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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by homelife on December 31, 2002, at 10:04:27
I'm in my late 40's and have been on zoloft for two years (also synthroid). Dosages started at 25, and were steadily increased to 150. About six months ago, because of cost and lack of confidence in the drug itself, I weaned off of it. My life is becoming one huge hell...Several people mention Prozac has worked better for them. Can I hear any testimonials/advice? I am at my wits end, and no time, or energy,or interest in my family (or cooking one of my hobbies). It has steadily gotten worse even when I was taking the zoloft...the everincreasing dosages made me feel like a zombie on aut0-pilot. The point that I am at now is overstress due to bankruptcy,children,work, and I will start laughing and before you know it I am crying. Am I Crazy? Can med change to prozac help? TIA
Posted by JohnL on December 31, 2002, at 12:04:11
In reply to Prozac vs Zoloft, posted by homelife on December 31, 2002, at 10:04:27
Hi! Wow, I'm very sorry to hear how tough things are right now. Zoloft and Prozac are two medications I have had as treatment at different times, so I am familiar with both of them. I know it won't help much right now, but I thought I would comment on my opinions of these meds. In a rough state, hope can be a great pain reliever and rejuvenator. So, here's some hope...
Disclaimer: My opinions only. Not scientific.
In my opinion, all except one of the SSRIs tend to be emotional numbing drugs. In the troughs of deep depression, that can be a huge relief. But for longterm treatment, you don't want to feel numbed, you just want to feel normal.
Though I don't understand the technical angle of receptors and all that, there are studies that show Prozac is unique in the SSRIs, whereas the others have more similarities with each other. While the others can be emotional anesthesia, Prozac often isn't. In my own experience, Prozac does feel a lot different than all the others. It isn't numbing like the others were to me.
Zoloft is notoriously guilty of causing lack of sexual desire, lack of libido, and anorgasmia. It's that numbing thing again.
But in a surprising number of cases, Prozac can actually be neutral for one's sex life or even beneficial. I find it beneficial because it has no effect on desire, sometimes even enhances the desire, it doesn't numb the important parts, and it lengthens the experience just the right amount of time. Prozac being OK for sex seems to be mostly a male thing though. Sometimes women report hypersexuality. But more often they complain of the usual SSRI side effects.
A real great trick with Prozac though is to initiate a small dose of Zyprexa at the same time. Any insomnia from the Prozac will be wiped out by the Zyprexa. Any lack of appetite or nausea caused from the Prozac can be counteracted by the Zyprexa. There is a ton of anecdotal evidence that Prozac plus Zyprexa is a good combination that works better than either alone, and that significant benefits can be expected anywhere from one day to one week. Scientific evidence too. Prozac alone will likely take weeks.
Zyprexa's side effect profile is mild. I feel hardly any side effects from it. Weight gain is the most common one. I gained significant weight in the first month, then it levelled off at about 3 months, and then slowly disappeared by itself and now I'm back at my beginning weight.
And because of its multi actions on serotonin, ne, and dopamine receptors in specific parts of the brain, Zyprexa is being used widely for a whole range of problems including psychosis, depression, mania, bipolar, anxiety, personality disorders, and aging disorders.
Thousands of opinions. But mine says go ahead with the Prozac. You can do custom sized tiny doses easy by dumping a capsule into juice, stir it well, drink only a small amount of it, save the rest in the fridge for the next day. It stays good for around a week, just stir it well. You can actually begin tiny amounts of Prozac while tapering off of the Zoloft, and make the transition smoother. With careful dosing, you can avoid the withdrawals and washout stuff.
But start Zyprexa at 2.5mg simultaneously. That's the trick. Leave this part out and all bets are off. The most common doses are 5mg, 7.5mg, and 10mg. I take 5mg Zyprexa and 20mg Prozac. Prozac for the day, Zyprexa for the night. I know from experience that I could stop the Prozac if I wanted to, because it is actually the Zyprexa doing the work. I just happen to like Prozac for its other benefits as well.
Can medication make all your bad feelings go away so you can just feel normal? Yes. It's tough to find the right meds to do it though, because everyone has unique brain wiring, personalities, and circumstances. That's why I favor the Prozac plus Zyprexa combination, because it seems to be good for a lot of people who try it, not just a few here and there. It might not work, but the odds are in your favor.
I'm real familiar with Prozac because I've been on it for years and studied the heck out of it. Same with Zoloft. I say go for the Prozac, partially because it is my favorite of them all.
But the real important part is to put the Zyprexa in there with it. You need fast relief. This combination has a good chance of helping you quickly, measured in days instead of weeks. And if it does, then you can expect it to continue getting better with time.
Anyway, I hope this is helpful in some way. Hang in there!
Sincerely,
JohnL
> I'm in my late 40's and have been on zoloft for two years (also synthroid). Dosages started at 25, and were steadily increased to 150. About six months ago, because of cost and lack of confidence in the drug itself, I weaned off of it. My life is becoming one huge hell...Several people mention Prozac has worked better for them. Can I hear any testimonials/advice? I am at my wits end, and no time, or energy,or interest in my family (or cooking one of my hobbies). It has steadily gotten worse even when I was taking the zoloft...the everincreasing dosages made me feel like a zombie on aut0-pilot. The point that I am at now is overstress due to bankruptcy,children,work, and I will start laughing and before you know it I am crying. Am I Crazy? Can med change to prozac help? TIA
Posted by KAM on December 31, 2002, at 12:41:25
In reply to Prozac vs Zoloft, posted by homelife on December 31, 2002, at 10:04:27
> I'm in my late 40's and have been on zoloft for two years (also synthroid). Dosages started at 25, and were steadily increased to 150. About six months ago, because of cost and lack of confidence in the drug itself, I weaned off of it. My life is becoming one huge hell...Several people mention Prozac has worked better for them. Can I hear any testimonials/advice? I am at my wits end, and no time, or energy,or interest in my family (or cooking one of my hobbies). It has steadily gotten worse even when I was taking the zoloft...the everincreasing dosages made me feel like a zombie on aut0-pilot. The point that I am at now is overstress due to bankruptcy,children,work, and I will start laughing and before you know it I am crying. Am I Crazy? Can med change to prozac help? TIA
I just turned 40 my issues are with my panic attacks, but I can relate to the medication. I have tried 4 SSRI's, am starting on my 5th tomorrow, had to change due to side effects and hives on one of them. Just wanted to let you know sometimes it takes a while to find the one that is right for you. My doctor assures me that I will find something, I also am taking xanax which is an immediate help. But I want to discontinue that. I am starting on Lexapro tomorrow I'm hoping this is the one for me. HANG IN THERE !!
Posted by KAM on December 31, 2002, at 12:45:29
In reply to Prozac vs Zoloft, posted by homelife on December 31, 2002, at 10:04:27
Oops sorry, just wanted to let you know it sometimes takes exploring different meds to find the right one, I have panic attacks and have gone through many SSRI's and have had to change for various reasons. I am starting on Lexapro a fairly new med tomorrow and am hoping this is the one. HANG IN THERE !!!
Posted by bookgurl99 on January 1, 2003, at 1:34:32
In reply to Prozac vs Zoloft, posted by homelife on December 31, 2002, at 10:04:27
Homelife,
you are not crazy. you _do_ have symptoms of stress and depression, and - from what i read of your having no energy or interest - possibly incompletely treated thyroid condition.
i'm also hypothyroid and treated with synthroid. as a result of my hypothyroidism. in the past, i've found that my depressive symptoms improved with treatment with t3 as well. (if you didn't know, t3 is another thyroid hormone -- like the t4 in synthroid, but more active.)
T3 treatment can alleviate symptoms of depression. Plus, when you feel like you're at your wit's end, the t3 provides added energy.
(Isn't it horrid to have so much to do when you have no energy? It's not that you're lazy and don't want to deal with things, it's that you are just so tired that even walking is a chore.)
To be honest, unless you're very overwhelmed, I'd try treating your thyroid differently before going on an AD. For one thing, the thyroid treatment will cost less, and you should know within a few weeks if it's helping.
Here's a small study that shows brain function improvement, including improvement in depression and energy, in hypothyroid women treated with t4 AND t3:
http://www.unc.edu/news/newsserv/research/feb99/prange2.htm
Here's a link with information on cytomel, the standardized form of t3 that doctors can prescribe in addition to synthroid.
http://thyroid.about.com/library/drugs/bl-cytomel.htmI hope you can ask your doctor to let you try this out. Let him/her know that you talked to someone who did better on t3 in addition to t4.
I think adding t3 is still a relatively new practice for MD's, who learned that synthroid was the 'best' treatment for hypothyroidism. But I'm sure your dr. would like to help you find the best treatment for you.
This is the end of the thread.
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