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Re: Is this safe?

Posted by Brainbeard on July 15, 2009, at 8:41:17

In reply to Re: Is this safe? » Brainbeard, posted by Deneb on July 14, 2009, at 23:16:31

> I take 40 mg Prozac, 40 mg Celexa, 1 mg Risperdal (now reduced to 0.75 mg though), 40 mg propranolol prn and 0.5 mg Risperdal prn.

OK, you're good with the Risperdal then, I'm relieved.

The Prozac-Celexa thing is a bit of an odd combination though, I think. Michael Jackson was on two SSRIs (Paxil and Zoloft), but I haven't heard of anyone else taking two SSRIs and both at therapeutic doses. Plus, Prozac inhibits Celexa's metabolism, so you're bound to have supra-therapeutic blood levels of Celexa.

Now, Celexa is a bit more likely than some other SSRIs to cause weight gain, since it does have some affinity for the histamine receptor. Certainly with your blood levels, it may cause significant weight gain.

Prozac may cause weight gain through 5HT2C-antagonism, but there have been studies showing Prozac to actually promote weight LOSS at high doses (60mg or up). This may only be a short-term effect though. You could try and cut down on the Celexa while going up with the Prozac. You never know what happens.

Sometimes SSRI-induced weight gain has been countered by adding bupropion (Wellbutrin). Bupropion's metabolism is not inhibited by Prozac, but it does inhibit 2D6 itself, just as Prozac, so that would make Celexa and Risperdal's levels go through the roof even more.


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