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Mental and behavioral disorders constitute a significant proportion of the global burden of disease, yet only a minuscule fraction of those suffering from such conditions can access primary treatment. In developing countries, only a tiny percentage of persons with mental disorders see a doctor, and health care is often unable to provide even the most basic mental health care. The experience of many countries shows that improving drug supply and use practices is a feasible task. Understanding the key elements regarding the therapeutic use of drugs and clinicians familiarity with the general principles of developmental and psychiatric pharmacotherapy is essential. To examine this topic in detail, the drug Prozac, which is an antidepressant, was reviewed.
Depression is defined as a depressed state, a loss of interest in making the patient happy. Additional criteria of depression doctors consider pessimism, low self-esteem, thoughts of death and suicide, appetite disorders, sleep problems, constant fears and anxiety, feelings of worthlessness and guilt, and inability to concentrate (Park & Zarate Jr, 2019). Prozac is on the list of the most important, safest, and most effective drugs, according to the World Health Organization (2019). The medication is prescribed most often for the treatment of depression. The drug is also used to treat obsessive-compulsive disorders and bulimia nervosa.
The active component in Prozac is fluoxetine, which is easily absorbed into the blood and can bind to plasma proteins and accumulate in body tissues. Fluoxetine belongs to a group of antidepressants called selective serotonin reuptake inhibitors. This group is considered a third-generation antidepressant, easily tolerated, and without significant side effects. At the beginning of therapy and increasing dose, anxiety and irritability, sleep disturbances, drowsiness, headache, nausea, vomiting, and diarrhea may appear ( Prozac, 2020). Rarely, convulsive seizures, allergic reactions in skin rash, itching, chills, fever, and pain in muscles and joints are possible. However, it is worth paying attention to the contraindications: it is prohibited for use during pregnancy, and lactation, with caution, is used in patients with liver dysfunction and contraindicated in severe renal dysfunction. As for children, the safety of fluoxetine use in children has not been established.
Fluoxetine and its metabolite, the substance into which it is converted in the body, norfluoxetine, can inhibit each other. Consequently, constant fluoxetine concentrations in the blood are reached only after four weeks of taking the drug (Zhao et al., 2017). Similarly, the effects of taking the medication do not go away immediately. Related to this is the difficulty in selecting the correct dose for the individual patient.
It is vital to note that people who have previously abused psychoactive substances may have an increased risk of developing psychological dependence and addiction to Prozac. Therefore, the drugs of older generations should not be abruptly withdrawn because they can cause psychological discomfort and unpleasant physical sensations. Doctors take this very seriously: they prescribe the correct use and the proper removal of drugs. In this regard, it is necessary not only to start therapy with the doctor but also to end it. However, the modern generation of medications eliminates the possibility of addiction. Nevertheless, difficulties can arise against the background of psychological attachment to systematic medication support, and the absence of pills in the daily diet provokes the development of anxiety and restlessness (Read, 2020). For this reason, doctors recommend that patients resort to a gradual withdrawal of antidepressants.
Patient education on the use of the drug when it is prescribed plays an important role. The direction of treatment and dosing regimen of a particular medication depends on its formulation and other factors. Accordingly, it is necessary not only to discuss all the nuances of taking this medication with the patient but also to prescribe the appropriate tests to minimize the risk of side effects and complications. Such instruction should also be given to medical professionals to get an initial referral and eliminate side effects. Medical doctors need to avoid stigmatizing the patient and approach treatment prescribing objectively and professionally. It requires communication with medical personnel in various forms: general and individual meetings, training, practical sessions, and lectures. A significant aspect, in this case, will also be the appointment of educational lessons and courses on professional development. An important consideration when prescribing therapy with Prozac, as with any antidepressant, is to maintain control of the course of treatment. Thus, regular meetings and conversations should be held to adjust the dosage and intensity of the medication.
Numerous aspects determine the effectiveness of drug therapy with psychotropic medications. These include the appropriateness of the choice of pills to the clinical picture of the disease, appropriateness of its dosing regimen, method of administration, and duration of the therapeutic course. In psychiatry, as in any field of medicine, it is necessary to consider the whole complex of drugs that a patient takes. Their joint action can lead to a change like the effects of each of them and the emergence of undesirable consequences. Choosing the proper medication depends on many factors, including symptoms and physical health. In any case, Prozac, as well as any other psychotropic drugs, should be prescribed by a doctor after appropriate consultation with the patient and several tests and examinations.
References
Park, L. T., & Zarate Jr, C. A. (2019). Depression in the primary care setting. New England Journal of Medicine, 380(6), 559-568.
Prozac. (2020). RxList. Web.
Read, J. (2020). How common and severe are six withdrawal effects from, and addiction to, antidepressants? The experiences of a large international sample of patients. Addictive behaviors, 102.
World Health Organization. World Health Organization model list of essential medicines: 21st list 2019. World Health Organization.
Zhao, Y., Yu, G., Chen, S., Zhang, S., Wang, B., Huang, J., Deng, S. & Wang, Y. (2017). Ozonation of antidepressant fluoxetine and its metabolite product norfluoxetine: Kinetics, intermediates and toxicity. Chemical Engineering Journal, 316, 951-963.
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