Not taking Prozac consistently — effects?

Originally Published: October 9, 2009
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Dear Alice,

Are there any side effects with Prozac if it is not taken on a regular basis?

Dear Reader,

Spontaneity may be the spice of life, but routine is a must when taking antidepressants like Prozac (fluoxetine). It's not clear from your question what you would mean by an "irregular basis," but these medications work best when they're taken as prescribed by a health care provider. Skipping doses or taking Prozac without a prescription will have different effects, potentially harmful, for each individual.

Assuming you have a prescription, you'll get the most benefit out of your meds if you take them regularly. Antidepressants work by altering the delicate balance of chemicals in your brain, so deviating from your medication schedule can upset this balance. If you miss a dose, don't double up. Simply skip the missed dose and resume taking your meds as scheduled. If you are having a difficult time remembering to take your medication as prescribed, try setting an alarm or including it as part of your morning or evening routine, like brushing your teeth.

If you stop taking your meds for several weeks at a time, you may experience withdrawal symptoms like headaches, nausea, irritability, or insomnia. For more info about these effects, check out Anti-depressant withdrawal in the Go Ask Alice! emotional health archive. If you're interested in going off Prozac or changing your dose, talk with your health care provider first.

If you haven't been prescribed Prozac, it's not a good idea to pop the pills occasionally. Unlike pain-relievers and cold medicine, antidepressants need to be taken over a period of time (several weeks at the minimum) to work effectively. You're not likely to have any mental health benefits from taking the pills occasionally, and you run the risk of side effects or an unintended overdose. Get medical attention right way if you have seizures, a speedy heart rate, nausea and vomiting, or uncontrollable trembling, all of which may be signs of an overdose. 

If you're taking Prozac and feel concerned about any side effects, make an appointment with your health care provider or psychiatrist before skimping on your meds. If you're feeling blue, you can talk with a health care provider before "trying out" Prozac or other antidepressants. Students at Columbia can make an appointment at Counseling and Psychological Services (CPS) by calling x4-2878.

Antidepressants work best when taken as prescribed, so if you're on Prozac routine is the name of the game.

Alice