Prozac (generic name fluoxetine) is one of the most prescribed psychiatric medications in the United States. In 2019, it was prescribed 27,110,302 times to 5,143,421 patients, making it was the 20th most prescribed drug and the second most-prescribed serotonin reuptake inhibitor (SSRI) after sertraline (trade name Zoloft).1
Though some people do have adverse reactions to it, fluoxetine is overwhelmingly considered safe and non-habit-forming by American medical professionals, which is why it is so widely prescribed. However, with so many people having access to the drug, it’s almost impossible to prevent improper or unauthorized use.2
Any instance a substance is used in a way that isn’t medically prescribed is considered to be “misuse” and the misuse of fluoxetine and other antidepressant medications, while rare, is a well-attested phenomenon.2,3,4
Aside from their approved use as antidepressants, Prozac and other SSRI-class drugs are widely prescribed for a wide variety of off-label purposes. They are commonly used off-label for treating anxiety disorders, obsessive-compulsive disorder, and other mental health issues associated with compulsive behavior or elevated risks of substance misuse.2,3,4
When prescribed in these scenarios, patients may take the drug in larger doses than recommended and may be more likely to continue taking them when not needed. They may also be more likely to combine fluoxetine with alcohol, which can cause a synergistic depressant effect in some individuals. Additionally, some individuals who are prone to trying any substance in an effort to get a “high” may use fluoxetine or combine it with other substances.2,3,4
One specific way that fluoxetine is sometimes misused is as a way to ease withdrawals from other substances like alcohol, cocaine, or opioids. While there have been some studies exploring the use of fluoxetine and other SSRIs for this purpose, this type of use is still not FDA-approved.2,5,6
While extremely rare, a few individuals report feeling euphoria from Prozac. This isn’t a typical effect for most people who use the medication as indicated. Most people are likely to feel a mood “leveling” effect where they could still have more or less the same emotions that they would often feel, though not as strongly as they might without the medication. Feelings of euphoria from fluoxetine have also been attributed to a placebo effect.3,4
Using fluoxetine in a way other than indicated can bring a host of different effects. Some effects may include:2
Some of these effects may still occur even at prescribed dosages. As with some other SSRI drugs, these effects may also subside within a few weeks or months of regular prescribed use.2
If you were prescribed fluoxetine or other SSRIs for a psychiatric disorder and you experience these effects, get in touch with your psychiatrist immediately. Do not stop using your medication as indicated until you have received specific instructions from your doctor.
By most accounts, cases of fluoxetine misuse that lead to serious harm are incredibly rare, and “fluoxetine use disorder” is not something that is known to happen and is not discussed in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Cases of regular fluoxetine misuse are usually tied to some other mental health condition.2,3,7
While safe, effective, and highly beneficial for millions of people with chronic depression, fluoxetine and other SSRI class drugs do have the potential to be misused, particularly when they are taken off-label or used for a purpose other than generally recommended. Misusing antidepressants can also be a sign of some other underlying mental health issue, particularly if the individual also misuses alcohol and other drugs.2
If you’re in the New England area, help for possible drug use disorders is just a phone call away. Boston Drug Treatment Centers gives you access to some of the country’s best programs for drug and alcohol rehabilitation within the Greater Boston area. Call (857) 577-8193 to discuss your options.