posted by admin on Mar 23

In no way is Prozac a substitute for lithium. Prozac is an antidepressant, and lithium is a mood stabilizer. Prozac has potent properties of relieving mild to major depression and perhaps prevents recurrent depression as well. At the same time, Prozac may induce mania or hypomania in patients who nave a bipolar manic depressive history but are not taking lithium.

Lithium, on the other hand, has a mild antidepressant effect in depressive disorders, a strong antimanic effect, and, finally, a prophylactic effect on both the highs and lows of bipolar illness and the lows of recurrent depression.

Although lithium is most successful in controlling manic highs, it does not always eradicate the depressive phases of bipolar disorders.

Has Prozac proven to be as effective long-term as lithium? Not yet Lithium, which offered the first effective, long-term treatment for manic depression, has been readily available in the United States since 1973 and was used as early as 1948 in Australia, 1954 in Denmark, and a few years later in England and Canada. Prozac was introduced to the American market in 1987. Consequently, lithium has been clinically evaluated for a much longer time in many more centers and studies around the world. Its uses are known. In many ways, Prozac is still being explored. Are there any long-term complications associated with Prozac or with the combination of Prozac and lithium? No long-term complications of Prozac are to date, although the full story is not in, since Prozac has only been on the market approximately seven years. Only after twenty or thirty years of closely observing a large number of patients taking an antidepressant can one make conclusions about any of its potential long-term complications.

Long-term effects of lithium have been identified, however. They include the possibility of goiter or altered thyroid function in a small percentage of patients. Some long-term lithium patients with previous kidney impairment tend to lose an even greater degree of kidney function over time. These patients should either switch to a lithium alternative such as Tegretol or Depakote, or be maintained on smaller doses of long-term lithium.

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