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Is Prozac addictive? A psychiatrist explains

Is Prozac addictive? A psychiatrist explains

You can't get addicted to Prozac the way you do with controlled substances, but you can develop a physical dependence to Prozac, which still isn't the same as a drug addiction.

Reviewed by:
Austin Lin, MD
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April 29, 2024
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Key takeaways

If you have certain mental health condition, an antidepressant like Prozac (fluoxetine) can help you find relief from your symptoms. If you’ve been prescribed Prozac you may have questions and reservations before getting started. Is it an addictive drug? Once I start, do I have to be on it forever?  

The short answer is ‘no’ to both. Prozac, like most antidepressants medications, isn't addictive Prozac helps balance the chemicals in your brain so you can get back to feeling like yourself. The effects aren't permanent, and they don't lead to a drug addiction.  

In this article, we’ll walk you through the differences between addiction and physical dependency, look at how this relates to Prozac use, and talk about its safety.


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Can you become addicted to Prozac?

Prozac, the brand name for the prescription medication fluoxetine. It’s a selective serotonin reuptake inhibitor (SSRI), the most commonly used type of antidepressant. This class of medications is generally safe, although like all medications they have some side effects.  

Like most antidepressants, Prozac is not addictive though you may experience some unpleasant side effects when you stop taking it, especially if you stop taking it suddenly. Up to 80% of people who abruptly stop taking an antidepressant develop withdrawal symptoms, also known as discontinuation symptoms, according to the National Alliance on Mental Illness. These usually appear within days of stopping the medication and can last for up to 2 weeks. The good news about Prozac is that it also has a long half-life (how long it takes for half of a medication to leave your system), so you’re less likely to have these effects compared to other SSRIs and SNRIs.

The withdrawal side effects will depend on how long you’ve been taking Prozac and the dose that you’re taking. If and when you are ready to stop taking Prozac, your doctor will help you come up with a plan to do so safely.

Discontinuation symptoms are a sign of physical dependence, which is different from addiction. Physical dependence is a normal way in which the body adapts when you take certain medications regularly. (We’ll explain more about the differences between dependence and addiction later on, as well as which side effects can occur when you stop taking Prozac.)

Prozac isn’t a controlled substance

One important thing to know is that in the United States, addictive substances are listed as controlled substances by the FDA, because of their potential for being misused. Mental health medications that are controlled substances include benzodiazepines, which is why it may not be prescribed by your doctor if you have a history of substance abuse or drug addiction. SSRIs such as Prozac, which are very safe medications, are not controlled substances.

In addition, addictive substances generally have an immediate pleasurable effect, like the relaxation you may experience with alcohol or the euphoria (aka the “high”) that comes with opiates. This does not happen with Prozac and most other antidepressants. (In fact, it takes 2 to 4 weeks for Prozac to work.)

People also do not crave Prozac the way they might with something addictive.  And when people stop taking it, while they might experience some slight discomfort, it isn’t nearly as intense as the withdrawal symptoms associated with addictive drugs and controlled substances.

Dependency vs. addiction

The terms “dependency” and “addiction” may seem similar, but they have distinct meanings in a medical context.  

Addiction refers to the compulsive seeking and use of a drug despite harmful consequences such as having relationship problems, losing your job, or experiencing physical harm. People can also develop a psychological drug addiction, which may show up as cravings, obsessing over obtaining or using the drug, or feeling anxious when not using it.

When a person develops an addiction to a substance, it is called a substance use disorder. Addiction can occur with substances such as:

  • Alcohol
  • Cocaine
  • Heroin
  • Opioids

Physical dependence is when your body adapts to the presence of a substance, especially with long-term use. The body is very adaptable, so this kind of change is normal.  

When you start taking an antidepressant, the goal is to make certain chemicals more available to your brain. For example, Prozac works by changing the level of the brain chemical serotonin. These changes help your brain find balance, which can alleviate your symptoms of depression. Over time, your brain gets used to this new way of being.  

This is physical Prozac dependence, which is not the same as addiction. Because of this physical dependence, if you stop taking Prozac abruptly or you reduce your dose too quickly, your brain doesn’t have enough time to adapt. This can cause physical discomfort in the form  headache, nausea, dizziness, or sleep problems.

While these symptoms can be unpleasant, they usually go away after a few weeks. Gradually reducing the dose you are taking—what’s known as tapering—can give your brain time to adjust, with fewer withdrawal symptoms. We’ll talk more about tapering below, and you can always ask your doctor any questions about stopping your medication.  

What happens when you stop taking Prozac?

When you stop taking an antidepressant, you may experience discontinuation symptoms (“withdrawal symptoms”), which can be avoided when it’s done gradually and safely with the help of your doctor. Experiencing these effects isn’t dangerous and will usually go away. They can include:  

  • Flu-like symptoms such as tiredness, headache, achiness, sweating
  • Difficulty falling asleep or staying asleep
  • Nausea
  • Dizziness or lightheadedness
  • Feeling anxious, irritable, or agitated

The symptoms depend upon the antidepressant you are taking, the dose you are on, and how quickly you stop taking the medication. In general, if you stop taking the drug abruptly, you are more likely to experience withdrawal symptoms.

Compared to other SSRIs, Prozac is less likely to cause withdrawal symptoms if you stop taking it suddenly. One study found that people were 100 more likely to have withdrawal symptoms when stopping Paxil abruptly, compared to Prozac.

Because people usually have fewer withdrawal symptoms when stopping Prozac, if you have a hard time tapering off an antidepressant drug such as Paxil (paroxetine), your doctor may switch you to Prozac and then have you gradually stop taking it.

How to go off of Prozac safely

How quickly you taper Prozac will depend on several factors, including the dose you’ve been taking, how long you’ve been taking the drug, and whether you are taking other medications affected by Prozac.  

Your psychiatrist or other mental health professional will help you decide how to taper off Prozac, and what to do should you experience any withdrawal symptoms. Do not stop taking Prozac—or any other medication—without talking to a medical professional first.  

In general, Prozac can be tapered over several weeks. This is because this drug has a long half-life. This is the time it takes for the amount of the drug in your body to be reduced by half. There is also a liquid version of Prozac, which allows you to taper more slowly, if needed.

Stopping Prozac abruptly may work for certain people, meaning they will have few withdrawal symptoms. However, some people have experienced symptoms such as confusion when they stopped taking Prozac too quickly. Tapering slowly reduces the chance that these kinds of symptoms will happen. If you do experience challenging withdrawal symptoms, restarting the antidepressant at the last dosage usually makes those symptoms go away or reduce the intensity of them to a manageable level.  

To learn more about going off antidepressants, check out: Can I go back on antidepressants after stopping?

Monitoring the effects of Prozac

Prozac is a safe treatment for major depressive disorder and a variety of anxiety disorders, including panic disorder. It is also sometimes prescribed for eating disorders like bulimia, premenstrual dysphoric disorder (PMDD), and obsessive-compulsive disorder (OCD). The most common side effects include sleep problems, nausea, diarrhea, dry mouth, headache, weight gain or weight loss, and others. Most side effects go away over time. If you experience any side effects of Prozac that concern you, especially sudden or severe mood swings, talk to your health care professional.

Your doctor can work with you to minimize the impact of these side effects. For example, if you have difficulty falling asleep or staying asleep while you are taking Prozac, taking the drug earlier in the day may allow you to sleep well at night. Your doctor may also recommend reducing the dose of Prozac or switching to another antidepressant medication.  

It is important that you talk to your doctor about how you’re feeling on your medication, including changes in your symptoms, your feelings and emotions, and any side effects. One way to track this is by writing this information down in a journal, which you can share with them if you’re comfortable. This will give them a better idea of how you are feeling, and if needed, help them adjust your medication or come up with other treatment options.

The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.

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Call the number on your insurance card and ask about your plan’s coverage for outpatient psychiatric services.

How does Talkiatry compare to face-to-face treatment?

For most patients, Talkiatry treatment is just as effective as in-person psychiatry (American Psychiatric Association, 2021), and much more convenient. That said, we don’t currently provide treatment for schizophrenia, primary eating disorder treatment, or Medication Assisted Treatment for substance use disorders.

What kind of treatment does Talkiatry provide?

At Talkiatry, we specialize in psychiatry, meaning the diagnosis and treatment of mental health conditions. Your psychiatrist will meet with you virtually on a schedule you set together, devise a treatment plan tailored to your specific needs and preferences, and work with you to adjust your plan as you meet your goals.

If your treatment plan includes medication, your psychiatrist will prescribe and manage it. If needed, your psychiatrist can also refer you to a Talkiatry therapist.

What's the difference between a therapist and psychiatrist?

Psychiatrists are doctors who have specialized training in diagnosing and treating complex mental health conditions through medication management. If you are experiencing symptoms of a mental health condition such as depression, anxiety, bipolar disorder, PTSD, or similar, a psychiatrist may be a good place to start.  

Other signs that you should see a psychiatrist include:  

  • Your primary care doctor or another doctor thinks you may benefit from the services of a psychiatrist and provides a referral    
  • You are interested in taking medication to treat a mental health condition  
  • Your symptoms are severe enough to regularly interfere with your everyday life

The term “therapist” can apply to a range of professionals including social workers, mental health counselors, psychologists, professional counselors, marriage and family therapists, and psychoanalysts. Working with a therapist generally involves regular talk therapy sessions where you discuss your feelings, problem-solving strategies, and coping mechanisms to help with your condition.

Who can prescribe medication?

All our psychiatrists (and all psychiatrists in general) are medical doctors with additional training in mental health. They can prescribe any medication they think can help their patients. In order to find out which medications might be appropriate, they need to conduct a full evaluation. At Talkiatry, first visits are generally scheduled for 60 minutes or more to give your psychiatrist time to learn about you, work on a treatment plan, and discuss any medications that might be included.

About
Austin Lin, MD

Dr. Austin Lin is a double board-certified adult and addiction psychiatrist who has been in practice for over 9 years. At the center of Dr. Lin’s clinical approach is a strong emphasis on establishing trust and using a collaborative approach to help patients develop an individualized and cohesive plan so that they are able to achieve their goals.

Dr. Lin's practice focuses on medication management. Typically, he offers this in conjunction with supportive therapy, motivational interviewing, and/or cognitive behavioral therapy in 30-minute follow-up visits. Occasionally, Dr. Lin may recommend that additional therapy is needed and ask that you bring a therapist into your care team in order to provide the best outcome.

Dr. Lin received his medical degree from St. George’s University School of Medicine. He went on to complete his residency in psychiatry at Harvard South Shore, an affiliate of Harvard Medical School, where he served as Chief Resident and earned his 360° Professionalism award. He then had additional training in Addiction Psychiatry through his fellowship at the University of Texas Southwestern Medical Center. After completing training, Dr. Lin has worked as an Addiction Psychiatrist and Director of Adult Services in the Trauma and Resilience Center (TRC) at the University of Texas Health Science Center at Houston (UTHealth). He specialized in treating patients with a history of depression, anxiety, trauma, and substance use disorders.

Dr. Lin has held an academic appointment at UTHealth, and he has spent his professional career supervising and teaching medical students and psychiatry residents.



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