Prozac. Prozac truth. Prozac side effects and Prozac withdrawal. Prozac information. List of Prozac side effects and how withdrawal from Prozac can be accomplished. Prozac.

Ms. Zion, who went to the hospital with a fever of 103.5, had been taking a prescribed antidepressant, phenelzine (Nardil). The combination of phenelzine and the narcotic painkiller meperidine (Demerol) given to her at the hospital could raise the level of circulating serotonin to dangerous levels. When she became agitated, a symptom of serotonin toxicity, and tried to pull out her intravenous tubes, she was restrained, and the resulting muscular tension is believed to have sent her fever soaring to lethal heights.

Now, with the enormous rise in the use of serotonin-enhancing antidepressants, often taken in combination with other drugs that also raise serotonin levels, emergency medicine specialists are trying to educate doctors and patients about this not-so-rare and potentially life-threatening disorder. In March 2005, two such specialists, Dr. Edward W. Boyer and Dr. Michael Shannon of Children’s Hospital Boston, noted that more than 85 percent of doctors were “unaware of the serotonin syndrome as a clinical diagnosis.”

In their review in The New England Journal of Medicine, Dr. Boyer and Dr. Shannon cited a report based on calls to poison control centers around the country in 2002 showing 7,349 cases of serotonin toxicity and 93 deaths. (In 2005, the last year for which statistics are available, 118 deaths were reported.)

The experts fear that failure to recognize serotonin syndrome in its mild or early stages can result in improper treatment and an abrupt worsening of the condition, leading to severe illness or death. Even more important, in hopes of preventing it, they want doctors — and patients — to know just what drugs and drug combinations can cause serotonin poisoning.

A Diagnostic Challenge

Serotonin syndrome was first described in medical literature in 1959 in a patient with tuberculosis who was treated with meperidine. But it wasn’t given its current name until 1982.

Recognizing the early signs is tricky because it has varying symptoms that can be easily confused with less serious conditions, including tremor, diarrhea, high blood pressure, anxiety and agitation. The examining physician may regard early symptoms as inconsequential and may not think to relate them to drug therapy, Dr. Boyer and Dr. Shannon noted.

In its classic form, serotonin syndrome involves three categories of symptoms:

¶Cognitive-behavioral symptoms like confusion, disorientation, agitation, irritability, unresponsiveness and anxiety.

¶Neuromuscular symptoms like muscle spasms, exaggerated reflexes, muscular rigidity, tremors, loss of coordination and shivering.

¶Autonomic nervous system symptoms like fever, profuse sweating, rapid heart rate, raised blood pressure and dilated pupils.

Widespread ignorance of the syndrome is another diagnostic impediment. But even when doctors know about it, the strict diagnostic criteria may rule out “what are now recognized as mild, early or subacute stages of the disorder,” Dr. Boyer and Dr. Shannon wrote.

Perhaps adding to the diagnostic challenge is the fact that a huge number of drugs — prescription, over the counter, recreational and herbal — can trigger the syndrome. In addition to selective serotonin reuptake inhibitors like Zoloft, Prozac and Paxil and serotonin/norepinephrine reuptake inhibitors like Effexor, the list includes tricyclic antidepressants and MAOIs (for monoamine oxidase inhibitors); narcotic painkillers like fentanyl and tramadol; over-the-counter cough and cold remedies containing dextromethorphan; the anticonvulsant valproate; triptans like Imitrex used to treat and prevent migraines; the antibiotic Zyvox (linezolide); antinausea drugs; the anti-Parkinson’s drug L-dopa; the weight-loss drug Meridia (sibutramine); lithium; the dietary supplements tryptophan, St. John’s wort and ginseng; and several drugs of abuse, including ecstasy, LSD, amphetamines, the hallucinogens foxy methoxy and Syrian rue.

Although serotonin poisoning can be caused by an antidepressant overdose, it more often results from a combination of an S.S.R.I. or MAOI with another serotonin-raising substance. Patients at particular risk, some experts say, are those taking combinations of antidepressant and antipsychotic drugs sometimes prescribed to treat resistant depression. All it may take is a small dose of another serotonin-inducing drug to cause the syndrome.

One patient, a 45-year-old Bostonian, had been taking four drugs to treat depression when he had surgery on an ankle last December. He developed several classic signs of serotonin syndrome while in the recovery room, where he had been given fentanyl when the anesthetic wore off.

As described by his wife, he suddenly developed tremors and violent shaking and started cracking his teeth. He was moved to the intensive care unit, where he thrashed and flailed, was oblivious to those around him, and had to be restrained to keep from pulling out his tubes. Two weeks later, he was still in intensive care and still very confused, despite being taken off all medications that could have caused his symptoms.

Serotonin syndrome can occur at any age, including in the elderly, in newborns and even in dogs. Since 1998, the poison control center at the American Society for the Prevention of Cruelty to Animals has gotten more than a thousand reports of the ingestion of antidepressant medications by dogs, which can develop symptoms rapidly and die. The syndrome can also occur weeks after a serotonin-raising drug has been discontinued. Some drugs remain active in the body for weeks, and the MAOIs disable an enzyme involved in serotonin metabolism that does not recover until weeks after the drugs are stopped.

Prevention and Treatment

Most cases of serotonin syndrome are mild and resolved within 24 hours. But if the doctor fails to recognize them and prescribes either a larger dose of a serotonin enhancer or another serotonin-raising drug, the consequences can be rapid and severe.

Most important to preventing the syndrome is for patients to give each of their doctors a complete list of drugs they regularly take — including prescriptions, over-the-counter medication, dietary supplements and recreational drugs — before a doctor prescribes something new.

Indeed, if you are taking any of the drugs described above, you might ask whether a new prescription is safe. And when filling a new prescription, it’s not a bad idea to also ask the pharmacist whether the medication, or an over-the-counter remedy you are considering, is safe to combine with any other drugs you take.

Once the syndrome develops, the first step is to stop the offending drugs. It is crucial to seek immediate care, preferably in a hospital. Most cases require only treatment of symptoms like agitation, elevated blood pressure and body temperature, and a tincture of time.

More severe cases are treated with drugs that inhibit serotonin and chemical sedation. Dr. Boyer and Dr. Shannon cautioned against using physical restraints to control agitation because they could enforce isometric muscle contractions that cause a severe buildup of lactic acid and a life-threatening rise in body temperature.

Prozac. Prozac truth. Prozac side effects and Prozac withdrawal. Prozac information. List of Prozac side effects and how withdrawal from Prozac can be accomplished. Prozac.

A Mix of Medicines That Can Be Lethal

Prozac side effects Body

Prozac side effects Dry Mouth - The usual amount to moisture in the mouth is noticeably less.

Prozac side effects Sweating Increased - A large quantity of perspiration that is medically caused.

Prozac side effects Cardiovascular (Involving the heart and the blood vessels)

Prozac side effects Palpitation - Unusual and not normal heartbeat, that is sometimes irregular, but rapid and forceful thumping or fluttering. It can be brought on by shock, excitement, exertion, or medical stimulants. A person is normally unaware of his/her heartbeat.

Prozac side effects Bradycardia - The heart rate is slowed from 72 beats per minute, which is normal, to below 60 beats per minute in an adult.

Prozac side effects Gastrointestinal (Involving the stomach and the intestines)

Prozac side effects General

Prozac side effects Allergy - The extreme sensitivity of body tissues triggered by substances in the air, drugs, or foods causing a reaction like sneezing, itching, asthma, hay fever, skin rashes, nausea and/or vomiting.

Prozac side effects Anaphylaxis - A violent, sudden, and severe drop in blood pressure caused by a re-exposure to a foreign protein or a second dosage of a drug that may be fatal unless emergency treatment is given right away.

Prozac side effects Asthenia - A physically weak condition.

Prozac side effects Chest Pains - Severe discomfort in the chest caused by not enough oxygen going to the heart because of narrowing of the blood vessels or spasms.

Prozac side effects Chills - Appearing pale while cold and shivering; sometimes with a fever.

Prozac side effects Edema of Extremities - Abnormal swelling of the body’s tissue caused by the collection of fluid.

Prozac side effects Fall - To suddenly lose your normal standing upright position as if you were shot.

Prozac side effects Fatigue - Loss of normal strength so as to not be able to do the usual physical and mental activities.

Prozac side effects Hot Flashes - Brief, abnormal enlargement of the blood vessels that causes a sudden heat sensation over the entire body. Women in menopause will sometimes experience this.

Prozac side effects Influenza-like Symptoms - Demonstrating irritation of the respiratory tract (organs of breathing) such as a cold, sudden fever, aches and pains, as well as feeling weak and seeking bed rest, which is similar to having the flu.

Prozac side effects Leg Pain - A hurtful sensation in the legs that is caused by excessive stimulation of the nerve endings in the legs and results in extreme discomfort.

Prozac side effects Malaise - The somewhat unclear feeling of discomfort you get when you start to feel sick.

Prozac side effects Pain in Limb - Sudden, sharp and uncontrolled leg discomfort.

Prozac side effects Syncope - A short period of light headedness or unconsciousness (black-out) also know as fainting caused by lack of oxygen to the brain because of an interruption in blood flowing to the brain.

Prozac side effects Tightness of Chest - Mild or sharp discomfort, tightness or pressure in the chest area (anywhere between the throat and belly). The causes can be mild or seriously life-threatening because they include the heart, lungs and surrounding muscles.

Prozac side effects Hemic and Lymphatic Disorders (Involving the blood and the clear fluids in the tissues that contain white blood cells)

Prozac side effects Bruise - Damage to the skin resulting in a purple-green-yellow skin coloration that’s caused by breaking the blood vessels in the area without breaking the surface of the skin.

Prozac side effects Nosebleed - Blood lost from the part of the face that has the organs of smell and is where the body takes in oxygen.

Prozac side effects Hematoma - Broken blood vessels that cause a swelling in an area on the body.

Prozac side effects Lymphadenopathy Cervical - The lymph nodes in the neck, which are part of the body’s immune system get swollen and enlarge by reacting to the presence of a drug. The swelling is the result of the white blood cells multiplying in order to fight the invasion of the drug.

Prozac side effects Metabolic and Nutritional Disorders (Energy and health)

Prozac side effects Arthralgia - Sudden sharp nerve pain in one or more joints.

Prozac side effects Arthropathy - Having joint disease or abnormal joints.

Prozac side effects Arthritis - Painfully inflamed and swollen joints. The reddened and swollen condition is brought on by a serious injury or shock to the body either from physical or emotional causes.

Prozac side effects Thirst - A strong, unnatural craving for moisture/water in the mouth and throat.

Prozac side effects Nervous System (Sensory channels)

Prozac side effects Psychiatric Disorders (Mental and emotional)

Prozac side effects Reproductive Disorder Female

Prozac side effects Breast Neoplasm - A tumor or cancer, of either of the two milk-secreting organs on the chest of a woman.

Prozac side effects Menorrhagia - Abnormally heavy menstrual period or a menstrual flow that has continued for an unusually long period of time.

Prozac side effects Menstrual Cramps - Painful, involuntary uterus contractions that women experience around the time of their menstrual period, sometimes causing pain in the lower back and thighs.

Prozac side effects Menstrual Disorder - A disturbance or derangement in the normal function of a woman’s menstrual period.

Prozac side effects Spotting Between Menses - Abnormal bleeding between periods. Unusual spotting between menstrual cycles.

Prozac side effects RESPIRATORY SYSTEM (Organs involved in breathing)

Prozac side effects Breath Shortness - Unnatural breathing using a lot off effort resulting in not enough air taken in by the body.

Prozac side effects Bronchitis - Inflammation of the two main breathing tubes leading from the windpipe to the lungs. The disease is marked with coughing, a low-grade fever, chest pains, and hoarseness, caused by an allergic reaction.

Prozac side effects Coughing - A cough is the response to an irritation, such as mucus, that causes the muscles controlling the breathing process to expel air from the lungs suddenly and noisily to keep the air passages free from the irritating material.

Prozac side effects Laryngitis - Inflammation of the voice box characterized by hoarseness, sore throat, and coughing. It can be cause by straining the voice or exposure to infectious, allergic or chemical irritation.

Prozac side effects Nasal Congestion - The presence of an abnormal amount of fluid in the nose.

Prozac side effects Pneumonia Tracheitis - Bacterial infection of the air passageways and lungs that causes redness, swelling and pain in the windpipe. Other symptoms are high fever, chills, pain in the chest, difficulty in breathing, and coughing with mucus discharge.

Prozac side effects Rhinitis - Chemical irritation causing pain, redness and swelling in the mucus membranes of the nose.

Prozac side effects Sinus Congestion - The mucus-lined areas of the bones in the face that are thought to help warm and moisten air to the nose. These areas become clogged with excess fluid or infected.

Prozac side effects Sinus Headache - The abnormal amount of fluid in the hollows of the face bone area especially around the nose. This excess fluid creates pressure, causing pain in the head.

Prozac side effects Sinusitis - The body reacting to chemical irritation causing redness, swelling and pain in the area of the hollows in the facial bones especially around the nose.

Prozac side effects SKELETAL

Prozac side effects SKIN and APPENDAGES DISORDERS (Skin, legs and arms)

Prozac side effects Acne - Eruptions of the oils glands of the skin, especially on the face, marked by pimples, blackheads, whiteheads, bumps, and more severely, by cysts and scarring.

Prozac side effects Eczema - A severe or continuing skin disease marked by redness, crusting and scaling with watery blisters and itching. It is often difficult to treat and will sometimes go away only to reappear again.

Prozac side effects Dermatitis - Generally irritated skin that can be caused by any of a number of irritating things such as parasites, fungus, bacteria, or foreign substances causing an allergic reaction. It is a general inflammation of the skin.

Prozac side effects Dry Lips - The lack of normal moisture in the fleshy folds that surround the mouth.

Prozac side effects URINARY SYSTEM DISORDER

Prozac side effects Blood in Urine - Blood is present when one empties liquid waste product of the kidneys through the bladder by urinating in the toilet turning the water pink to bright red. Or you could see pots of blood in the water after urinating.

Prozac side effects Dysuria - Difficult or painful urination.

Prozac side effects Kidney Stone - Small hard masses of salt deposits that the kidney forms.

Prozac side effects Urinary Frequency - Having to urinate more often than usual or between unusually short time periods.

Prozac side effects Urinary Tract Infection - An invasion of bacteria, viruses, fungi, etc., of the system in the body that starts with the kidneys and eliminates urine from the body. If the invasion goes unchecked it can injure tissue and progress into disease.

Prozac side effects Urinary Urgency - A sudden compelling urge to urinate, accompanied by discomfort in the bladder.

Prozac side effects UROGENITAL (Urinary tract and genital structures or functions)

Prozac side effects Anorgasmia - Failure to experience an orgasm.

Prozac side effects Ejaculation Disorder - Dysfunction of the discharge of semen during orgasm.

Prozac side effects Menstrual Disorder - Dysfunction of the discharge during the monthly menstrual cycle.

Prozac side effects Toxic Epidermal Necrolysis - An abnormal condition where a large portion of skin becomes intensely red and peels off like a second-degree burn. Often the symptoms include blistering.

Prozac side effects Gastrointestinal Hemorrhage - Stomach and intestinal excessive internal bleeding.

Prozac side effects
Body

Prozac side effects
Dry Mouth - The usual amount to moisture in the mouth is noticeably less.

Prozac side effects
Sweating Increased - A large quantity of perspiration that is medically caused.

Prozac side effects
Cardiovascular (Involving the heart and the blood vessels)

Prozac side effects
Palpitation - Unusual and not normal heartbeat, that is sometimes irregular, but rapid and forceful thumping or fluttering. It can be brought on by shock, excitement, exertion, or medical stimulants. A person is normally unaware of his/her heartbeat.

Prozac side effects
Bradycardia - The heart rate is slowed from 72 beats per minute, which is normal, to below 60 beats per minute in an adult.

Prozac side effects
Gastrointestinal (Involving the stomach and the intestines)

Prozac side effects
General

Prozac side effects
Allergy - The extreme sensitivity of body tissues triggered by substances in the air, drugs, or foods causing a reaction like sneezing, itching, asthma, hay fever, skin rashes, nausea and/or vomiting.

Prozac side effects
Anaphylaxis - A violent, sudden, and severe drop in blood pressure caused by a re-exposure to a foreign protein or a second dosage of a drug that may be fatal unless emergency treatment is given right away.

Prozac side effects
Asthenia - A physically weak condition.

Prozac side effects
Chest Pains - Severe discomfort in the chest caused by not enough oxygen going to the heart because of narrowing of the blood vessels or spasms.

Prozac side effects
Chills - Appearing pale while cold and shivering; sometimes with a fever.

Prozac side effects
Edema of Extremities - Abnormal swelling of the body’s tissue caused by the collection of fluid.

Prozac side effects
Fall - To suddenly lose your normal standing upright position as if you were shot.

Prozac side effects
Fatigue - Loss of normal strength so as to not be able to do the usual physical and mental activities.

Prozac side effects
Hot Flashes - Brief, abnormal enlargement of the blood vessels that causes a sudden heat sensation over the entire body. Women in menopause will sometimes experience this.

Prozac side effects
Influenza-like Symptoms - Demonstrating irritation of the respiratory tract (organs of breathing) such as a cold, sudden fever, aches and pains, as well as feeling weak and seeking bed rest, which is similar to having the flu.

Prozac side effects
Leg Pain - A hurtful sensation in the legs that is caused by excessive stimulation of the nerve endings in the legs and results in extreme discomfort.

Prozac side effects
Malaise - The somewhat unclear feeling of discomfort you get when you start to feel sick.

Prozac side effects
Pain in Limb - Sudden, sharp and uncontrolled leg discomfort.

Prozac side effects
Syncope - A short period of light headedness or unconsciousness (black-out) also know as fainting caused by lack of oxygen to the brain because of an interruption in blood flowing to the brain.

Prozac side effects
Tightness of Chest - Mild or sharp discomfort, tightness or pressure in the chest area (anywhere between the throat and belly). The causes can be mild or seriously life-threatening because they include the heart, lungs and surrounding muscles.

Prozac side effects
Hemic and Lymphatic Disorders (Involving the blood and the clear fluids in the tissues that contain white blood cells)

Prozac side effects
Bruise - Damage to the skin resulting in a purple-green-yellow skin coloration that’s caused by breaking the blood vessels in the area without breaking the surface of the skin.

Prozac side effects
Nosebleed - Blood lost from the part of the face that has the organs of smell and is where the body takes in oxygen.

Prozac side effects
Hematoma - Broken blood vessels that cause a swelling in an area on the body.

Prozac side effects
Lymphadenopathy Cervical - The lymph nodes in the neck, which are part of the body’s immune system get swollen and enlarge by reacting to the presence of a drug. The swelling is the result of the white blood cells multiplying in order to fight the invasion of the drug.

Prozac side effects
Metabolic and Nutritional Disorders (Energy and health)

Prozac side effects
Arthralgia - Sudden sharp nerve pain in one or more joints.

Prozac side effects
Arthropathy - Having joint disease or abnormal joints.

Prozac side effects
Arthritis - Painfully inflamed and swollen joints. The reddened and swollen condition is brought on by a serious injury or shock to the body either from physical or emotional causes.

Prozac side effects
Thirst - A strong, unnatural craving for moisture/water in the mouth and throat.

Prozac side effects
Nervous System (Sensory channels)

Prozac side effects
Psychiatric Disorders (Mental and emotional)

Prozac side effects
Reproductive Disorder Female

Prozac side effects
Breast Neoplasm - A tumor or cancer, of either of the two milk-secreting organs on the chest of a woman.

Prozac side effects
Menorrhagia - Abnormally heavy menstrual period or a menstrual flow that has continued for an unusually long period of time.

Prozac side effects
Menstrual Cramps - Painful, involuntary uterus contractions that women experience around the time of their menstrual period, sometimes causing pain in the lower back and thighs.

Prozac side effects
Menstrual Disorder - A disturbance or derangement in the normal function of a woman’s menstrual period.

Prozac side effects
Spotting Between Menses - Abnormal bleeding between periods. Unusual spotting between menstrual cycles.

Prozac side effects
RESPIRATORY SYSTEM (Organs involved in breathing)

Prozac side effects
Breath Shortness - Unnatural breathing using a lot off effort resulting in not enough air taken in by the body.

Prozac side effects
Bronchitis - Inflammation of the two main breathing tubes leading from the windpipe to the lungs. The disease is marked with coughing, a low-grade fever, chest pains, and hoarseness, caused by an allergic reaction.

Prozac side effects
Coughing - A cough is the response to an irritation, such as mucus, that causes the muscles controlling the breathing process to expel air from the lungs suddenly and noisily to keep the air passages free from the irritating material.

Prozac side effects
Laryngitis - Inflammation of the voice box characterized by hoarseness, sore throat, and coughing. It can be cause by straining the voice or exposure to infectious, allergic or chemical irritation.

Prozac side effects
Nasal Congestion - The presence of an abnormal amount of fluid in the nose.

Prozac side effects
Pneumonia Tracheitis - Bacterial infection of the air passageways and lungs that causes redness, swelling and pain in the windpipe. Other symptoms are high fever, chills, pain in the chest, difficulty in breathing, and coughing with mucus discharge.

Prozac side effects
Rhinitis - Chemical irritation causing pain, redness and swelling in the mucus membranes of the nose.

Prozac side effects
Sinus Congestion - The mucus-lined areas of the bones in the face that are thought to help warm and moisten air to the nose. These areas become clogged with excess fluid or infected.

Prozac side effects
Sinus Headache - The abnormal amount of fluid in the hollows of the face bone area especially around the nose. This excess fluid creates pressure, causing pain in the head.

Prozac side effects
Sinusitis - The body reacting to chemical irritation causing redness, swelling and pain in the area of the hollows in the facial bones especially around the nose.

Prozac side effects
SKELETAL

Prozac side effects
SKIN and APPENDAGES DISORDERS (Skin, legs and arms)

Prozac side effects
Acne - Eruptions of the oils glands of the skin, especially on the face, marked by pimples, blackheads, whiteheads, bumps, and more severely, by cysts and scarring.

Prozac side effects
Eczema - A severe or continuing skin disease marked by redness, crusting and scaling with watery blisters and itching. It is often difficult to treat and will sometimes go away only to reappear again.

Prozac side effects
Dermatitis - Generally irritated skin that can be caused by any of a number of irritating things such as parasites, fungus, bacteria, or foreign substances causing an allergic reaction. It is a general inflammation of the skin.

Prozac side effects
Dry Lips - The lack of normal moisture in the fleshy folds that surround the mouth.

Prozac side effects
URINARY SYSTEM DISORDER

Prozac side effects
Blood in Urine - Blood is present when one empties liquid waste product of the kidneys through the bladder by urinating in the toilet turning the water pink to bright red. Or you could see pots of blood in the water after urinating.

Prozac side effects
Dysuria - Difficult or painful urination.

Prozac side effects
Kidney Stone - Small hard masses of salt deposits that the kidney forms.

Prozac side effects
Urinary Frequency - Having to urinate more often than usual or between unusually short time periods.

Prozac side effects
Urinary Tract Infection - An invasion of bacteria, viruses, fungi, etc., of the system in the body that starts with the kidneys and eliminates urine from the body. If the invasion goes unchecked it can injure tissue and progress into disease.

Prozac side effects
Urinary Urgency - A sudden compelling urge to urinate, accompanied by discomfort in the bladder.

Prozac side effects
UROGENITAL (Urinary tract and genital structures or functions)

Prozac side effects
Anorgasmia - Failure to experience an orgasm.

Prozac side effects
Ejaculation Disorder - Dysfunction of the discharge of semen during orgasm.

Prozac side effects
Menstrual Disorder - Dysfunction of the discharge during the monthly menstrual cycle.

Prozac side effects
Toxic Epidermal Necrolysis - An abnormal condition where a large portion of skin becomes intensely red and peels off like a second-degree burn. Often the symptoms include blistering.

Prozac side effects
Gastrointestinal Hemorrhage - Stomach and intestinal excessive internal bleeding.