Prozac For Anxiety: Benefits, Dosage, Side Effects, and More

It’s normal to feel anxious from time to time, especially in stressful situations. But if you’re prone to severe or persistent anxiety, or if you frequently experience panic attacks, you may be one of the tens of millions of American adults with an anxiety disorder.

Fortunately, several medications are available to treat anxiety; the antidepressant drug Prozac® is one such medication.

Prozac, which contains the active ingredient fluoxetine, works by changing the activity of natural chemicals in your body that control moods and feelings. Taken consistently, it can help to treat several common forms of anxiety, improving your mental well-being and quality of life.

Below, we explain what Prozac is, as well as how Prozac and similar medications work to treat the symptoms of anxiety.

We also go over how you can use Prozac for anxiety, from approved dosages to potential side effects, as well as drug interactions that you should be aware of before you start treatment.

The Food and Drug Administration (FDA) first approved Prozac, the brand name for the active ingredient fluoxetine, in 1987 as a treatment for major depressive disorder (MDD).

In addition to depression, it’s approved to treat:

• PMDD (premenstrual dysphoric disorder)

• Obsessive-compulsive disorder (OCD)

• Panic disorder

• Bipolar disorder

• Bulimia nervosa

Providers often prescribe Prozac off-label for conditions other than those approved by the FDA, such as:

• Social anxiety disorder

• Post-traumatic stress disorder (PTSD)

• Raynaud phenomenon

• Selective mutism

How Does Prozac Work?

Prozac belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs). Like other SSRIs, Prozac works by increasing the activity of serotonin—a neurotransmitter that regulates mood, happiness, and anxiety levels and plays a role in sleep and mental health — in the brain and body.

Researchers aren’t totally sure how Prozac works for anxiety. They think it may be effective because it resets the way the body uses serotonin.

So, by modifying serotonin activity, the benefits of Prozac include alleviating anxiety symptoms and making it easier to maintain a normal life.

Prozac can provide real benefits for people with certain anxiety conditions, though it doesn’t necessarily treat every type of anxiety.

Specifically, the FDA approves Prozac to treat panic disorder, a common type of anxiety disorder characterized by intense periods of fear, discomfort, and panic attacks. Panic attacks involve symptoms like a sense of impending doom, sweating, a pounding heart, and feeling out of control.

Clinical trials have found that Prozac reduces panic attacks in people with panic disorder. For instance, one of them reported that 42 percent of participants were panic-attack-free after 12 weeks of treatment, and another found an even higher success rate of 62 percent.

Prozac is also commonly used off-label to treat social anxiety disorder, which involves intense fears in social situations such as parties, meetings, and other social events.

A meta-analysis found that SSRIs, including Prozac, can improve social functioning, and another study found that they’re comparable to cognitive behavioral therapy (CBT) for treating social anxiety.

So, how effective is Prozac in treating other forms of anxiety? Another small trial suggested fluoxetine effectively treated generalized anxiety, separation anxiety disorder, and social phobia in youths, although research in adults is lacking.

There’s also emerging research suggesting Prozac’s potential in treating PTSD.

To summarize, Prozac can be helpful for panic disorder, while its effectiveness for generalized anxiety disorder (GAD) is less well-established and warrants further studies.

Prozac is a prescription medication, meaning it requires a prescription from a licensed healthcare professional.

After reviewing your symptoms and health history, your provider might prescribe Prozac if they think you’re a good fit for the medication.

You can also access psychiatric resources online through trusted telehealth platforms like ours.

Prozac is generally an effective medication for some anxiety conditions, but it doesn’t deliver instant relief. In other words, you won’t immediately feel calm and relaxed.

It can take four to five weeks for Prozac to start fully working. During this time, you may begin to experience small, gradual improvements in some anxiety symptoms, including your mood.

It’s important to continue your Prozac prescription even if you don’t notice improvements during the first four to five weeks. Try to be patient and stick to your prescribed Prozac routine. Over time, there’s a good chance you’ll start to notice improvements as the medication becomes more effective.

Prozac is typically prescribed at a dose of 10 to 20 mg daily for panic disorder. Your healthcare provider may adjust this dose over time based on your response to Prozac, your risk of side effects, and other factors.

Most people respond well to Prozac at a dose of 20 to 40 mg daily. The maximum FDA-approved dosage of Prozac is 80 mg per day.

There’s currently no precise dose of Prozac for off-label uses, such as social anxiety disorder.

Like other antidepressants, Prozac can cause side effects. It’s important to let your healthcare provider know if you have any severe or bothersome side effects or if they do not improve over time.

Common side effects of Prozac include:

• Abnormal dreams

• Sexual dysfunction, like lower sex drive or difficulty reaching orgasm

• Initial, temporary anxiety and nervousness

• Increased yawning

• Loss of appetite

• Drowsiness and fatigue

• Insomnia and altered sleep habits

• Nausea

• Sweating and hot flashes

Keep in mind that many adverse effects of Prozac improve gradually as your body starts to adjust to the effects of this medication.

It’s also important to note that Prozac can cause another serious side effect in children, adolescents, and young adults: the potential for suicidal thoughts and behaviors. It’s extra important to monitor any worsening of suicidal thinking and behavior.

Additionally, Prozac can interact with other medications. When used with medications that increase serotonin activity, Prozac may cause a potentially dangerous drug interaction called serotonin syndrome, where serotonin levels increase beyond a safe level.

Serotonin syndrome can cause serious, potentially harmful symptoms, including:

• Shivering

• Elevated blood pressure

• Heart palpitations

• Tremor

• Muscle jerking

• Overly active reflexes

Severe cases of serotonin syndrome may cause renal failure, blood clots, coma, and even death. Medications and supplements that may interact with Prozac include:

• Tricyclic antidepressants (TCAs)

• Monoamine oxidase inhibitors (MAOIs)

• Other SSRIs and antidepressants

• Fentanyl, tramadol, and other opioid pain medications

• Anxiety medications, such as buspirone (Buspar®)

• Amphetamines

• St. John’s wort

• Tryptophan

To reduce your risk of experiencing serotonin syndrome or other drug interactions, make sure to inform your healthcare provider about any medications you currently take or have recently taken before starting treatment with Prozac.

It’s especially important to inform your healthcare provider if you’ve used an MAOI or other type of antidepressant medication to treat any medical conditions within the last 14 days.

If you're concerned about an interaction with your ADHD medication, you can read more about it in our guide to taking Prozac and Adderall® together.

Lastly, you should inform your provider if you’re pregnant or breastfeeding, or if you have other preexisting conditions, like heart disease, before using Prozac.

Prozac is an easy medication to use. It’s available as a capsule, tablet, and solution. Translation: You take it orally.

A healthcare professional will give you medical advice about when to take Prozac and how much medication to take each day.

In general, the following tips will help you get the best results from Prozac as an anxiety treatment:

• Take Prozac at around the same time every day. Prozac works best when it’s taken at a consistent time of day, in the morning. Try to follow your healthcare provider’s instructions as closely as you can and aim to take Prozac at around the same time daily.

• If you miss a dose, take it as soon as you remember. However, if it’s almost time for your next dose of Prozac, skip the missed dose and continue as normal. Do not take two doses of Prozac at once to make up for a missed dose.

• Combine Prozac with psychotherapy. Prozac and other antidepressants often have a greater effect when they’re combined with certain forms of talk therapy, such as cognitive behavioral therapy (CBT). Your healthcare provider may recommend meeting with a therapist.

• Wait two to four weeks before assessing your results from Prozac. It usually takes two to four weeks for Prozac to start working properly, during which you may or may not notice any improvements in your moods, feelings, or anxiety symptoms. Try to be patient and wait at least four weeks before you start assessing your results.

• If Prozac doesn’t work for you, don’t worry. It’s normal to try several antidepressants before finding the right one for you. If Prozac doesn’t seem to work well for you after two to four weeks, let your healthcare provider know. They may adjust your dosage or recommend switching to a different antidepressant or anti-anxiety medication that’s better suited to your needs.

• Never stop taking Prozac abruptly. If you stop Prozac abruptly, it can potentially cause withdrawal symptoms, including mood changes, dizziness, agitation, sleep issues, headaches, and a return of your anxiety symptoms. Instead of stopping it abruptly, let your healthcare provider know you’d like to stop treatment. They’ll help you taper your dosage and stop using Prozac safely.

There’s no one best anxiety medication for everyone. The good news is that there are options, and your healthcare provider can help you identify the best one for your symptoms, severity, and other factors.

Below are a few alternative anxiety medications.

Other Selective Serotonin Reuptake Inhibitors (SSRIs)

As we’ve mentioned, Prozac is an SSRI. These are some of the most common types of antidepressants prescribed to treat anxiety. Different types of SSRIs for anxiety include:

• Escitalopram (Lexapro®)

• Paroxetine (Paxil® and Seroxatr®)

• Sertraline (Lustral® and Zoloft®)

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) SNRIs

These are another type of antidepressant for anxiety. They work similarly to SSRIs, although they target multiple brain chemicals, including norepinephrine and serotonin.

Commonly prescribed SNRIs include:

• Venlafaxine (Effexor®)

• Desvenlafaxine (Pristiq®)

• Duloxetine (Cymbalta®)

SNRIs have similar side effects to SSRIs. Some may also increase blood pressure and cause headaches and sweating.

Benzodiazepines

Benzodiazepines were developed specifically to treat anxiety. They are fast-acting, which means the calming effect happens quickly. Some examples include:

• Alprazolam (Xanax®)

• Chlordiazepoxide (Librium®)

• Clonazepam (Klonopin®)

• Diazepam (Valium®)

• Lorazepam (Ativan®)

Some common side effects of benzodiazepines include:

• Drowsiness and confusion

• Headache

• Nausea or vomiting

• Shallow breathing

Benzodiazepines can cause tolerance and physical dependence, so they should only be used occasionally.

Tricyclic Antidepressants (TCAs)

TCAs are an older class of antidepressants. They aren’t FDA-approved for anxiety disorders, but they’re sometimes prescribed off-label because studies show they can help with panic attacks. Examples include:

• Imipramine (Tofranil®)

• Clomipramine (Anafranil®)

• Nortriptyline (Pamelor®)

TCAs have more side effects than other antidepressants and some anxiety medications, so they aren’t typically prescribed as the first line of defense.

Beta-Blockers

Beta-blockers like propranolol were initially used for cardiovascular disorders like high blood pressure and irregular heartbeat. They’re sometimes prescribed off-label to help manage anxiety disorders, prevent panic attacks, and treat other stress-related medical conditions.

They work by blocking stress hormones from triggering your body’s fight-or-flight response.

Though they can work well under some circumstances, they’re typically less effective than SSRIs, SNRIs, and benzodiazepines.

There are many reasons your healthcare provider may prescribe Prozac, including symptoms of anxiety. Here’s what to keep in mind about this antidepressant as you consider it:

• Prozac is a popular, effective medication for treating panic disorder, a common form of anxiety that can involve sudden panic attacks. However, there is less research when it comes to using Prozac for social anxiety or generalized anxiety disorder.

• You take Prozac orally in tablet, capsule, or solution form. You should take it around the same time every day (most people choose to do so in the morning because Prozac can be activating, like a cup of coffee).

• Common side effects of Prozac include nausea, insomnia, headache, and sexual dysfunction, though these often subside over time.

• It can take a few weeks for you to start feeling the effects of Prozac. If you’re prescribed Prozac for anxiety, make sure to closely follow your mental health provider’s instructions and inform them if you experience any side effects.

• Prozac works best when combined with talk therapy, like cognitive behavioral therapy (CBT).

• Don’t stop taking Prozac without medical advice. Let your healthcare provider know if you’d like to stop treatment, and they’ll help you stop using Prozac safely.

• If you don’t think you’re a good fit for Prozac, there are other treatment options for anxiety. Some examples include other SSRIs, SNRIs, TCAs, benzodiazepines, and beta-blockers.

Wherever you are on your mental health journey, dealing with anxiety can feel overwhelming.

But you made it here, and learning about the different treatment options is a major step toward managing your symptoms and feeling better.

We offer access to a full range of medications for anxiety and depression online following a consultation with a psychiatry provider who will determine if a prescription is appropriate.