially in the first month of treatment 7,20-25,41
  • Elevated mood, euphoria 40
  • Symptoms of low blood sugar, induced tachycardia, cold sweats, chills, shakiness, anxiety, unsteady gait, loss of balance, and confusion. 42,43
  • Insomnia, agitation, anxiety, tremors, nausea vomiting, diarrhea, weight loss, anorexia, appetite changes 7,44
Severe Prozac side effects that may require hospitalization:
  • Serotonin syndrome:  life-threatening toxic reaction, coma, seizure, unconsciousness, rigidity, sudden fever, delirium, death is possible.7,31
  • Hyponatremia or symptoms of low sodium such as seizure, confusion, weakness, and thirst.7,33
  • NMS, or other serious allergic reaction, rash, hives, itching, swelling, peeling skin, etc.7,34
  • Convulsions or seizures 7,35
  • Suicidal behaviors and agitated behaviors or thoughts, feeling restless, agitated, anxious, aggressive, hostile, overly emotional, feeling of wanting to hurt oneself, feeling of wanting to hurt others.24,25
  • Signs of bleeding in the stomach such as black tarry stool, vomiting blood, frequent nosebleeds, etc., can occur because of decreased coagulation of blood platelets.7,32,36
  • Signs of liver problems include nausea, yellowing of the skin or eye-whites, dark urine, pale stools, itching, etc.32
  • Enlargement of breasts in males and females, tenderness or discharge of milk from the breasts.37,38
  • Movement disorders, tardive dyskinesia, parkinsonism, unusual body or facial movements or tics, and involuntary movements.39
  • Mania, uncontrolled speech, thoughts, impulsive behaviors.7,40

Prozac (fluoxetine) FAQs

Below is some information regarding some frequently asked questions about Prozac and some of the characteristics of the drug.

Ask your doctor if you have more questions about Prozac such as when to take it, if you have concerns about side effects, concern that your dosage needs to be changed, and whether to consider Prozac withdrawal. These are important questions requiring qualified medical advice.

Is Prozac Highly Addictive?

Prozac is not considered to be addictive according to the organizations that regulate prescription medication. Regulatory bodies that oversee prescribing medications do not classify Prozac as habit-forming or addictive. However, recreational users do report being attracted to its speed-like high and do at times seek treatment for what they are viewing as Prozac addiction or dependence. Because the drug is prescribed, often for a very long time, Prozac addiction can develop unnoticed. The very fact that the FDA advises against abruptly stopping Prozac, informs that dependence is of prime concern for the safety of the patient.

Are Prozac and Xanax (benzodiazepine) the Same Thing?

Xanax is a benzodiazepine, where Prozac is an SSRI antidepressant. For some users, Prozac has a sedating effect that may resemble a benzodiazepine-type effect.

Can Prozac Make You Sleepy?

One known Prozac side effect is that it can cause the person to feel sleepy or drowsy. This common Prozac side effect may make it difficult to drive a car, or operate heavy machinery safely. CFS or chronic fatigue syndrome is defined as chronic fatigue of unknown cause. However, if Prozac was the known cause of chronic drowsiness and the drug was continued for a substantial period of time, it is possible that chronic fatigue syndrome may have been diagnosed in error.

In clinical trials done, aerobic exercise has been proven more effective in the treatment of CFS than Prozac, and even when exercise and Prozac were combined, there was no further improvement than that attained with exercise alone.5

Is Prozac Dangerous?

Prozac is not recommended for all cases of depression, and questions have been raised by the medical community about guidelines in the DSM-5 regarding who should and who should not be prescribed Prozac as a first line of treatment.45 Especially where other medications are being taken, and certain health conditions exist, these types of factors can heighten certain risks and should be taken into consideration before prescribing Prozac. Because of the euphoric high that many users report, Prozac addiction is a dangerous yet frequently overlooked potential consequence.

Some factors can increase the risk of what is called the “overstimulation reaction.” This is where there have been reports of people acting in dangerous ways to themselves and/or others after taking this medication. This could be a case of what is called disinhibition, where a person on Prozac or other medications like benzodiazepines, alcohol, or others, acts in sexually disinhibited or other unsafe behaviors. Careful assessment of these potentials in an individual may preclude Prozac as the right choice in such cases.46

Only a competent medical doctor who has access to patient history and current information can assess and determine the risk-to-benefit ratio for the individual.

Concerns have been raised about the content of fluoride in Prozac and other medications and health products. There are unresolved questions concerning the safety of fluoride in products made for ingestion, and this area remains under discussion within the FDA and is also of interest to health advocacy groups.6

Treatment for Prozac Abuse and Addiction?

At Alternative to Meds Center, programming and assessment is done on an individual basis to design a set of protocols designed to assist a person to safely benefit from Prozac withdrawal help. Prozac withdrawal can be comfortable as well as safe, allowing for natural mental health protocols to replace prescription medication.

Many people seek relief from depression, or other unwanted symptoms, for which prescription drugs may not have provided a complete answer. Recovery of health can include relief from mental health symptoms, without relying on drugs that tend to mask symptoms, rather than fix the root causes. Prozac withdrawal treatment may be significantly beneficial in such a situation.

Removal of neurotoxic accumulationsneurotoxic accumulations from the body, and corrective nutrition can provide a good starting point for the recovery of health at Alternative to Meds Center. We specialize in holistic neurotransmitter repair — another treatment delivered at Alternative to Meds Center. Our holistic protocols may be of interest when a person is seeking relief of symptoms without being encouraged to resort to prescription drugs to suppress or mask these types of symptoms.

At Alternative to Meds Center, we can work in many ways with individuals who are seeking bettered natural mental health. A gentle Prozac taper is one important part but not the only area to address during our Prozac withdrawal treatment program. We are aiming to help our clients achieve natural mental health through correction of diet, supplementation, counseling, and many other therapies that can be viewed on our services overview pages. We invite you to contact us at Alternative to Meds Center, and we would be happy to supply more information about our holistic, inpatient Prozac withdrawal on request.

1 (800) 301-3753 for Prozac Withdrawal Help

1. “Top antidepressant drugs in the United States based on prescriptions dispensed in 2011-2012” Statista Pharmaceutical Products and Market Report [cited 2022 July 27]

2. Hillhouse TM, Porter JH. A brief history of the development of antidepressant drugs: from monoamines to glutamate. Exp Clin Psychopharmacol. 2015;23(1):1-21. doi:10.1037/a0038550 [cited 2022 July 27]

3. Van Voorhees BW, Smith S, Ewigman B. Treat depressed teens with medication and psychotherapy. J Fam Pract. 2008;57(11):735-9a. [cited 2022 July 27]

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5. Stevens DL. Chronic fatigue. West J Med. 2001;175(5):315-319. doi:10.1136/ewjm.175.5.315 [cited 2022 July 27]

6. Grandjean P. Developmental fluoride neurotoxicity: an updated review. Environ Health. 2019 Dec 19;18(1):110. doi: 10.1186/s12940-019-0551-x. PMID: 31856837; PMCID: PMC6923889. [cited 2022 July 27]

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9. Wilson E, Lader M. A review of the management of antidepressant discontinuation symptoms. Ther Adv Psychopharmacol. 2015;5(6):357-368. doi:10.1177/2045125315612334 [cited 2022 July 27]

10. Henssler J, Heinz A, Brandt L, Bschor T. Antidepressant Withdrawal and Rebound Phenomena. Dtsch Arztebl Int. 2019;116(20):355-361. doi:10.3238/arztebl.2019.0355 [cited 2022 July 27]

11. Van Geffen EC, Brugman M, Van Hulten R, Bouvy ML, Egberts AC, Heerdink ER. Patients‘ concerns about and problems experienced with discontinuation of antidepressants. Int J Pharm Pract. 2007; 15:291–293. [cited 2022 July 27]

12. Offidani E, Guidi J, Tomba E, Fava GA. Efficacy and tolerability of benzodiazepines versus antidepressants in anxiety disorders: a systematic review and meta-analysis. Psychother Psychosom. 2013;82(6):355-62. doi: 10.1159/000353198. Epub 2013 Sep 20. PMID: 24061211. [cited 2022 July 27]

13. Black K, Shea C, Dursun S, Kutcher S. Selective serotonin reuptake inhibitor discontinuation syndrome: proposed diagnostic criteria. J Psychiatry Neurosci. 2000 May;25(3):255-61. PMID: 10863885; PMCID: PMC1407715. [cited 2022 July 27]

14. Lane RM. SSRI-induced extrapyramidal side-effects and akathisia: implications for treatment. J Psychopharmacol. 1998;12(2):192-214. doi: 10.1177/026988119801200212. PMID: 9694033.[cited 2022 July 27]

15. Lacasse JR, “Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature.” PLOS Medicine 2005 Dec; 2(12): e392 [cited 2022 July 27]

16. Danborg PB, Valdersdorf M, Gøtzsche PC. Long-term harms from previous use of selective serotonin reuptake inhibitors: A systematic review. Int J Risk Saf Med. 2019;30(2):59-71. doi: 10.3233/JRS-180046. PMID: 30714974; PMCID: PMC6839490. [cited 2022 July 27]

17. Kirsch I. Antidepressants and the Placebo Effect. Z Psychol. 2014;222(3):128-134. doi:10.1027/2151-2604/a000176 [cited 2022 July 27]

18. Fan KY, Liu HC. Delirium Associated With Fluoxetine Discontinuation: A Case Report. Clin Neuropharmacol. 2017 May/Jun;40(3):152-153. doi: 10.1097/WNF.0000000000000214. PMID: 28452902. [cited 2022 July 27]

19. Wilson E, Lader M. A review of the management of antidepressant discontinuation symptoms. Ther Adv Psychopharmacol. 2015 Dec;5(6):357-68. doi: 10.1177/2045125315612334. PMID: 26834969; PMCID: PMC4722507. [cited 2022 July 27]

20. US Dept of Health and Human Services,  Antidepressant use in children, adolescents, and adults. published online Jan 11, 2017 [cited 2022 July 27]

21. Sharma T, Guski LS, Freund N, Gøtzsche PC. Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports. BMJ 2016;352:i65. [cited 2022 July 27]

22. Bielefeldt AØ, Danborg PB, Gøtzsche PC. Precursors to suicidality and violence on antidepressants: systematic review of trials in adult healthy volunteers. J R Soc Med 2016;109:381-392. [cited 2022 July 27]

23. Molero Y, Lichtenstein P, Zetterqvist J, Gumpert CH, Fazel S. Selective Serotonin Reuptake Inhibitors and Violent Crime: A Cohort Study. PLoS Med. 2015;12(9):e1001875. Published 2015 Sep 15. doi:10.1371/journal.pmed.1001875 [cited 2022 July 27]

24. Lagerberg T, Fazel S, Molero Y, et al. Associations between selective serotonin reuptake inhibitors and violent crime in adolescents, young, and older adults – a Swedish register-based study. Eur Neuropsychopharmacol. 2020;36:1-9. doi:10.1016/j.euroneuro.2020.03.024 [cited 2022 July 27]

25. Moore TJ, Glenmullen J, Furberg CD. Prescription drugs associated with reports of violence towards others. PLoS One. 2010 Dec 15;5(12):e15337. doi: 10.1371/journal.pone.0015337. PMID: 21179515; PMCID: PMC3002271. [cited 2022 July 27]

26. Pesce N, “Anti-anxiety medication prescriptions have spiked 34% during the coronovirrus pandemic.” May 26 2020 Marketwatch Report [cited 2022 July 27]

27. Miron O, Yu KH, Wilf-Miron R, Kohane IS. Suicide Rates Among Adolescents and Young Adults in the United States, 2000-2017. JAMA. 2019;321(23):2362-2364. doi:10.1001/jama.2019.5054 [cited 2022 July 27]

28. Zajecka J, Tracy KA, Mitchell S. Discontinuation symptoms after treatment with serotonin reuptake inhibitors: a literature review. J Clin Psychiatry. 1997 Jul;58(7):291-7. doi: 10.4088/jcp.v58n0702. PMID: 9269249.[cited 2022 July 27]

29. Haddad P. Newer antidepressants and the discontinuation syndrome. J Clin Psychiatry. 1997;58 Suppl 7:17-21; discussion 22. PMID: 9219489. [cited 2022 July 27]

30. Akagi H, Kumar TM. Lesson of the week: Akathisia: overlooked at a cost. BMJ. 2002;324(7352):1506-1507. doi:10.1136/bmj.324.7352.1506 [cited 2022 July 27]

31. Brambilla P, Cipriani A, Hotopf M, Barbui C. Side-effect profile of fluoxetine in comparison with other SSRIs, tricyclic and newer antidepressants: a meta-analysis of clinical trial data. Pharmacopsychiatry. 2005 Mar;38(2):69-77. doi: 10.1055/s-2005-837806. PMID: 15744630. [cited 2022 July 27]

32. Voican CS, Corruble E, Naveau S, Perlemuter G. Antidepressant-induced liver injury: a review for clinicians. Am J Psychiatry. 2014 Apr;171(4):404-15. doi: 10.1176/appi.ajp.2013.13050709. PMID: 24362450. [cited 2022 July 27]

33. De Picker L, Van Den Eede F, Dumont G, Moorkens G, Sabbe BG. Antidepressants and the risk of hyponatremia: a class-by-class review of literature. Psychosomatics. 2014 Nov-Dec;55(6):536-47. doi: 10.1016/j.psym.2014.01.010. Epub 2014 Apr 21. PMID: 25262043. [cited 2022 July 27]

34. Jonsson GW, Moosa MY, Jeenah FY. Toxic epidermal necrolysis and fluoxetine: a case report. J Clin Psychopharmacol. 2008 Feb;28(1):93-5. doi: 10.1097/jcp.0b013e3181604015. PMID: 18204349. [cited 2022 July 27]

35. Bloechliger M, Ceschi A, Rüegg S, Kupferschmidt H, Kraehenbuehl S, Jick SS, Meier CR, Bodmer M. Risk of Seizures Associated with Antidepressant Use in Patients with Depressive Disorder: Follow-up Study with a Nested Case-Control Analysis Using the Clinical Practice Research Datalink. Drug Saf. 2016 Apr;39(4):307-21. doi: 10.1007/s40264-015-0363-z. PMID: 26650063. [cited 2022 July 27]

36. Laporte S, Chapelle C, Caillet P, Beyens MN, Bellet F, Delavenne X, Mismetti P, Bertoletti L. Bleeding risk under selective serotonin reuptake inhibitor (SSRI) antidepressants: A meta-analysis of observational studies. Pharmacol Res. 2017 Apr;118:19-32. doi: 10.1016/j.phrs.2016.08.017. Epub 2016 Aug 10. PMID: 27521835. [cited 2022 July 27]

37. Amsterdam JD, Garcia-España F, Goodman D, Hooper M, Hornig-Rohan M. Breast enlargement during chronic antidepressant therapy. J Affect Disord. 1997 Nov;46(2):151-6. doi: 10.1016/s0165-0327(97)00086-4. PMID: 9479619. [cited 2022 July 27]

38. Kaufman KR, Podolsky D, Greenman D, Madraswala R. Antidepressant-selective gynecomastia. Ann Pharmacother. 2013 Jan;47(1):e6. doi: 10.1345/aph.1R491. Epub 2013 Jan 16. PMID: 23324513. [cited 2022 July 27]

39. Gerber PE, Lynd LD. Selective serotonin-reuptake inhibitor-induced movement disorders. Ann Pharmacother. 1998 Jun;32(6):692-8. doi: 10.1345/aph.17302. PMID: 9640489. [cited 2022 July 27]

40. Henry C, Sorbara F, Lacoste J, Gindre C, Leboyer M. Antidepressant-induced mania in bipolar patients: identification of risk factors. J Clin Psychiatry. 2001 Apr;62(4):249-55. doi: 10.4088/jcp.v62n0406. PMID: 11379838.[cited 2022 July 27]

41. Machado-Vieira R, Baumann J, Wheeler-Castillo C, et al. The Timing of Antidepressant Effects: A Comparison of Diverse Pharmacological and Somatic Treatments. Pharmaceuticals (Basel). 2010;3(1):19-41. Published 2010 Jan 6. doi:10.3390/ph3010019 [cited 2022 July 27]

42. Gomez R, Huber J, Tombini G, Barros HM. Acute effect of different antidepressants on glycemia in diabetic and non-diabetic rats. Braz J Med Biol Res. 2001 Jan;34(1):57-64. doi: 10.1590/s0100-879×2001000100007. PMID: 11151029. [cited 2022 July 27]

43. Desimone ME, Weinstock RS. Hypoglycemia. [Updated 2018 May 5]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279137/ [cited 2022 July 27]

44. Brambilla P, Cipriani A, Hotopf M, Barbui C. Side-effect profile of fluoxetine in comparison with other SSRIs, tricyclic and newer antidepressants: a meta-analysis of clinical trial data. Pharmacopsychiatry. 2005 Mar;38(2):69-77. doi: 10.1055/s-2005-837806. PMID: 15744630.[cited 2022 July 27]

45. Schildkrout B. How to Move Beyond the Diagnostic and Statistical Manual of Mental Disorders/International Classification of Diseases. J Nerv Ment Dis. 2016 Oct;204(10):723-727. doi: 10.1097/NMD.0000000000000547. PMID: 27748696. [cited 2022 July 27]

46. Harris E, Eng HY, Kowatch R, Delgado SV, Saldaña SN. Disinhibition as a side effect of treatment with fluvoxamine in pediatric patients with obsessive-compulsive disorder. J Child Adolesc Psychopharmacol. 2010 Aug;20(4):347-53. doi: 10.1089/cap.2009.0126. PMID: 20807074. [cited 2022 July 27]

Originally Published Sep 13, 2018 by Diane Ridaeus


This content has been reviewed and approved by a licensed physician.

Dr. John Motl, M.D.

Dr. Motl is currently certified by the American Board of Psychiatry and Neurology in Psychiatry, and Board eligible in Neurology and licensed in the state of Arizona.  He holds a Bachelor of Science degree with a major in biology and minors in chemistry and philosophy. He graduated from Creighton University School of Medicine with a Doctor of Medicine.  Dr. Motl has studied Medical Acupuncture at the Colorado School of Traditional Chinese Medicine and at U.C.L.A.

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