It depends on your basic temperament and chemistry. Patients who begin taking Prozac when they are both deeply depressed and highly irritable usually find that irritability diminishes or disappears along with the depression. This has the effect of improving their relationships with their spouses, peers, colleagues, and children. Spouses and grown children sitting in my office with their formerly depressed loved ones have often told me how much easier it is to get along now that the crankiness or anger outbursts have faded along with the depression. Of course, many depressed patients are withdrawn rather than angry.

It is another story with patients who have a tendency toward bipolar mood swings with manic highs characterized by irritability, anger, and paranoid delusions rather than by euphoria and grandiosity. If they take Prozac during a depressed phase and have not been previously stabilized on lithium, the hypomanic or manic side of the mood may emerge in the form of these symptoms.


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