Posted by Ron Hill on March 16, 2002, at 22:23:01
In reply to Anyone respond to subtherapeutic med doses only ?, posted by colin wallace on March 16, 2002, at 11:42:10
> Prozac trial: I take one 20mg capsule, and within hours feel uplifted, a slightly dizzying or tipsy feeling, and music enters my mind so that I feel like whistling!Hmmmm. A (slightly)giddying state in which to go about one's ordinary life, but great for a Saturday night.Much preferable to feeling like crap-but needs some tuning down I think.
> Next day: 200mg Sam-e.Terrific- achieved just the right 'pitch', and life's back in focus.
> Next day: 20mg prozac- Yeuch...not fun at all! WAY overstimulated....don't raise your voice at me or I'll ******* pulverize you!!Snarl!Hmmmm.
> Must tone this down!Where's my genial good nature gone?? And the whistling...?
> Next day: 200mg sam-e- still far too strung out, but human and sociable again by the evening.
> Okay, try again.... two days washout.
> next day.20mg prozac- whistlin' dixie.
> next three days in a row-200mg Sam-e...nothing else.
> Fifth day: cautious 20mg prozac...wait for it...aah, a telltale foot tapping to the radio, a breezy 'hello' on the telephone.... a brief whistle and a tentative early morning stiffie, perhaps heralding....anyway, you get the picture here.
> Question: Can the therapeutic window of Prozac, or indeed any SSRI be THAT narrow? Can I really benefit from less than 5mg a day?Am I med. hypersensitive? This perhaps seems a plausible explanation.This may well explain my wholesale rejection of all things SSRI in the past.No wonder I turned into Hannibal Lecter on 150mg effexor.Pause for thought.Like the feel of prozac (at infant-like doses),seems to complement sam-e very well.But have to put up with feeling 'overly upbeat and stupefied' every fifth day, till things settle down.
> So, I wondered if anyone else has had a similar reaction/overreaction to Prozac , or another ssri.Anyone tried liquid prozac?? (didn't particularly like celexa either..)
> Just coming back down to earth..........
>
> (whistlin') Col.
---------------------------------------------Dear Mr. Whistlin:
I like your humor. Colin, you and I have touched base recently, so you know that I react in a simillar fashion as you to SSRI's and SAM-e. Since my last pdoc visit four months ago, my med cocktail has been 600 mg/d Lithobid, 12.5 mg/d Zoloft, and 200 mg/d SAM-e.
Like you, I feel the uplifting effect of an SSRI almost as soon as I swallow it and I usually become slightly hypomanic for a day. But within a few days the beneficial effects are overtaken by unwanted side effects. My side effect symptoms are different than yours. Instead of getting irritable on an SSRI, I get anergic (low energy, low motivation, blunted emotions, etc). As a side note, I usually get highly irritable (GRRRRRRRRRRR!) when coming off of an SSRI, even a micro-dose like you and I take. As you recall from prior posts, the 200 mg/d SAM-e add-on to the low dose SSRI effectly eliminated the anergic side effects for four months.
However, here's the latest. Yesterday, I once again began to feel the anergic side effects caused by the SSRI (Zoloft). It figures that no sooner than I begin to post the success of SAM-e, something would go wrong! In an attempt to solve this problem, I have stopped taking the low-dose Zoloft and increased the SAM-e dose to 400 mg/d. I feel pretty good today. Time will tell if SAM-e can provide enough of an antidepressant effect without the help of a low dose SSRI.
Ok, enough about me, let's focus on you. I realize that Prozac has a long half life but none-the-less wouldn't it make more sense to take a very small dose every day as opposed to a "normal" dose every third or forth day? I wonder if the daily low-dose might be less of a shock to your system than the big hit periodically. You can open the 20 mg Prozac capsule and divide it into, say, four equal portions. I buy empty capsules at the health food store so I can make my own low dose capsule. At one point I looked into buying a liquid SSRI (Zoloft in my case), but I felt that the added convenience was small in comparison to the higher cost. I am self insured.
I forget if you are bipolar. I am bipolar and I believe that's why I have problems with AD's in general. Please refresh my memory by telling me your dx and a list of the meds you currently take.
A little bit of SSRI and its "Whistle While You Work",
But too much Prozac and its "Colin The Irritable Jerk".Been there, done that.
-- Ron
poster:Ron Hill
thread:98301
URL: http://www.dr-bob.org/babble/20020313/msgs/98361.html