Psycho-Babble Medication Thread 396937

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Overmedicated???Prozac and Effexor

Posted by lexman on September 29, 2004, at 16:54:25

my dr. has me on 60mg prozac and 50mg effexor.Last night i didnt get any sleep at all and it ruined my whole day.I take the prozac in the morning, 25mg effexor in the morning and 25mg at night.Could this be too much prozac?I havent had an appetite at all.Its scarying me because i am getting really skinny...

 

Re: Overmedicated???Prozac and Effexor

Posted by King Vultan on September 29, 2004, at 19:14:26

In reply to Overmedicated???Prozac and Effexor, posted by lexman on September 29, 2004, at 16:54:25

> my dr. has me on 60mg prozac and 50mg effexor.Last night i didnt get any sleep at all and it ruined my whole day.I take the prozac in the morning, 25mg effexor in the morning and 25mg at night.Could this be too much prozac?I havent had an appetite at all.Its scarying me because i am getting really skinny...


There is an enzyme interaction between these two drugs that is boosting the blood plasma level of the Effexor substantially--I assume your doctor is aware of this, and that is why you are only on 50 mg of the Effexor. In combination with the Prozac, the amount you are taking is probably being boosted to the equivalent of 150 mg/day or more of Effexor taken by itself.

That be said, this seems like kind of a strange combination of drugs. You are combining an SSRI and another drug that is very serotonergic--I am always a little concerned about the possibility of suffering serotonin syndrome in these cases. Either one of these drugs by itself would give me insomnia, so I am not surprised that the combination is giving you sleep problems. Both drugs can also cause a lack of appetite. I would certainly let your doctor know of the problems you are having. He may know what he's doing, but it doesn't really sound like a good combination to me.

Todd

 

Partially disagreeing with King Vultan on this

Posted by Racer on September 30, 2004, at 12:14:54

In reply to Re: Overmedicated???Prozac and Effexor, posted by King Vultan on September 29, 2004, at 19:14:26

I took Effexor XR 225mg and Prozac 10mg for several years. Obviously, the relative dosages are far different, but it did produce partial remission for me during much of the time I was on it.

I do agree that serotonin syndrome is a serious concern, but I'm not sure that it's reason enough to doubt the combination can be safe and effective. I guess I'd ask if it's working for you?

As for the insomnia, I'd point to the evening dose of Effexor. When it was first prescribed for me, I was told to take it at night. (This was Effexor XR, by the way.) That caused pretty severe insomnia, so I switched to taking it in the morning which cleared it up for me. You might want to try taking the evening dose earlier, and see if that helps, or switching to the XR formulation so that you can take it all in the AM. Also, lowering the Prozac might help, since Prozac is very activating.

Hope that helps.


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