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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Sergios on May 15, 2001, at 10:47:32
I am more than four months on Zyprexa, currently on 10mg at night. A month ago my doctor switched me from Paxil to Prozac, 40mg. Currently I have a lot of anxiety and need Xanax to combat it, I feel irritable, dysphoric and hypomanic at times. Do you people think it is too early for me yet? Doc said to wait another 20 days. Also I feel hypersexual, nervous, my pain levels have decreased (I have FMS) and I have some minor suicide thoughts which I didn't had before.
Posted by loosmrbls on May 15, 2001, at 11:06:42
In reply to Prozac and Zyprexa combination, posted by Sergios on May 15, 2001, at 10:47:32
I have a few questions:
1) Why the switch from one SSRI to another, in this case Paxil to Prozac?
2) How much Paxil were you on?
3) Since you are on Zyprexa as well, what diagnosis are you being treated for?Paxil is one of the shortest half-life SSRI's out there, and it probably cleared your system pretty quickly and by now, a month later, should be completely gone. So I think some residual Paxil effect is unlikely.
Prozac can take as long as 4-6 weeks to reach steady states. I might give it another week at the most, but I don't know why pdocs expect these overnight miracles. If you haven't had any improvement after a month of Prozac, I wouldn't expect more than a partial response (based on my own drug experiences).
These symptoms you describe sound somewhat hypomanic or even mixed in nature.
But to answer your question based on the info, I would give it maybe another week. If no improvement, I don't see what waiting another two weeks will do.
Posted by Sergios on May 15, 2001, at 15:28:51
In reply to Re: Prozac and Zyprexa combination, posted by loosmrbls on May 15, 2001, at 11:06:42
> 1) Why the switch from one SSRI to another, in this case Paxil to Prozac?
because I had great problems with bulimia on Paxil and it lowered very much my blood pressure.
> 2) How much Paxil were you on?
40mg also.
> 3) Since you are on Zyprexa as well, what diagnosis are you being treated for?
I have social anxiety, panic attacks, depression with some psychotic features (voices), and bulimia.
> But to answer your question based on the info, I would give it maybe another week. If no improvement, I don't see what waiting another two weeks will do.
thank you for your response.
Posted by medlib on May 15, 2001, at 16:22:37
In reply to Prozac and Zyprexa combination, posted by Sergios on May 15, 2001, at 10:47:32
Sergios--
You might want to consider trying just 20mg Prozac/day with your Zyprexa before giving up on Prozac altogether.
I began taking 20mg Prozac the first week it was on the market and it was a lifesaver for years. When it finally pooped out 18 months ago, my pdoc began trying other drugs. Recently I "added back" 20mg. Prozac to my med cocktail with very good results. Then I moved up to 30mg./day at pdoc's suggestion that "maybe more is better." Within a week I felt worse; by the third week I was *much* worse and was having active suicidal thoughts for the first time in over a year. I returned to 20 mg. and, a week later, was inching back to "better." NOW I remember why I took only 20mg./day for so many years.
Prozac is a slow-motion drug; I believe that it has the longest half-life of any psychoactive med. Its full effects may not be apparent for 6-8 weeks, and may continue to build for months in some. (Obviously, I'm don't think that intolerable side effects should be endured for that long.) What I 'm suggesting is that, with Prozac, the *direction* of week-to-week changes is more significant than the nature or amount of those changes. The adage "only time will tell" was never more true than with Prozac.
Over the 18 months I've followed this board, a significant number of posters have had a "less is more" reaction to a variety of meds (hence, our motto YMMV.} Many people have found Zyprexa plus Prozac to be a powerful combination (JohnL on this board, for example). Perhaps, you just need a bit less "power."
Well wishes---medlib
Posted by ChrisK on May 15, 2001, at 17:16:43
In reply to Prozac and Zyprexa combination, posted by Sergios on May 15, 2001, at 10:47:32
You are taking a very high dosage of Zyprexa for anything related to depression. You said that you had voices which may be why but many people are helped by low dose Zyprexa of 2.5 mg/day. You may want to check with your doctor and make sure that 10 mg/day is the dose you should be taking.
Posted by Sergios on May 16, 2001, at 7:06:32
In reply to Re: Prozac and Zyprexa combination, posted by ChrisK on May 15, 2001, at 17:16:43
> You are taking a very high dosage of Zyprexa for anything related to depression. You said
I started at 5mg a day and there was no response. Even now I believe that those 10mg are a small dose. ie. I barely notice sedation or increased apettite.
Posted by Sergios on May 16, 2001, at 7:08:41
In reply to Re: Prozac--sometimes more is less, posted by medlib on May 15, 2001, at 16:22:37
> You might want to consider trying just 20mg Prozac/day with your Zyprexa before giving up on Prozac altogether.
thank you for this suggestion, I started Prozac at 20mg for 3 weeks and then added the other 20. I believe now that it is just too early for me to see effects. When I had started paxil I saw the light after 4 months. And the first two were quite bad.
Thanks everyone for the suggestions and info!
Posted by Mr.Scott on May 20, 2001, at 22:57:14
In reply to Re: Prozac--sometimes more is less » medlib, posted by Sergios on May 16, 2001, at 7:08:41
This thread may be dead, but for what it's worth the symptoms you describe on 40 mg of Prozac are identical to mine. Unfortunately 20 mg does nothing.
mr.scott
Posted by Sergios on May 21, 2001, at 9:19:21
In reply to Same Feeling on Prozac, posted by Mr.Scott on May 20, 2001, at 22:57:14
> This thread may be dead, but for what it's worth the symptoms you describe on 40 mg of Prozac are identical to mine. Unfortunately 20 mg does nothing.
>
> mr.scottI'm seriously considering going to 60mgr. The last days have been much better re: depression and dysphoria. Now I am just melancholic - I want to listen to goth music and such. Still on 1.5mgr/day of xanax, any less and I get panic attacks. Maybe prozac needs a lot of time, I am not even on the second month?
Posted by Mr.Scott on May 21, 2001, at 21:43:13
In reply to Re: Same Feeling on Prozac » Mr.Scott, posted by Sergios on May 21, 2001, at 9:19:21
You may be right... Please keep me posted about your results.
This is the end of the thread.
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