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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by priskind on October 18, 2007, at 14:34:56
I'm currently on 60 mg of prozac and have only noticed moderate effects. My doctor started me at 10 mg in June and we've slowly increased the dosage to where I am now. I've been on 60 mg for about 6 weeks now.
My side effects are also only mild.
At this point is it more common to try augmentation with something like Wellbutrin, or try a yet-higher-dose of Prozac (80 mg). In general, I'd like to avoid being at the maximum recommended dosage of any drug.
Posted by Racer on October 18, 2007, at 16:32:31
In reply to Combination v. high dose of prozac, posted by priskind on October 18, 2007, at 14:34:56
>
> My side effects are also only mild.
>
> At this point is it more common to try augmentation with something like Wellbutrin, or try a yet-higher-dose of Prozac (80 mg). In general, I'd like to avoid being at the maximum recommended dosage of any drug.
>It depends -- if you're tolerating the medication well, and you're having benefits from the medication, raising it makes sense. The "standard" range for Prozac is 20 - 60 mg, but the range does go up to 120mg, so raising that would probably be fine. In many other cases, though, you get more benefit from adding another drug to augment the Prozac -- whether that's the best solution for you depends in part on what symptoms you're still having trouble with. Sometimes adding a drug more specific to those issues makes more sense than increasing the dose.
Another factor in the decision, though, is your doctor's comfort level -- there are still some doctors out there who say that you never combine anti-depressants. Are they keeping up with the standard of care? No, but they still have the prescription pads, so you have to decide with those doctors whether it's worth changing doctors. (Sometimes even those doctors who are not keeping up with the literature have other qualities that makes it worth keeping them.)
If you want to know more about what might help you, let us know what symptoms you're having most problem with, and what benefits and adverse effects you're getting from Prozac. I'm sure someone will jump in with advice.
Good luck.
Posted by bleauberry on October 18, 2007, at 20:05:05
In reply to Combination v. high dose of prozac, posted by priskind on October 18, 2007, at 14:34:56
Options to think about:
Higher dose, up to 120mg.
Modafinil
Wellbutrin
Zyprexa (no higher than 5mg please)
Explore other causes...
Lead, mercury, copper excess
Amalgam fillings
Undiagnosed food intolerances you are not aware of.
Hypoadrenalism
Hypothyroidism
Bad dietI know one girl who had been on high dose prozac with little benefit. What little she did get from it kept pooping out needing a higher dose. She ended up doing great on just 5mg prozac along with 25mg 5htp. Apparently it wasn't the serotonin reuptake she needed so much of, just a little, but rather more serotonin in the first place with a bit of reuptake.
Posted by linkadge on October 18, 2007, at 21:45:52
In reply to Re: Combination v. high dose of prozac, posted by bleauberry on October 18, 2007, at 20:05:05
I wouldn't increase it. You're on a fairly high dose. You've probably saturated your serotonin transporters already. I'd wean slowly down to say 20mg or 40mg then augment with wellbutrin.
Linkadge
Posted by alienatari on October 19, 2007, at 6:10:06
In reply to Re: Combination v. high dose of prozac » priskind, posted by Racer on October 18, 2007, at 16:32:31
> Another factor in the decision, though, is your doctor's comfort level -- there are still some doctors out there who say that you never combine anti-depressants.And there are other doctors (like my old pdocs) that want to combine your antidepressant with anything and everything lol.
Posted by msanjelpie on October 26, 2007, at 4:02:41
In reply to Combination v. high dose of prozac, posted by priskind on October 18, 2007, at 14:34:56
I was at Prozac 60mg and not feeling the full effect. Doctor switched me to 20mg Lexapro (the upgrade to Prozac) and that did the trick...
Posted by vicksnow on October 28, 2007, at 9:22:41
In reply to Re: Combination v. high dose of prozac, posted by alienatari on October 19, 2007, at 6:10:06
ive been on 60mg of prozac and wellbutrin 300mg xl now for years. (plus risperdol 3mg and klonopin 1mg x 4)Wonderful combination. i'm happy 95% of the time where as before life was one of complete despair. i had to self medicate with alcohol abusing it everyday for 25 years. now sober for 6 1/2 years. yes these meds are are good cocktail. best "cocktail " i ever had... i told my brother about this combo and now he is doing much better mentally as well by taking the same meds.
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