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Re: Prozac and paranoia

Posted by JohnL on October 13, 2000, at 4:16:44

In reply to Prozac and paranoia, posted by Linda already exists on October 12, 2000, at 16:52:41

> I am on day 6 of Prozac. I am feeling very hyper, nervous, and all of a sudden VERY paranoid about my health. I started taking it to help with severe PMS (and I am not in PMS mode now).
> My husband said that this could just be a normal initial side effect that may go away - but I feel crazy.
> Has anyone else experienced this?
> I have a very important appointment tonight and I can't appear as if I am spaced out or crazy. Oh God!

It could be that these are initial side effects, which should subside in time. It could also be that Prozac is somehow influencing dopamine levels causing the paranoia. If that is the case, a tiny dose of an antipsychotic like Zyprexa would work very to regain normalcy. It would also enhance the Prozac's effectiveness and at the same time provide you with real good sleep, if the Prozac is causing insomnia. For a lot of reasons, it seems like a very small dose (1.5mg to 2.5mg) of Zyprexa added to the Prozac could be something to consider.

But here's something you can do right away...
Instead of taking the whole Prozac capsule all at once, you could try this instead. Empty the contents of a capsule into juice. Stir it well. Then drink just a portion of it and save the rest in the fridge for next time. With this method, you could do one of two things:
1) Take little doses at various times throughout the day, rather than one dose all at once.
2) Customize your daily dosage to a lower level. For example, if you have 10mg capsules, you could drink half a glass a day to take 5mg instead. After a week or two, then increase to 10mg a day. If the capsules are 20mg, then just drink 1/4 of the glass per day.

Just be sure to stir it well before drinking. Prozac will not dissolve, and it will settle to the bottom. Also worth noting is that in one clinical study they analyzed results on Prozac at various doses on all available clinical studies in literature where Prozac was tested. What they discovered was that, in general, there was no difference in efficacy between 5mg, 10mg, or 20mg a day. The study concluded that if 5mg doesn't work, 20mg could work, but isn't likely. The bottom line...you can try a lower dose if you want to. There is a method to do it (the juice trick) and there is scientific data to support it. But in the back of your mind, realize that the possibility of adding a low dose AP or switching to a different AD exists. I think for now taking a smaller dose makes the most sense.
John


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