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Re: Prozac

Posted by JohnL on May 17, 2000, at 3:39:54

In reply to Prozac, posted by Lucy on May 15, 2000, at 9:25:26

> I have been taking prozac for about a week and find it is helping a lot. How long should I expect to take it, what are the long-term side effects, and are there any other medicines or anything else I should avoid while taking it?

Lucy,
Noticing improvement in just a week is certainly encouraging.

How long should you take it? Well, that depends. Is this your first episode of depression? Second? Third? Has it lingered for a long time? The reason I ask is because if it is your first experience, there is a 50/50 chance it will happen again after discontinuing medication. Most doctors I think like to see the patient stay on the medication for a good six months. But don't forget...50/50. If you've experienced two separate depressive episodes, the odds of it happening again are closer to 90%. And if you've had it three or more times, well, it's highly likely to be with you for life and likely increase in intensity with age. And in general, the longer a depression has lingered, the longer it takes for a medication to work fully. Not always, but in general I think.

A way I like to look at longterm (lifelong) treatment is this...protection, insurance, prophylactic. Even when you've felt recovered for a long time, I think it makes sense to continue medication to keep the monster away. Discontinuing medication is like letting your guard down. You're open for invasion by the beast. While most doctors seem to want to take patients off their medication after 6 months or a year of recovery, too often I have seen that as a bad idea. The depression often returns and turns out to be more intense and more stubborn than it was before. And it's not unusual for the same medication to not work well the second time around.

You are ultimately in control of your treatment decisions, but I thought I would bring this information to the table for you to ponder.

What drugs to avoid with Prozac? Well, Prozac has interaction with quite a few other drugs. Usually what it does is interfere with the metabolism of certain drugs, which increases the level of the drug in your system. The usual remedy for the interaction is to keep the dose of the second drug lower than normal. Sometimes the interaction is used as a tool however. For example, if a tricyclic medication is added to Prozac, it allows a much lower dose of the tricyclic. That's because Prozac will increase the amount of the tricyclic in your bloodstream anywhere from 2 to 14 times. Other than obvious no-no's, like taking an MAOI inhibitor, I can't think of any dangerous interactions right off the top of my head. Common things like OTC pain relievers, cold and flu remedies, etc, are all OK to the best of my knowledge. If ever in doubt though, a call to your pharmacist or your doctor will provide a quick professional answer to whether a certain drug is OK with Prozac or not.
JohnL


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