Prozac for Treatment of Anorexia Nervosa Essay

Prozac for Treatment of Anorexia Nervosa Essay

Prozac for Treatment of Anorexia Nervosa Essay

Anorexia nervosa is an eating disorder characterized by restriction of nutrient intake relative to body requirements leading to a significant reduction in body weight (Moore et al., 2022). Psychotherapy, Nutritional therapy, and behavioral therapy are the main modes of treatment. However, Prozac (Fluoxetine) is an antidepressant that can be added after the initial treatment to prevent relapse and to manage the symptoms after adequate weight restoration.

Mode of Action

            Prozac is a widely used antidepressant belonging to the class of selective serotonin reuptake inhibitors, SSRIs (Jacob P, 2021). Upon administration, it is converted to its active metabolite norfluoxetine by the cytochrome P450 enzymes in the liver. Norfluoxetine acts on the presynaptic terminal inhibiting the serotonin reuptake receptors, 5HT1A, 5HT2A, and 5HT2C. This increases the concentration of serotonin at the synapse and hence its action in the postsynaptic terminal (Sohel et al., 2022). Prozac has minimal effect on noradrenergic reuptake.

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Monitoring

            Assessment for suicidal risk and depression should be done during treatment initiation and dose adjustments. Other than that, one can assess for anxiety/panic attacks, features of serotonin syndrome, social functioning, and mania/mood lability (Sohel et al., 2022). In the elderly, blood glucose, liver function tests, and ECG assessments in patients at risk for QT prolongation or ventricular arrhythmias may be ordered. In breastfeeding mothers, the levels of norfluoxetine should be assessed regularly as high levels may lead to abnormal height and weight in breastfeeding infants.

Adverse Effects

Adverse effects include decreased libido, anxiety, insomnia, dry mouth, anorexia, and headache. Most of these side effects are time and dose-dependent, they appear immediately and disappear spontaneously. (Sohel et al., 2022). Thus, watchful waiting is recommended as far as the management of these adverse effects is concerned.

Drug-drug Interactions

Drug-drug interactions are due to Prozac metabolism by the cytochrome P450 enzyme hence blocking the metabolism of other drugs (Sohel et al., 2022). Therefore, concomitant administration with lithium salts, calcium channel blockers, anticonvulsants, anxiolytics, L-dopa, and L-tryptophan increases their serum concentrations.

Conclusion

            Anorexia nervosa is an eating disorder that can lead to depression during the course of the disease or treatment. Prozac is an SSRI that inhibits the presynaptic serotonin reuptake receptors increasing the synaptic concentration of serotonin and subsequently its effect in the postsynaptic terminal hence alleviating depression.

References

Moore, C. A., & Bokor, B. R. (2022). Anorexia Nervosa. https://pubmed.ncbi.nlm.nih.gov/29083743/

Sohel, A. J., Shutter, M. C., & Molla, M. (2022). Fluoxetine. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459223/

Select a medication used in evidence-based treatment guidelines for the condition chosen in the first discussion question. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions of which one should be aware.