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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by rjlockhart37 on October 2, 2015, at 0:07:53
yet it's the safest SSRI to use in adolecent, and children under the age 8.......
http://www.emedexpert.com/compare/ssris.shtml
http://link.springer.com/article/10.1023%2FA%3A1006986824213#page-1
but i wanted to say, my first ever AD was wellbutrin, and it increased alertness, but it caused anxiety badly, switched to Cymbalta and it was effective, yet i don't know why but Prozac was started in 05, it didnt produce a big noticable effect, but i noticed i was more up lifted and content........but i've read articles, that people responded better to seratiline and effexor much better than fluoxetine
fluoxtine does have mood elevating effects, but it's hard to descibe how it produces a antidepressant effect, it's not adderall wake wake feeling, not caffeine, just you feel more content.... wellbutrin was more with motivation and doing things, cymbalta was more content feeling with a small kick (due to NE reuptake)
but fluoxetine works well with some people and not others......
yet it's the best tolerated in adolecents.....and children, compared to the horror stories of Paxil and others....
r
Posted by bleauberry on October 2, 2015, at 13:17:05
In reply to Prozac lesser effective than other AD's, posted by rjlockhart37 on October 2, 2015, at 0:07:53
Of all the different antidepressants I tried....all except Nardil....Prozac was my favorite in terms of efficacy, effect, and side effects. It significantly boosts NE and DA function along with the SSRI action, and that makes it unique from the others.
Posted by rjlockhart37 on October 3, 2015, at 13:05:00
In reply to Re: Prozac lesser effective than other AD's, posted by bleauberry on October 2, 2015, at 13:17:05
yea when i started it, i rerember the content feelin it gave me, and when it was moved to 40mg i noticed mood lift, it was diffrent from Cymbalta, and Wellbutrin. I think it effects multiple serotoinin receptors and some DA, because it's not as selective as others, but still i read effexor has superior improvement rates compared to fluoxetine.......
it's good at imroving mood, and keep away depression for me, not totally making me in a good mood but it prevents the mood from going in the slumps....
Posted by Lucy_B on October 27, 2015, at 10:02:15
In reply to Re: Prozac lesser effective than other AD's, posted by rjlockhart37 on October 3, 2015, at 13:05:00
Prozac has been by far the most effective AD for me, and I've tried them all. It's also a breeze to wean off of (although I've never personally been able to go more than a year without having to start it again, as my depression/anxiety always comes back). The last time I re-started it, it took about 9 weeks to kick in, which is a pretty long time. I was absolutely miserable in the interim (weight loss, worsened mood, INSOMNIA, muscle twitching, etc.) but it was so worth the wait. One morning, it was literally like someone turned on the lights. Everything was normal again. And it's been getting better and better every day (I'm at about 15 weeks now). That being said, everyone is different. Celexa also worked well for me when I first took it a long time ago, but it pooped out at around 4 years. I've never had any poop out issues from Prozac, even after more than a decade of use.
Posted by SLS on October 27, 2015, at 13:19:30
In reply to Re: Prozac lesser effective than other AD's, posted by Lucy_B on October 27, 2015, at 10:02:15
> Prozac has been by far the most effective AD for me, and I've tried them all. It's also a breeze to wean off of (although I've never personally been able to go more than a year without having to start it again, as my depression/anxiety always comes back). The last time I re-started it, it took about 9 weeks to kick in, which is a pretty long time. I was absolutely miserable in the interim (weight loss, worsened mood, INSOMNIA, muscle twitching, etc.) but it was so worth the wait. One morning, it was literally like someone turned on the lights. Everything was normal again. And it's been getting better and better every day (I'm at about 15 weeks now). That being said, everyone is different. Celexa also worked well for me when I first took it a long time ago, but it pooped out at around 4 years. I've never had any poop out issues from Prozac, even after more than a decade of use.
What is your motivation for discontinuing Prozac? I'm sure you know that SSRIs often don't work as well when they are discontinued and restarted too many times. For some people, even one discontinuation is enough to prevent achieving remission upon restarting the drug. Paxil is notorious for this. That it takes longer and longer for Prozac to kick-in for you upon restart is worrisome.
The brain likes homeostasis (staying the same), and will make adjustments in order to maintain it. If you are one of the lucky people whose brain establishes a new homeostasis that approaches normal while taking an antidepressant, you may not want to upset it. If you remove the drug, things change enough so that the brain must establish a new equilibrium again that doesn't always replicate exactly that which existed before the first drug exposure. In other words, the brain might be "ready" for re-exposure to the same medication, and is less likely to respond favorably.
It is not always indicated that someone remain on an antidepressant indefinitely. For instance, it might not make sense to treat someone for longer than a year for a first episode, especially if there is no family history of mental illness. However, if depression becomes recurrent or chronic, indefinite treatment should be considered - especially when first-degree relatives are affected.
Okay - that's the traditional wisdom. Perhaps your responsivity to Prozac will continue, despite pulsing. I understand how resistant one can become to the idea of being dependent on a drug.
- Scott
Posted by Lucy_B on October 27, 2015, at 20:49:15
In reply to Re: Prozac lesser effective than other AD's » Lucy_B, posted by SLS on October 27, 2015, at 13:19:30
> > Prozac has been by far the most effective AD for me, and I've tried them all. It's also a breeze to wean off of (although I've never personally been able to go more than a year without having to start it again, as my depression/anxiety always comes back). The last time I re-started it, it took about 9 weeks to kick in, which is a pretty long time. I was absolutely miserable in the interim (weight loss, worsened mood, INSOMNIA, muscle twitching, etc.) but it was so worth the wait. One morning, it was literally like someone turned on the lights. Everything was normal again. And it's been getting better and better every day (I'm at about 15 weeks now). That being said, everyone is different. Celexa also worked well for me when I first took it a long time ago, but it pooped out at around 4 years. I've never had any poop out issues from Prozac, even after more than a decade of use.
>
> What is your motivation for discontinuing Prozac? I'm sure you know that SSRIs often don't work as well when they are discontinued and restarted too many times. For some people, even one discontinuation is enough to prevent achieving remission upon restarting the drug. Paxil is notorious for this. That it takes longer and longer for Prozac to kick-in for you upon restart is worrisome.
>
> The brain likes homeostasis (staying the same), and will make adjustments in order to maintain it. If you are one of the lucky people whose brain establishes a new homeostasis that approaches normal while taking an antidepressant, you may not want to upset it. If you remove the drug, things change enough so that the brain must establish a new equilibrium again that doesn't always replicate exactly that which existed before the first drug exposure. In other words, the brain might be "ready" for re-exposure to the same medication, and is less likely to respond favorably.
>
> It is not always indicated that someone remain on an antidepressant indefinitely. For instance, it might not make sense to treat someone for longer than a year for a first episode, especially if there is no family history of mental illness. However, if depression becomes recurrent or chronic, indefinite treatment should be considered - especially when first-degree relatives are affected.
>
> Okay - that's the traditional wisdom. Perhaps your responsivity to Prozac will continue, despite pulsing. I understand how resistant one can become to the idea of being dependent on a drug.
>
>
> - Scott
Well, I'm back on it now, but the original reason for stopping was so as to get pregnant (didn't want to be on SSRI's and carrying a baby). But now it's been determined that I can't carry due to another health issue, so I've restarted the meds. Luckily, I feel like it's working better than ever this go-round. But it definitely took forever to take effect, and that may very well be due to the phenomenon you describe. Very interesting!
Posted by SLS on October 27, 2015, at 23:57:21
In reply to Re: Prozac lesser effective than other AD's » SLS, posted by Lucy_B on October 27, 2015, at 20:49:15
> Well, I'm back on it now, but the original reason for stopping was so as to get pregnant (didn't want to be on SSRI's and carrying a baby). But now it's been determined that I can't carry due to another health issue, so I've restarted the meds. Luckily, I feel like it's working better than ever this go-round. But it definitely took forever to take effect, and that may very well be due to the phenomenon you describe. Very interesting!
I'm glad Prozac is working so well for you.
I am very sorry about your health issue.
:-(
Stay well.
- Scott
Posted by Lucy_B on October 28, 2015, at 4:50:58
In reply to Re: Prozac lesser effective than other AD's » Lucy_B, posted by SLS on October 27, 2015, at 23:57:21
Thanks, Scott. :)
Posted by herpills on November 25, 2015, at 15:17:38
In reply to Re: Prozac lesser effective than other AD's » Lucy_B, posted by SLS on October 27, 2015, at 13:19:30
> >I'm sure you know that SSRIs often don't work as well when they are discontinued and restarted too many times.
>
> - ScottHi Scott- Is this something that is unique to the SSRIs or do you think this applies to other psych meds as well?
Posted by SLS on November 29, 2015, at 20:00:00
In reply to Re: Prozac lesser effective than other AD's » SLS, posted by herpills on November 25, 2015, at 15:17:38
> > >I'm sure you know that SSRIs often don't work as well when they are discontinued and restarted too many times.
> >
> > - Scott
>
> Hi Scott- Is this something that is unique to the SSRIs or do you think this applies to other psych meds as well?
>Hi.
It is not unique to SSRIs, but seems to occur more often with them. Paxil is probably the worst offender. I sometimes wonder if Paxil ruins the ability of other SSRIs to work well. This would be an example of cross-tolerance. It's just a thought. I have not come upon anything in the medical literature indicating this.
For me, a combination of Parnate (MAOI) and desipramine (TCA) lost its potency after the drugs were discontinued and restarted. Nardil is also known to do this. My impression is that TCA and SNRI are less likely to poop-out, but I don't know to what degree they lose their therapeutic properties if they are discontinued and restarted. Overall, I don't think that "pulsing" antidepressants makes much sense.
I think the bottom line is that one must evaluate the rate of recurrence or chronicity of depression in order to determine the need for indefinite treatment. If you find something that works well and is tolerable, you should consider continuing with it until there are scientific breakthroughs that allow for a completely different treatment paradigm - or even a cure. Perhaps you can think of your current treatment as being a temporary bridge to the future.
- Scott
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