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Questions about Prozac/Prozac Weekly

Posted by Ame Sans Vie on November 5, 2003, at 10:15:39

Hi everyone,

Haven't posted in about a week I think... I've just been so busy starting to get my life back on track now that the meds are helping. I convinced the university to reinstate my full academic scholarship which I lost after dropping out twice a few years back (pre-agoraphobia). I start school again in January -- couldn't be more excited about that. :-) I've also gotten together some friends and started up a new band. It's been so long since I've been able to get up on stage and sing, so, thrilled as I am, I'm nervous as hell, lol. Anyway, that's just an update, and here are the questions...

I've been on Prozac 20mg for two weeks now, and was on 10mg for a week before that. I have another week at 20mg before I go back to see my pdoc. The drug is working great -- I see no need for dosage adjustment, and I haven't needed to use my prn Ativan or meprobamate at all yet. Xanax, Klonopin, and Adderall XR will remain a part of my regimen, I'm sure. I want to switch to Prozac Weekly, but I need to know a few things...

1. Is it too soon? Should I wait another month or so before attempting the switch?

2. How do most doctors handle the transition from Prozac to Prozac Weekly? Does anyone have any info concerning whether it's more beneficial to take the first dose immediately or to wait a week, as some suggest?

3. Will the 90mg capsule really provide me with the same blood levels of the drug that would normally necessitate 140mg/week of fluoxetine?

4. What is its release mechanism? I understand that it releases some immediately and the rest over an extended period of time, but can anyone tell me exactly how it achieves this week-long release? (not to mention why other drugs have yet to employ similar technology... does Eli Lilly have a patent on the release mechanism?)

5. Does anyone know if Medicaid will cover the cost (I'm in TX)? I'd like to find this out before I even bring it up with my doctor, as it was pretty frustrating to go fill my first Rx for Xanax XR and find that Medicaid wouldn't cover it.

6. I know that fluoxetine is cited in drug references as being an inhibitor of the metabolism of clonazepam (via CYP2D6?). Has anyone noticed any significant alterations of the effect of clonazepam (or other benzos for that matter) due to concomitant fluoxetine administration? I haven't noticed an increase in clonazepam's effects as of yet, but that may be attributable to the fact that the benzos are largely keeping the mild akathisia and nervousness that I've had since beginning fluoxetine subdued. When/if these side effects dissipate, maybe the clonazepam dosage can be lowered? I'm currently on 6mg clonazepam and 6mg alprazolam... just trying to think ahead. :-)

And perhaps most importantly...

7. Any success stories with the Weekly formulation? I have a friend who uses it to successfully treat her depression, but she is one of those lucky &*#$@'s that was able to get her meds right on the first try, so I'm skeptical, lol. Also, she found she had to go from 20mg daily to 180mg weekly -- she's very athletic, very thin, very fast metabolism... think this could be why she needs the higher dose?

Thanks for any and all responses!

Michael


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poster:Ame Sans Vie thread:276801
URL: http://www.dr-bob.org/babble/20031105/msgs/276801.html