AboutNigel Simmons Expertise I am happy to answer general questions on medicines and hospital care. If possible, please use approved / chemical names rather than brands which are not internationally recognised.
Like all health professionals I am bound by a duty of care which prevents me giving detailed information about medication or treatment of people other than the questioner.
I will endeavour to help wherever possible or point towards more appropriate advice. If however your question crosses too far into patient confidentiality, I hope you will understand why I cannot answer your question.
Consider.. would you want me to discuss your care with a friend or relative without your knowledge?
Experience Registered as a UK pharmacist in 1982 and have worked in a number of hospital and health management posts around the UK. Formerly Chief Pharmacist for a 440 bed general hospital in Cambridgeshire.
Past/Present clients Previously Sysop on CompuServe UK Professionals forum.
My doctor gave me prozac for OCD
But I read it was ototoxic, so I'm not taking it - do you know of any medication I can ask my doctor about that isn't ototoxic?
Thanks
ANSWER: Nicola
As far as I am aware there is no formally defined adverse effect on hearing as a result of taking Prozac. As you can see from the main US and UK product monographs, there is no specific statement.
However, like all drugs acting on the brain and its chemistry, it is possible that side effects such as tinnitus or dizziness may occur, but specific ototoxicity leading to deafness does seem unlikely. Were it an established risk, it would be referenced in the product monographs.
Without knowing the source where you found the information I cannot comment on its quality, but given the many millions of people taking Prozac and the lowest level of side-effect usually listed is around 1 in 100,000, I would suggest that any risk is very small. Ultimately though, the decision is yours.
As for other treatments, the normal approach to OCD is to use Cognitive Behavioural Therapy to help manage the psychological elements of the problem. Adding in a serotoninergic drug such as Prozac helps. If you don't want to use Prozac, then another drug in the class may be an option, but the very small potential risk would still be there for those or any other centrally acting drug.
Thats the only website that mentions it - but it seems like he has done a lot of research - thats why I was worried and I already have tinnitus
I'm having CBT and the doctor gave me prozac to help with it, like you said
I know no one is forcing me to take it - I just wanted some views
So what do you think of the website?
Answer Nicola
This is the site I tracked down yesterday, and I'm a little sceptical about how credible it is. While I don't wish to criticise someone I don't know, one key thing is that the organisation is led by someone who is not medically qualified. He uses the title Doctor because he has a PhD, but no details are given as to where or what the qualification relates to. It's also not clear what the reason behind his interest is - certainly he has financial interests through the products he promotes and sells.
I am also uncomfortable about some of the statements made:
>>The truth is, the ototoxic side effects of drugs are seldom specifically studied during drug trials. As a result, information on ototoxicity is sketchy at best. That is why little or nothing is officially known about the permanence of the ototoxic side effects of most drugs, including the SSRIs.<<
It is correct that ototoxicity is not specifically monitored during drug trials, but then neither is in-growing toenail or hair loss. Side effects are predicted (and then monitored) from early research and class effects, but ultimately the long-term evidence and identification of minor side effects will only come when may thousands of humans are exposed to the drug. Animal studies and a few hundred trial patients can't predict everything.
In the case of Prozac, were problems to be more apparent, they would be reflected in the product monographs which are always under review by the company and the regulatory authorities.
>>When I rate any drugs for their risk of ototoxicity, it is my own personal and subjective rating based on very incomplete data. This rating is based on any information available to me at the time I made it. It is typically not based on the results of double blind, or other studies. I may be totally off the mark, but this rating is still my best guess.<<
This is a significant statement and a back-covering defense. It is clearly stated that the information is a guess and therefore not supported by firm evidence.
If you already suffer with tinnitus, then your concerns are justified and understandable. As I said previously, Prozac and other SSRIs may affect other nerve functions, so changes to the function of auditory or sensory nerves is always a possibility.
Perhaps the best action is to either ask a local pharmacist or the Medicines Information pharmacist at your hospital to raise your concerns with the company. They are obliged to present accurate information to health professionals, so if they have suggestive or causitive evidence they can provide it. You can then digest the information they can obtain and you can then share your fears with your doctor.
