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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by jessers11581 on April 17, 2006, at 17:56:12
This afternoon, after a brief phone conversation, my psychiatrist prescribed Prozac to me. Basically, Cymbalta just isn't working out. It's not addressing my anxiety, and I've been very obsessive-compulsive. I'm also not happy a lot of the time, and I'm not enjoying life because I'm constantly worrying about my health, or my future, or whatever I can find to worry over. I've never tried Prozac before, but I know a lot of people call it the "gold standard" SSRI. My p-doc wants me to start at 10 mg. added to the Cymbalta, then after a week, stop the Cymbalta and increase to 20 mg. Prozac, and go up from there. The things I'm mainly worried about are: losing energy, gaining weight, feeling "stupid" or like I can't think straight, and getting intestinal side effects (because I have intestinal trouble anyway). What are some experiences that you've had with this drug?? I'm so desperate to find something that works for me. I hope with all my heart that this is it... Thanks for any replies!! Jess
Posted by blueberry on April 17, 2006, at 18:47:31
In reply to Trying Prozac...what to expect? Please respond!, posted by jessers11581 on April 17, 2006, at 17:56:12
I was on prozac for about 8 years. I have tried all the ssri's except effexor. Of them all, I liked prozac the best.
What to expect? Well, it varies from person to person. Some people get sleepy. But it is usually stimulating, especially when first starting. It is kind of unique in the ssri class in that it partially blocks the 5th2 receptor, which stimulates the release of norepinephrine and dopamine, in addition to the serotonin reuptake inhibition. The others don't do that.
I think docs are too aggressive with prozac. Personally, I would start with 5mg. Dump the capsule in juice, stir it well, and drink half the glass, put the leftover in the fridge for the next day. Personally, I would stay at 10mg for a while, maybe a month to three months, before deciding to move up. The reason is because 10mg can actually work pretty good. It can feel just right at a certain dose, but at a higher dose it can just get blah like all the others.
Some people gain weight, but generally speaking people lose a little weight on prozac. Since you are concerned about intestinal problems, I think that is another reason to start low and go slow. But then again, I found cymbalta to be much harsher on the gut than prozac.
For many people prozac has a good deal of anxiety as a start up side effect. Another reason to start low.
All the ssri's tend to make you feel flat. But of them all, prozac did that the least to me.
All of the ssri's seem lousy for sex. Prozac at 10mg actually gave me a boost in the sexual department. Even at 20mg I had no problems. But I was also taking zyprexa with it.
But as you know, mileage varies. I may be back on prozac soon. Never been the same since stopping it.
It is going to be confusing though, which I think your doc underestimated. Coming off cymbalta is probably going to feel weird. It might be hard to tell what is doing what. That's why I say go low and ssslllowww, both with the prozac and the cymbalta (empty the capsules out and whittle down how many beads you take each day instead of dropping down by whole capsules).
Posted by jessers11581 on April 17, 2006, at 19:15:50
In reply to Re: Trying Prozac...what to expect? Please respond!, posted by blueberry on April 17, 2006, at 18:47:31
Blueberry: thanks so much for the detailed response! I really appreciate the advice. :) Jess
Posted by Phillipa on April 17, 2006, at 22:09:51
In reply to Re: Trying Prozac...what to expect? Please respond!, posted by blueberry on April 17, 2006, at 18:47:31
Blueberry I know peoples experiences and mileage vary but I really had no problem going form 60mg of cymbalta to 30mg and then starting another AD. No washout perios none of my pdocs have ever done that. Just started a new med. But I've never taken the MAOI's a different story. Love Phillipa ps second time I used cymbalta I couldn't tolerate 30mg and had to come off of it due to extreme anxiety.
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