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What are the pro's and con's to prozac vs. zoloft for teen girls with family mental health issues?

4 Answers

LaurieShay 6 Dec 2013

Both are antidepressants of the serotonin reuptake inhibitor category. Prozac has been on the market much longer than Zoloft though not that this makes it any better. It really is a matter of trial and error to see which one helps the individual as we are all different.

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msmomma1 6 Dec 2013

well I myself have taken both and had a lot of bad side effects on the zoloft ie. shakes, restless feeling, sick to my stomach and have heard that it can cause infertility. The prozac had some of the same things but they all subsided within a few days and from what I have read these things do not in the zoloft. My concern is is that my daughter has just recently been hospitalized for mental issues and the Dr and I orriginally agreed that the prozac would be a better fit for what she is dealing with, I then discovered they have switched her to the zoloft and I am not likeing this decision.I do understand that we all are different and it will effect her different than me but most of the family that has this type of history were also given prozac and it worked so in that sence I am wanting to go the route I know.

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I also understand that there does have to be a trial and error on dealing with mental illness but with a side effect that can cause infertility I don't want that to be something she will have to deal with if there is something out there that I am familier with then that is the way I am going to go. She is only 15 and I just want what is best for her. I am wanting to know if there is a better side to either and if maybe there is something I don't know about when dealing with this medicine. I am one of those parents that do not really believe in giving kids medicines for long term use bieng that I myself have been 'medicated' for most of my life and have had more health problems due to this and I just don't want to go through a whole cycle of meds only to end up right back where we started!!! That is exactly what happened with me. I just want her to be better and have a better way to handle her illness than the way I had to.

DzooBaby 6 Dec 2013

Is she getting counselling? I'm with you on the opinion that drugs should be sparingly used and only when absolutely necessary. I prefer the counselling route. If a person learns the ability to cope with their feelings, it is much better than drugging them. All anti-depressants do have side effects. The impairment in fertility with Zoloft has not been noted in humans, only in rats at 4 times the normal dosage so I wouldnt be too concerned on that front.

msmomma1 6 Dec 2013

Yes she is getting counsleing and has been for almost 2 yrs but with the anniversary of the death of her grandfather and step father passing within 4months of each other and some things she got involved in personaly she has fallin back into the behaviors she was displaying before. At that time she began cutting and showing the all to well known signs of deppression so I began the help right away. She stopped and was doing very well not bieng medicated and has since began again. I myself have been through EXACTLY what she is going through (and I mean everything). All of the things she is displaying and how she is copeing are the 'red flags' that is always discussed so I was not willing to take a chance for it to get out of hand. As they say I would rather be safe than sorry! Haveing the mental health issues myself I just want as much help and info as I can get.Just don't want her to have as many struggles as I did because my parents were not as informed and did not really know how to help me.

DzooBaby 6 Dec 2013

It is good that you are supportive and understanding. Poor girl! I hope she gets to doing better. Depression is a terrible dark hole and no way to live!

DzooBaby 6 Dec 2013

Most antidepressants have a black box warning against suicide in adolescents and young adults. No matter which drug you decide, keep a close eye for signs of increasing depression. I lost two cousins, one on each side of the family so I am very outspoken about suicide prevention and I take possible suicide very seriously. I was very depressed in my early 20's (I was even hospitalized at one point) and Prozac was a drug I tried and I was never, ever suicidal the whole time I was depressed except during the time I was on Prozac. (My son was tried on Zoloft when he was very young and it made him almost wildly manic. He even tried to climb onto my brothers 2 story roof from the second story balcony of their house! He was out of control wild and couldnt settle down! I immediately took him off the Zoloft and he went back to normal. It was quite scary.) It doesnt happen to everyone but it is something you should be aware of.

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These drugs have also been known to be life savers for many people. Everyones brain chemistry is different and people react very differently to these drugs so I just wanted you to be aware. Look both of them up here on DDC and print them out-read the reviews-before making a decision. I have pasted the warning from each drug. See below:
Zoloft (sertraline)
Suicidality and Antidepressant Drugs

Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of Zoloft or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Zoloft is not approved for use in pediatric patients except for patients with obsessive compulsive disorder (OCD). (See Warnings: Clinical Worsening and Suicide Risk, Precautions: Information for Patients, and Precautions: Pediatric Use)

Prozac (Fluoxetine)
Warnings and Precautions

5.1 Clinical Worsening and Suicide Risk

Patients with Major Depressive Disorder (MDD), both adult and pediatric, may experience worsening of their depression and/or the emergence of suicidal ideation and behavior (suicidality) or unusual changes in behavior, whether or not they are taking antidepressant medications, and this risk may persist until significant remission occurs. Suicide is a known risk of depression and certain other psychiatric disorders, and these disorders themselves are the strongest predictors of suicide. There has been a long-standing concern, however, that antidepressants may have a role in inducing worsening of depression and the emergence of suicidality in certain patients during the early phases of treatment. Pooled analyses of short-term placebo-controlled trials of antidepressant drugs (SSRIs and others) showed that these drugs increase the risk of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults (ages 18 to 24) with Major Depressive Disorder (MDD) and other psychiatric disorders. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction with antidepressants compared to placebo in adults aged 65 and older.

The pooled analyses of placebo-controlled trials in children and adolescents with MDD, or other psychiatric disorders included a total of 24 short-term trials of 9 antidepressant drugs in over 4400 patients. The pooled analyses of placebo-controlled trials in adults with MDD or other psychiatric disorders included a total of 295 short-term trials (median duration of 2 months) of 11 antidepressant drugs in over 77,000 patients. There was considerable variation in risk of suicidality among drugs, but a tendency toward an increase in the younger patients for almost all drugs studied. There were differences in absolute risk of suicidality across the different indications, with the highest incidence in MDD. The risk differences (drug versus placebo), however, were relatively stable within age strata and across indications. These risk differences (drug-placebo difference in the number of cases of suicidality per 1000 patients treated) are provided in Table 2.

Table 2: Suicidality per 1000 Patients Treated

Age Range Drug-Placebo Difference in Number of Cases of Suicidality per 1000 Patients Treated
Increases Compared to Placebo
<18 14 additional cases
18 to 24 5 additional cases
Decreases Compared to Placebo
25 to 64 1 fewer case
≥65 6 fewer cases
No suicides occurred in any of the pediatric trials. There were suicides in the adult trials, but the number was not sufficient to reach any conclusion about drug effect on suicide.

It is unknown whether the suicidality risk extends to longer-term use, i.e., beyond several months. However, there is substantial evidence from placebo-controlled maintenance trials in adults with depression that the use of antidepressants can delay the recurrence of depression.

All patients being treated with antidepressants for any indication should be monitored appropriately and observed closely for clinical worsening, suicidality, and unusual changes in behavior, especially during the initial few months of a course of drug therapy, or at times of dose changes, either increases or decreases.

The following symptoms, anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, and mania, have been reported in adult and pediatric patients being treated with antidepressants for Major Depressive Disorder as well as for other indications, both psychiatric and nonpsychiatric. Although a causal link between the emergence of such symptoms and either the worsening of depression and/or the emergence of suicidal impulses has not been established, there is concern that such symptoms may represent precursors to emerging suicidality.

Consideration should be given to changing the therapeutic regimen, including possibly discontinuing the medication, in patients whose depression is persistently worse, or who are experiencing emergent suicidality or symptoms that might be precursors to worsening depression or suicidality, especially if these symptoms are severe, abrupt in onset, or were not part of the patient’s presenting symptoms.

If the decision has been made to discontinue treatment, medication should be tapered, as rapidly as is feasible, but with recognition that abrupt discontinuation can be associated with certain symptoms [see Warnings and Precautions (5.13)].

Families and caregivers of patients being treated with antidepressants for Major Depressive Disorder or other indications, both psychiatric and nonpsychiatric, should be alerted about the need to monitor patients for the emergence of agitation, irritability, unusual changes in behavior, and the other symptoms described above, as well as the emergence of suicidality, and to report such symptoms immediately to health care providers. Such monitoring should include daily observation by families and caregivers. Prescriptions for fluoxetine should be written for the smallest quantity of capsules consistent with good patient management, in order to reduce the risk of overdose.

It should be noted that fluoxetine is approved in the pediatric population only for Major Depressive Disorder.

Votes: +1
DzooBaby 6 Dec 2013

As an aside, I mentioned the death of my two cousins. They were not related to antidepressant therapy but interestingly enough, they were both on Accutane at the time, which was later discovered to increase suicidal ideation as well. They both fell into depression and the signs were there but they werent really noticed until after the fact. Both were 17 y/o, and just about ready to graduate High School. One was an athlete, football player, wrestling champ-had gone to the State meet that year and had done well. He started Accutane for his acne and went into a deep depression after relationships with two different girls broke up. He had talked to many of the adults in our family about his depression but was never sent for professional help. He took his own life in his parents basement-pieced together a handgun that was taken apart for a younger brothers safety, and shot himself in the chest and was found by his parents.

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The other cousin never mentioned depression to anyone but the signs were there. One week he began giving away some of his prized possessions, and one night, called his mother at work just to tell her that he loved her (which he had never done before), went into his room, turned the music up loud, and put a shotgun under his chin and pulled the trigger. His older brother was downstairs on the couch napping when something woke him (the gunshot, he now figures) he went upstairs to investigate and found his little brother. It was very sad and devastating for our families. I dont tell you this to scare you, please, that is not my intention. I just want to warn you to look for the signs and be aware. Read all you can about suicide and the signs to look for. If your teen begins to exhibit those signs, get her help immediately-if you have to hospitalize her on a suicide watch-do it! Dont wait hoping it will get better in time! I would spare anyone the heartache of a teen suicide! I hope and pray all gets better for her. It is good that you are supporting her and getting her help!

fayfaith 23 Jan 2014

Thank you so much for sharing your story. I believe sincerely that sharing this here on DC will help so many people & possibly save a life or many lives. God bless U and your families & God bless the woman + daughter you're sharing this with right now. Fay

Beverleya 6 Dec 2013

I have been on both Prozac and Zoloft.
The Zolf did nothing for me other than create terrible shakiness. Prozac did wonders.
Good luck and I wish you the best.

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Hal2323 16 Mar 2017

I have been on both zolft and prozac. Zolft made me VERY mean and angry. Prozac worked very well for me.

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