Fluoxetine (Prozac)

Fluoxetine (Prozac) is an approved antidepressant drug. It is manufactured by Dista Products, a subsidiary of Eli Lilly and Co. Ltd.

Fluoxetine works by prolonging the action of a chemical called 5-hydroxytryptamine (serotonin), which acts as a messenger between nerve cells in the brain. 5-hydroxytryptamine levels are thought to affect mood. People who have been taking fluoxetine for a period of time often reported relief from the symptoms of depression, such as withdrawal from social contact, feelings of sadness, tiredness and helplessness, preoccupation with problems and loss of appetite.

Fluoxetine has been shown to be more effective in relieving symptoms of depression in HIV-positive patients diagnosed with depression, regardless of their CD4 cell count.1

Common side-effects can include nausea, diarrhoea, loss of appetite, insomnia, nervousness, drowsiness and increased sweating. A range of other, rare side-effects has also been reported. Although clinical trials have not shown fluoxetine to be any more effective in alleviating depression than other types of antidepressant, its side-effects tend to be much better tolerated. This improves the chance that a patient will stay on the course of treatment long enough to benefit from it.

Patients who have already been treated with an antidepressant of the monoamine oxidase inhibitor type such as phenelzine (Nardil), moclobemide (Manerix), tranylcypromine (Parnate / Parstelin) or isocarboxazid, it is dangerous to begin treatment with fluoxetine for at least five weeks after ceasing the previous course of treatment.

As with other antidepressants, it may take two to five weeks before relief from depressive symptoms is experienced. It is usually recommended that treatment for depression continue for at least three to six months, especially in the case of recurrent depression.

Fluoxetine should not be used by people with diabetes or a history of heart problems.

Fluoxetine levels may be increased in patients taking antiretroviral drugs, particularly protease inhibitors, due to similar routes of clearance from the body. This may raise the risk of side-effects.2 There is no significant interaction with nelfinavir (Viracept) or the non-nucleoside reverse transcriptase inhibitors (NNRTIs) efavirenz (Sustiva) and nevirapine (Viramune).


  1. Rabkin JG et al. Fluoxetine treatment for depression in patients with HIV and AIDS: a randomised placebo-controlled trial. Am J Psychiatr 156: 101-107, 1999
  2. DeSilva KE et al. Serotonin syndrome in HIV-infected individuals receiving antiretroviral therapy and fluoxetine. AIDS 15: 1281-1285, 2001

Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.