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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Greg on May 19, 2000, at 22:02:39
I was taken off Wellbutrin today due to irritability side effects and started on 20mg Prozac. I came home and started searching the net for info and for every informational site I found, I'd find two others with names like "Prozac Survivors", "Prozac, the drug we hate" or Prozac and suicidal thoughts". These sites contained some VERY disturbing first hand accounts from users who had gone through hell with it. It was, to say the least, unnerving (sp?). I'm supposed to start taking it at bedtime tonight and it has me a little freaked. I tried it briefly about 2 months ago, but discontinued it because it was causing extreme fatigue and I already had a major problem with fatigue anyway.
Can anybody relate any positive experiences with it (or negative ones)? I'd appreciate the help.
Greg
Posted by Racer on May 19, 2000, at 22:30:24
In reply to Prozac - any experience/info you can share?, posted by Greg on May 19, 2000, at 22:02:39
I heard those stories too. I love my Prozac, you can't take it away from me!!!
OK, now for some actual experience, rather than the "Hey, works for me..." genera...
I've taken Prozac twice. The first time, I wasn't on it for a long enough time, because I was uninsured and trying to pay full retail price for it -- at a time I was living with a terrible man who didn't see any reason for me to spend any money on it when it was only my bad character that it was supposed to help. I think it was starting to work, or would have been if I'd had some support at home.
The second time was about a year ago. At the time, I'd had a terrible depression, a worse experience with Serzone and with the doctor who prescribed it, and then started Effexor XR. The Effexor XR worked on the anxiety, did away with the active despair, but left the lethargic depression. The next doctor was willing to listen to me, as I told her that I was usually responsive to SSRIs, but only at very high doses and that I had a lot of side effects. As an experiment, we tried adding Prozac to the Effexor. Yippee! It worked. The depression lifted almost immediately, but the dosages were low enough to avoid side effects.
As a result, I'm healthy and happy. I hope you have a similar result.
Now for some theorizing:
First of all, since Prozac does do away with the inhibitions of depression pretty quickly, it's been suggested that suicidal thoughts/actions may be linked to someone feeling better enough to act on the feelings they've had for a while. (Damn, not very articulate tonight, am I?) Another thought from my own little brain: ever met one of those people who insist that they can't do anything about depression, because nothing has worked, will ever work, against it? "Nothing at all works for me, so why waste my time trying? I'm destined to be this miserable forever." You know the sort of thing I mean, right? I think a lot of those types blame the drug, rather than admitting it could be a case of it not being the right drug for them. Someone who finds comfort in the disfunction might not want to move on from it, and might use the drug as an excuse. Since one aspect of depression is not expressing anger, maybe the drug is working and allows the anger to be expressed, leaving the person scared by having to admit the anger was always there?
Those are just some random musings. They're probably meaningless, but they're offered for what they're worth. This is worth more, I hope: My best wishes to you that you find relief with Prozac, as I have, or with another drug. Live well, and don't give up hope.
Posted by afatchic on May 20, 2000, at 0:15:13
In reply to Prozac - any experience/info you can share?, posted by Greg on May 19, 2000, at 22:02:39
Greg,
I took Prozac for a few years. I thought it was a great drug. Initially, it killed my appetite and increased my energy level but the stimulant effect wore off after a couple weeks. As an AD, it was very effective. I truly believed that it was a perfect drug! I quit having orgasms shortly after I started Prozac and eventually lost almost all interest in sex. Gee, I thought I was just bored. I never thought there was a connection because I never knew that Prozac commonly caused sexual problems. I quit taking it 6 weeks ago and had no withdrawl problems. My sexuality is finally returning (yippee!). Like you, I was irritable on Wellbutrin and had to stop taking it. At this point, I'm taking St John's Wort and I'm not sure if I'll go back to prescription drugs. The side-effects aren't worth it for me.
> I was taken off Wellbutrin today due to irritability side effects and started on 20mg Prozac. I came home and started searching the net for info and for every informational site I found, I'd find two others with names like "Prozac Survivors", "Prozac, the drug we hate" or Prozac and suicidal thoughts". These sites contained some VERY disturbing first hand accounts from users who had gone through hell with it. It was, to say the least, unnerving (sp?). I'm supposed to start taking it at bedtime tonight and it has me a little freaked. I tried it briefly about 2 months ago, but discontinued it because it was causing extreme fatigue and I already had a major problem with fatigue anyway.
>
> Can anybody relate any positive experiences with it (or negative ones)? I'd appreciate the help.
>
> Greg
Posted by bob on May 20, 2000, at 0:26:00
In reply to Re: Prozac - any experience/info you can share?, posted by Racer on May 19, 2000, at 22:30:24
To chime in along with Racer -- you never see those "Prozac saved my life!" sites because (I'm projecting just a bit here) people for whom ADs work so dramatically tend to have better things to do than create web sites and sing its praises. Besides, the web is full of "personal complaint sites" -- whether its psych meds or local governments or Coca Cola all the way up to various hate-mongering sites. I'm sure you could easily find some "Neo-Luddite" sites screaming about how bad technology is for us as well (it's not the medium--it's the message ;^). Unhappy people have a ready medium with a huge potential audience here.
A lot of people seem to find both prozac and wellbutrin, individually, too "activating" to handle. Strangely enough, they're prescribed in combination quite often.
I was actually on both for a while. My AD response to SSRIs was generally poor as was my AD response to wellbutrin, but the two together didn't do all that bad. Prozac plus lithium was a better combination for me, but again I just don't respond well enough to SSRIs for lithium to have made a big enough difference in augmenting my response.
As for a cocktail horror story -- I was initially on monotherapy with wellbutrin. Once I got up to 450mg SR/d, I wasn't just irritable -- I was close to psychotic. We're talking unprovoked, nearly-uncontrollable almost-mindless rage. And when it *was* provoked, even slightly? Fuggedabowdit! Anyway, my pdoc is really high on wellbutrin and he wanted me to stick with it, so we decided (quickly!!) to treat the rage side effect with a neuroleptic, perphenazine. I guess for truly psychotic individuals, doses can get very high and Tardive Dyskinesia is a very real threat, but I was on a rather light dose of 4mg/d. The stuff knocked me out, but the rage disappeared.
When I didn't really respond all that well to 600mg wellbutrin SR, we added the prozac. Over the next 1.5 months, I became more and more paranoid, agoraphobic, extremely emotionally dependent on my girlfriend, and I had more and more muscle rigidity ... a lot of cogwheeling. It happened gradually enough, though, that the only person who really noticed the difference was my therapist, who picked up on the cogwheeling. I started having panic attacks again -- I'd leave work at noon (midtown Manhattan) and was so terrified of being away from home, of the subway, and of having to walk out in these skyscraper canyons to get to the subway that I'd just take a cab to my apartment in Brooklyn ($20 a ride). I'd get home, turn the air conditioner on max, and curl up in a ball on my bed and shake (not at all from the cold) till my girlfriend got home from work/school. The worst thing about it was I was convinced I was getting better--my girlfriend and I had been having a lot of difficulties and I was interpreting this anxiety-driven dependence as devotion. It made me think I could live with the rest of it. Eventually, I had such a traumatic panic attack while at my therapist's, she took me into the ER. The attending psychiatrist recognized what was wrong immediately ...
As it turns out, prozac blocks a liver enzyme that is responsible for metabolizing perphenazine. My pdoc was aware of this, but the literature talks about it happening at those much higher dosage levels for perphenazine and there was nothing out there about it being much of a threat at low levels. So, apparently, I wasn't getting ANY of the perphenazine out of my system and I was highly sensitive to it ... it was getting toxic at fairly low levels.
So stay away from neuroleptics if you go on prozac -- that's my advice.
I do have to admit that once I dropped the wellbutrin and the perphenazine, two really good things happened. #1, my pdoc put me on klonopin and its been the most effective med I've taken (but, of course, for my anxiety and not my depression =^( ). #2, I actually lost ten pounds on prozac as my sole AD. Wound up gaining it back plus another forty when I switched to zoloft four months later, but that's another story.
cheers,
bob
Posted by Chris A. on May 20, 2000, at 0:33:18
In reply to Re: Prozac - any experience/info you can share?, posted by afatchic on May 20, 2000, at 0:15:24
> Greg,
I experienced my first hypomanic episode on it about ten years ago. For about four months I was well on it. Just do some self examination and make sure you don't have any bipolar tendencies or family history of it first. Must get to sleep. I had ECT today and feel better than I have been.'night,
Chris A.
Posted by medlib on May 20, 2000, at 2:42:43
In reply to Prozac - any experience/info you can share?, posted by Greg on May 19, 2000, at 22:02:39
Greg--
I'm quite sure I hold the longevity record on Prozac, at least here. My prescription for it was the first ever filled at my local pharmacy--I had been waiting impatiently for its release. (It was the first of the "newer" AD's, and I'd "done" all the old ones.) I was on Prozac from then until 7 months ago (with one 2 month hiatus when I was on Wellbutrin.) That is longer than at least one poster on this board has been alive!
I will *never* forget starting on Prozac; it was, quite literally, a light switch--from dark to light. It never made me happy or hopeful (or suicidal); it never gave me more energy--it simply made things POSSIBLE. It put a floor, a safety net under how far I could fall. I was still dysthmic (although unaware of the term), but minus the major depressions. Even when more SSRI's became available, then all the other new meds, I was never willing to give up my bird in the hand to try out others in the bush.
When Prozac began pooping out, finally, and I grew less and less functional, I tried adding Wellbutrin to it (because my brother was doing so well on W.). I thought I detected some small improvement (probably placebo effect), so I stopped Prozac altogether and went onto Wellbutrin. Gave up on W. after 2 mos. because I felt worse re depression (and irritability) and had significant hair loss. Back to Prozac, which didn't regain any of its old effectiveness the second time around. Finally went to a pdoc, who put me on Effexor XR (recently augmented by Ritalin)--which have yet to be as effective as the Prozac once was.
Hope you have success w. Prozac. Since it has such a looong half-life, you might try taking it in the evening, if initial fatigue is a problem. And, as Bob suggests, "adding back" some Wellbutrin may help with P. side effects.
Well wishes--medlib
Posted by dls on May 20, 2000, at 12:06:46
In reply to Prozac - any experience/info you can share?, posted by Greg on May 19, 2000, at 22:02:39
Greg,
I've been through two regimens of Prozac - one in 1990, then again in 1994. Both times it worked well for me for about 2 months. Then I would become very lethargic, sleep 12 to 14 hours per day and really piled on the weight.
Had similar experiences with Effexor and Celexa. But then, I don't react typically to most meds - valium makes me climb the walls and I can get a 'high' from benedryl that ought to be illegal.
So far I haven't experienced the irritability from Wellbutrin - but couldn't tolerate either neurontin or depakote - both made me feel as though my head was in a vice and my thought processes became very disjointed.
On the other hand, some of my co-workers have had success with Prozac. If I remember correctly, L. Ron Hubbard and his 'church' disseminated quite a bit of anti-Prozac literature in the early 90's, but I discounted that just because of the source.
Personally, I think this is all a 'crap shoot' anwyay. Sometimes I feel like a 'lab rat' as my docs don't seem to know what to do with me.
Hope this helps,
dls
Posted by Greg on May 21, 2000, at 21:13:43
In reply to Re: Prozac - any experience/info you can share?, posted by dls on May 20, 2000, at 12:06:46
Just wanted to take a minute out of what has been the busiest weekend I've EVER had to thank you all for your feedback. I've been OK with the Prozac for the last 2 days, maybe a little more tired than usual, but nothing I can't handle so far. My reason asking about Prozac was not only because of what I read on the Internet (which I know I have to take with a grain of salt), but because out of all the many drugs discussed at this site, I very rarely read about it here. I guess I thought Prozac might be taboo.
As usual, through your information and sharing of experience, I feel more at ease. Thank God for Babbleland....
A million thanks,
Greg
Posted by Sassy on May 24, 2000, at 19:16:03
In reply to Re: Prozac - any experience/info you can share?, posted by Racer on May 19, 2000, at 22:30:24
Hi Racer,
What doseages are you taking this in.
I'm one of the ones who have bad side effects with effexor,(severe bloating and excessive weight gain) but take it when it's really bad.
I'm back on Prozac, at least this month, and
I am very depressed I had problems with the effexor because nothing works as well.May try your doseage.
Sassy
> I heard those stories too. I love my Prozac, you can't take it away from me!!!
>
> OK, now for some actual experience, rather than the "Hey, works for me..." genera...
>
> I've taken Prozac twice. The first time, I wasn't on it for a long enough time, because I was uninsured and trying to pay full retail price for it -- at a time I was living with a terrible man who didn't see any reason for me to spend any money on it when it was only my bad character that it was supposed to help. I think it was starting to work, or would have been if I'd had some support at home.
>
> The second time was about a year ago. At the time, I'd had a terrible depression, a worse experience with Serzone and with the doctor who prescribed it, and then started Effexor XR. The Effexor XR worked on the anxiety, did away with the active despair, but left the lethargic depression. The next doctor was willing to listen to me, as I told her that I was usually responsive to SSRIs, but only at very high doses and that I had a lot of side effects. As an experiment, we tried adding Prozac to the Effexor. Yippee! It worked. The depression lifted almost immediately, but the dosages were low enough to avoid side effects.
>
> As a result, I'm healthy and happy. I hope you have a similar result.
>
> Now for some theorizing:
>
> First of all, since Prozac does do away with the inhibitions of depression pretty quickly, it's been suggested that suicidal thoughts/actions may be linked to someone feeling better enough to act on the feelings they've had for a while. (Damn, not very articulate tonight, am I?) Another thought from my own little brain: ever met one of those people who insist that they can't do anything about depression, because nothing has worked, will ever work, against it? "Nothing at all works for me, so why waste my time trying? I'm destined to be this miserable forever." You know the sort of thing I mean, right? I think a lot of those types blame the drug, rather than admitting it could be a case of it not being the right drug for them. Someone who finds comfort in the disfunction might not want to move on from it, and might use the drug as an excuse. Since one aspect of depression is not expressing anger, maybe the drug is working and allows the anger to be expressed, leaving the person scared by having to admit the anger was always there?
>
> Those are just some random musings. They're probably meaningless, but they're offered for what they're worth. This is worth more, I hope: My best wishes to you that you find relief with Prozac, as I have, or with another drug. Live well, and don't give up hope.
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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