Posted by bleauberry on January 5, 2012, at 8:26:57
In reply to low dose prozac more effective AD than high dose?, posted by n_shrimpie on January 4, 2012, at 19:41:34
There is a certain phenomenon that happens with some people and it has been reported here multiple times. With that phenomenon, what happens is a patient will feel surprisingly better while weaning off a med or shortly after stopping it....but as soon as it is totally washed out, their symptoms return.
It could be a lower dose is better for you, and maybe you saw a hint of that while weaning off the med. It might be worth a shot to try lower dosing. I have personally experienced with both meds and herbs there is a therapeutic window with just about all of them....too little does nothing, the right amount works good, too much doesn't work or makes things worse....but the key to understanding this topic is to accept the premise that each and every patient is uniquely and sometimes profoundly different in biological terms than the next patient. So when they say 20mg is the therapeutic dose of prozac, I laugh. It probably is the generally accepted dose for a majority of people, but that in no way means someone else might do best with 120mg, someone else with 5mg. Personally I felt best for months on just 10mg, and before that at 5mg, and only went to 20mg when those lower doses tended to poop out somewhat over months.
Hey one of my doctors has had patients do well with as little as 1mg lexapro....but of course we all know 1mg won't do anything it has to be at least 5mg but really 10mg, right? Wrong. No matter where we look in life, the crowd is usually wrong.
On the opposite extreme, someone I know takes 400mg of prozac per day....in that case it is for OCD not depression. The point is....400mg is unheard of, clearly grossly above the generally accepted highest dose range, and yet for this person it works and has hardly any side effects even at that incredible dose.
Extremes happen. Are you one? Is your extreme on the low side? Just questions to consider. Or was it just that weird phenomenon of stopping a serotonin med that did it?
At this point we don't know if prozac will work for you or what the right dose was. All we know is you felt better when getting off it and that it did not work at 20mg. So that leaves two options....try a higher dose to see what happens....try a lower dose to see what happens. Given that you already have some strong clues pointing to the lower dose, I would try that.
But of course the long halflife of prozac will make it trickier to switch to a different med if the prozac experiments don't work out. My gut instinct says what you experienced was the phenomenon, but there is enough doubt and suspicion to perhaps warrant a retrial at lower doses. Using juice, you can empty a prozac capsule into juice, stir it well (won't dissolve) and drink custom sized doses. This way you can make any size dose you want....1mg, 3mg, 7mg, whatever. Stays good in the fridge for a week but must be stirred well each time it is used.
As a final comment I wanted to say I am not a fan of straight up SSRIs. I am in the camp that believes if you want the most robust performance, the fastest performance, and the longest enduring performance, all SSRIs require a counterpart med to balance out norepinephrine circuits with the serotonin circuits. That usually means adding to the ssri right from the start....nortriptyline, desipramine, ritalin, reboxetine, amisulpride, or milnacipran. In choosing ssri for such combos, I favor either zoloft or prozac for a variety of reasons. In the case of zoloft, because of its lower drug/drug interactions. In the case of prozac because of its broad influence on other neurotransmitter circuits besides just serotonin.
poster:bleauberry
thread:1006346
URL: http://www.dr-bob.org/babble/20111226/msgs/1006402.html