Prozac and Diabetes

Prozac is a brand of Fluoxetine, an antidepressant that belongs to the selective serotonin reputable inhibitor (SSRI) class. It’s employed in the management of major depression, panic disorder, and obsessive-compulsive disorder. It works by inhibiting the reuptake of the serotonin (5-hydroxytryptamine) neurotransmitter in presynaptic terminals, making it more available in the brain.

Commonly regarded as “the happy hormone,” serotonin aids the regulation of mood, happiness, and feelings of well-being. Hence, by enhancing its availability in the brain, Prozac may help manage depression. In depressed adults, oral dosage starts at 20 mg and can be increased to a maximum of 80 mg daily.

Although there is no scientifically proven reason for this condition in diabetics, a possible explanation most share relates depression to the psychological burden of being ill. However, research confirms that diabetes causes structural changes to the brain, which is a possible cause.

Research suggests that fluoxetine efficiently reduces the severity of depression in diabetics and promotes improved glycemic control. In an eight-week controlled trial where 60 diabetics were administered up to 40 mg of fluoxetine daily, the findings include a decrease in depression symptoms, considerable improvement in depression based on specific scales, and an increased depression remission rate.

It’s crystal clear that Prozac does benefit diabetics managing depression. However, what other benefits/risks does it pose in this population? Stick with us as we walk you through the most prominent ones, as observed in research.

Weight and Blood Glucose Management

Short-term therapy of Prozac has been linked to a loss of weight and reduced blood glucose levels — desirable for diabetes. In one meta-analysis that examines the metabolic effects of fluoxetine in type 2 diabetic adults, reductions in body weight, fasting plasma glucose, triglycerides, and HbA1c (glycated hemoglobin) levels were observed.

Increased Insulin Sensitivity

Fluoxetine has been shown to reduce insulin sensitivity — the primary cause of type 2 diabetes. In one study on 12 non-diabetic obese patients, administering 60 mg of fluoxetine once daily for three weeks improved insulin sensitivity index considerably. However, this improvement isn’t linked to weight loss in these patients.

Elevated Risk of Diabetes in Youths

While some studies illuminate the diabetes-friendly benefits of Prozac, certain studies prove otherwise when used alongside other antidepressants. In one study that examines 119,608 youths, those who took SSRIs (e.g., Prozac) and serotonin and norepinephrine reuptake inhibitors (SNRIs like Effexor) for more than 150 days were 2.39 times more likely to develop type 2 diabetes than those who used them for a lesser period.

Increased Risk of Hypoglycemia in Type 1 Diabetics

Although Prozac proves to be beneficial in managing depressed type 2 diabetics, research on people with type 1 diabetes presents a contrary opinion. One study examines the effect of fluoxetine administration in a 25-year old Caucasian woman who had type 1 diabetes and on continuous insulin infusion.

Following the presentation of depressive symptoms, the daily administration of 20 mg of fluoxetine yielded recurrent hypoglycemic episodes in one week, prompting a graded reduction in her insulin dose. Expectedly, her insulin needs increased back to the initial amount after fluoxetine administration was stopped.

On the one hand, this study presents interesting findings that may influence the use of Prozac in type 1 diabetics. On the other hand, one major limitation to the research is its minimal sample population. Hence, there’s a need for more extensive observational studies to verify these claims.

Self-medicating when opting for an antidepressant is not advisable because it can cause severe side effects when taken wrongly. Here are some tips to avoid causing harm to yourself when taking antidepressants like Prozac:

• To prevent constipation caused by antidepressants, add one tablespoon of ground psyllium husk to your diet.
• Avoid quitting antidepressants abruptly to avoid withdrawal symptoms like dizziness, irritability, nausea, nightmares, etc. Rather, contact your health specialist to help you develop a plan that allows for a tapered reduction of drug intake.
• Always be consistent with your medication use, as irregular use can reduce effectiveness.
• Do not use Prozac if you have used a monoamine oxidase inhibitor (MAOI like Azilect and Nardil) in the last two weeks. Also, wait for five weeks after Prozac use before commencing an MAOI. This is essential to avoid a reaction known as “serotonin syndrome” — marked by agitation, rapid heart rate, hypertension, fever, etc.