Prozac, also sold under the generic name fluoxetine, is a selective serotonin reuptake inhibitor (SSRI) that is given for depression. Prozac works by preventing the reuptake of the neurotransmitter serotonin, which results in an improvement of mood. However, not all patients respond to Prozac, and some have adverse side effects, such as sexual dysfunction; in those cases, another treatment option is recommended. Alternatives include trying a different medication, electroconvulsive therapy or psychotherapy.
Other Medication Options
If Prozac does not work for you, or if the side effects do not go away, your doctor may prescribe another SSRI, such as paroxetine, sertraline, citalopram or escitalopram. The Mayo Clinic notes that other reuptake inhibitors are effective as an alternative to SSRIs. These include serotonin and norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine and norepinephrine, and dopamine reuptake inhibitors (NDRIs) like bupropion. Older antidepressants, like tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs), are also options; imipramine is an example of a tricyclic antidepressant and isocarboxazid is an example of an MAOI. However, these two types of antidepressants have more side effects than reuptake inhibitors, and are not prescribed unless other antidepressants do not work. The National Institutes of Health (NIH) adds that lithium and thyroid supplements may be added to a medication regimen to increase the effectiveness of antidepressants; antipsychotics may also be prescribed if the patient also has hallucinations and delusions.
Electroconvulsive Therapy
Electroconvulsive therapy is another treatment option for depression that uses electrical current, causing a seizure that decreases symptoms; the induced seizure may alter neurotransmitter levels in the brain. Other similar treatments are transcranial magnetic stimulation (TMS) and vagus nerve stimulation (VNS); TMS uses magnetic fields, while VNS sends electrical impulses to an implanted pulse generator. These treatment options provide a quick reduction of symptoms, and are given to patients with severe or chronic depression.
Psychotherapy
Psychotherapy treats the underlying cause of depression, and is often combined with medication to reduce the severity of the symptoms. With psychotherapy, like cognitive behavioral therapy, the patient works with her therapist to identify the source of her negative thoughts; the patient also tries to adopt healthy coping mechanisms to deal with the depression when she is not in therapy. The patient also can choose to participate in group therapy, where members of the group share how they deal with their symptoms.
