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Dr. Bob is Robert Hsiung, MD,
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Posted by Dan on March 3, 2000, at 12:06:29
In the new edition of David Burns' "Feeling Good," he states that after several weeks of regular doses of Prozac (at which time it has reached a "steady state" blood level), it is possible to reduce the dosage dramatically--to 5 mg or less per day--without losing the antidepressive effect. Because of Prozac's long half-life, it only takes a little to replace the amount being lost. The advantage of reducing the dosage, he says, is that you can reduce or eliminate the side effects.
This is a very attractive idea for me, because after 7 weeks at 20 mg, I continue to have a whole range of fairly unpleasant side effects, although my mood has improved. I haven't seen any other sources making this claim, even though Burns says that it's "well known among the psychiatric profession." I saw some references to weekly dosing (20+ mg) in the Psychopharmacology Tips, but it seems to me that that might produce side effects for at least a short time after taking the Prozac.
Does anyone have any personal experience or other info about this kind of reduction? If so, how quickly could it be done, and how low could an efficacious dose be?
Thanks -
Dan
Posted by jd on March 3, 2000, at 17:09:19
In reply to Reducing Prozac dosage, posted by Dan on March 3, 2000, at 12:06:29
Dan,
I'm not sure if dosage reduction is a good idea for everyone (nor whether Burns explanation is entirely valid), but it's definitely true that some people simply don't need 20mg of Prozac a day over the long term--a minority of people even do well on doses as low as 1 or 2 mg/day, even from the getgo. If you've been on 20mg for more than a few weeks, your blood levels WILL go down after a reduction, even despite Prozac's long half-life. One could theoretically experiment by first going down to 10mg/day or to 20mg every other day, but it would be a good idea to discuss this with your doctor first. While weekly dosing may not be often enough for many people, alternate day dosing might be a workable compromise. But everyone responds differently so it's hard to predict these things in advance.
best,
jd> In the new edition of David Burns' "Feeling Good," he states that after several weeks of regular doses of Prozac (at which time it has reached a "steady state" blood level), it is possible to reduce the dosage dramatically--to 5 mg or less per day--without losing the antidepressive effect. Because of Prozac's long half-life, it only takes a little to replace the amount being lost. The advantage of reducing the dosage, he says, is that you can reduce or eliminate the side effects.
>
> This is a very attractive idea for me, because after 7 weeks at 20 mg, I continue to have a whole range of fairly unpleasant side effects, although my mood has improved. I haven't seen any other sources making this claim, even though Burns says that it's "well known among the psychiatric profession." I saw some references to weekly dosing (20+ mg) in the Psychopharmacology Tips, but it seems to me that that might produce side effects for at least a short time after taking the Prozac.
>
> Does anyone have any personal experience or other info about this kind of reduction? If so, how quickly could it be done, and how low could an efficacious dose be?
>
> Thanks -
> Dan
This is the end of the thread.
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