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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by Bonnie_CA on June 18, 2006, at 3:18:32
I've been on Prozac for five weeks now. I really don't like it. I have to take xanax to even feel normal. When I don't take Xanax, I feel floaty and weird. I'm not having anxiety per se, but I feel weird. Sometimes it is really stimulating, and I need the xanax to counteract that for sure. I've been on this dose (20mg) for four of those five weeks. Is this long enough to decide that this isn't working? I'm just wondering, because I'm going to call my doc soon about it. I just wanted to know if anyone had success that took longer than 5 weeks.
-Bonnie
Posted by FrequentFryer on June 18, 2006, at 5:59:00
In reply to Is five weeks long enough to decide if it works?, posted by Bonnie_CA on June 18, 2006, at 3:18:32
Yep I reckon its about the perfect amount of time to determine if its gonna work or not.
Some people say wait longer. But stuff waiting around for months when you feel depressed.
I reckon your on to low of a dose, but if you dont like the stimulation I would change pills.
Posted by elanor roosevelt on June 18, 2006, at 8:27:23
In reply to Re: Is five weeks long enough to decide if it works?, posted by FrequentFryer on June 18, 2006, at 5:59:00
prozac made me feel like i was coming out of my skin
took many baths a day
then changed meds
the question of how long do i wait relies on your doctor
if he/she is good then 5 weeks is plenty
if he/she is one of those two months blah blah
change docs
Posted by blueberry on June 18, 2006, at 8:52:13
In reply to Is five weeks long enough to decide if it works?, posted by Bonnie_CA on June 18, 2006, at 3:18:32
A recent study involving thousands of patients over several years showed that many people who had not responded by 6 weeks did respond in the 8 to 12 week timeframe. That's an aweful long time to wait when you feel bad. Maybe in a clinical study it is easier because you are connected to other people involved.
On the other hand, there is some evidence that an early response is a fairly good predictor of a fuller recovery later on. But I've had the opposite happen as well where I felt better early but felt worse over time.
I think the main thing is the side effects...they should have diminished to tolerable levels by now and not have you crippled at 5 weeks. Since they haven't, that may well be the final deciding factor that you move to another medication.
Higher doses of prozac may be helpful for some people, but clinical studies show that doses higher than 20mg generally don't provide any more benefit. Some people actually do best on 5mg or 10mg a day. In any case, if you increase the dose to try to get more benefit, those side effects that are troubling you will become more intense as well.
Posted by ed_uk on June 18, 2006, at 12:34:05
In reply to Is five weeks long enough to decide if it works?, posted by Bonnie_CA on June 18, 2006, at 3:18:32
>Sometimes it is really stimulating
You might find 20mg on alternate mornings to be more tolerable. I would recommend trying it.
Ed
Posted by Phillipa on June 18, 2006, at 14:05:36
In reply to Re: Is five weeks long enough to decide if it works? » Bonnie_CA, posted by ed_uk on June 18, 2006, at 12:34:05
My pdoc said every three days as it has such a long half-live. But what about starting at really low does say 5mg. But I'd a wait a few days first as it will be in your system even longer than that. Love Phillipa
Posted by Bonnie_CA on June 18, 2006, at 14:49:02
In reply to Re: Is five weeks long enough to decide if it works? » Bonnie_CA, posted by ed_uk on June 18, 2006, at 12:34:05
So just take my dose every other day? I had thought about that, since I know that Prozac has a long half life. When I was on Paxil, it didn't hurt me to take off a day or two, so I would imagine that Prozac would be similar. Celexa, however, if I skipped my dose once I was a mess. Much shorter half life.
I'll give that a shot. Thanks!
-Bonnie
Posted by Bonnie_CA on June 18, 2006, at 18:19:36
In reply to Re: Is five weeks long enough to decide if it works?, posted by blueberry on June 18, 2006, at 8:52:13
> A recent study involving thousands of patients over several years showed that many people who had not responded by 6 weeks did respond in the 8 to 12 week timeframe. That's an aweful long time to wait when you feel bad. Maybe in a clinical study it is easier because you are connected to other people involved.
>
> On the other hand, there is some evidence that an early response is a fairly good predictor of a fuller recovery later on. But I've had the opposite happen as well where I felt better early but felt worse over time.
>
> I think the main thing is the side effects...they should have diminished to tolerable levels by now and not have you crippled at 5 weeks. Since they haven't, that may well be the final deciding factor that you move to another medication.
>
> Higher doses of prozac may be helpful for some people, but clinical studies show that doses higher than 20mg generally don't provide any more benefit. Some people actually do best on 5mg or 10mg a day. In any case, if you increase the dose to try to get more benefit, those side effects that are troubling you will become more intense as well.Thanks for the input! I wonder if I'm on too high of a dose, so perhaps doing it every other day stop the floaty feeling. I've never had that odd sensation before on other SSRIs, and I don't know what is causing it, but I figure maybe I've got too much seratonin up there or something. Then again, prozac has the longest halflife of the SSRIs, so that could be possible. Maybe I wouldn't find that taking this dose longer would help, but maybe lowering the dose and not switching again. Then, if it still sucks, after 8 weeks, I'll switch meds.
-Bonnie
Posted by Bonnie_CA on June 18, 2006, at 23:35:45
In reply to Is five weeks long enough to decide if it works?, posted by Bonnie_CA on June 18, 2006, at 3:18:32
Posted by ed_uk on June 19, 2006, at 12:40:56
In reply to Re: Is five weeks long enough to decide if it works? » ed_uk, posted by Bonnie_CA on June 18, 2006, at 14:49:02
>So just take my dose every other day?
Yes. Hope it helps :)
Ed
Posted by Bonnie_CA on June 19, 2006, at 20:05:22
In reply to What causes the floaty feeling? (nm), posted by Bonnie_CA on June 18, 2006, at 23:35:45
Posted by pseudoname on June 20, 2006, at 10:13:59
In reply to I guess noone knows what causes the floaty feel :( (nm), posted by Bonnie_CA on June 19, 2006, at 20:05:22
> I guess no one knows what causes the floaty feeling :(
Hi, Bonnie.
Do you mean physiologically how could Prozac be creating this effect? I don't know.
But there's not a lot of specificity in your description. One woman's "floaty feeling" is another woman's... dizziness? medicine head? micropsia?
Can you describe it more?
Posted by Bonnie_CA on June 20, 2006, at 12:23:35
In reply to that floaty feeling » Bonnie_CA, posted by pseudoname on June 20, 2006, at 10:13:59
Well, it doesn't feel like the lightheadedness that caused me to go to the doctor a long time ago in the first place, but my head feels like it's floating. I don't feel like I'm all there. I'm not dizzy, just feel like my head is somewhat detached from my body, and it's just floating above my shoulders. The best visual descriptor I can think of is the South Park episode where Mr Mackey tries drugs, and his head inflates and floats away as if it were a balloon. I feel "out of it", like I'm just floating through the day. I sometimes wonder if that is what it's like to take ecstasy to a mild degree (those people always have that look in their eyes like they're floating). If I take a little bit of xanax, I feel like my head is brought back down to Earth. The problem is, I switched off of Celexa so I wouldn't have to take xanax, so the Prozac is completely defeating the purpose. I would have been better off staying on Celexa. Anyway, that's the best I can describe the floaty feeling. I hope someone can give me some input on that. Thanks!
-Bonnie
Posted by pseudoname on June 20, 2006, at 14:08:54
In reply to Re: that floaty feeling » pseudoname, posted by Bonnie_CA on June 20, 2006, at 12:23:35
> my head feels like it's floating. I don't feel like I'm all there.
Thanks, Bonnie. I didn't see the South Park but it also sounds like that commercial where the woman takes a cold or sinus med and her head floats up as a "medicine head" balloon.
I predict that it will go away the longer you stay on Prozac. (Easy for me to say, I know.)
Posted by puravida on June 20, 2006, at 23:44:13
In reply to Re: that floaty feeling » Bonnie_CA, posted by pseudoname on June 20, 2006, at 14:08:54
I know what you are talking about... I started on 20 but then we cut to 10 mg and added Wellbutrin. Prozac itself may not be the problem - for me, I thought it was the drug, but it was the dose...
PV
Posted by Bonnie_CA on June 21, 2006, at 1:22:24
In reply to Re: that floaty feeling, posted by puravida on June 20, 2006, at 23:44:13
> I know what you are talking about... I started on 20 but then we cut to 10 mg and added Wellbutrin. Prozac itself may not be the problem - for me, I thought it was the drug, but it was the dose...
>
> PVI sometimes wonder if just lowering my dose would be adequate. I have also had some amount of hypomania, insomnia, and mild headaches. All of this makes me think it's just too high. I think my doc thinks because I was on 40 mg of Celexa and 20 mg of Paxil previously that 20 mg of Prozac would be appropriate. I am going to give a call back to the doc tomorrow (probably to make an appt), and I'll see if I can just get a lower dosage (I'd split the pill but I can't) without an appt. I am trying ed_uk's suggestion of taking the 20 mg every other day. I skipped yesterday, and I'll skip tomorrow. I'll see how that works out too. I guess that works similarly to lowering the dose. *shrugs*
-Bonnie
Posted by ed_uk on June 21, 2006, at 13:54:39
In reply to Re: that floaty feeling, posted by Bonnie_CA on June 21, 2006, at 1:22:24
Hi
>I guess that works similarly to lowering the dose. *shrugs*
Alternate day dosing is fine with Prozac, it has a very long duration of action. Some people even take it once weekly! As well as the usual tablets and capsules, Prozac is also available as a 90mg capsule called Prozac Weekly.
http://www.prozac.com/how_prozac/once_a_week.jsp?reqNavId=2.4.1
Ed
Posted by Bonnie_CA on June 21, 2006, at 15:32:25
In reply to Re: that floaty feeling » Bonnie_CA, posted by ed_uk on June 21, 2006, at 13:54:39
> Alternate day dosing is fine with Prozac, it has a very long duration of action. Some people even take it once weekly! As well as the usual tablets and capsules, Prozac is also available as a 90mg capsule called Prozac Weekly.
>
> http://www.prozac.com/how_prozac/once_a_week.jsp?reqNavId=2.4.1
>
> Edyeah, I've heard of Prozac weekly. I've gotten conflicting reports on how long Prozac works on the system. What is the real length? How long does a 20 mg dose work on the body? I'm desperately trying to understand how this medicine might be working in my body. BTW, I called the doc about my meds today, and the nurse said it would be fine to try taking it every other day. I was calling because I wanted to know if I could switch to something else, because I never had this much trouble with Celexa or Paxil. I'm getting so frustrated, I feel like asking to go back on Paxil, to hell with the sexual side effect! I NEVER had any problems (with my anxiety) on Paxil, just made me gain 20 lbs and I had trouble getting "ready" for intercourse. Celexa was awesome (NO side effects), but it pooped out. Oh, but those were the days... :-\
-Bonnie
Posted by pulse on June 23, 2006, at 7:09:53
In reply to Is five weeks long enough to decide if it works?, posted by Bonnie_CA on June 18, 2006, at 3:18:32
for most, prozac is activating at start-up. i like that extra boost. why i started prozac in 1st place & why i've returned to it more than others - & i DO gave GAD. activating, yet shortly down road, also calming, so nice mix. fractured sleep that never goes away - not so good.
i've taken all newer gx ads + combos.
for me, the VERY slight, but wholly pleasurable 'stimulation' remains. YMMV. gi SEs most tolerable of all ads; now, even these too much. may have over-sensitized serotonin receptors in gut, but - NO doubt about it! - reflux started as DIRECT result of all mood stabilizers tried over 9 yrs. of a mis-dx BP1.
subgroup of prozac users ARE better at lower doses. true for me. i remitted at 3 wks, each time, but many take longer.
IF you have the tablet, just break in half =10 mgs., since scored. if dosage gives you remission, you *may* want to have doc call pharmacy to change existing rx to 10 mg tabs.
floating description sounds like depersonalization - common at start-up of prozac. however, i've never heard of anyone having it for 5 wks!
NO possibility that you're having prozac-induced apathy - if that ever even happens to you - at 5 wks.
i agree with ed uk - give it more time..
pulse
Posted by puravida on June 23, 2006, at 9:52:20
In reply to Re: that floaty feeling » ed_uk, posted by Bonnie_CA on June 21, 2006, at 15:32:25
Bonnie,
Of course every one is different, but after several similar experiences with Prozac, I am fairly convinced that IF the does is right it works the best for me. And I have tried bunches of meds. I am in a similar spot because I think after 18 months my 10 mg of Prozac pooped. The Dr upped it to 20, but that doesn't seem to be working much better. All I have is 20 mg caps right now, so I am going to experiment with alternating 20 mg and 40 mg. For me, I can feel the effects of Prozac pretty quickly - if the does is too high I feel too wired, but if it is just right, it just lifts the fog. "Just" - lol -that is what we are after, right?
Not sure if I mentioned, but Wellbutrin and Buspar have both been good additions to the Prozac for any breakthrough sexual side effects and/or anxiety.
Good luck - let us know how you go-
pv
Posted by Bonnie_CA on June 23, 2006, at 15:55:48
In reply to Re: Is five weeks long enough to decide if it work, posted by pulse on June 23, 2006, at 7:09:53
Thank you, I'm happy to hear from someone with GAD also. So Prozac was alright for you? My doctor just called in a 10 mg dose of Prozac (I need to go pick that up soon) because he thinks it'd be better for me than taking 20 every other day. Yeah, I suspected that it was too high because of that floaty feeling. It's like, it made me hypomanic for the first few weeks, and then that finally subsided (thank goodness, that was really annoying!). Then I just started feeling floaty, sort of high when I took 20 mg everyday. When I skipped my dose on Monday and Wednesday, yesterday when I took my 20mg dose I felt just fine, no floaty feeling, no anxiety, just ok. Sooo perhaps I was right in thinking it was too high, and hopefully the 10 mg dose will be just the ticket. I don't want to change meds again (for a third time this year!) because I'm afraid that will screw me up more than just trying to find the right dose of Prozac. Anyway, at least I have a really cheap drug plan, so it's no problem trying different doses.
I have tried BuSpar alone before (worthless!) but I have read online and in other posts that it's good with ADs. I had Wellbutrin when I was taking Paxil, and I didn't notice that it made the sexual side effects subside, and it just made me bounce off the walls. I haven't had any sexual side effects that I have noticed from Prozac *crosses fingers*, so hopefully I won't need any of that. I didn't have any sexual side effects from Celexa either, but it pooped out on me too. Paxil never pooped out on me, but blah, those SE were enough to make me crazy (chubby AND no sex? No thanks!).
Thank you so much for your input. IMO, it has been the most valuable so far. Not to discount everyone else's contributions, but it's great to hear from someone who took it for the same condition I'm taking it for and say that it was alright.
-Bonnie
Posted by pulse on June 24, 2006, at 5:59:24
In reply to Re: Is five weeks long enough to decide if it work » pulse, posted by Bonnie_CA on June 23, 2006, at 15:55:48
thank you so very much, Bonnie_CA.
i'm so glad you got the 10 mg. script called in. i sincerely hope this works out well to very well for you.
wellbutrin = bouncing off walls. i just can't fathom how anyone finds it good for anxiety, but many do. my gp's gal friday took the newest version, but for smoking cessation, and she was psychotically anxious for a week, until doc said STOP NOW.
my best regards,
pulse
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