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Re: Prozac and Celexa together?

Posted by JohnL on May 12, 2000, at 3:44:48

In reply to Prozac and Celexa together?, posted by Lynne on May 11, 2000, at 19:03:15

> I have a friend who is using low doses of these two SSRI's together. I have never heard of this before. She says that it is working well for her. Has anyone else used this combo?

I don't think it's very common to see two different SSRIs combined. I am aware of a few cases where Prozac + Effexor have been combined successfully. But Prozac + Celexa?

Theoretically the psychiatric commmunity would pretty much agree combining SSRIs is wrong and not needed. As my GP told me once, they all do the same thing, so why mix them? BUT, I think he's wrong. Sure they have the same end result, but they do so in very different ways. All the SSRIs are actually very different in what they do and how they do it.

In my world, I could care less anyway. All that matters to me is that the patient feels good, has few side effects, and the meds are relatively safe. It sounds to me like Prozac+Celexa is accomplishing all of these things. If your friend experimented by removing one or the other drug, she might find results aren't as good. Even a higher dose of one or the other to compensate might not work. So basically, I agree with you that I've never heard of this combination before either, but who cares...if it works it works. Right? Sometimes we just have to put the textbooks on the storage shelf and go with whatever works.

One concern might be metabolism interference which would manifest itself in uncomfortable side effects, such as strange anxiety or headaches or whatever. This happens when two drugs compete for the same liver enzymes. That doesn't appear to be a problem in this particular case. Another concern would be serotonin syndrome, or serotonin overload, which sometimes occurs when two different serotonin meds are mixed. It's a dangerous syndrome. But here too it does not appear to be a problem in this particular case. So if all is well, more power to her. I'm very happy she has discovered something she's comfortable with and improves her life.
JohnL


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