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Re: Please, need info from Prozac users/former use » Jack Smith

Posted by jrbecker on May 12, 2003, at 23:18:46

In reply to Re: Please, need info from Prozac users/former use » jrbecker, posted by Jack Smith on May 12, 2003, at 16:23:19

overall, I prefer prozac over celexa, but in combo with other meds, I've found that celexa is a better base med. B/c of Prozac's long half-life, it can exacerbate my sleep issues when in combo with other drugs.

There is nothing wrong in considering a prozac/zyprexa combo. In fact, Lilly is manufacturing both compounds in one pill now. Or did you mean by "risks," just increased risks of side effects. I don't have any experience with APs so I'm probably not the best one to ask, especially about comboing it with an AD. Maybe some of the other posters with that experience, such as Ritch or Scott can help answer that.


Stims are great if you can handle the rebound- depression frequently reported. It sounds like you might, considering your tolerance of wellbutrin. perhaps you should try a long-acting version to try it out to see if it balances the daytime sedation with effexor. if you like the feeling of the stimulant effect (I don't) then it's a matter of finding the right one and the proper dosing schedule. If this fails, I would suggest looking into a few more options 1) nicotine patches, 2) light box therapy, 3) very low doses of pregnenolone or DHEA (be careful). I would also experiment taking the effexor at different times. Can you get away with taking it in the ealry afternoon without causing sleep disrup? Or what about at bedtime, any luck there? How about taking it divided doses throughout the day. And by the way, how are you sleeping? If you're getting uneven sleep, then that's part of your problem.

I would try out these options before you go for the remeron. Once you buy into the remeron, you're gonna have to sit tight and adapt to the sedation for a while. Make sure that effexor is really not worth it before you ditch it.

As for prozac and sexual dysfunction... It's mostly the 5HT2A antagonism that helps with the sexual dysfunction more than 5HT2C. And, unlike other SSRIs, Prozac's half-life is so long that there's really no waning of the effect by night-time (presuming you're taking it in the morning). Other factors are also likely at play.


JB

> JR, you are a wealth of information!
>
> > Prozac is by far my favorite of the SSRIs. I am quite sensitive to most ADs, so my optimum dosage was probably 10mg. At this level, the sedation was minimal.
>
> I thought you preferred Celexa, my favorite SSRI that pooped out. Hmm, I wonder if Prozac would be good for me. What is your opinion of Prozac-zyprexa combo or would you say too many risks?
>
> >
> >It acts on GABA too, so perhaps this is why it's great for anxiety for some people -- I really never found prozac all that activating since I took it at such low doses.
>
> I've never found ANY drug activating, including Wellbutrin and adrafinil (those did not sedate me though). Never tried stimulants. Do you think a stimulant would do well with Effexor? What about a stimulant to counter the beginning sedation of Remeron?
>
> >
> > ANnother thing to note about prozac is that it is an antagonist at the 5HT2C site, which is quite the opposite effect from all the other SSRIs. As a result, there is an increase in dopaminergic/NE activity in the prefrontal cortex. It's my belief that this is the reason prozac is a better drug for treating anhedonia than the rest of the SSRIs.
> >
>
> That's interesting but don't you think Prozac would have less sexual side effects than the rest of the ssri's because of its 5ht2c antagonism?? I always thought it was one of the worst ssri's in this regard.
>
> Thanks,
>
> JACK


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poster:jrbecker thread:225329
URL: http://www.dr-bob.org/babble/20030505/msgs/226235.html