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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by lukh on August 27, 2010, at 10:45:59
Fluoxetine alone doesnt help me a lot, maybe edronax or what other medicines should i have to potentiate the antidepressant effect?
I take 400mg seroquel , 1 mg delorazepam, depakin chrono 500 mgs and 20 mg fluoxetine.
Posted by morgan miller on August 27, 2010, at 12:23:18
In reply to prozac not strong enough, posted by lukh on August 27, 2010, at 10:45:59
It's possible that seroquel and lorazepam are interfering with therapeutic effects of fluoxetine. Are you taking generic or brand Prozac?
How much are you taking?
Have you tried Zoloft or any other antidepressant/ssri?
Many have had success with combining an SSRI with Nortriptyline. I haven't tried this but may be trying it soon.
Morgan
Posted by Roslynn on August 27, 2010, at 16:43:35
In reply to Re: prozac not strong enough, posted by morgan miller on August 27, 2010, at 12:23:18
Hi, I hope you don't mind me jumping in on your thread. Morgan, I was not aware that seroquel and lorazepam could interfere with the effects of Prozac. Could you please explain this mechanism if you get a chance?
(I am on Prozac 60mg, lorazepam 3mg, seroquel 100mg, lithobid 600mg).
Thank you for any answers!
Roslynn
> It's possible that seroquel and lorazepam are interfering with therapeutic effects of fluoxetine. Are you taking generic or brand Prozac?
>
> How much are you taking?
>
> Have you tried Zoloft or any other antidepressant/ssri?
>
> Many have had success with combining an SSRI with Nortriptyline. I haven't tried this but may be trying it soon.
>
> Morgan
Posted by Phillipa on August 27, 2010, at 21:44:30
In reply to Re: prozac not strong enough » morgan miller, posted by Roslynn on August 27, 2010, at 16:43:35
I wasn't aware of this either. Phillipa
Posted by Maxime on August 28, 2010, at 20:33:12
In reply to prozac not strong enough, posted by lukh on August 27, 2010, at 10:45:59
20 mg of Prozac isn't very much. I went as high as 100 mg when I was on it. I think the recommended max is 60 mg.
Posted by morgan miller on August 28, 2010, at 21:47:09
In reply to Re: prozac not strong enough » morgan miller, posted by Roslynn on August 27, 2010, at 16:43:35
Couldn't find any hard science behind it, but since benzodiazepines like lorazepam are CNS depressants like alcohol, it is thought that they may also interrupt with the efficacy of antidepressant drugs in in the same way alcohol can. I've been to two psychiatrists that believed this could be the case believe it or not. Also, if you started an SSRI while on a benzo, how would you know if you would have been just fine after a few months of sticking it out with the SSRI? Your brain gets used to these drugs and it may react differently to medications that are introduced after being altered by another medication. Now, if you were to try to get off lorazepam, you would have to deal with withdrawals and a long adjustment period. It may be a while before you find out if you do well without it.
As far as seroquel is concerned, again, it's a CNS depressant and could interfere with the antidepressant action of Prozac. This is all just theory. Then again, drugs like seroquel and lithium could help balance out and temper some of the stimulating and possibly destabilizing effects of Prozac.
I'm biased, really not a fan of seroquel and lorazepam, I think they are over prescribed. I would prefer a low dose of Zyprexa if an antipsychotic were really necessary. I've been able to break free from things like Zyprexa and Depakote. Now I just take 20 mg Prozac and 600 mg Lithium, plus all my mood/energy enhancing supplements and diet.
Morgan
Posted by lukh on August 29, 2010, at 8:35:19
In reply to Re: prozac not strong enough » Roslynn, posted by morgan miller on August 28, 2010, at 21:47:09
Thank you all, Ill try to ask my doctor about adding efexor (venlafaxine) maybe at the 75-150 range or edronax (reboxetine) 8-12 mgs/day to augment the fluoxetine, I take the generic brand Sandoz.
Seroquel is too much dumbing for me. the benzo delorazepam seems to quiet the anxiety whilst id like to face it.
My problem came when i quitted the lithium carbonate from 300x3/day to 0.
I can say it was strenghtening my brain.Luca (luke)
Posted by morgan miller on August 29, 2010, at 10:13:45
In reply to Re: prozac not strong enough, posted by lukh on August 29, 2010, at 8:35:19
> Thank you all, Ill try to ask my doctor about adding efexor (venlafaxine) maybe at the 75-150 range or edronax (reboxetine) 8-12 mgs/day to augment the fluoxetine, I take the generic brand Sandoz.
> Seroquel is too much dumbing for me. the benzo delorazepam seems to quiet the anxiety whilst id like to face it.
> My problem came when i quitted the lithium carbonate from 300x3/day to 0.
> I can say it was strenghtening my brain.
>
> Luca (luke)Why not get back on lithium and drop the seroquel?
You might also want to get your doctor to tell your insurance company that you need brand Prozac due to negative reactions to generic. It is possible brand my work better than generic.
Have you ever tried Zoloft?
Do you take moderate doses of fish oil as an adjunct to medication treatment?
Morgan
Posted by ed_uk2010 on August 29, 2010, at 12:26:08
In reply to Re: prozac not strong enough, posted by lukh on August 29, 2010, at 8:35:19
Hi Luca,
>Thank you all, Ill try to ask my doctor about adding efexor (venlafaxine) maybe at the 75-150 range or edronax (reboxetine) 8-12 mgs/day to augment the fluoxetine, I take the generic brand Sandoz.
You wouldn't normally add venlafaxine to fluoxetine. The venlafaxine would replace the fluoxetine. Reboxetine, on the other hand, can be combined with fluoxetine if necessary.
I wouldn't worry about Sandoz fluoxetine. Sandoz is part of Novartis, a major pharmaceutical company. I have not heard of any quality issues with Sandoz (or Novartis) products. They are a reputable company.
>the benzo delorazepam seems to quiet the anxiety
Are you in Italy? Delorazepam is only available in a few countries.
Posted by ed_uk2010 on August 29, 2010, at 12:27:18
In reply to Re: prozac not strong enough, posted by lukh on August 29, 2010, at 8:35:19
>My problem came when I quitted the lithium carbonate from 300x3/day to 0.
Do you think you could benefit from lithium again?
Posted by lukh on August 30, 2010, at 1:44:04
In reply to Re: prozac not strong enough » lukh, posted by ed_uk2010 on August 29, 2010, at 12:27:18
Thank you for your replies :) Ill ask my doctor todiminish the Seroquel and give me some Efexor because years ago I took the Efexor at 150 mgs plus 10 mgs of Prozac and it could move mountains after having added the P.
Luca
Posted by Roslynn on August 30, 2010, at 16:20:18
In reply to Re: prozac not strong enough » Roslynn, posted by morgan miller on August 28, 2010, at 21:47:09
Morgan,
Thank you. What you wrote makes sense.
I've been trying desperately to get off Seroquel. the thing is, it works to block that terrible anxiety. But the trade-off is, it makes you lose IQ points...
Thanks for your follow-up to my question.
Roslynn
> Couldn't find any hard science behind it, but since benzodiazepines like lorazepam are CNS depressants like alcohol, it is thought that they may also interrupt with the efficacy of antidepressant drugs in in the same way alcohol can. I've been to two psychiatrists that believed this could be the case believe it or not. Also, if you started an SSRI while on a benzo, how would you know if you would have been just fine after a few months of sticking it out with the SSRI? Your brain gets used to these drugs and it may react differently to medications that are introduced after being altered by another medication. Now, if you were to try to get off lorazepam, you would have to deal with withdrawals and a long adjustment period. It may be a while before you find out if you do well without it.
>
> As far as seroquel is concerned, again, it's a CNS depressant and could interfere with the antidepressant action of Prozac. This is all just theory. Then again, drugs like seroquel and lithium could help balance out and temper some of the stimulating and possibly destabilizing effects of Prozac.
>
> I'm biased, really not a fan of seroquel and lorazepam, I think they are over prescribed. I would prefer a low dose of Zyprexa if an antipsychotic were really necessary. I've been able to break free from things like Zyprexa and Depakote. Now I just take 20 mg Prozac and 600 mg Lithium, plus all my mood/energy enhancing supplements and diet.
>
> Morgan
This is the end of the thread.
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