Dangers of Combining Prozac and Xanax

Please do not use this article as a substitute for a mental health professional’s diagnosis.

Prozac (fluoxetine) and Xanax (alprazolam) are two of the most prescribed drugs for mental disorders.  Prozac is often prescribed long-term (over six months) while Xanax is prescribed usually prescribed for short term use only due to its highly addictive nature.  Although many patients can take both Prozac and Xanax without problems, for some patients, this combination may worsen their depression or anxiety.

Usual Symptoms

Xanax helps slow down brain function.  There are many advantages to a slowing of brain function, particularly for patients suffering from debilitating panic attacks or flashbacks to traumatic events.  People experience significant physical pain from panic attacks and flashbacks, which only reinforces their fears and makes it hard to shake off the past.  When a patient can be freed from the physical symptoms, it helps them to take in good stimuli and help them with talk therapy. 

But when brain functions are slowed down, people tend to get sleepy.  Antidepressants are notorious for making people sleepy.  However, people on Prozac tend to lose this sleepy feeling after two to four weeks since their first dose.  But taking Xanax on top of Prozac may cause sleepiness or a feeling of all-encompassing fatigue.  Some people adjust and some people do not.

Unusual Symptoms

Medication Madness: The Role of Psychiatric Medications in Cases of Violence (Macmillan; 2009) chronicles many instances of patients reacting badly to a combination of Xanax and Prozac.  They became even more depressed, loss interest in anything, had suicidal thoughts and had more frequent panic attacks or bouts of crippling anxiety.  Some people even became violent or engaged in dangerous activity such as risky sex.

However, some of people of these lurid tales also took other medications such as sleeping pills or drank alcohol – a practice highly discouraged for anyone taking benzodiazepines.

One less dramatic unusual side effect from the mixing of the two drugs is bad constipation.  Constant constipation that lasts more than two weeks can also be a problem, particularly if the constipation also causes painful cramps.  Eventually, a patient will have to taper off of Xanax, but call a doctor to see if a reduction should start sooner than planned.

Proceed With Caution

Everyone reacts differently to prescription drugs – and a combination of prescription drugs.  No matter if a patient has taken Prozac for years without side effects, adding Xanax should be a matter of proceeding with caution.  Since a patient’s brain functions are slowed and they may be battling comorbidities such as migraines or epilepsy, the patient may become easily confused due to fatigue and physical pain.

When any patient is prescribed a new psychiatric medication, the patient needs supervision to be sure unusual symptoms do not develop.  This person needs to be a trusted friend or family member.  If the patient has none, then the doctor’s office should at least call every few days and schedule check up appointments one to four times a month.  Any missed appointments should be a red flag.

Sources

Breggin, Peter.  Medication Madness: The Role of Psychiatric Medications in Cases of Violence, Suicide and Crime.  Macmillan; 2009.

Drugs.com “Xanax Information.” 2010.  http://www.drugs.com/xanax.html

Author’s personal experience

Image "The Drowsy One" (1840) by Friederich von Amerling from Wikimedia Commons