Psycho-Babble Medication Thread 1033154

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Similar Meds to Prozac?

Posted by Trepanist on December 17, 2012, at 0:00:42

I have severe OCD and I noticed a substantial improvement moving from 20mg of Lexapro to 40mg of Prozac. However, I have pretty bad gastritis form taking it. I tried taking it w/ food, and that did solve the problem for a few months, but now it's back with a vengeance :(

My thoughts are that because Prozac is the least selective of all the SSRI's (additional action on Dopamine and Norepinephrine), I am guessing that's where the additional benefit came from. So, how can I replicate this with other medications? 'cause I have to go back to Lexapro now.

Anyone familiar with these extra actions that Prozac has and what might be a good substitute?

Thanks!

Re: Similar Meds to Prozac?

Posted by jono_in_adelaide on December 17, 2012, at 0:22:11

In reply to Similar Meds to Prozac?, posted by Trepanist on December 17, 2012, at 0:00:42

So hard to say *which* of the extra actions of prazac might have been respoinsible for the extra improvement

A few thoughts

- Could you take Proaoc along with a drug for gastritis (Prilosec or one of the other PPI's)

- If you have to go back to Lexapro, try taking Lexapro in the morning and either nortriptyline or mirtazapine at night. Both of these directly hit noradrenalin and by mirtazapine indirectly hits dopamine. Nortriptyline will cause fewer sedative side effects, but mirtazapine might have the edge.

- Try Effexor in a moderatly high dose (300mg/day) - this hits noradrenalin as well as seretonin

- Take the Lexapro along with a low dose atypical antipsychotic (risperidone 0.5-1mg at night)

hth

Re: Similar Meds to Prozac?

Posted by Trepanist on December 17, 2012, at 0:27:48

In reply to Re: Similar Meds to Prozac?, posted by jono_in_adelaide on December 17, 2012, at 0:22:11

> So hard to say *which* of the extra actions of prazac might have been respoinsible for the extra improvement
>
> A few thoughts
>
> - Could you take Proaoc along with a drug for gastritis (Prilosec or one of the other PPI's)
>
> - If you have to go back to Lexapro, try taking Lexapro in the morning and either nortriptyline or mirtazapine at night. Both of these directly hit noradrenalin and by mirtazapine indirectly hits dopamine. Nortriptyline will cause fewer sedative side effects, but mirtazapine might have the edge.
>
> - Try Effexor in a moderatly high dose (300mg/day) - this hits noradrenalin as well as seretonin
>
> - Take the Lexapro along with a low dose atypical antipsychotic (risperidone 0.5-1mg at night)
>
> hth

Thanks Jono. I was actually thinking about taking .5mg of Risperdal as that has helped in the past, but I am intrigued by your Mirtazapine suggestion.

Re: Similar Meds to Prozac?

Posted by jono_in_adelaide on December 17, 2012, at 0:43:05

In reply to Re: Similar Meds to Prozac?, posted by Trepanist on December 17, 2012, at 0:27:48

I'd seriously give mirtazapine a go, it has several different actions that could well help your situation. 15mg at night for 4 nights, then 30mg at night...... depending on response after a few weeks, hold it there or go upto 45mg

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