Posted by Peter Jay on February 4, 2002, at 15:39:22
How do I go about augmenting an SSRI with anafranil to further raise serotonin?
A friend of mine has OCD and she is on 100mg daily of Prozac (which I know is a realtively high dose). However she gets few side effects and is not getting a lot of benefit. I know that SSRIs like prozac can be augmented with anafranil (which she can take up to 175mg daily although she then gets somnolence).
Maybe she is not a good responder to prozac but it took so long to get her to 100mg that before re-starting with another SSRI or Effexor, i think it would be worth trying to augment the prozac.
Of course, the main problem with such augmentation will be a risk of too much serotonin and there will be a need to watch out for any symptoms of 'serotonin syndrome'. I accept this.
However, I am not clear how to proceed with the augmentation.
Should the SSRI be reduced (to something like 50mg or 60mg daily) and then a dose (25mg???) of anafranil started. And then to increase week by week by 10mg anafranil?
Or is it completely the other way around: get onto, say, 125 mg anafranil and then add Prozac?
I have to ask this here because her doc is not big on meds but much prefers CBT. (There is nothing wrong with CBT of course but better still to have CBT plus meds.) As a result her doc is not all that familiar with SSRI+anafranil. However, I gather it is a well-known combination used by many psychopharmacologists.
Can anyone advise?
Thank you
Peter
poster:Peter Jay
thread:92851
URL: http://www.dr-bob.org/babble/20020131/msgs/92851.html