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Revisiting fluoxetine (Proxac) and suicidal preoccupations
1Department of Psychiatry, University of Florida, Gainesville 32608.
The Journal of Emergency Medicine
|September 1, 1994
Summary
Fluoxetine (Prozac) has been linked to suicidal thoughts and actions in some patients. While initially dismissed as a symptom of depression, recent research suggests the antidepressant may induce suicidal behavior by affecting serotonin and causing akathisia.
Area of Science:
- Psychiatry
- Neuroscience
- Pharmacology
Background:
- Reports in 1990-1991 linked fluoxetine (Prozac) to suicidal ideation and attempts.
- Subsequent retrospective studies suggested suicidal preoccupation was a symptom of depression, not the antidepressant.
- Emerging research indicates fluoxetine may induce suicidal behavior.
Purpose of the Study:
- To evaluate the potential link between fluoxetine (Prozac) and suicidal behavior.
- To explore the neurobiological mechanisms possibly underlying this association.
Main Methods:
- Review of psychiatric and medical literature.
- Analysis of recent studies investigating fluoxetine's effects on serotonergic pathways and extrapyramidal symptoms.
Main Results:
- Fluoxetine may adversely affect serotonergic neuronal discharge.
- The drug can induce an akathisia-like extrapyramidal reaction.
- A small subset of patients may consider or attempt suicide while on fluoxetine.
Conclusions:
- Fluoxetine (Prozac), despite a favorable side effect profile compared to tricyclic antidepressants, may precipitate suicidal behavior in susceptible individuals.
- Akathisia is a potential adverse effect linked to fluoxetine-induced suicidal ideation or actions.