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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 gerri on April 2, 2010, at 20:40:25
Hi
I'm fairly new to this forum. I posted last time about my cessation of Prozac 20mg due to possible hypersensitivity reaction after 20 years.
I ceased Prozac early Feb and commenced Doxepin 100mg for its powerful anitihistamine effect as I have chronic urticaria. I am also on lots of H1 and H2 antihistamines and a PPI for GERD.Prozac had helped me cope better over the last 20 years as up to the time I started it when I was 40 I had bad social phobia and agorophobia.
It's now 6 weeks or so since I stopped Prozac. I still have symptoms but the terrible urticarial vasculitis is gone. So i don't know if the prozac has anything to do with my current condition. My self diagnosis is mast cell activation disorder and I have an appointment to see a haematologist soon.
I find I am really missing Prozac, I don't know whether it is mind over matter. I had a bad attack of loss of confidence at a social event recently.
Of course doctors and pharmacists say no you cannot start back on Prozac while you are on Doxepin. I need the Doxepin for its antihistamine effects. I didn't think TCAs had a serotonin increasing effect. I think they (GPs) are afraid of serotonin syndrome. I'm sure I have seen on this list that people take SSRIs and TCAs together. I know you cannot take MAOIs and SSRIs together.
You people on this forum are so knowledgeable I was wondering if you could give your opinion
Thanks
gerri
Posted by Phillipa on April 3, 2010, at 11:03:32
In reply to Doxepin and small ammont Prozac together, posted by gerri on April 2, 2010, at 20:40:25
Some do take both maybe low doses. Phillipa
Posted by ed_uk2010 on April 3, 2010, at 11:20:08
In reply to Doxepin and small ammont Prozac together, posted by gerri on April 2, 2010, at 20:40:25
Rather than restarting fluoxetine (Prozac), I think that you should consider taking a different SSRI such as sertraline (Zoloft), citalopram (Celexa) or escitalopram (Lexapro) instead. These medications are chemically different to fluoxetine but have similar benefits. Personally, I would be tempted to go for sertraline.
Doxepin increases serotonin levels minimally, certainly not to the extent of an SSRI. Combining sertraline, citalopram or escitalopram with a low dose of doxepin (eg. 25mg) should be OK. Now that your urticaria symptoms have improved, you should be able to start reducing the dose of doxepin eg. from 100mg to 75mg to 50mg to 25mg (then add sertraline). Even at low doses, doxepin is a potent antihistamine and reduces urticaria. Alternatively, if you don't need the doxepin anymore, you can stop it completely before starting sertraline. Like all antidepressants, doxepin should be stopped gradually. For your current (milder) symptoms, a non-sedating antihistamine may be sufficient. Cetirizine is particularly useful for urticaria.
Posted by gerri on April 3, 2010, at 18:27:56
In reply to Try a different SSRI, posted by ed_uk2010 on April 3, 2010, at 11:20:08
Thanks Ed_UK. Sounds like a good plan.
Not sue if I'm doing this follow up post correctly.
GerriHi
I'm fairly new to this forum. I posted last time about my cessation of Prozac 20mg due to possible hypersensitivity reaction after 20 years.
I ceased Prozac early Feb and commenced Doxepin 100mg for its powerful anitihistamine effect as I have chronic urticaria. I am also on lots of H1 and H2 antihistamines and a PPI for GERD.Prozac had helped me cope better over the last 20 years as up to the time I started it when I was 40 I had bad social phobia and agorophobia.
It's now 6 weeks or so since I stopped Prozac. I still have symptoms but the terrible urticarial vasculitis is gone. So i don't know if the prozac has anything to do with my current condition. My self diagnosis is mast cell activation disorder and I have an appointment to see a haematologist soon.
I find I am really missing Prozac, I don't know whether it is mind over matter. I had a bad attack of loss of confidence at a social event recently.
Of course doctors and pharmacists say no you cannot start back on Prozac while you are on Doxepin. I need the Doxepin for its antihistamine effects. I didn't think TCAs had a serotonin increasing effect. I think they (GPs) are afraid of serotonin syndrome. I'm sure I have seen on this list that people take SSRIs and TCAs together. I know you cannot take MAOIs and SSRIs together.
You people on this forum are so knowledgeable I was wondering if you could give your opinion
Thanks
gerri
This is the end of the thread.
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