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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Deneb on August 8, 2009, at 19:14:12
I take 40 mg generic Prozac and 40 mg generic Celexa, as well as 0.75 mg Risperdal.
Are Prozac and Celexa very different from one another?
Posted by morganpmiller on August 8, 2009, at 19:55:28
In reply to What could be a reason for two SSRI's?, posted by Deneb on August 8, 2009, at 19:14:12
Wow, that is typically considered a dangerous combination I think.
Prozac is a "dirtier" drug that Celexa, meaning it does more that just selectively inhibit the reuptake of serotonin. Maybe your doctor is trying to get the benefit of Prozac's other mechanisms while getting the benefit of Celexa's very selective serotoning reuptake inhibition. Still, you would think a much lower and safer dose of Prozac or Celexa would be used to do this. Maybe 40 mgs of Celexa and 5 mgs of Prozac. Or, 40 mgs of Prozac and 5 mgs of Celexa.
I'm sure a few others here can better elucidate the reason why you would be on both SSRIs at such doses.
Posted by Deneb on August 8, 2009, at 20:27:57
In reply to Re: What could be a reason for two SSRI's?, posted by morganpmiller on August 8, 2009, at 19:55:28
I've been on this combo for several years now. My pdoc added the Prozac when I started becoming bulimic. I'm not bulimic any more.
Maybe she added the Prozac for the bulimia?
How is this combo dangerous? Serotonin syndrome? What should I watch out for?
Posted by morganpmiller on August 8, 2009, at 20:49:24
In reply to Re: What could be a reason for two SSRI's? » morganpmiller, posted by Deneb on August 8, 2009, at 20:27:57
Well you've gone a few years without any issues so I think you are fine. I was just thinking about serotonin syndrome. So I guess you feel good on the combo huh?
I think Prozac addressed the more compulsive behaviors that come with bulimia. At least that is what I believe.
I'm not sure you have to worry too much if you have been doing well for so long on this combo. Why did you ask? Was it because you were starting to notice that other people were not on 2 SSRIs at the same time and it seemed you were the only one?
Posted by Deneb on August 8, 2009, at 21:19:28
In reply to Re: What could be a reason for two SSRI's?, posted by morganpmiller on August 8, 2009, at 20:49:24
> Well you've gone a few years without any issues so I think you are fine. I was just thinking about serotonin syndrome. So I guess you feel good on the combo huh?
>
> I think Prozac addressed the more compulsive behaviors that come with bulimia. At least that is what I believe.
>
> I'm not sure you have to worry too much if you have been doing well for so long on this combo. Why did you ask? Was it because you were starting to notice that other people were not on 2 SSRIs at the same time and it seemed you were the only one?Yeah, I noticed no one else was on 2 SSRI's and my pharmacist was worried about serotonin syndrome.
Can you get serotonin syndrome without knowing it? Like, can it be a problem you don't notice?
Posted by Phillipa on August 8, 2009, at 21:44:04
In reply to Re: What could be a reason for two SSRI's? » morganpmiller, posted by Deneb on August 8, 2009, at 21:19:28
No you'd notice it and I've been on two at the same time. Prozac stimulating for me and celexa made me tired. Phillipa
Posted by morganpmiller on August 8, 2009, at 22:10:04
In reply to Re: What could be a reason for two SSRI's? » morganpmiller, posted by Deneb on August 8, 2009, at 21:19:28
I agree with Phillipa that you would notice serotonin syndrome if it were a problem.
I am actually interested in adding a low dose of prozac to 100mgs of Zoloft. You're case gives me a bit more confidence in being able to make this combo work. I would only take 5mgs of Prozac.
I would go see another doctor and see what they think about there possibly being a problem in the future with this combination.
Posted by rvanson on August 8, 2009, at 23:29:45
In reply to What could be a reason for two SSRI's?, posted by Deneb on August 8, 2009, at 19:14:12
> I take 40 mg generic Prozac and 40 mg generic Celexa, as well as 0.75 mg Risperdal.
>
> Are Prozac and Celexa very different from one another?Yes, but they are compatable with one another.
40 mg of both seems like alot but if its working
for you why worry? Sounds like you lucked out an have a good Pdoc.
Posted by morganpmiller on August 8, 2009, at 23:55:33
In reply to Re: What could be a reason for two SSRI's?, posted by rvanson on August 8, 2009, at 23:29:45
> > I take 40 mg generic Prozac and 40 mg generic Celexa, as well as 0.75 mg Risperdal.
> >
> > Are Prozac and Celexa very different from one another?
>
> Yes, but they are compatable with one another.
>
> 40 mg of both seems like alot but if its working
> for you why worry? Sounds like you lucked out an have a good Pdoc.
>How are they compatible? I mean, I think I understand why they may work well with each other at the right doses, but I don't know anyone, doctor or not, that would flat out say, "Yeah Prozac and Celexa are compatible, they make a good combo".
Posted by Deneb on August 9, 2009, at 0:13:05
In reply to Re: What could be a reason for two SSRI's?, posted by morganpmiller on August 8, 2009, at 23:55:33
I just sometimes worry that my pdoc doesn't know what she's doing since she is first and foremost my therapist. I see her weekly.
But I guess she must know her stuff since she is a pdoc.
Posted by morganpmiller on August 9, 2009, at 1:04:04
In reply to Re: What could be a reason for two SSRI's?, posted by Deneb on August 9, 2009, at 0:13:05
She is a medical doctor and board certified to practice psychiatry is she not? IMO, 90 percent of the doctors out there would not even think of mixing 2 SSRIs.
Posted by Deneb on August 9, 2009, at 1:37:36
In reply to Re: What could be a reason for two SSRI's?, posted by morganpmiller on August 9, 2009, at 1:04:04
Yeah, she must be board certified. She is the chief psychiatrist at my university's health centre.
She gives me therapy every week and prescribes meds.
I think I am pretty lucky to have her. Living in Canada, I don't have to pay for this therapy since an M.D. provides it. I would have to pay for a psychologist though.
Posted by morganpmiller on August 9, 2009, at 2:14:12
In reply to Re: What could be a reason for two SSRI's? » morganpmiller, posted by Deneb on August 9, 2009, at 1:37:36
That's awesome you don't have to pay for therapy. I think in the states it might be hard to find a good, empathetic, compassionate therapist that also has an M.D. and can prescribe meds. It makes sense that this would be easier to find in Canada.
Posted by tensor on August 9, 2009, at 7:50:56
In reply to Re: What could be a reason for two SSRI's? » morganpmiller, posted by Deneb on August 8, 2009, at 20:27:57
http://health.msn.com/health-topics/depression/articlepage.aspx?cp-documentid=100198099
I agree with the doc in the article and ask your pdoc about the reasons of doing so.
/Mattias
Posted by Deneb on August 9, 2009, at 8:16:32
In reply to Re: What could be a reason for two SSRI's? » Deneb, posted by tensor on August 9, 2009, at 7:50:56
Hmmm...I'm concerned now.
My pdoc is on vacation. I don't see her until Sept. What should I do in the meantime?
Posted by Deneb on August 9, 2009, at 8:38:55
In reply to Re: What could be a reason for two SSRI's? » tensor, posted by Deneb on August 9, 2009, at 8:16:32
The reason I feel like sometimes she doesn't know what she is doing regarding meds is because we never talk about meds. We just do therapy and then she just asks if I have enough meds.
I saw another pdoc for a few months like 4 or 5 years ago when my pdoc went on maternity leave. He added Wellbutrin and Risperdal.
When my pdoc came back she was VERY worried about seizures so she stopped the Wellbutrin and added Prozac.
She doesn't change my meds. I just take the same ones. Sometimes she'll increase my SSRI or Risperdal. She is concerned about excessive sleep though and she wants to decrease the Risperdal.
I find the Risperdal very helpful though.
I don't know about the SSRIs. I guess the Prozac stopped my bulimia.
Posted by Deneb on August 9, 2009, at 8:51:42
In reply to Re: What could be a reason for two SSRI's?, posted by Deneb on August 9, 2009, at 8:38:55
One thing is good though. I am no longer depressed and my anxiety is much better now. OK two things. LOL
I haven't been depressed in a long time.
Posted by tensor on August 9, 2009, at 18:13:17
In reply to Re: What could be a reason for two SSRI's?, posted by Deneb on August 9, 2009, at 8:51:42
> One thing is good though. I am no longer depressed and my anxiety is much better now. OK two things. LOL
>
> I haven't been depressed in a long time.If you have taken this combo for a long time there is no need to worry. Serotonin syndrome is serious but rare and the onset is fast, so I think you should lax about it. And since you're symptoms are under control, what's the problem? ;-)
There are two circumstances why your pdoc would prescribe you these meds, the first is, she doesn't have a clue what she is doing, or, she's an expert and know exactly what she's doing. I believe in the latter./Mattias
Posted by morganpmiller on August 9, 2009, at 19:17:10
In reply to Re: What could be a reason for two SSRI's? » Deneb, posted by tensor on August 9, 2009, at 18:13:17
I'm kinda envious, I want your psychiatrist. I too think she may be an expert and knows what she is doing.
This is the end of the thread.
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