Prozac®

What is Prozac?

Prozac belongs to a class of medications called selective serotonin reuptake inhibitors (SSRIs). These are primarily used to treat mental health problems such as depression, anxiety, and panic attacks. Because the capsules are known to help delay orgasms, they are sometimes prescribed ‘off-label’ to manage premature ejaculation, which is often referred to as ‘PE’. 

Off-label prescribing is when medications are used outside of their manufacturer’s license.^[1] Prozac hasn’t been approved by the FDA to treat premature ejaculation, but it’s been found to be effective for it. When prescribing a treatment off-label, a doctor will always review the risks and benefits beforehand, and make a decision based on the suitability of the person they’re treating, and any available research. If a clinician thinks Prozac is a safe option for you, they’ll recommend it as a treatment for PE. 

How does Prozac work?

Selective serotonin reuptake inhibitors like Prozac work by slowing down absorption of a chemical in the brain. Serotonin is a neurotransmitter, a chemical messenger that plays an important part in lots of your body’s functions, including sleep, wound healing and mood. SSRIs work by preventing serotonin from being reabsorbed (also called ‘reuptake’) once it has delivered a message. 

Although it’s not fully understood why, low serotonin levels are thought to be a cause of mood disorders like depression and anxiety. So by having more serotonin, the symptoms of a low mood can be alleviated. 

5-HT is another term for serotonin, and one theory is that by increasing 5-HT transmission, SSRIs can delay ejaculation.^[2] Like depression and anxiety, the cause of premature ejaculation isn’t always clear. Physical and mental health can be factors, or sometimes a combination of the two. 

What doses of Prozac are there?

Prozac is available in 20mg capsules. The active ingredient in them is called fluoxetine. It’s used in varying amounts depending on the condition it’s being used for. For depression, the recommended dose is one capsule a day, but this can be increased to as much as 60mg daily. 

Because there is no FDA-approved dose schedule for using Prozac to treat premature ejaculation, your clinician can discuss which starting dose they think will work for you. 

How to take Prozac

Swallow the capsules with a glass of water. They can be taken with or without food.

Taking Prozac at the same time each day can help you get into a routine, and means you’ll be less likely to take more medication than you need or miss a dose entirely. You could try setting an alarm for the same time each day, or store the capsules somewhere visible where you’re likely to see them.

For people with liver problems, it’s sometimes advised to take Prozac every other day rather than daily.

How long does it take Prozac to work?

There’s no guarantee how long Prozac will take to work for premature ejaculation. For depression, the capsules are usually prescribed for six months to a year, as the medication takes a while to build up in your system.^[1]

This means you might need to take Prozac for a while before you see any improvements, but responses to the capsules will differ person-to-person.

If you feel like you’re seeing no changes to your PE after several weeks, let us know and we can discuss your options.

What should I do if I make a mistake when taking Prozac?

You should avoid using more Prozac than you’ve been prescribed. Taking more capsules than you need won’t help improve your PE, and could cause unpleasant side effects. SSRIs build up in your system, and so they don’t need to be taken prior to having sex in order to work effectively.

If for any reason you miss your usual dose, take your capsule(s) as soon as you remember. If it’s getting close to the time your next dose is due, skip the missed dose and carry on with your usual routine.