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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by 3 Beer Effect on April 17, 2005, at 22:39:16
Hello,
I´ve been on 20 mg generic Prozac for about 6 months now & it has been a wonder drug for me. It allowed me to kick my nasty addiction to psychostimulants/Dextrostat & I quit drinking all together. (I am now of the opinion that psychostimulants/amphetamines are the spawn of the devil & should not be taken for depression or social phobia because they make it worse in the long run & their short half lives seem to contribute to mental dependency & mood swings). Anyways, the wonderful effects of Prozac on getting rid of social phobia are starting to wane, & it feels like my social anxiety is coming back.I guess an easy solution is to increase the dose, but won´t you the same poop out happen at 40 mg in another six months? I wonder if there is some other solution that won´t cause the same tolerance effect. Sometimes Buspar is used to augment SSRIs since I guess it helps increase the amount of Serotonin available at the synapse? I wonder if augmentation might be a better choice than increasing the Prozac dose? But, I´ve heard that Buspar is destroyed in the stomach & isn´t very bioavailable. Did they ever come out with an improved buspar like medicine (gepirone etc? or a sublingual buspar?).
Does buspar make you dumb? (I need to be able to solve problems & think quickly at work, Prozac is the only SSRI that doesn´t have a dumb drug effect on me.)What about lower dose 5-htp (50 mg) or l-tryptophan? Will these cause serotonin syndrome when combined with prozac? If 5-htp doesn´t help me sleep, will tryptophan? (milk does seem to help me sleep).
Thanks,
3 Beer Effect
Posted by lotus on April 18, 2005, at 1:32:50
In reply to How to combat Prozac poop out?, posted by 3 Beer Effect on April 17, 2005, at 22:39:16
I've used 100mg 5htp with 50mg Zoloft and had no problems.I would suggest starting with 50mg 5htp and see if that helps,then titrate upward until you get an effect.
Posted by JayDee on April 18, 2005, at 10:33:14
In reply to How to combat Prozac poop out?, posted by 3 Beer Effect on April 17, 2005, at 22:39:16
Hi,
Can you go into more detail with your problems with Stimulants? what was your dosage/interval etc... what problems did it cause?
Posted by tendency on April 18, 2005, at 10:59:53
In reply to How to combat Prozac poop out?, posted by 3 Beer Effect on April 17, 2005, at 22:39:16
> What about lower dose 5-htp (50 mg) or l-tryptophan? Will these cause serotonin syndrome when combined with prozac? If 5-htp doesn´t help me sleep, will tryptophan? (milk does seem to help me sleep).
>
> Thanks,
> 3 Beer Effecthi. i strongly recommend always taking SSRIs with either tryptophan or 5-htp - whichever works better. personally i take 50mg sublingual 5-htp 3 times a day with it. my therapist, who's worked with others taking SSRIs, has found that augmenting with a serotonin boosting aminos has a great synergistic effect and helps prevent needing to up the dose. remember, the SSRIs wont do much if there isnt enough serotonin there to begin with. taking 5-htp really has made a big difference (i think) in the effectiveness of the celexa im currently on.
Posted by TenMan on April 18, 2005, at 12:13:55
In reply to How to combat Prozac poop out?, posted by 3 Beer Effect on April 17, 2005, at 22:39:16
Perhaps you could look into low dose memantine or naltrexone, both of which have been used with some success for stimulant and anti-d poop-out.
Pindolol might be another option.
Are you taking fish oil? If not high dose fish oil (10-15 caps daily) might do the trick all by itself.
Good luck.
Posted by Bill LL on April 18, 2005, at 12:47:49
In reply to How to combat Prozac poop out?, posted by 3 Beer Effect on April 17, 2005, at 22:39:16
I would increase it to 40 mg right now. I would eventually go up to at least 80 mg if needed. Then, augment it with Strattera, or replace it with Cymbalta. Strattera will increase norepinephrine. Cymbalta will increase both serotonin and norepinephrine.
> Hello,
> I´ve been on 20 mg generic Prozac for about 6 months now & it has been a wonder drug for me. It allowed me to kick my nasty addiction to psychostimulants/Dextrostat & I quit drinking all together. (I am now of the opinion that psychostimulants/amphetamines are the spawn of the devil & should not be taken for depression or social phobia because they make it worse in the long run & their short half lives seem to contribute to mental dependency & mood swings). Anyways, the wonderful effects of Prozac on getting rid of social phobia are starting to wane, & it feels like my social anxiety is coming back.
>
> I guess an easy solution is to increase the dose, but won´t you the same poop out happen at 40 mg in another six months? I wonder if there is some other solution that won´t cause the same tolerance effect. Sometimes Buspar is used to augment SSRIs since I guess it helps increase the amount of Serotonin available at the synapse? I wonder if augmentation might be a better choice than increasing the Prozac dose? But, I´ve heard that Buspar is destroyed in the stomach & isn´t very bioavailable. Did they ever come out with an improved buspar like medicine (gepirone etc? or a sublingual buspar?).
> Does buspar make you dumb? (I need to be able to solve problems & think quickly at work, Prozac is the only SSRI that doesn´t have a dumb drug effect on me.)
>
> What about lower dose 5-htp (50 mg) or l-tryptophan? Will these cause serotonin syndrome when combined with prozac? If 5-htp doesn´t help me sleep, will tryptophan? (milk does seem to help me sleep).
>
> Thanks,
> 3 Beer Effect
Posted by JayDee on April 18, 2005, at 12:51:02
In reply to How to combat Prozac poop out?, posted by 3 Beer Effect on April 17, 2005, at 22:39:16
Can you try Brand Prozac? I found it to be much more effective. I even experienced the full withdrawl symptoms when trying generic Prozac to save $$$, whic dissapeared 2 days afer restarting brand Prozac.
Posted by paulbwell on April 18, 2005, at 18:16:26
In reply to Re: How to combat Prozac poop out?, posted by JayDee on April 18, 2005, at 12:51:02
You used to be so pro Dex-did you have a nasty abuse prob?
Posted by JKL on April 20, 2005, at 4:52:11
In reply to How to combat Prozac poop out?, posted by 3 Beer Effect on April 17, 2005, at 22:39:16
How to combat prozac poop out. That's a good question. Prozac has been one of my primary meds for years, and I've felt its benefits fade over time, requiring me to make adjustments in an effort to get the goodness back.
The addition of low dose zyprexa helped a lot, and extended the period of goodness several months. But eventually things got dull again.
My doc said it would be ok to add in st johns wort with the prozac and zyprexa. By the second day I was so impressed with how good I was feeling that I started tapering off prozac. Stopped it completely. About 10 days went by with no ill effects. Then I started getting the common withdrawals...spaciness, dizziness, weakness, lack of concentration, general unconnectedness. So I added back in 10mg prozac. Within 4 hours I felt so much better. Then it became clear to me that whenever I lose the good effects of prozac, all I need to do is stop it for a few days and then restart it.
There is new evidence coming out that when serotonin neurons are disabled by an ssri, the serotonin is taken up by dopamine neurons. I wonder what other cross-actions are taking place that we don't know about, such as with the norepinephrine, gaba, or opioid neurons. I wonder how all this ties into poopout. Does blocking a whole bunch of different neurons help? That's what sjw does, and I think it does help.
Though prozac is said to work primarily on serotonin, there are plenty of clinical studies showing that it significantly boosts dopamine and norepinephrine as well. Maybe poopout has something to do with dopamine tolerance setting in.
I tried low dose naltrexone, as it supposedly prevents prozac poopout. It was useless for me. As were lithium, buspar, and pindolol.
When generic prozac first hit the market, my insurance company would only cover the generic, so I had to stop taking the branded Ely Lilly original. I swear I felt a difference. It could just be my imagination, but I swear Ely Lilly prozac is much better.
Poopout is a tough one. About all you can do is experiment with different things.
Posted by temoigneur on May 7, 2005, at 16:24:51
In reply to Re: How to combat Prozac poop out?, posted by JKL on April 20, 2005, at 4:52:11
> How to combat prozac poop out. That's a good question. Prozac has been one of my primary meds for years, and I've felt its benefits fade over time, requiring me to make adjustments in an effort to get the goodness back.
>
> The addition of low dose zyprexa helped a lot, and extended the period of goodness several months. But eventually things got dull again.
>
> My doc said it would be ok to add in st johns wort with the prozac and zyprexa. By the second day I was so impressed with how good I was feeling that I started tapering off prozac. Stopped it completely. About 10 days went by with no ill effects. Then I started getting the common withdrawals...spaciness, dizziness, weakness, lack of concentration, general unconnectedness. So I added back in 10mg prozac. Within 4 hours I felt so much better. Then it became clear to me that whenever I lose the good effects of prozac, all I need to do is stop it for a few days and then restart it.
>
> There is new evidence coming out that when serotonin neurons are disabled by an ssri, the serotonin is taken up by dopamine neurons. I wonder what other cross-actions are taking place that we don't know about, such as with the norepinephrine, gaba, or opioid neurons. I wonder how all this ties into poopout. Does blocking a whole bunch of different neurons help? That's what sjw does, and I think it does help.
>
> Though prozac is said to work primarily on serotonin, there are plenty of clinical studies showing that it significantly boosts dopamine and norepinephrine as well. Maybe poopout has something to do with dopamine tolerance setting in.
>
> I tried low dose naltrexone, as it supposedly prevents prozac poopout. It was useless for me. As were lithium, buspar, and pindolol.
>
> When generic prozac first hit the market, my insurance company would only cover the generic, so I had to stop taking the branded Ely Lilly original. I swear I felt a difference. It could just be my imagination, but I swear Ely Lilly prozac is much better.
>
> Poopout is a tough one. About all you can do is experiment with different things.
Hi JKL - I'm very interested in your experiences /w sjw, I felt great when I first tried prozac, but after 4 months, crippling anxiety and OCD came flooding back in. I've supplemented and augmented with everything I know of - but never thought of sjw, or heard that MAO theory.I do remember, trying Sjw, many years ago, with prozac, I felt like I was going to have a stroke or a seizure, I got scared and stopped - did your pdoc say anything about a hypertensive crisis risk, - do you take the sjw the day after stopping prozac, do you take it at the same time or do you have a washout period between stopping prozac and restarting sjw. I take a high dose of prozac/clomipramine for OCD - equiv. to 80mg prozac, do you think I can just add sjw. what dosage do you take, any particular formulation info.
Thank you
Ben
Posted by KarenRB53 on April 5, 2006, at 21:07:39
In reply to How to combat Prozac poop out?, posted by 3 Beer Effect on April 17, 2005, at 22:39:16
> Hello,
> I´ve been on 20 mg generic Prozac for about 6 months now & it has been a wonder drug for me. It allowed me to kick my nasty addiction to psychostimulants/Dextrostat & I quit drinking all together. (I am now of the opinion that psychostimulants/amphetamines are the spawn of the devil & should not be taken for depression or social phobia because they make it worse in the long run & their short half lives seem to contribute to mental dependency & mood swings). Anyways, the wonderful effects of Prozac on getting rid of social phobia are starting to wane, & it feels like my social anxiety is coming back.
>
> I guess an easy solution is to increase the dose, but won´t you the same poop out happen at 40 mg in another six months? I wonder if there is some other solution that won´t cause the same tolerance effect. Sometimes Buspar is used to augment SSRIs since I guess it helps increase the amount of Serotonin available at the synapse? I wonder if augmentation might be a better choice than increasing the Prozac dose? But, I´ve heard that Buspar is destroyed in the stomach & isn´t very bioavailable. Did they ever come out with an improved buspar like medicine (gepirone etc? or a sublingual buspar?).
> Does buspar make you dumb? (I need to be able to solve problems & think quickly at work, Prozac is the only SSRI that doesn´t have a dumb drug effect on me.)
>
> What about lower dose 5-htp (50 mg) or l-tryptophan? Will these cause serotonin syndrome when combined with prozac? If 5-htp doesn´t help me sleep, will tryptophan? (milk does seem to help me sleep).
>
> Thanks,
> 3 Beer EffectJust wondering if you tried the St.Johns wort or 5HTP with the Prozac and if you had any success? Like you said, Prozac is the only antidepressant that works for me but it does fade out and then I just get the side effects of agitation and irritability. Thanks for any info.
Karen
Posted by Caedmon on April 7, 2006, at 15:09:45
In reply to Re: How to combat Prozac poop out?, posted by KarenRB53 on April 5, 2006, at 21:07:39
I didn't find SJW useful. I decided not to try too much of it since it messes with your enzymes.
Why not try a small dose increase, just to see what it does? IOW, 30mg fluoxetine?
- C
Posted by Maxime on April 7, 2006, at 22:00:42
In reply to Re: How to combat Prozac poop out?, posted by KarenRB53 on April 5, 2006, at 21:07:39
Often a low dose of the anti-psychotic Risperdal is used. Another thing is to add Nortriptaline ( I know I spelled that wrong).
Maxime
> > Hello,
> > I´ve been on 20 mg generic Prozac for about 6 months now & it has been a wonder drug for me. It allowed me to kick my nasty addiction to psychostimulants/Dextrostat & I quit drinking all together. (I am now of the opinion that psychostimulants/amphetamines are the spawn of the devil & should not be taken for depression or social phobia because they make it worse in the long run & their short half lives seem to contribute to mental dependency & mood swings). Anyways, the wonderful effects of Prozac on getting rid of social phobia are starting to wane, & it feels like my social anxiety is coming back.
> >
> > I guess an easy solution is to increase the dose, but won´t you the same poop out happen at 40 mg in another six months? I wonder if there is some other solution that won´t cause the same tolerance effect. Sometimes Buspar is used to augment SSRIs since I guess it helps increase the amount of Serotonin available at the synapse? I wonder if augmentation might be a better choice than increasing the Prozac dose? But, I´ve heard that Buspar is destroyed in the stomach & isn´t very bioavailable. Did they ever come out with an improved buspar like medicine (gepirone etc? or a sublingual buspar?).
> > Does buspar make you dumb? (I need to be able to solve problems & think quickly at work, Prozac is the only SSRI that doesn´t have a dumb drug effect on me.)
> >
> > What about lower dose 5-htp (50 mg) or l-tryptophan? Will these cause serotonin syndrome when combined with prozac? If 5-htp doesn´t help me sleep, will tryptophan? (milk does seem to help me sleep).
> >
> > Thanks,
> > 3 Beer Effect
>
> Just wondering if you tried the St.Johns wort or 5HTP with the Prozac and if you had any success? Like you said, Prozac is the only antidepressant that works for me but it does fade out and then I just get the side effects of agitation and irritability. Thanks for any info.
> Karen
Posted by SLS on April 7, 2006, at 22:21:12
In reply to Re: How to combat Prozac poop out? » KarenRB53, posted by Maxime on April 7, 2006, at 22:00:42
Wellbutrin often complements SRIs like Prozac.
- Scott
> Often a low dose of the anti-psychotic Risperdal is used. Another thing is to add Nortriptaline ( I know I spelled that wrong).
>
> Maxime
>
>
> > > Hello,
> > > I´ve been on 20 mg generic Prozac for about 6 months now & it has been a wonder drug for me. It allowed me to kick my nasty addiction to psychostimulants/Dextrostat & I quit drinking all together. (I am now of the opinion that psychostimulants/amphetamines are the spawn of the devil & should not be taken for depression or social phobia because they make it worse in the long run & their short half lives seem to contribute to mental dependency & mood swings). Anyways, the wonderful effects of Prozac on getting rid of social phobia are starting to wane, & it feels like my social anxiety is coming back.
> > >
> > > I guess an easy solution is to increase the dose, but won´t you the same poop out happen at 40 mg in another six months? I wonder if there is some other solution that won´t cause the same tolerance effect. Sometimes Buspar is used to augment SSRIs since I guess it helps increase the amount of Serotonin available at the synapse? I wonder if augmentation might be a better choice than increasing the Prozac dose? But, I´ve heard that Buspar is destroyed in the stomach & isn´t very bioavailable. Did they ever come out with an improved buspar like medicine (gepirone etc? or a sublingual buspar?).
> > > Does buspar make you dumb? (I need to be able to solve problems & think quickly at work, Prozac is the only SSRI that doesn´t have a dumb drug effect on me.)
> > >
> > > What about lower dose 5-htp (50 mg) or l-tryptophan? Will these cause serotonin syndrome when combined with prozac? If 5-htp doesn´t help me sleep, will tryptophan? (milk does seem to help me sleep).
> > >
> > > Thanks,
> > > 3 Beer Effect
> >
> > Just wondering if you tried the St.Johns wort or 5HTP with the Prozac and if you had any success? Like you said, Prozac is the only antidepressant that works for me but it does fade out and then I just get the side effects of agitation and irritability. Thanks for any info.
> > Karen
>
>
This is the end of the thread.
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