If you are looking for information about switching or "bridging" to Prozac to go off your antidepressant, read this ENTIRE topic: http://survivinganti...ng-with-prozac/
Prozac was the first popular SSRI, released in 1987, and was a substantial source of profit for Eli Lilly for many years. It became available in a generic form in 2001 (Lilly's fortunes subsequently plummeted).
It comes in 10mg, 20mg, and 40mg capsules, as well as a liquid (20Mg/5Ml), which is very helpful for tapering off. After a single oral 40 mg dose, peak plasma concentrations occur after 6 to 8 hours.
It also comes in a 90mg weekly capsule, containing coated pellets for delayed release adding 2 hours for peak plasma concentrations (very rarely prescribed).
It has the longest half-life of any SSRI. After you take it for a few days, half-life is about 16 days. Fluoxetine itself has a half-life of 2-4 days, but as it is processed, your body creates an active antidepressant metabolite, norfluoxetine, which has a half-life of 7-15 days. So Prozac keeps on extending its half-life as it is metabolized.
According to http://en.wikipedia....wiki/Fluoxetine , fluoxetine and norfluoxetine inhibit each other's metabolism, extending the half-life of the drug. Because the half-lives are so long, the full effect of Prozac on the brain may not be felt for several weeks.
fluoxetine (1-6 days) ---> norfluoxetine (up to 16 days) ---> other metabolites
Prozac is mainly metabolized by the liver enzymes identified by cytochrome P450 CYP2D6 and CYP2C9/2C19, and inhibits its own metabolism via cyp 2D6 and cyp 2c19, which means lower doses get metabolized faster. (Prozac and its metabolites are also mild to moderate inhibitors of CYP1A2, CYP2B6, CYP2C9, and CYP3A4.)
Is Prozac "self-tapering"?
Because of its very long half-life, Prozac has the reputation of being "self-tapering," meaning it requires only a short taper. However, some people do suffer withdrawal from Prozac, just as severe as other SSRIs. Because of the long half-life, withdrawal symptoms simply take longer to appear.
We suggest starting out with a slow taper of 10% per month for a couple of months; if no withdrawal symptoms appear, rate of taper may be increased -- but slow down if withdrawal symptoms arise.
Reduce by 10% per month to start
The 10% rule holds for Prozac, just like other psychiatric drugs: Reduce by 10% per month, calculated on the last dosage. (The amount of the reduction gets progressively smaller.)
See Why taper by 10% of my dosage?
Using fluoxetine liquid to taper
This is by far the easiest way to taper by very small amounts. It comes in a concentation of 20mg fluoxetine in 5mL of liquid, meaning there is 4mg of fluoxetine in 1mL. If you are taking 10mg Prozac now, the liquid equivalent would 2.5mL. If you want to take 9mg of Prozac, you would take 2.25mL of the liquid.
Always check the concentration of the liquid you get as it can vary among manufacturers, and adjust your calculations accordingly.
If your fluoxetine liquid contains 20mg fluoxetine in 5mL of liquid:
- 1 mL= 4mg
- 0.5mL = 2mg
- 0.25mL = 1mg
- 0.2ml = 0.8mg
You will need an oral syringe to measure out your dose of the liquid.
To use the oral syringe, you need a special cap to put on the bottle of liquid Prozac. The cap should have a hole in it, the tip of the oral syringe fits into this. Read this about oral syringes.
If your pharmacist doesn't have a cap, ask for a smaller medicine bottle with this type of cap. Pour some of your liquid Prozac into it and draw your dosage from the smaller bottle.
Here's an illustration of how to draw the medication from the bottle http://survivinganti...ndpost__p__2284
Also see http://survivinganti...dpost__p__21391
See more detail about how to measure and taper Prozac-brand liquid here http://survivinganti...dpost__p__41090
Making your own Prozac liquid
Prozac is one of the few psychiatric medications with a long history of do-it-yourself dilution in water or juice. Mixed in cranberry juice, it's been called "Cranzac."
My own personal preference would be to dilute it with water, to avoid any degradation that might be caused by sugar or acid in the juice. Also, it will be easier to see how well the Prozac is dissolved in water. (There may be particles swirling around, that's the filler in the Prozac capsule that doesn't dissolve.)
Your Prozac solution may be a little bitter -- just swallow it quickly. You might want to chase it with a little fruit juice.
There are instructions for DIY Prozac solution here: http://depression.ab.../ht/cranzac.htm
(A psychiatrist posts about it here.)
For very gradual tapering, for example, you can dissolve a 10mg capsule in 10mL of water to make a solution with 1mg Prozac in 1mg of water. To take 1mg Prozac, use an oral syringe to take out 1mL.
Refrigerated, it's supposed to be stable for 14 days.
This can be a very precise way to taper.
Using a combination of tablets or capsules and liquid
Rather than switch directly to an all-liquid dose, you may wish to take part of your dose in liquid and part in lower-dose tablets or capsules, gradually converting to all liquid as you get to lower dosages. This can be very convenient and reduce any problems switching from one form of the drug to another.
For example, if you are taking more than 10mg Prozac per day, you could get your prescription filled in 10mg capsules and take part of your daily dosage in a 10mg capsule and the rest in liquid.
If your doctor prescribes liquid and tablets or capsules at the same time, most likely, he or she will have to indicate "divided doses" in the prescriptions to get the drugs covered by insurance.
Dividing contents of capsules into empty gelatin capsules
One way of tapering is to split up the powder in a capsule into smaller dosages. Go to a health food store and get empty gelatin capsules, the biggest they've got.
When you open up a Prozac capsule, you can carefully pour a fraction of the powder into empty gelatin capsules.
You won't have 5mg per capsule exactly, because it's difficult to eyeball the amounts.
If you want to be more precise, carefully pour the powder onto a piece of black paper and divide it into quarters with a knife, then scoop each 1/4 into an empty gelatin capsule.
See more about this technique at http://survivinganti..._3033#entry3033
If you are very sensitive to variations in dosage, this method will not be precise enough for you to control your taper.
Divide up capsule contents with an electronic scale
If you want to be even more precise, weigh the powder in a capsule with an electronic scale, divide it up, and put it into empty gelatin capsules. The powder is very fluffy, though -- make sure it doesn't blow off the scale.
Have a compounding pharmacy make up capsules of smaller dosages
A compounding pharmacy will accurately weigh the doses and put them into capsules for you. See http://survivinganti..._3001#entry3001
Edited by Altostrata, 21 June 2015 - 02:01 PM.