Posted by Cam W. on September 27, 2000, at 6:50:18
In reply to HELP!!!!! Anxiety and Panic Attacks!, posted by Nic on September 26, 2000, at 9:26:10
Nic - You may be experiencing what people on this board call "Prozac poop-out". For some reason, SSRI antidepressants sometimes stop workimg after a while. Several strategies have been tried; all with varying degrees of success in different people. Some docs lower the SSRI dose (others increase the dose), both of which sometimes helps. Others add an augmenting agent; either an antidepressant with slightly different properties; like your doc has done, or something like lithium or an atypical antipsychotic (like Zyprexa). Serzone and Prozac are often taken together, but there is a low risk of serotonin syndrome (flushing, rapid heartrate, etc.) if the blood levels of the augmenting antidepressant (Serzone) get too high (usually not a problem at 200mg daily).
Usually though, docs change to a similar antidepressant; in this case another SSRI like Paxil or Zoloft. Paxil is used fairly extensively because it has some better antianxiety activity than other SSRIs. A new SSRI may make your attacks worse for the first couple of weeks, as your bdoy adjusts to the drug, but in the long run the Paxil seems to hold the Panic in check, in many people. You need to give the Paxil at least an 8 week trial to see full effects with it (as needs to be done with any antidepressant). This is something to talk to your doc about.
Also, your increase in Ativan use should be a concern, if it continues. This may be a signal that Prozac poop-out may be occuring. It is definitely something to talk to the doc about.
Hope this helps some (& welcome to the board) - Cam
poster:Cam W.
thread:45313
URL: http://www.dr-bob.org/babble/20000926/msgs/45347.html