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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by orbital on March 20, 2010, at 9:58:02
Hi everyone,
I was on Prozac for several months; it worked wonders for my depression (huge boost in motivation, vastly increased energy etc), however it worsened my anxiety and caused bad insomnia. I was able to easily manage the anxiety by increasing my Klonopin (threefold!) but the insomnia didn't respond to anything. I toyed with the dosage to no avail.
So, following my pdoc's suggestion, I reluctantly stopped the Prozac and went back to Lexapro.
The first month on Lex was wonderful, as Prozac's positive effect lingered, with the added benefits of Lexapro (very good sleep, anxiety vanished, calm and relaxed feeling).I was also able to drop back down to my usual 1mg of Klonopin.
The past few weeks have been less than stellar, though. Prozac's effects faded, and I'm getting the Lexapro blahs again, my depression is back (though manageable).
So now I'm wondering if I could try alternating between the two meds on a monthly basis. My pdoc is uncomfortable with me taking both meds simultaneously, which does make sense.
Has anybody tried this? Any ideas?
Thanks in advance :)
ps. I should add that I've tried many meds, and nothing worked as well as the Prozac-escitalopram crossover period. I so wish someone would come up with a half-and-half med - Prolex, anybody? ;)
Posted by Brainbeard on March 20, 2010, at 10:29:16
In reply to Alternating SSRIs monthly?, posted by orbital on March 20, 2010, at 9:58:02
Hooray! to an interesting suggestion.
I have pondered about taking all SSRI's simultaneously in micro-doses, but this is also an interesting idea. 'Which month is it? -It's Prozac month, currently, Zoloft month in three days from now.'
Prozac of course has a very long half-life, and it will stay in your blood for at least a month after having taken it for four weeks or more. Prozac also inhibits Lexapro's metabolism, boosting its levels in the blood.
Perhaps adding low dose Prozac to regular dose Lexapro might help (I won't get into the technical details here, but theoretically it could make a difference). Or adding low dose Lexapro to high dose Prozac? The possibilities are endless.
I have taken low dose Prozac (5mg) a couple of times while on 5mg Lexapro, but couldn't notice the usual effect I get (stimulation, motivation) when taking low dose Prozac on its own (or together with Valium, a combination that can work truly wonderful for me).
I suggest any Lexapro<-*+/-*->Prozac experiences will be reported in this thread.
Posted by orbital on March 20, 2010, at 11:26:05
In reply to Re: Alternating SSRIs monthly?, posted by Brainbeard on March 20, 2010, at 10:29:16
BBeard, I've been adding 10mg Prozac to my 20 mg Lexapro a couple of times a week - my pdoc frowns at this. When I do it, I notice a surge in energy etc the *next* day, but it's very limited. Lower doses of either med do nothing for me.
I'm warming to the alternating thing. For instance, I'm starting a new job soon, so I'd like to be calm and collected during the first few weeks - hence, Lexapro. I know I'm bound to burn out further on, at which point I could switch back to Prozac.
Of course I could try a different med altogether, but really, I'm tired of failed trials; these two do work for me, in very different ways (I consider them to be polar opposites in the way they affect me). I also seem to respond extremely quickly to both. I typically feel the Prozac stimulation like 2 days after starting it, and Lexapro is like a sleeping pill for me - instant effect. Switching them at regular intervals could also prevent poop out.
Thanks for your response :) I appreciate your insights.
> Hooray! to an interesting suggestion.
>
> I have pondered about taking all SSRI's simultaneously in micro-doses, but this is also an interesting idea. 'Which month is it? -It's Prozac month, currently, Zoloft month in three days from now.'
>
> Prozac of course has a very long half-life, and it will stay in your blood for at least a month after having taken it for four weeks or more. Prozac also inhibits Lexapro's metabolism, boosting its levels in the blood.
>
> Perhaps adding low dose Prozac to regular dose Lexapro might help (I won't get into the technical details here, but theoretically it could make a difference). Or adding low dose Lexapro to high dose Prozac? The possibilities are endless.
>
> I have taken low dose Prozac (5mg) a couple of times while on 5mg Lexapro, but couldn't notice the usual effect I get (stimulation, motivation) when taking low dose Prozac on its own (or together with Valium, a combination that can work truly wonderful for me).
>
> I suggest any Lexapro<-*+/-*->Prozac experiences will be reported in this thread.
Posted by Phillipa on March 20, 2010, at 12:39:29
In reply to Re: Alternating SSRIs monthly? » Brainbeard, posted by orbital on March 20, 2010, at 11:26:05
At one time was prescribed 12.5 of luvox and 2.5 of paxil and it was okay. I think custom meds is a great idea. I might try lowering 50 of luvox tonight and know must have a bottle of prozac take a smidgen of it too. Phillipa
Posted by orbital on March 21, 2010, at 8:38:40
In reply to Re: Alternating SSRIs monthly? » orbital, posted by Phillipa on March 20, 2010, at 12:39:29
I've read about your terrible experience with Prozac, Phillipa. Mine was very similar.. it was the first psych med I ever took and I wound up in the ER with severe panic attacks - the experience was so scary that I refused to take any meds for years.
This was almost 10 years ago, since then I've become somewhat jaded and pretty savvy when it comes to dealing with side effects. I've found that, though intense, the Prozac startup anxiety is pretty short-lived and manageable.
Anyway, good luck with your experiment - keep us posted :)
> At one time was prescribed 12.5 of luvox and 2.5 of paxil and it was okay. I think custom meds is a great idea. I might try lowering 50 of luvox tonight and know must have a bottle of prozac take a smidgen of it too. Phillipa
Posted by Phillipa on March 21, 2010, at 15:46:22
In reply to Re: Alternating SSRIs monthly? » Phillipa, posted by orbital on March 21, 2010, at 8:38:40
So are you saying that you lost the fear of start up effects? If so may I ask how? Chickened out last night. Phillipa
Posted by orbital on March 21, 2010, at 22:07:18
In reply to Re: Alternating SSRIs monthly? » orbital, posted by Phillipa on March 21, 2010, at 15:46:22
Phillipa, yeah, I've definitely lost that fear, mostly by finding a good pdoc. Whenever I start a new med she's very honest about what to expect, and takes my concerns seriously, instead of brushing me off like the other ones I've had in the past.
The one side effect that does scare me is increased anxiety / panic, which my Klonopin treats perfectly; my pdoc is very benzo friendly, she trusts my judgement and allows me to manage benzos at my discretion (I've never abused them and always try to use the lowest dose possible).
With that in place, I can handle any other side effects very easily - I just ignore them and hang in there until they lessen. I've tried dozens of meds and, barring anxiety, I'm more than willing to put up with side effects if I think that the med might be worth the trouble.
Hope this helps :)
Matt
> So are you saying that you lost the fear of start up effects? If so may I ask how? Chickened out last night. Phillipa
Posted by Brainbeard on March 22, 2010, at 5:06:31
In reply to Alternating SSRIs monthly?, posted by orbital on March 20, 2010, at 9:58:02
Posted by bearfan on March 23, 2010, at 1:21:07
In reply to Re: Alternating SSRIs monthly? » Phillipa, posted by orbital on March 21, 2010, at 22:07:18
Its not really a great idea. What about just increasing the lexapro dose?
Posted by orbital on March 23, 2010, at 9:04:42
In reply to Re: Alternating SSRIs monthly?, posted by bearfan on March 23, 2010, at 1:21:07
> Its not really a great idea. What about just increasing the lexapro dose?
Lexapro alone does nothing for my depression, although it kills my anxiety. Higher doses just make me feel very foggy and flat.
I'm curious, why do you think the alternating strategy is not a good idea?
Thanks :)
Posted by mmsn on March 23, 2010, at 18:44:13
In reply to Re: Alternating SSRIs monthly?, posted by orbital on March 23, 2010, at 9:04:42
i've been on prozac 10 mg and celexa 10 mg at the same time, good combo for me. Prozac get motivation and for odc, celexa makes lower my anxiety and depression. Unfortunaly my sex drive decrease too much.(i think these ssri impact on prolactin and testo levels)
Now i'm on Luvox 100 mg very good for ocd, nothing for depression, but no sexual side effects.
Still try for life saver combo drugs!
Posted by orbital on March 25, 2010, at 9:45:58
In reply to Re: Alternating SSRIs monthly?, posted by mmsn on March 23, 2010, at 18:44:13
Thanks for the feedback :) Strangely enough, Prozac really increases my sex drive (but Lexa kills it).
> i've been on prozac 10 mg and celexa 10 mg at the same time, good combo for me. Prozac get motivation and for odc, celexa makes lower my anxiety and depression. Unfortunaly my sex drive decrease too much.(i think these ssri impact on prolactin and testo levels)
> Now i'm on Luvox 100 mg very good for ocd, nothing for depression, but no sexual side effects.
> Still try for life saver combo drugs!
This is the end of the thread.
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