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Is it Safe to Take Suboxone With Prozac?

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Feb 20, 2024 • 9 cited sources

The prescription medications Suboxone (buprenorphine/naloxone) and Prozac (fluoxetine) can interact and cause health issues. Never take these two medications together without checking with your doctor first.

While Suboxone and Prozac can cause interactions, the U.S. Food and Drug Administration says doctors should approach the issue with care.[7] In the past, some doctors withheld medications like Suboxone in people taking drugs like Prozac. The FDA says the damages associated with untreated opioid use disorder (OUD) are so high that the benefits of combined medications may outweigh the risks. This is especially true because depression is very common among people with OUD, and it is important to treat both conditions in that case.

What Are Prozac & Suboxone?

Before taking any prescription medication, ensure that you understand why it’s prescribed and how it works. Ask your doctor or pharmacist if you’re unsure. 

Here’s what you should know about both Prozac and Suboxone:


Fluoxetine (or Prozac) is an antidepressant used to treat a variety of conditions, such as these:[2]

  • Depression
  • Obsessive-compulsive disorder (OCD)
  • Bulimia
  • Premenstrual dysphoric disorder (PMDD)
  • Panic disorder 

Prozac belongs to a group of medications known as selective serotonin reuptake inhibitors (SSRIs). Fluoxetine works by increasing the time that serotonin (a special communicating chemical called a neurotransmitter) stays active in the nerves within your central nervous system. 


Suboxone contains two ingredients: buprenorphine and naloxone.[3] When combined, they treat opioid use disorder (OUD). 

What Is Serotonin Syndrome?

Serotonin is a neurotransmitter involved with regulating behavior, mood, memory and core body functions. Medications like Prozac work directly on the serotonin system, and sometimes, they cause problems.[8]

High levels of serotonin can cause serotonin syndrome, which can be life-threatening. Experts say the true incidence of serotonin syndrome is unknown, as most cases are mild and easily overlooked. Even serious cases might be attributed to some other cause.[9]

However, it’s important to know what serotonin syndrome looks like, as combining Suboxone and Prozac can lead to increased risks.

Researchers say some opioids can increase serotonin levels.[8] Combining these drugs can lead to a buildup of the hormone, and it can cause difficult clinical signs.

Serotonin syndrome can be mild. Out of 46,000 calls to poison control centers due to SSRIs in 2011, only 11 of those cases resulted in death.[5]

However, just in case, you should understand the side effects of serotonin syndrome so you can call your doctor if symptoms appear.[6]

Signs of Serotonin Syndrome from Taking Suboxone and Prozac

Signs & Symptoms of Serotonin Syndrome

If you believe you are experiencing serotonin syndrome, you must call your doctor. Seek emergency services immediately if your symptoms are severe.

Signs and symptoms of serotonin syndrome may include the following:

  • Agitation
  • Anxiety
  • Restlessness
  • Disorientation
  • Sweating
  • High body temperature
  • Fast heart rate 
  • Nausea
  • Vomiting 
  • Tremors
  • Rigid, jerking or overactive muscles
  • Dilated pupils
  • Dry mucous membranes
  • Flushed skin
  • Increased bowel sounds

Doctors treat serotonin syndrome by discontinuing your medications and monitoring you until they improve.[4] With prompt care, your problems should fade. This syndrome is temporary and resolved once you discontinue the medications. 

If you have any concerns about your medication interactions, talk with your doctor.

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

  1. Suboxone Prescribing Information. U.S. Food and Drug Administration. February 2018. Accessed November 2022.
  2. Fluoxetine. National Library of Medicine. January 2022. Accessed November 2022.
  3. Buprenorphine Sublingual and Buccal (Opioid Dependence). National Library of Medicine. January 2022. Accessed November 2022.
  4. Serotonin Syndrome (Serotonin Toxicity). Up To Date. May 2022. Accessed November 2022.
  5. Serotonin Syndrome With Fluoxetine: Two Case Reports. The Ochsner Journal. 2016. Accessed November 2022. 
  6. Opioids and Antidepressants: Which Combinations to Avoid. Australian Prescriber. April 2021. Accessed November 2022.
  7. FDA Drug Safety Podcast: FDA Urges Caution About Withholding Opioid Addiction Medications from Patients Taking Benzodiazepines or CNS Depressants: Careful Medication Management Can Reduce Risks. U.S. Food and Drug Administration. January 2022. Accessed January 2024.
  8. Physiology, Serotonin. StatPearls. July 2023. Accessed January 2024.
  9. Serotonin Syndrome. StatPearls. July 2023. Accessed January 2024.

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