![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Red_Rach on February 4, 2006, at 17:39:54
I am from the uk and suffer from OCD. Recently I've had a blip and Ive been taking up to 80mg of Prozac to not much affect it would seem. Ive been told off by my GP as taking 80mg in this country is not licenced.
I asked about prozac alternatives and the doctor recomended Celexa. Thing is my doctor dosnt want me to start taking the celexa until 3 weeks, she wants me to reduce the prozac slowly. Is this really nessisary?
I need to start feeling better, and Im considering going back up to 80mg again without the doctors consent!!
Posted by Phillipa on February 4, 2006, at 21:03:00
In reply to Prozac to Celexa, posted by Red_Rach on February 4, 2006, at 17:39:54
The only thing I know is that prozac stays in the body a long time. And even if you miss a dose it wiil be okay. So waiting to change meds doesn't seem unusual to me. Fondly, Phillipa
Posted by yxibow on February 4, 2006, at 21:57:53
In reply to Prozac to Celexa, posted by Red_Rach on February 4, 2006, at 17:39:54
> I am from the uk and suffer from OCD. Recently I've had a blip and Ive been taking up to 80mg of Prozac to not much affect it would seem. Ive been told off by my GP as taking 80mg in this country is not licenced.
>
> I asked about prozac alternatives and the doctor recomended Celexa. Thing is my doctor dosnt want me to start taking the celexa until 3 weeks, she wants me to reduce the prozac slowly. Is this really nessisary?
>
> I need to start feeling better, and Im considering going back up to 80mg again without the doctors consent!!Prozac was the first SSRI and has more harsh side effects. It also has a half life of up to 7 days. Most people consider a drug eliminated from the body when 5 half lives have passed, so the Prozac wouldn't be gone for over a month. Luvox (fluvoxamine) is also a good medication for OCD, it is a bit more sedating, it has gone generic here in the states, I dont know what NHS does, but I've taken it up to 400mg. Celexa or Lexapro are also alternates. Your GP is probably concerned that if you start the Celexa immediately you could suffer Serotonin Syndrome, because there would still be a large blood level of Prozac in your body. She is being conservative but SS is not particularly pleasant to go through. You could ask your GP about a crosstaper, if that is feasible, remembering that the Prozac would be leaving your body very slowly.
Posted by Red_Rach on February 5, 2006, at 12:52:59
In reply to Re: Prozac to Celexa » Red_Rach, posted by yxibow on February 4, 2006, at 21:57:53
Well the idea is that I reduce it by 20mg every week. This week Im on 60, and by Friday I should go down to 40. Im not sure I can do it though, esp after being used to 60 for so long.
Posted by ed_uk on February 5, 2006, at 17:20:29
In reply to Prozac to Celexa, posted by Red_Rach on February 4, 2006, at 17:39:54
Hi Rach
>Ive been told off by my GP as taking 80mg in this country is not licenced.
80mg is now the licensed maximum dose in the UK. It used to be 60mg but it was changed to 80mg a while back. Your GP is not up to date.
Taking 80mg fluoxetine is fine. It can take up to 3 months at 80mg to get the full benefit. I would encourage you to stay on floxetine. Switching to a different SSRI is not necessary or sensible. Your GP needs to be educated on fluoxetine.
He can simply look in his BNF - all GPs have a BNF. The latest BNF will inform him that the maximum licensed dose is 80mg.
Regards
Ed
Posted by Red_Rach on February 6, 2006, at 14:20:57
In reply to Re: Prozac to Celexa » Red_Rach, posted by ed_uk on February 5, 2006, at 17:20:29
Hi,
Thanks for the information Ed. Is there anywhere I can read about this licensing information? its not that I dont beleive you, Im quite releaved to hear this, its just I suspect that my doctor may have another tantrum if I am not armed with information.
I must say prozac has always been my number 1, its only pooped out on me once and even then after 6 months or so I returned to it.
Posted by ed_uk on February 6, 2006, at 15:30:29
In reply to Re: Prozac to Celexa, posted by Red_Rach on February 6, 2006, at 14:20:57
Hi Rach
Here is the dosing information for fluoxetine from the current British National Formulary. The BNF is an official UK publication distributed to all doctors and pharmacists.
(Your doc can read this in his own copy)
Dose: depressive illness, 20 mg once daily increased after 3 weeks if necessary, usual dose 20–60 mg (elderly 20–40 mg) once daily; max. 80 mg (elderly max. 60 mg) once daily; child and adolescent under 18 years not recommended
Bulimia nervosa, 60 mg once daily; max. 80 mg once daily; child and adolescent under 18 years not recommended
Obsessive-compulsive disorder, initially 20 mg once daily increased after two weeks if necessary, usual dose 20–60 mg (elderly 20–40 mg) once daily; max. 80 mg (elderly max. 60 mg) once daily; discontinue if no improvement within 10 weeks; child and adolescent under 18 years not recommended
>I must say prozac has always been my number 1, its only pooped out on me once and even then after 6 months or so I returned to it.
Don't switch to citalopram. You'll be disappointed. Stick with fluoxetine.
Regards
Ed
Posted by Red_Rach on February 6, 2006, at 23:21:02
In reply to Re: Prozac to Celexa » Red_Rach, posted by ed_uk on February 6, 2006, at 15:30:29
Back to 80mg for me then!!!
Posted by ed_uk on February 7, 2006, at 13:40:06
In reply to Re: Prozac to Celexa, posted by Red_Rach on February 6, 2006, at 23:21:02
Hi
Did your doc agree to prescribe the higher dose?
Ed
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.