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Re: Relapsed Depression and trying High-Dose Prozac

Posted by Sarahmarie on April 9, 2002, at 22:34:23

In reply to Re: Relapsed Depression and trying High-Dose Prozac, posted by SLS on April 8, 2002, at 10:05:35

> Hi Sarahmarie.
>
> > > Does anyone know of success stories for remission of major depresssion and OCD on high doses of Prozac (160 - 200 mg per day). I just started at 150mg today and I am still rather depressed. Please Help!!!!
>
> I don’t know what to think about taking such high dosages of Prozac. Perhaps there is some precedence for this in the literature, but I have not wandered across it. Those sound more like Zoloft dosages.
>
> Hi Charlotte.
>
> > *These dosages are intended for information purposes only. All dosage administration should be directed through your physician. Please consult your doctor for actual dosage information.
>
> > Depression
> > 20 mg per day is the recommended initial dose.
>
> > Bulimia Nervosa
> > 60 mg per day is the recommended dose.
>
> > Obsessive-Compulsive Disorder
> > 20 mg to 60 mg per day is the recommended dose.
>
> > Premenstrual Dysphoric Disorder
> > 20 mg per day is recommended continuously throughout the menstrual cycle. Initial treatment should be limited to six months, after which patients should be reassessed regarding the benefit of continued therapy.
>
> This is a great summary. These recommendations fall in line with what I have read over the past few years, although I would perhaps extend the dosage range for depression to 20-40mg. One study done at Harvard / Mass. General did show added benefit to non-responders at 60mg. The thing that stuck out in my mind regarding Sarahmarie was her OCD. I thought that it might indicate the necessity for the higher dosage range recommended, but going up to 150mg sure seems high. I’d like to know if anyone else has heard of this being done.
>
> I didn’t know about the PMDD recommendations. I find it particularly salient that an evaluation is recommended after only 6 months. Doesn’t this seem short to you? How many menstrual cycles does it take to see a substantial benefit?
>
> I haven’t read a Prozac package insert recently. Do the dosage recommendations listed above appear on it?
>
> > You should know that the recommended length of treatment with an antidepressant is 6 to 12 months, because one of the long-term goals of treatment is to keep depression from troubling you again.
>
> For severe or recurrent cases, I tend to believe that 12 – 14 months should be the minimum, with 18 months being perhaps optimal. It is sad to see how many people terminate a course of SSRI therapy early, only to relapse and become unresponsive to the same drug when it is reintroduced.
>
>
> - Scott

Hi Scott

The reason for the high dosages recommended to me did have a lot to do with my OCD. At one medical school in my county I had heard that it was common practice to treat individuals with major depression and OCD on 120 mg. per day of Prozac.

It wasn't until I was taking 80 mg Prozac that I noticed real relief in the depression, however the OCD continued.

I am just tired of the depression returning after one year at a certain level of Prozac. I am beginning to accept the fact that I will need to be on meds for life. I just don't know what it will take. If anyone knows anything about people on higher doses of Prozac -- Please Help...


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