The differences in treatment with Prozac (Fluoxetine) vs Zoloft (Sertraline)

Prozac (Fluoxetine) vs Zoloft (Sertraline) as proved medications for anxiety and depression treatments

On today’s pharmaceutical market there are a lot of medications that are designed to treat anxiety-connected disorders and depression. We will see what the differences between the two such medications, namely Prozac and Zoloft are. We will also examine what these two have in common.

How both Zoloft and Prozac Work? Mechanism of action explained

The human central nervous system sends millions of signals, known as synaptic transmissions, to the various parts of the body in order to ensure their proper functioning and our overall well-being. The normal rate of heart beating, the digestion by the stomach, and numerous other functions depend on the signals originated in the human brain.

The set of anxiety-related conditions has something in common. Namely, these are caused by the low levels of a neurotransmitter known as serotonin. Neurotransmitter serotonin, when released, causes a chain reaction which ensures more production of neurotransmitters that go all the way to the organ they are targeting and make it function properly. After every serotonin production, inside the cells of the human brain, a few of the remains of serotonin are taking up by the postsynaptic cleft to the presynaptic cleft where they originated. This mechanism of utilizing unused serotonin is known in neurobiology as reuptake. Unused serotonin is stored for future reuse.

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What medications like Prozac and Zoloft do is they inhibit this reuptake process. That is, unused serotonin is not taken back anymore but continues to send signals over and over again. This way serotonin levels increase dramatically.

More serotonin essentially equals more good mood. When you have your levels of serotonin increased, the activity of the overall chains gets also increased, neuron circuits’ activity is heightened, and the symptoms of anxiety-related conditions recede. The mood is being regulated and anxiety symptoms are pushed to their normal levels. As a result, anxiety ceases.

Because of the above described mechanism, these medications are called Selective Serotonin Reuptake Inhibitors. There are other active ingredients except for Zoloft (sertraline) and Prozac (fluoxetine) that belong to this group. After taking even one pill of these, there is an immediate impact on serotonin, though it can take up to four weeks to reach its full benefits.

This should be noted that, while the general principle of the action of these antidepressants is clear, there are certain specifics to each of the medications that belong to this group. We will see further what the differences are between the two.

Zoloft vs Prozac: targeting different conditions

The conditions both drugs are targeting well

Zoloft (sertraline) and Prozac (fluoxetine) both designed to target a variety of conditions associated with:

  • Depression, including severe depression, also known in psychiatry as major depressive disorder;
  • Both drugs have also proved effective in treating obsessive-compulsive disorder in children and in adults;
  • In the treatment of anxiety;
  • Both medications can be used as an aid in treating panic disorder manifested in recurrent sudden panic attacks.

The conditions either Prozac or Zoloft are better in targeting

Prozac is usually prescribed when a patient is suffering from bulimia nervosa, which manifests itself in overwhelming desire to lose weight.

Zoloft, on the other hand, is considered to be a more reliable medication in the treatment of post-traumatic stress disorder, premenstrual dysphoric disorder, and social anxiety, when individuals are afraid of social interaction and are unable to communicate. It is important to note, that these conditions are often manifest themselves while being accompanied by one another.

General Effects both Zoloft (sertraline) and Prozac (fluoxetine) help to reach

  • The reduction of depression;
  • The improvement of mood;
  • The reduction of anxiety.

Are Prozac and Zoloft effective in every patient?

Zoloft is specifically effective in the treatment of depression in patients with a variety of cardiovascular diseases.

For minors, the primal indication of Zoloft is in the treatment of obsessive-compulsive disorder.

Some effects are noticed in the first weeks of taking the medication. The overall efficacy builds over the following several weeks.

Prozac vs Zoloft negatives

The side effects of both medications are very similar. They may include the following:

  • Dizziness;
  • Mild headache;
  • Excessive sweating;
  • Dry mouth;
  • Sexual dysfunction, which may include decreased pleasure, delayed ejaculation, decreased libido, anorgasmia;
  • Agitation;
  • Sleep disturbance;
  • Sudden mood shifts;
  • Feeling impulsive;
  • Feeling hyperactive.

Possible negative effects of Zoloft vs Prozac

  • Zoloft is known to have diarrhea as a side-effect, while Prozac rarely causes this condition.
  • Sleep disturbances are associated mostly with Prozac, while extremely rarely observed upon treatment with Zoloft.
  • Both medications are known to not cause weight gain. The absence of this downside distinguishes both drugs from the majority of other known antidepressants.

Extreme side effects sometimes manifest themselves in thoughts of suicide, or as a persistent desire to hurt oneself. However, these are observed in teenagers and young adults mostly. For this reason, a parental or any other family member’s guidance at all times is recommended for younger patients taking any of these drugs.

Should you notice any of these side effects in the course of taking any of the two medications, make sure to report the case immediately to your doctor.

Zoloft vs Prozac: dosages

  • Both medications must be taken in accordance with doctor’s recommendations.
  • Zoloft is usually taken starting from 25-50 mg a day and is gradually increased to a dosage of up 50-300 mg a day. The adjustments are made solely based on a treatment response. The ending maintenance dose can reach up to 50-200 mg per day, depending on the each individual case.
  • With Prozac, the basic dose is recommended to be 20 mg orally (administered once daily.) The maintenance dose can reach 60 mg daily.
  • The maximum dose can be as high as 80 mg orally daily, but it is rarely used.

Zoloft vs Prozac: safety and potential overdose

Both medications are considered by medical specialists to be largely safe in overdose. While it is theoretically possible to have a dangerous overdose, most such cases would include a combination with other medications. The severe side effects are rare.

Withdrawal does exist with these medications. Withdrawal doesn’t occur for everyone, though. But many patients reported they have experienced mild withdrawal symptoms after the course of taking each of these medications. Should you have a persistent desire to continue taking the medications after your recommended course is over, make sure to consult your medical specialist. Do not take more pills that were prescribed to you.

Zoloft vs Prozac: availability

Prozac is available in the form of capsules. Zoloft, on the other hand, is available as tablets and in a liquid form.


Drug interactions and counter interactions of Prozac and Zoloft

Prozac (fluoxetine) drug interactions and counter interactions

It is not recommended to administer Prozac if a patient has taken a MAO inhibitor in the 2 weeks prior. Conversely, it is not recommended to take thioridazine or a MAOI for 5 weeks after stopping the course of Prozac.

Avoid taking Prozac if you know you are allergic to its active ingredient, fluoxetine. Do not combine Prozac with pimozide or thioridazine or with the treatment with methylene.

Make sure to inform your doctor before taking Prozac, if you know you have one of the following conditions:

  • Liver or kidney diseases.
  • Seizures;
  • Glaucoma;
  • Diabetes;
  • In the case of the previous or current treatment with electroconvulsive therapy;
  • Manic-depressive disorder (sometimes referred to as bipolar disorder);
  • Any other mood disorders, such as borderline personality disorder;
  • If you ever had suicidal thoughts in the past.

Zoloft (sertraline) drug interactions and counter interactions

Inform your doctor if you are taking or planning to take one of the following medications before taking Zoloft:

  • Aspirin,
  • Ibuprofen,
  • Naproxen,
  • Celecoxib,
  • Diclofenac,
  • Indomethacin,
  • Meloxicam.

In general, any medications that belong to a class of nonsteroidal anti-inflammatory drugs can be counter-indicative with Zoloft.

  • Avoid drinking alcohol excessively, as alcohol is known to increase the risk of several side-effects of Zoloft.

Only for liquid Zoloft:

  • Do not combine it with disulfiram, as liquid Zoloft has a small amount of alcohol, and, as a result, the possible bad reaction to disulfiram can take place.

Make sure to inform your doctor if you are using or planning to use any of these meds:

  • Antidepressants;
  • Cimetidine;
  • Tramadol;
  • Phenytoin;
  • Blood thinners;
  • Heart rhythm pills;
  • Medicines designed to treat anxiety-connected disorders, mood-related conditions, or severe mental illness (schizophrenic syndrome.);
  • Migraine and/or headache pills.

Zoloft, when combined with other medications that cause drowsiness or make your breathing slow, can enhance these effects.

Tell your doctors as far as your plans for following medications are concerned.

  • Sleeping pills;
  • Narcotic pain meds;
  • Any medicine designed to relieve seizures symptoms;
  • Medicines that work as muscle relaxers;
  • Medicines designed to treat anxiety-connected disorders.

For both Prozac and Zoloft (drug interactions and counter interactions)

Both pills can potentially cause complications if you are carrying a child or feed your child with your milk. Why is that so? Both medications can find their way straight to the feeding milk components and be harmful to a baby, particularly harmful to the lungs.

Make sure to inform a doctor about all other antidepressants you have taken in the past before taking either Zoloft or Prozac.

Prozac vs Zoloft: How to take?

Directions for Zoloft and Prozac pills:

  • For both medications, you should rely on the recommendations of your doctor.
  • It is not recommended to change the dosage to lower or to higher one without consulting your medical specialist;
  • It is also not recommended to take these medications for a longer period of time than it was recommended.
  • Be aware that both medications are working rather slowly, considering. It can be two, three, and sometimes four weeks, before their effects start to show improvements in your condition.
  • Avoid crushing, chewing, or opening a delayed-release capsule which contains the medication. You should swallow a capsule whole.
  • Make sure to take it approximately at the same time of the day.

NOTE: Zoloft and Prozac are known to show positive result during the regular drug-screening test. Make sure to tell the staff in the test laboratory that you are prescribed with these medications.

Directions for liquid Zoloft:

  1. Zoloft in liquid form has to be diluted in a small amount of water prior to talking.
  2. To make sure you are about to administer the correct dosage, measure the Zoloft-liquid with a regular dropper, which is available in any pharmacy.
  3. Mix the dosage with one-half cup of plain water. You can substitute water for other liquid substances. Consult the list of liquids you can use with a doctor in case of doubt.
  4. Stir the mixture thoroughly.
  5. Drink it in one gulp.
  6. To make sure you got the whole dose, pour a small amount water to the cup you used, stir and drink again.

Article by Canadian  Online Pharmacy Team