My daughter is 7 and she was recently put on Prozac for depression. She's been on it for about 3 weeks now and her behavior was getting worse and worse. She's acting like she's had 20 cups of coffee, then melting down and crying and screaming, then eventually crashing and falling asleep. So now we have taken her off it, because apparently she was already on the lowest dose so we don't need to taper. I'm worried about withdrawal symptoms and wondering when her system will be fully cleared from the medicine. She has 2 psychiatrists but they are rarely available and they don't answer my questions very well. I am in the process of finding her a new psychiatrist but in the mean time thought I'd try to reach out and get some opinions. I feel pretty worried and don't know what to expect with her going off all medication. Is there a chance she could crash even worse and become suicidal?
"Factors that influence Prozac withdrawal:
There are various factors that will influence your withdrawal period from Prozac. If you have been on the medication for years and are taking a relatively high dosage, it may be more difficult to quit than if you were only taking it for a few months. Generally, the longer you are on a medication, the more difficult it will be to quit, but there are other factors that influence withdrawal as well.
1. Time Span
How long have you been taking Prozac (or generic Fluoxetine)? If you have been taking the medication for longer than a year, it is going to be more difficult to come off of than someone who has only taken it for a few months. The time span that you took a drug is always going to influence the withdrawal process.
2. Dosage (10 mg, 20 mg, 40 mg, 60 mg)
Generally Prozac is prescribed as one of four dosages. The range is from 10 mg all the way up to 60 mg. Someone who is taking just 10 mg is likely going to have an easier time coming off of the medication than someone who had been taking 60 mg.
Time span along with dosage plays a huge role in influencing withdrawal. Someone who takes 60 mg for a period of 5 years is going to struggle more with coming off of the drug than someone who took 20 mg for 8 months. Typically the greater the dosage, the more you will need to focus on a gradual tapering process.
The phrase “everyone is different” holds true when it comes to medication withdrawal. Although two people may experience the same or similar symptoms, one person may have a more difficult time coping with them. For one individual the dizziness and headaches may cause them to panic and/or lead to “panic attacks.”
For another person experiencing dizziness may bother them, but may not elicit a panic response. Individuals with better familial and social support, healthier habits (e.g. diet and exercise), and more self-awareness will likely have an easier time withdrawing from Prozac.
4. Cold turkey vs. tapering
It is much easier to quit Prozac cold turkey than other SSRI medications. I have successfully quit this medication cold turkey with no major withdrawal symptoms. Individuals that have been on this medication for a long period of time and/or at a high dosage should still use a tapering method of withdrawal. It is never advised to quit “cold turkey” unless you are on an extremely low dose.
Note: In comparison to most antidepressants, fluoxetine has a long half-life. In other words, Prozac stays in your system for a longer duration than other drugs after stopping. This is beneficial when it comes to withdrawal because SSRI’s with a short half-life tend to produce the most extreme withdrawal symptoms.
Prozac Withdrawal Symptoms: List of Possibilities
The withdrawal symptoms that you will experience coming off of Prozac may not be the same as someone else. Everyone has a different reaction to medications as well as how their body responds and readjusts to life without the drug. Some people may experience very minimal withdrawal symptoms, while others may be plagued by seemingly everything on this list.
Agitation: Many people report feeling agitated, restless, and irritable while coming off of Prozac. This is a result of how they are feeling without the calming serotonin that was increased while they were on the medication. Now that they are coming off of Prozac, they experience somewhat of a polar opposite to relaxation.
Anger: Some people report feeling extremely angry and/or exhibit outbursts of rage while coming off of Prozac. With this medication, it is less common to feel extreme anger than other medications, but some people may get really upset. Very little things can trigger anger because the person withdrawing is going through a lot.
Anxiety: Since this medication helps calm a person down by treating both anxiety and depression symptoms, it is no wonder that they experience anxiety while coming off of the medication. Even if the person didn’t have a “chemical” imbalance before taking Prozac, they will have one after coming off of the medication as a result of withdrawal. The serotonin system will eventually reset itself back to homeostasis.
Blurred vision: People have reported weird effects from withdrawal on their vision. Some individuals experience blurred vision, while others see “floaters” (or small objects floating in their field of vision). Your vision is likely not affected in any way by the medication, but it may take your brain to readjust and thus recover from the withdrawal-induced vision changes.
Confusion: It is common to experience confusion and/or subtle amnesia when withdrawing. Extreme confusion is uncommon, but being slightly confused in addition to slowed cognition is all part of the process.
Crying spells: The emotional upheavals that you may experience while coming off of Prozac may feel unbearable. This may result in crying spells as a way to release some of the pain that you are experiencing. Just know that it is normal to cry as a result of the emotion that you are experiencing – it is uncontrollable emotion.
Depersonalization: Some individuals report feeling unlike their natural selves during withdrawal. They may feel like they have transformed into a zombie or that their “true self” will never come back. This is called “depersonalization” and is a result of brain chemistry changes and going through major withdrawal. Rest assured that you will eventually return to normal over time.
Depression: Feeling depressed while withdrawing from Prozac? This is because you were taking it to treat depression. When you stop taking it, you are going to feel depressed because your brain is no longer inhibiting the reuptake of serotonin. Even if you already have depression, withdrawing may make symptoms worse and more extreme.
Dizziness: As with all SSRI’s, Prozac withdrawal may result in dizziness and/or vertigo. This is a common symptom that will eventually subside. Try not to freak out – there is not something more extreme wrong with you, it’s just medication withdrawal.
Emotional numbing: It is common to feel emotionally numb as a result of withdrawal. This numbing makes some people feel like “zombies” or that they have zero emotions and contributes to depersonalization-like symptoms. This is something that I experienced to a degree with Prozac.
Fatigue: You may feel extremely tired or fatigued all day. The lethargy may be so extreme that you may have a difficult time completing various tasks. As weeks pass, you will eventually recover and begin to notice that your energy levels are starting to return to normal.
Headaches: You may experience minor or very intense headaches when quitting Prozac. It is not always easy to deal with them, but most of the severe headaches should subside within a couple weeks. The longer you are off the drug, the less severe these typically are.
Inability to concentrate: Withdrawal may lead to some people experiencing ADHD-like symptoms. You may not be able to concentrate in school and/or during work projects. It may seem as though no matter how you try, focusing on tasks is a lost cause. Your concentration will eventually return, but it will take time.
Insomnia: Some people are unable to fall asleep at night during withdrawal. Although tiredness is extremely common, so is insomnia. People may stay up well into the night just wishing that they could somehow fall asleep. It is the emotional upheavals and anxiety that keeps people awake.
Lightheadedness: In addition to dizziness and headaches, many people report feeling lightheaded during withdrawal. This actually may contribute to some people feeling dizzy – just know that it will eventually fix itself.
Memory problems: Many individuals have reported having memory problems and/or reduced capacity to remember things upon withdrawal. This is something that I’ve personally experienced and it’s certainly not fun. Do your best to cope with your memory impairment, it will eventually return to normal functioning.
Mood swings: One moment you may feel angry and you may quickly transition to feeling sad. The next hour your may feel aggressive and/or extremely anxious. As your brain recalibrates itself, you are going to experience changes in mood. Do your best to cope with whatever you experience.
Muscle pain: Many individuals report body aches, muscle weakness, and various muscular pains. These can be difficult to deal with, but know that they are only temporary.
Nausea: It is common to experience nausea, and in some cases, flu-like symptoms. The nausea may be extreme enough to trigger vomiting.
Night sweats: You may experience profuse sweating while you sleep. This is basically your body’s attempt to restore itself. Prozac affects us not only on a mental level, but also physically.
Panic attacks: This medication typically helps people with panic attacks, so when they come off of it, the panic may be way worse than when they initially started the medication. People may freeze up in social situations and/or randomly experience panic. This is a result of the brain being in a hypersensitive state and low serotonin levels.
Stomach pain: Feeling stomach cramps and pains is pretty common during the early stages of withdrawal. This is just your body’s way of readjusting to life without the medication.
Suicidal thoughts: There are black box warnings on all antidepressants forewarning people about potentially experiencing suicidal thoughts. When you come off of a major antidepressant, it is common to experience suicidal thoughts. Many drug companies may hide this little fact, but having suicidal thoughts and urges during withdrawal is extremely common. Do whatever you can do recognize that these will likely subside in intensity over time. However, if you are unable to cope with these thoughts, be sure to seek immediate professional help.
Tiredness: You may want to sleep all day and just stay in bed. The tiredness may be so extreme that you may think you have something wrong like chronic fatigue syndrome. You do not have chronic fatigue – you are going through withdrawal. It may take a lengthy period of time before you return to normal energy levels."
As a mother I empathize with your situation. I found it a bit unnerving that a child was prescribed Prozac. To put a 7 year old on Prozac and not be available for the child or parents borders malpractice.
I am glad you are seeking a new psych doctor. You may want to seek a children's therapist/psychologist to work with the psych doctor.
You know your child better than anyone. You should be able to tell by her behavior how she is doing coming off the drug. You may want to call her general doctor if she has one or if things get worst take her to the emergency room. No one knows how she is going to react coming off the Prozac abruptly.
My thoughts are with you and your family.
- Prozac Information for Consumers
- Prozac Information for Healthcare Professionals (includes dosage details)
- Side Effects of Prozac (detailed)
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