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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by n_shrimpie on January 4, 2012, at 16:18:52
I took prozac for about a month with no discernable difference, (still had anhedonia)with the intention of trying something else, but after about four days off i regained my cognitive capacity and ability to feel pleasure. This lasted for about 3 amazing weeks, and week 4 i crashed in one day, so i resumed it a week ago. could it be that the prozac took more than 4 weeks to start working, and even though when i discontinued it after 4 weeks there was enough left in my system due to the long half life to finally start working after 4.5 weeks? i just started it again about a week ago, hoping that if i stay on through week 5 it will work.
Posted by Phidippus on January 4, 2012, at 21:06:50
In reply to when does prozac start working?confused,need help., posted by n_shrimpie on January 4, 2012, at 16:18:52
It takes 4-8 weeks for prozac to take effect.
Eric
Posted by SLS on January 4, 2012, at 22:49:43
In reply to Re: when does prozac start working?confused,need help. » n_shrimpie, posted by Phidippus on January 4, 2012, at 21:06:50
> It takes 4-8 weeks for prozac to take effect.
It probably takes an extra week to reach equilibrium at any given dosage due to its long half-life.
- Scott
Posted by Phillipa on January 4, 2012, at 23:02:54
In reply to Re: when does prozac start working?confused,need help., posted by SLS on January 4, 2012, at 22:49:43
Why by day 3 when wasn't anxious before did I escalate to full blown panic on day three? Day one lots of energy? Jan/P
Posted by SLS on January 4, 2012, at 23:25:55
In reply to Re: when does prozac start working?confused,need help. » SLS, posted by Phillipa on January 4, 2012, at 23:02:54
> Why by day 3 when wasn't anxious before did I escalate to full blown panic on day three? Day one lots of energy? Jan/P
I don't know. Prozac does interact with 5-HT2c receptors as an antagonist, which are known to facilitate anxiety. This would seem counterintuitive, though. It is not unusual for someone to experience temporary anxiety when starting Prozac.
- Scott
Posted by godess on January 5, 2012, at 3:25:43
In reply to Re: when does prozac start working?confused,need help., posted by SLS on January 4, 2012, at 23:25:55
Took me 12 weeks of nothing, then i swear remission over night .From wreck to pandorer on 20mg.
Posted by n_shrimpie on January 5, 2012, at 14:28:44
In reply to Re: when does prozac start working?confused,need help., posted by SLS on January 4, 2012, at 22:49:43
> > It takes 4-8 weeks for prozac to take effect.
>
> It probably takes an extra week to reach equilibrium at any given dosage due to its long half-life.
>
>
> - Scottok so should i stay with this trial for at least 6 weeks or should i just bail now and try something else? good news is that when it was washing out of my system i felt fine and the sexual side effects went away. so maybe i should just take 10mg a day. or stay on 20 until it works and then try lowering it to 10 to see if i can maintain the ad effects w/o the sexual side effects. sorry this is so confusing, but i'm desperate and the waiting is intolerable. and right now i'm having horrid anxiety, which i hope passes.
Posted by SLS on January 5, 2012, at 15:01:29
In reply to Re: when does prozac start working?confused,need help., posted by n_shrimpie on January 5, 2012, at 14:28:44
Six weeks seems like a reasonable length of time to wait for fluoxetine to work. Not too many people will begin to respond beyond six weeks. I would go with the higher dosage and then experiment with lower dosages if it works.
Good luck. I hope you don't have to wait too much longer.
- Scott
Posted by godess on January 6, 2012, at 4:14:10
In reply to Re: when does prozac start working?confused,need help. » n_shrimpie, posted by SLS on January 5, 2012, at 15:01:29
I give all meds 10weeks , just so i can cross them of my list for good,otherwise you will think , if only i had tried longer. I got into this habit after a young doctor changed my meds every 2 weeks years ago.All that achieved was total mistust of doctor,s.In the case of prozac an trial, i was so sick of med test,s i conducted the long term therory, it was either that or start up another 8 week trail.And as i say 12 weeks an the magic bullet, i forgot the months of missory over night. It would not work like this for everyone but hey?? never say never
Posted by SLS on January 6, 2012, at 6:20:50
In reply to Re: when does prozac start working?confused,need help., posted by godess on January 6, 2012, at 4:14:10
One study conducted at Harvard/Mass General reported that if someone doesn't show any improvement by 4 weeks, the likelihood of obtaining a response falls off greatly thereafter. I think they looked at fluoxetine. I would still hold out for 6 weeks, though - maybe even 8 for fluoxetine.
The thing is, the beginnings of an antidepressant response might be so subtle, that the patient doesn't recognize it and aborts the trial prematurely. Using a depression rating scale during the trial might tease out small improvements.
- Scott
Found it:
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http://www.ncbi.nlm.nih.gov/pubmed/10964858Am J Psychiatry. 2000 Sep;157(9):1423-8.
Timing of onset of antidepressant response with fluoxetine treatment.Nierenberg AA, Farabaugh AH, Alpert JE, Gordon J, Worthington JJ, Rosenbaum JF, Fava M.
SourceDepression and Clinical Research Program, Massachusetts General Hospital, Boston, MA 02114, USA. anierenberg@partners.org
Abstract
OBJECTIVE:The purpose of this study was to assess the time until onset of antidepressant response with fluoxetine treatment.
METHOD:The authors evaluated 182 outpatients with major depression who had a sustained acute response to fluoxetine treatment. The outpatients received 8 weeks of treatment with 20 mg/day of fluoxetine and were assessed biweekly with the 17-item Hamilton Depression Rating Scale. The onset of response was defined as a 30% decrease in score on the Hamilton depression scale that persisted and led to a 50% decrease by week 8. The Kaplan-Meier product limit and Cox regression analysis were used to model the relationship between relevant variables and time until onset of response.
RESULTS:The authors found that at weeks 2, 4, and 6, the probabilities of having an onset of response (for responders) were 55.5%, 24.7%, and 9.3%, respectively. The cumulative probabilities of onset of response at each time point were 55.5%, 80.2%, and 89.5%. Neither demographics nor clinical characteristics of depression predicted time until initial response.
CONCLUSIONS:These data suggest that more than half of eventual responders to fluoxetine treatment at 8 weeks start to respond by week 2; over 75% start to respond by week 4. Conversely, the lack of onset of response at 4-6 weeks was associated with about a 73%-88% chance that patients would not have an onset of response by 8 weeks.
Posted by godess on January 6, 2012, at 11:53:33
In reply to Re: when does prozac start working?confused,need help., posted by SLS on January 6, 2012, at 6:20:50
Plus the start of a new med trial useually make,s you feel worse than you already are. Many people abort med,s within day,s because of this.So in my eyes it could be a couple of weeks before you even get to feel like before the med, then slowly something hopefully starts to happen by week 4 or 5. I am the exception to the rule hear , mabye because of the 2 week Med trials forced on me by incompetence years ago.If a med works i feel no change for 2 to three months , then releaf as if magic, or not if the med fail,s.But if it does fail i never return to that med.
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