The first time I went to my GP with depression I was prescribed citalopram (Cipramil), which helped my symptoms but made me feel a bit like a zombie, so I didn’t take it for long. I had another spell on it a few years later, with the same result. For the past 3 years or so (I am a bit shocked that I don’t really know) I have been prescribed Prozac, which suits me better. I have tried stopping it a couple of times, but the depression symptoms became unmanageable again after a while. I do wonder if, now I am looking after myself better (no alcohol, exercise etc), I could manage without Prozac altogether. Think I’d need to to crank up the mindfulness to be successful though.

Prozac is a trade name of fluoxetine and is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. Fluoxetine is used for the treatment of major depressive disorder, obsessive-compulsive disorder (in both adults and children), bulimia nervosa, panic disorder and premenstrual dysphoric disorder. [source:  wikipedia]

It’s thought that SSRIs work by increasing the levels of a chemical called serotonin in the brain.  Serotonin is a neurotransmitter (a messenger chemical that carries signals between nerve cells in the brain).  It’s thought to have a good influence on mood, emotion and sleep.

After carrying a message, serotonin is usually reabsorbed by the nerve cells (known as ‘reuptake’).  SSRIs work by blocking (‘inhibiting’) reuptake, meaning more serotonin is available to pass further messages between nearby nerve cells.

It would be too simplistic to say that depression and related mental health conditions are caused by low serotonin levels, but a rise in serotonin levels can improve symptoms and make people more responsive to other types of treatment, such as CBT. [source: NHS Choices]

There’s an interesting discussion on the development of SSRIs to treat depression, and on the theories of how they work in the New York Times here.  It is clear that role of serotonin in depression is not well understood yet, but that SSRIs seem to be effective in helping people with severe depression (and much less effective for moderate or mild depression).

The urge to stop taking Prozac now I feel OK is strong – why is that when I believe it’s helping correct a genetic chemical imbalance in my brain?  One of the reasons is the desire to be drug-free (I blame Harper Lee for this – we did To Kill A Mockingbird at school and Mrs Dubose’s determination to come off morphine before she died has stuck with me), and another is to explore whether the persistent tiredness I feel is a side effect of Prozac

Very common side effects (more than 1 in 10 people who take Prozac):

  • diarrhoea
  • difficulty sleeping
  • headaches
  • nausea
  • tiredness
  • weakness

[source: NHS Choices – common side effects (1 in 100 people), listed there also]




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