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The Prozac switch or "bridging" with Prozac


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#73 Barbarannamated

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Posted 28 July 2012 - 09:07 AM

I asked this in my intro thread but I wanted to ask again.If we are helped to switch to prozac for withdrawls, why don't the doctors forget the other SSRI's and usually just prescribe prozac? I fear doctors/pharmacy reps have a host of reasons, but the main one may well be M-O-N-E-Y.


I suspect many doctors are unaware. Despite all of this information here and various places about the dangers of SS/NRIs, I believe they are still perceived as safe. The startup effects of mania seem to be acknowledged, but not long term physiological maladaptation, worsening of "depression", and acute and protracted withdrawal. I dont know if the rate of prescribing for depression is lessening at all, but I know that SNRIs are being used as preferred agent in chronic pain. My pain management doc is writing the guideline (on steering committee) and just told me this a few days ago. The fear of opiate addiction is so great and docs are being guided to SS/NRIs and Neurontin type drugs for pain. My feeling is that drugs used on daily basis are being pushed as safer than prn meds and addiction is being blamed. More $$ in chronic, daily meds.

Sorry, that veered off topic. Bottom line = $$$
Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

#74 melo

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Posted 06 February 2013 - 07:17 AM

Do you think getting on prozak slowly because I am very sensitive to meds would calm my anxiety and panic attacks and allow me to get off klonopin. I cant take the severe anxiety getting bed bound. Ive tried tapering slowlyoff k ca nt do it. I .also know prozak is stimulating and I would have to take more klonopin to get on it beca use no matter wha t I try. In sma ll doses I get more anxiety. They tell me I have to get on reg dose for 4 weeks for it to wotk please help I hsve to put ice pscks on chest and neck for psin I was never stable on it. I tried lexspro 1 mg per week until I reached 5mg that is. As far as I could go that was 2 yrs ago my anxiety settled down but then when I tried to get off k I had major attacks but I was cutting. 1mg a time. My klonopin dose increased from .75 mg to 2 mg just to get to 5 mg my dr said if u csnt reach. 10mg it wont work. Any advise because I cant get off k by itself help

#75 Skyler

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Posted 06 February 2013 - 07:26 AM

Hi melo, see my response in the other thread you started in this section. Many people think they are tapering small doses of klonopin and do not realize this may yet be too rapid. Did you begin by tapering 10% a month, then the same off each successive dose. This can be too fast for many people, but does work for many.

As stated previously, ADs, including Prozac, do not help with benzo WD. You can get off klonopin and need a taper tailored to your needs.

I tried to get off k I had major attacks but I was cutting. 1mg a time. My klonopin dose increased from .75 mg to 2 mg just to get to 5 mg my dr said if u csnt reach. 10mg it wont work. Any advise because I cant get off k by itself help


So you went from .75 mgs of klonopin to 2 mgs. You tried 5 mgs.. of Prozac, and your doc wants you to increase this to 10mgs. You are not on Prozac now, is this correct? Prozac will not help with benzodiazepine WD regardless of the dose because the neuro receptors in your body are not the same for the two classes of drugs (they are not the same between classes either, but that discussion if for another time).

So you were taking 2 mgs of k... how much did you cut off that? How long ago did you start cutting, when did you start feeling as bad as you do now. Again, what you describe is very much WD symptoms due to cutting your benzo.

Take a deep breath and try to focus.. we can help you sort this out and develop an effective strategy, but we need more info. Posted Image

Once held for NINE months to good effect!


 

Requip - current: 2/10/16 .010 mgs. One more cut to go, then OFF!  On 9/1/215 restarted requip taper at .15 mgs (was originally .25 mgs). It's going faster than diazepam or lyrica so I'm assuming it has a lighter psychotropic 'footprint'. The two withdrawal symptoms I'm having are insomnia and tinnitus.. the tinnitus being the more troublesome. Still.. almost there after 5+ years; what a long ride this has been.

 

Lyrica: 8/16/15 ZERO after a two year taper. Highest dose was 300 mgs. No adverse symptoms to report on discontinuation.

History: After 25 years (including a 3 yr 4 mo. taper), I'm BENZO FREE! Tapered from 7/2010 thru 10/13. Off benzos for the first time in 25 years. Started 4.5 mgs K. cross tapered to 20 mgs. diazepam 10-12/10. On requip .25 mgs. and on and off Lyrica 150 to 300 mgs. for several years prior to tapering, start tapers 3/12. Read my intro thread here, and check the about me section.

"No matter how cynical you get, it's almost impossible to keep up." Lily Tomlin


#76 Skyler

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Posted 06 February 2013 - 09:12 AM

PS... Melo, sometimes people use ADs to bridge from one AD to another for purposes of tapering, but benzos are another drug class entirely and useless for this purpose. Prozac is a very activating AD capable of making your anxiety worse. Increasing the dose to 10 mgs would probably only make you more symptomatic. It's not a matter of getting the med into your system before it starts to act and Prozac can give you an unwanted boost straight away.

Once held for NINE months to good effect!


 

Requip - current: 2/10/16 .010 mgs. One more cut to go, then OFF!  On 9/1/215 restarted requip taper at .15 mgs (was originally .25 mgs). It's going faster than diazepam or lyrica so I'm assuming it has a lighter psychotropic 'footprint'. The two withdrawal symptoms I'm having are insomnia and tinnitus.. the tinnitus being the more troublesome. Still.. almost there after 5+ years; what a long ride this has been.

 

Lyrica: 8/16/15 ZERO after a two year taper. Highest dose was 300 mgs. No adverse symptoms to report on discontinuation.

History: After 25 years (including a 3 yr 4 mo. taper), I'm BENZO FREE! Tapered from 7/2010 thru 10/13. Off benzos for the first time in 25 years. Started 4.5 mgs K. cross tapered to 20 mgs. diazepam 10-12/10. On requip .25 mgs. and on and off Lyrica 150 to 300 mgs. for several years prior to tapering, start tapers 3/12. Read my intro thread here, and check the about me section.

"No matter how cynical you get, it's almost impossible to keep up." Lily Tomlin


#77 Nikki

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Posted 06 February 2013 - 09:23 AM

Drugs stocks are the ones that soared and made money in the last three years. People became so depressed over the economic downturn they went on meds. Melo I can't advise you on K, I have not taken it. The Prozac bridge is not that good for most people. Prozac is very stimulating and was designed for people with serious depression. I tried it for a week, years ago and I made the anxiety unbearable (even dangerous). The Psych Nurse I see helps people 'bridge' with a tricyclic 'Imipramine'. It works for me. It is not stimulating like Prozac. It's been around for many, many years. I think Prozac may be considered an old drug by now :rolleyes: The tricyclics tend to be sedating and calm anxiety. The chemical structure of Imipramine (tricyclics) and very different from the structure of SSRI's. Alto would know more about the differences. Then again, no one really knows for sure how we will react to another drug. Hugs

Intro: http://survivinganti...ndown-with-ads/

 

Paxil 1997-2004

Crossed over to Lexapro Paxil not available

at Pharmacies GSK halted deliveries

Lexapro 40mgs

Lexapro taper (2years)

Imipramine

Imipramine and Celexa

Now Nefazadone/Imipramine 50mgs. each

45mgs. Serzone  50mgs. Imipramine


#78 Skyler

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Posted 06 February 2013 - 09:32 AM

The Psych Nurse I see helps people 'bridge' with a tricyclic 'Imipramine'. It works for me. It is not stimulating like Prozac. It's been around for many, many years. I think Prozac may be considered an old drug by now :rolleyes: The tricyclics tend to be sedating and calm anxiety.

The chemical structure of Imipramine (tricyclics) and very different from the structure of SSRI's. Alto would know more about the differences.

Then again, no one really knows for sure how we will react to another drug.Hugs

Hi Nikki, I've been reading about your progress as you taper onto Imipramine and am delighted for you. I hope this continues!

Melo needs to understand that klonopin is in another class of psychotropic drugs, benzodiazepines. The information in this thread is about crossing from one AD to another. Bridging does not work when we go from an AD to a benzodiazepine.

Melo, unfortunately, this is not a benzo site, and we are not geared to help with specific benzodiazepine taper protocols, but we can help you sort out what is going on with them and address your AD questions. A lot of folks have issues with both, so we frequently get questions that are not in isolation. If you still want help with benzo tapering specifics, we'll direct you to other resources, and will be here in any event.

Skyler

Once held for NINE months to good effect!


 

Requip - current: 2/10/16 .010 mgs. One more cut to go, then OFF!  On 9/1/215 restarted requip taper at .15 mgs (was originally .25 mgs). It's going faster than diazepam or lyrica so I'm assuming it has a lighter psychotropic 'footprint'. The two withdrawal symptoms I'm having are insomnia and tinnitus.. the tinnitus being the more troublesome. Still.. almost there after 5+ years; what a long ride this has been.

 

Lyrica: 8/16/15 ZERO after a two year taper. Highest dose was 300 mgs. No adverse symptoms to report on discontinuation.

History: After 25 years (including a 3 yr 4 mo. taper), I'm BENZO FREE! Tapered from 7/2010 thru 10/13. Off benzos for the first time in 25 years. Started 4.5 mgs K. cross tapered to 20 mgs. diazepam 10-12/10. On requip .25 mgs. and on and off Lyrica 150 to 300 mgs. for several years prior to tapering, start tapers 3/12. Read my intro thread here, and check the about me section.

"No matter how cynical you get, it's almost impossible to keep up." Lily Tomlin


#79 Nikki

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Posted 06 February 2013 - 05:43 PM

Melo needs to understand that klonopin is in another class of psychotropic drugs, benzodiazepines. The information in this thread is about crossing from one AD to another. Bridging does not work when we go from an AD to a benzodiazepine.Skyler

Melo I can't advise you on K, I have not taken it. The Prozac bridge is not that good for most people. Prozac is very stimulating and was designed for people with serious depression.
I tried it for a week, years ago and I made the anxiety unbearable (even dangerous).

The Psych Nurse I see helps people 'bridge' with a tricyclic 'Imipramine'. It works for me. It is not stimulating like Prozac. It's been around for many, many years. I think Prozac may be considered an old drug by now :rolleyes: The tricyclics tend to be sedating and calm anxiety.


Yes the topic is bridging from one AD to another which is why I posted with my experience. As I explained to Melo I can't advise on K.

Melo when you log onto this site there is a section on benzos. I do not participate in it. You may want to take a look at it for info.

Hang in there.

Intro: http://survivinganti...ndown-with-ads/

 

Paxil 1997-2004

Crossed over to Lexapro Paxil not available

at Pharmacies GSK halted deliveries

Lexapro 40mgs

Lexapro taper (2years)

Imipramine

Imipramine and Celexa

Now Nefazadone/Imipramine 50mgs. each

45mgs. Serzone  50mgs. Imipramine


#80 TigerLily

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Posted 12 June 2013 - 01:26 PM

Hi there,

 

I'm wondering if anyone has used Dr. Glenmullen's method to taper from Effexor? If so, what was your experience like?

I see my Doctor on Friday, and want to come up with a plan before hand.

 

 I need to get down to 37.5 mg from 150 mg. He says to take a month, I'm thinking I should take longer. Any suggestions?

 

Once I'm at 37.5 mg, and have been on it for at least a week (maybe longer?), I will switch to 10 mg of Prozac every day for two weeks.

 

Then, I will take 1 pill out per week, until I am down to nothing?

 

Thank you in advance for any suggestions,

 

Tiger Lily

 

 


Effexor XR for the last 10 years (started at 75 mg, increased to 150 mg 5 years ago.

Planning to begin tapering very soon.


#81 Altostrata

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Posted 12 June 2013 - 04:10 PM

Dr. Glenmullen's schedule may be too fast for some people. See http://survivinganti...ng-with-prozac/


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#82 Lilu

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Posted 11 August 2013 - 05:18 PM

As for how Prozac manages substitution even for SNRIs, nobody knows how that works. Perhaps the actual mechanisms of these drugs are not completely understood.

 
Prozac shown to affect Norepinephrine and Dopamine
 
CONCLUSION: Amongst the SSRIs examined, only fluoxetine acutely increases extracellular concentrations of norepinephrine and dopamine as well as serotonin in prefrontal cortex, suggesting that fluoxetine is an atypical SSRI. 
source: http://www.biopsychi...fluoxdopnor.htm
 
5 mg shown to be just as effective as 10 or 20 mg
 
source: http://forums.studen...ad.php?t=795088
 
"The results of three dose-effect studies... [demonstrated that] a dose of 5 mg per day was as effective as any of the higher doses." N Engl J Med 1994; 331:1354-1361.
 
5 mg helped 54% with major depression; 20 mg helped 64%. Fewer adverse effects with the 5 mg dose. Conclusion: "No lower limit for an effective dose of this potent serotonin uptake inhibitor has been demonstrated in moderately depressed outpatients. Psychopharmacology Bulletin 1998:

In the 5 mg, 20 mg, and 40 mg fixed-dose study, there were no differences in effectiveness between the active treatment groups, all of which were superior to placebo. Side effect dropouts increased significantly with dosage....With endpoint analysis, numerically, 5 mg/day outperformed 40 mg/day which outperformed 20 mg/day...These data point to 5 mg/day as optimal, although there is no evidence that doses below 5 mg/day are not equally effective." 
Journal of Clinical Psychiatry, 1992

"We conclude that starting fluoxetine at doses lower than 20 mg is a useful strategy because of the substantial fraction of patients who cannot tolerate a 20-mg dose but appear to benefit from lower doses.... Patients often benefitted clinically from treatment at lower doses, and failure to tolerate 20 mg/day of fluoxetine should not be taken as evidence that the agent cannot be used efficaciously in these patients. 
Journal of Clinical Psychiatry, 1993

........................................................................................................................................
 
So, perhaps Prozac is the best switch option after all. Especially for those of us who have been taking SNRI's.  And perhaps going up to 20 mg is really unnecessary when switching or bridging.  
 
Having taken Prozac in the past, I don't remember it ever being stimulating, but it wasn't sedating until I started taking really high doses of it.  This wouldn't be the case if the N & D were only effective at higher doses. 
 
Ughh...I just don't know. I'm thinking of switching to Prozac from Lexapro, which is making me so tired and drowsy all the time.  But I'm scared, cause when I took Prozac, I gained a lot of weight very quickly. I was hungry all the time, and I had leg jerks, and then I started sleeping a lot, but that was on 90 mgs.


Edited by Petu, 04 October 2014 - 12:08 AM.
fixed text

2005-2008 Effexor xr; 1/2008 - 3/2008 Tapered Effexor for 3 months, then off for 4 months. Reinstated Effexor 7/2008; 2008-2009 Effexor xr; 2009-3/2013 Pristiq;

3/2013 - 5/2013 Lexapro 10mg, then 5mg 1 wk, then CT; 5/2013 Reinstated 5mg Lexapro for 6 weeks after 2 week withdrawal syndrome 8/2013-8/20/14 Tapering Lexapro.

Nov 2014 -8/2015: Developed severe insomnia, resumed using Ambien & Klonopin

12/2014-6/2015 Tried Ativan, Lunesta, Sonata, Trazadone, Seroquel, Rameron - Adverse Reactions

June-July 2015 (5 weeks) Lexapro 5 mg and Klonopin .5 mg daily; CT Lexapro (2 weeks) 

7/2015 Reinstated Lexapro at 2 mg.; Quit Klonopin CT suddenly paradoxical) Started Gabapentin 100-300 mg for 3 weeks. Developed severe lumbar jerking movements (myoclonus).Quit Gabapentin CT. 

8/2015 Continuing Lexapro 2 mg. Baclofen 10mg-AM/20mg-PM for myoclonus & insomnia. (very helpful)

2/2016 Lexapro 5 mg tabs, Baclofen 30 mg

Intro page: http://survivinganti...rsened-by-meds/


#83 PorkPie

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Posted 30 October 2013 - 08:33 AM

Afternoon!

 

I'm about to switch directly from Sertraline (100mg) to Prozac (20mg) and taper down from there, with the idea being to lessen withdrawal.  However, I've since seen online that the recommended dose of Prozac is equivalent to 50mg of Sertraline... surely I'd end up feeling the missing 50 as well as any potential start up symptoms?  It strikes me as rather counterproductive.  Would doubling the dose head off at least the withdrawal and allow me to continue on my merry way?



#84 Altostrata

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Posted 30 October 2013 - 10:42 AM

I don't believe anyone can answer that precisely. What knowledgeable doctors do is explained in prior posts in this topic. Here's a guess from http://www.globalrph...depressants.htm  

Approximate equivalent dosages of antidepressants: Citalopram 20 mg Escitalopram 5-10 mg Fluvoxamine 100 mg Fluoxetine 20 mg Paroxetine 20 mg Sertraline 50-75 mg Venlafaxine 75 mg

 

It's safer to taper directly rather than switching drugs, because the switch can be rough and doesn't always work to eliminate withdrawal problems. Have you tried tapering sertraline? It comes in a liquid http://survivinganti...oft-sertraline/

 

PorkPie, please update your topic at http://survivinganti...-porkpie-intro/


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#85 jotuna

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Posted 29 December 2013 - 02:13 PM

OK, it has taken me all dang day to read through this topic and skim others. My question is: should I cross-taper directly from to fluoxetine from 50mg desvenlafaxine?

 

I am close to 70, in good health, active, my brain works pretty well and I have a supportive spouse and social network. I'm truly blessed, as we say around here. So after reading everything my concerns are 1) that withdrawal will get too complicated - like having to step from desvenlafaxine to venlafaxine to fluoxetine, and 2) that whichever route I take will be destabilizing for long periods.

 

My history is not too complicated: I took Strattera/atomoxetine for several years. The downside to the Strattera was nausea if I took it with or before a meal for the first few months. Trying to quit Strattera cold turkey was BAD within a week so my family doctor put me on 50mg Pristiq/desvenlafaxine about 2 years ago. Side effects have ranged from minor - tinnitus - to insomnia. I took Prozac/fluoxetine briefly about 15 years ago during menopause with no particular side effects and no withdrawal problems. I take no other mood-affecting drugs or prescriptions. I don't think a slow metabolizer but I am 'old'.

 

I understand that you aren't substitutes for an expert mental health experts but in this backwater we don't have any. I'm just looking for informed opinion.

 

Thanks to all who spend time curating this site - good job!


Jotuna

2005-2012 Strattera

2012-2013 50mg Pristiq; planning withdrawal in early 2014

20-Jan-14 Bridging Pristiq 50mg to 2.5ml liquid Prozac

03-Feb-14 2.5ml liquid Prozac 

10-Feb-14 2.3ml liquid Prozac

 


#86 Meimeiquest

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Posted 30 December 2013 - 01:35 PM

Have you ruled out an Effexor bridge? I have no opinion, just asking because it is similar to Pristiq.
1st round Prozac 1989/90, clear depression symptoms. 2nd round Prozac started 1999 when admitted to dr. I was tired. Prozac pooped out, switch to Cymbalta 3/2006. Diagnosed with bipolar disorder due to mania 6/2006--then I was taken abruptly off Cymbalta and didn't know I had SSRI withdrawal. Lots of meds for my intractable "bipolar" symptoms.
Zyprexa started about 9/06, mostly 5mg. Tapered 4/12 through12/29/12
Wellbutrin. XL 300 mg started 1/07, tapered 1/18/13 through 7/8/13
Oxazepam mostly continuously since 6/06, 30mg since 12/12, tapered 1.17.14 through 8.26.15
11/06 Lithium 600mg twice daily, 2.2.14 400mg TID DIY liquid, 2.12.14 1150mg, 3.2.14 1100mg, 3.18.14 1075mg, 4/14 updose to 1100mg, 6.1.14 900 mg capsules 7.8.14 810mg, 8.17.14 725mg, 8.24.24 700mg...10.22.14 487.5mg, 3.9.15 475mg, 4.1.15 462.5mg 4.21.15 450mg 8.11.15 375mg, 11.28.15 362.5mg, back to 375mg four days later
9/4/13 Toprol-XL 25mg daily for sudden hypertension, tapered 11.12.13 through 5.3.14, last 10 days or so switched to atenolol
7.4.14 Started Walsh Protocol
55 years old

#87 Altostrata

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Posted 30 December 2013 - 02:23 PM

Early posts in this topic describe cross-tapering, that is, overlapping Pristiq and Prozac dosages to ease the transition from one to the other. A cold switch without overlap is riskier. Switching to Effexor is probably somewhat less risky than switching to Prozac, but you're right, then you have to get off Effexor. See http://survivinganti...xr-venlafaxine/ I would not make a plan to switch from Pristiq to Effexor to Prozac. Two switches ups the risk even more. Going on and off drugs is highly stressful to the nervous system. Switches should be minimized.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#88 jotuna

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Posted 30 December 2013 - 07:00 PM

Thanks for your input Meimeiquest & Altostrata! Yes, I considered Effexor, but then the last bit of tapering looked dicey. Prozac looked better for its long half life and the fact that it is available by prescription in a liquid. That sounds easier than trusting myself to concoct a dose correctly/consistently.

 

So let me get this straight: I'm now taking 50mg Pristiq. I could ask my doc for a one week prescription of 10mg Prozac to take concurrently with the Pristiq, then a 20mg Prozac prescription to take concurrently, then continue to take 20mg of Prozac only for a month to see if I'm stable. After that I could taper by 10% a month (of each preceding dose) as tolerated - is that right? 

 

Altostrata, I remember somewhere you had a link to an authority - Dutch, I think - that explained how SSRIs worked on receptors at the cellular level. I'd like to review it again but can't find it. Could you point me to it?

 

Thank you again for all the support!


Jotuna

2005-2012 Strattera

2012-2013 50mg Pristiq; planning withdrawal in early 2014

20-Jan-14 Bridging Pristiq 50mg to 2.5ml liquid Prozac

03-Feb-14 2.5ml liquid Prozac 

10-Feb-14 2.3ml liquid Prozac

 


#89 Altostrata

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Posted 31 December 2013 - 12:13 PM

In the Prozac switch topic, one doctor suggests overlapping with 10mg Prozac, not increasing it, and tapering from there. I would do that. I wouldn't count on tapering only one month on Prozac. I'd allow a couple of months. If you do this, I hope it works for you. Please let us know.

 

I don't know which topic you're looking for. Sounds like it's in the Journals forum. Please look there.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#90 jotuna

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Posted 25 January 2014 - 12:23 PM

OK, finally got my doc to prescribe liquid Prozac and started bridging 21-Jan-14. No noticeable changes 5 days on. 

 

BTW, when googling to see what a brain zap is so I will know if/when it occurs I found this link on Psychforums:  http://pubmedcentral...bmj33100824.pdf

 

Sounds bad but at least it will mean withdrawal is progressing - right?


Jotuna

2005-2012 Strattera

2012-2013 50mg Pristiq; planning withdrawal in early 2014

20-Jan-14 Bridging Pristiq 50mg to 2.5ml liquid Prozac

03-Feb-14 2.5ml liquid Prozac 

10-Feb-14 2.3ml liquid Prozac

 


#91 Altostrata

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Posted 25 January 2014 - 03:31 PM

No, a brain zap means you are tapering too fast and your nervous system is complaining.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#92 jotuna

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Posted 25 January 2014 - 05:10 PM

OK, got it; thanks Altostrata. Will finish the week with both Pristiq and Prozac, then Prozac only for 4 weeks. Fingers crossed and doing meditation!


Jotuna

2005-2012 Strattera

2012-2013 50mg Pristiq; planning withdrawal in early 2014

20-Jan-14 Bridging Pristiq 50mg to 2.5ml liquid Prozac

03-Feb-14 2.5ml liquid Prozac 

10-Feb-14 2.3ml liquid Prozac

 


#93 jaschembra

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Posted 21 February 2014 - 06:19 PM

I've been on antidepressants for over 10 yrs.  2 years ago, I switched from Cymbalta 60 to Pristiq 50 and went up to 100mg shortly after.... I want to be 100% clean from these drugs.  I feel I am in a much better place in my life and should be able to deal with issues as they arise.  I never had bad depression and as I think back I wonder how/why I've been on these drugs for so long.    1 month ago, I went from 100mg to 50mg Pristiq.  That went pretty smoothly.  2 weeks later, the NP said to go, 1 day on, 1 day off...  Well, my 1st day off was okay, but the next day I was extremely ill.  I took my 50mg that morning, but it took until the next day to fully function at best.  Was sick on a Sun. and missed work Mon.  Now I've been on the 50mg every day for 2 more weeks.  The plan is to switch to 20 mg Prozac tonight.  (took Pristiq 50 this a.m. and will start the 20mg Prozac at night).  Stop the Pristiq and continue on 20 mg Prozac for 6 wks.  Then see my Dr. for the next weaning process... which from reading seems to be 10 mg, and then liquid.   This stuff is sure scary.  I would never have thought a drug would have such control and if I would have known about Pristiq when it was prescribed, I would never have gotten on it (It did work well, but if you miss just hours of the dose, you would feel ill, I didn't like that!)  Any insight would be appreciated.  I pray this goes well.



#94 Ignacio

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Posted 02 August 2014 - 07:47 AM

Hi guys,

 

Ive been reading this post recently and I would appreciate if you could lend me some advice as I'm looking not exactly looking to switch to Prozac but I have a similar problem.

 

  • I've taken 20mg Prozac for 2 years.
  • 2 months ago I stopped Prozac and started Lexapro as my psych commanded it.
  • Recently after starting Lexapro (which I think made me feel bad) I decided to taper of AD's. * Alto told me to taper from 10 mg Prozac, but at the time I thought  it didnĀ“t matter to be on one drug or another, after I found that I could have withdrawal symptoms from Prozac.
  • I was only 7 days on 10 mg of Lexapro, and then lowered to 3 mg up till now.
  • My current dose is 3 mg Lexapro.

Since I changed to Lexapro and started the taper Ive been feeling worse, and was thinking that maybe this was due to Prozac withdrawal, as really the dose Ive been on lexapro have been a stable 3 mg nearly the whole time.

 

The last two days Ive made the mistake to try to up my Lexapro dose this was two days ago, it made me feel really frustrated and angry for no reason, so I suppose this is not the answer and yesterday I tried to take 1.5mg of Prozac, took 3 mg because I measured the wrong cuantity and made me feel a bit disoriented, nervous and activated. Today I can feel struck by the changes and will not be making any more changes like this (I can only learn from doing things wrong).

 

I wanted to know If I can be right about being Prozac the causative of withdrawal and if I could do something to make it ease. Maybe switching to Prozac is too much but, I dont know...

 

 

I would appreciate any help, I can see youve helped many people, 

 

Thank you


1/12: 20 mg Prozac.

6/14: Doc decides to switch me to Lexapro in may. The switch consisted in overlaping fluoxetine and half lexapro for 2 weeks, then stop fluoxetine and go on 10mg Lexapro, I was a week on 10mg lexapro and stopped as I was feeling bad then went on 3mg and taper from it .After that I learned from withdrawal and all that.

7/14: 2.5mg Lexapro for 1 year.

7/15: cold turkeyed from 2.5 mg.


#95 Altostrata

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Posted 02 August 2014 - 03:48 PM

Ignacio, no one can answer that question with certainty.

 

You may be having problems because you went on and off drugs before and that stressed your nervous system. Prozac might not be any better than Lexapro in that case. Or, you might be having Prozac-specific withdrawal symptoms that Lexapro is making worse.

 

Adding the Prozac as you did might have confused your nervous system even more.

 

Very sorry, I don't think we can give you any definite answers.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#96 LexAnger

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Posted 29 August 2014 - 11:43 AM

Thanks all for the great info and experience sharing!

 

Any thoughts about the equivalent dose between Lexapro and Prozac?

 

I never thought to switch to be very conservative not playing with psych drugs as I am super sensitive to tiny changes of Lexapro during the tapering in the past 1.5 year, but now I have to consider this option as lex is giving me horrible side effects, most severe pain all over every day from the minute I start taking the liquid of it (4mg now over sever hours as taking the whole thing same time throw me into panic attack and heart failure from the pain) and it last many hours until very late of the evening.

 

It was believed lex is much more powerful than other ssris, how much Prozac is equivalent to, say 10mg of lex? And for my case, 4mg lex, what would be a good switching Prozac dose?

 

Any comments/thoughts are much appreciated.


Mar 2009: lexapro 10mg for headache for 2 weeks then stopped.

Since then on and off 1/4 to 1/3 of 10mg until June 2012
June 2012-Jan 2013: 1/4-1/3 of 10mg generic, bad jaw pain
Jan 2013-Mar 2013: 10 mg generic. severe jaw and head pain
Mar 2013-Aug 2013: started tapering (liquid ever since) from 10 to 5 (one step) then gradually down to 2.25 mg, first ever panic attack, severe head/jaw pain
Aug 2013: back to 2.75 mg
Nov. 2013: back to Brand Lex. 2.75mg -- 3mg, slight improvement with pain after 3 month
July 2014: stopped PPI, head pressure/numbness. updosed 4.5mg, severe reaction various sxs

Aug 2014-Oct 2015: Micro taper down to 3.2mg, .025mg (<1%) cut holding 2-3 weeks. daily needling, head pain, numbness, pressure and random brain non-functional, anixety/fatigue/heart issue, been holding at 3.2 since Oct. 2015, worsening brain non-functional with other sxs up and down

.


#97 LexAnger

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Posted 30 August 2014 - 09:51 AM

Also found this and thought good to share:http://www.ncbi.nlm....les/PMC3267353/

Mar 2009: lexapro 10mg for headache for 2 weeks then stopped.

Since then on and off 1/4 to 1/3 of 10mg until June 2012
June 2012-Jan 2013: 1/4-1/3 of 10mg generic, bad jaw pain
Jan 2013-Mar 2013: 10 mg generic. severe jaw and head pain
Mar 2013-Aug 2013: started tapering (liquid ever since) from 10 to 5 (one step) then gradually down to 2.25 mg, first ever panic attack, severe head/jaw pain
Aug 2013: back to 2.75 mg
Nov. 2013: back to Brand Lex. 2.75mg -- 3mg, slight improvement with pain after 3 month
July 2014: stopped PPI, head pressure/numbness. updosed 4.5mg, severe reaction various sxs

Aug 2014-Oct 2015: Micro taper down to 3.2mg, .025mg (<1%) cut holding 2-3 weeks. daily needling, head pain, numbness, pressure and random brain non-functional, anixety/fatigue/heart issue, been holding at 3.2 since Oct. 2015, worsening brain non-functional with other sxs up and down

.


#98 Altostrata

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Posted 30 August 2014 - 03:34 PM

LexAnger, the substitution dosages of Prozac are discussed in detail in the early posts of this topic.

 

Thank you for the reference to that paper. Yes, there can a danger of serotonin syndrome when overlapping antidepressants. This is also addressed above.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#99 LexAnger

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Posted 30 August 2014 - 06:21 PM

Hi alto, thank you for responding! I read the entire post carefully and learned a great deal. There is info about equavelent dosage for other ssris but no for lexapro. My appointment with doctor shipko is on 9/3. I will see what comes out of that. Even the decision is to switch, I will wait until I'm relatively stable with lex.

I have another question, during the overlapping dosing of the crossover, how far away the two drugs should be taken on a day? I'm guessing it's not a good idea to take both at the same time.

Kindest regards,
Lex anger

Mar 2009: lexapro 10mg for headache for 2 weeks then stopped.

Since then on and off 1/4 to 1/3 of 10mg until June 2012
June 2012-Jan 2013: 1/4-1/3 of 10mg generic, bad jaw pain
Jan 2013-Mar 2013: 10 mg generic. severe jaw and head pain
Mar 2013-Aug 2013: started tapering (liquid ever since) from 10 to 5 (one step) then gradually down to 2.25 mg, first ever panic attack, severe head/jaw pain
Aug 2013: back to 2.75 mg
Nov. 2013: back to Brand Lex. 2.75mg -- 3mg, slight improvement with pain after 3 month
July 2014: stopped PPI, head pressure/numbness. updosed 4.5mg, severe reaction various sxs

Aug 2014-Oct 2015: Micro taper down to 3.2mg, .025mg (<1%) cut holding 2-3 weeks. daily needling, head pain, numbness, pressure and random brain non-functional, anixety/fatigue/heart issue, been holding at 3.2 since Oct. 2015, worsening brain non-functional with other sxs up and down

.


#100 Altostrata

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Posted 31 August 2014 - 09:10 AM

Of the methods described above, my personal preference is the one that uses a somewhat lower dosage of Prozac -- not an equivalent dosage -- to substitute for an SSRI such as Lexapro. This also lessens the danger of excessive stimulation during the overlap period. I trust the psychiatrist who came up with that.

 

You should be able to discuss this with Dr. Shipko.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#101 LexAnger

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Posted 31 August 2014 - 09:27 AM

I like your thoughts Alto, thank you for the reminder And confirmation! I hope dr shipko agrees.

I'm thinking 5mg to start, or even lower using liquid. I can increase if bad withdrawal but its better than SS. My hope is to stablize at 5mg prozac and taper from there later on.

Should I decrease lex along with the pace of increase of Prozac or take both with a constant dose then just drop lex at week 2?


From this post, it seems one other important thing is NOT to exceed 2 weeks overlapping.

Kind regards,

Mar 2009: lexapro 10mg for headache for 2 weeks then stopped.

Since then on and off 1/4 to 1/3 of 10mg until June 2012
June 2012-Jan 2013: 1/4-1/3 of 10mg generic, bad jaw pain
Jan 2013-Mar 2013: 10 mg generic. severe jaw and head pain
Mar 2013-Aug 2013: started tapering (liquid ever since) from 10 to 5 (one step) then gradually down to 2.25 mg, first ever panic attack, severe head/jaw pain
Aug 2013: back to 2.75 mg
Nov. 2013: back to Brand Lex. 2.75mg -- 3mg, slight improvement with pain after 3 month
July 2014: stopped PPI, head pressure/numbness. updosed 4.5mg, severe reaction various sxs

Aug 2014-Oct 2015: Micro taper down to 3.2mg, .025mg (<1%) cut holding 2-3 weeks. daily needling, head pain, numbness, pressure and random brain non-functional, anixety/fatigue/heart issue, been holding at 3.2 since Oct. 2015, worsening brain non-functional with other sxs up and down

.


#102 Altostrata

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Posted 31 August 2014 - 11:30 AM

Lex, all I can do is point to those methods described by doctors who have done this successfully. Clearly there's no one right way to accomplish the switch.

 

My own intuition is that the cross-taper with an overlap of perhaps a week (that brings the Prozac up to steady state in the blood level) and then a quick step-down of the other drug over maybe a week is what I'd prefer.

 

But I can't tell if that will work well for you, or if it is what Dr. Shipko would do. Please confer with him to work this out.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#103 LexAnger

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Posted 31 August 2014 - 01:30 PM

Hi Alto, my sincere appreciation for your taking time ESP. Over the holiday weekend and your great advice! They all make great sense. One week overlapping provides the best rational per Prozac hilt life (4-6).

With all your help, I feel I'm close to a logistic and strategic for the switch. I will update after the 9/2 appointment with dr shipko.

Intolerable tapering of lex with as little as 0.05 mg decrease from 4.3mg (jaw and head pain, brain nonfunctioning, panic attack, heart problems, overall disability)
Intolerable maintenance with lex round 4.25 mg with hours sever needling pain plus other systematic damage inc. Constant physical (pain, numbness, hearing, vision problems). mental (confusion, loss of memory, concentration, thinking). Psychological (anxiety, depression, depersonalization) just name a few.
Pain killer had severe interaction with lex, not using pain killer for the rest of life is impossible
Was put on lex originally for a headache not anxiety or depression

What to be proposed to the doctor:
Add Low dose of Prozac on top of current lex 4.25mg for one week
Increase Prozac (to 5mg ?) start of second week and decrease lex (by 2mg?)
Stop lex end of the second week

Taper Prozac once it's stable

Now only thing left is praying. This will be a life changing event and its very scary, but I am pushed to the dead corner so have to make a move.

Kind regards,

Mar 2009: lexapro 10mg for headache for 2 weeks then stopped.

Since then on and off 1/4 to 1/3 of 10mg until June 2012
June 2012-Jan 2013: 1/4-1/3 of 10mg generic, bad jaw pain
Jan 2013-Mar 2013: 10 mg generic. severe jaw and head pain
Mar 2013-Aug 2013: started tapering (liquid ever since) from 10 to 5 (one step) then gradually down to 2.25 mg, first ever panic attack, severe head/jaw pain
Aug 2013: back to 2.75 mg
Nov. 2013: back to Brand Lex. 2.75mg -- 3mg, slight improvement with pain after 3 month
July 2014: stopped PPI, head pressure/numbness. updosed 4.5mg, severe reaction various sxs

Aug 2014-Oct 2015: Micro taper down to 3.2mg, .025mg (<1%) cut holding 2-3 weeks. daily needling, head pain, numbness, pressure and random brain non-functional, anixety/fatigue/heart issue, been holding at 3.2 since Oct. 2015, worsening brain non-functional with other sxs up and down

.


#104 Altostrata

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Posted 01 September 2014 - 01:14 PM

I believe that it's best to be prepared before talking with a doctor. You've done this, Lex.

 

I cannot predict whether your plan will be comfortable for you or whether switching to Prozac will be a better way for you to exit SSRIs. Your plan seems reasonable. It has caution built in. I don't know if ramping up on the Prozac would be necessary, but your plan tests the waters first.

 

Listen to what Dr. Shipko has to say and be prepared to be flexible. If he seems to understand your situation, he may have suggestions that are better.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#105 clarabella79

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Posted 16 March 2015 - 09:09 AM

Hi Everyone,

 

I'm just curious to find out what people think about how fast - or slow - the Prozac switch should be best done. I've managed to wean down from 20mg to 10mg of Paroxetine over the last 6 months (probably too fast - hence why I'm going to be holding at this dose for at least 4 weeks), with the long term aim of moving onto Fluoxetine (Prozac) via a process of cross-tapering. I then want to reduce the Fluoxetine. I've read (on here and on various other sites) that Prozac is stimulating so I'm thinking of introducing it very gently because I've spent years on a sedative antidepressant. Does it sound like an over cautious plan - as an initial step - to introduce 1mg Prozac when I drop to 9mg Paroxetine and hold for as long as it takes me to feel "ok"? I'm going to book a GP appointment soon so want to go in with a plan of action of sorts. I can't see there being a problem with obtaining Prozac liquid, but if there is, I'll make my own from ground up 10mg pills. Any thoughts at all would be greatly appreciated :)


1st Sep '14 - reduced to 18mg from 20mg; 15th Sep - 17mg; 29th Sep -16mg; 21st Oct - 15mg; 10th Nov - 13.5mg; 1st Dec - 13mg;

11th Dec - 12.5mg; 5th Jan '15 - 12mg; 20th Jan - 11.5mg; 11th Feb  - 11mg; 26th Feb - 10.5mg; 5th Mar - 10mg; 1st Apr - 9mg; 29th Apr - 8.5mg; 29th May - 8mg; 18th Jun - 7.7mg; 9th July - 7.4mg; 11th Aug - 6.8mg; 2nd Sep - 6.5mg; 12th Sep - 6.3mg; 26th Sep - 6mg; 10th Oct - 5.7mg; 30th Oct - 5.3mg; 28th Nov - 4.8mg; 20th Dec - 4.4mg. 

Medication History:

January 1997: 20mg Paroxetine (Seroxat) daily for depression with anxiety. CT withdrawal attempted 1997 and 1999. Dividing pills withdrawal attempted 2002. Liquid/pill 13 month tapered withdrawal 2007/8. Started to become very ill days after CTing at 2mg. Prescribed other antidepressants (CitalopramMirtazipine) but neither were as effective and had more side effects, so Paroxetine 20mg reinstated June 2008.


#106 Sarasmiles

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Posted 16 March 2015 - 12:16 PM

I'll be interested to read the answers you get to your question, Clarabella.  

 

I'm trying to figure things out myself. I would really appreciate any feedback I could get.

 

On February 6, 2015, I told my psychiatrist I wanted to get off of Lexapro.  He recommended a switch to Prozac, because it has worked well for me in the past, and because I found it less difficult to withdraw from than Lexapro, which I tried to discontinue about a year ago, without success.   My true desire when I told him I wanted to get off of Lexapro was to be medication free at last.  I told him this, but he was skeptical that this would work for me.  He has seen me discontinue and suffer from bad depression in the past, and he seems to feel I will need to be on an SSRI for the foreseeable future.  So I agreed to the switch to Prozac, but told him, "if I do okay, I'd still like to taper off the Prozac eventually."  I was viewing the Prozac as a bridge drug, but he was viewing it as a replacement, albeit a replacement I could hope to get off of somewhat more easily should I insist upon that.

 

Okay, so he prescribed:

 

10 mg. Prozac for one week, while still taking 20 mg. Lexapro.  

10 mg. Lexapro for one week, increase to 20 mg. Prozac

5 mg. Lexapro for one week, 20 mg. Prozac

Quit Lexapro, stay on 20 mg. Prozac

 

After spending hours reading here, I decided not to increase the Prozac to 20 mg., but instead to see if I could be stable reducing the Lexapro while taking 10 mg. Prozac.  I did that.  So I have been off of Lexapro entirely since 2/28. I had some dizziness and a few brain zaps each day after beginning the Lexapro reduction, but basically felt pretty good. I continued to take  10 mg. of Prozac until 3/3, when I shaved a tiny bit off of my 10 mg. tablet. Since then I have continued to do that, taking 9 mg. of Prozac each day, until 3/10, when I reduced that to 5 mg.  I thought, based on past experience, that I could probably handle that reduction.

 

That brings us to yesterday, when I had my first emotional sign of withdrawal. I became unreasonably enraged with my husband. There is a lot of anger built up for me in that relationship, so it was not coming from out of nowhere, but it was definitely out of proportion to the immediate situation, and I felt almost dizzy with anger.  It was that hot, visceral, sickening rage I have only felt a few times in my life. And it was over a minor issue. I stayed in control of my behavior and my words, and he doesn't know just how angry I was. 

 

Today I woke up with a massive headache, and felt hung over, although I haven't had a drink in months.  Fortunately, I had the day off, and I was able to spend some of it in bed.  I feel better now.

 

Would anyone be willing to advise me about how I should proceed from here?  I could hold at the 5 mg. of Prozac and see how I do in the days to come.  I could go back up to 9 or 10 mg.. I could taper by smaller amounts, which would require me to use a liquid form.  My pharmacy wouldn't do a refill as a liquid unless I get a new prescription written that way.  I'm uncomfortable asking my psychiatrist to do that, given his disapproval of my going drug free at all, but I could do it, or make my own.

 

This afternoon I feel fine.  I needed the rest I got today, but I am good now. Just mildly dizzy.  Of course, I don't know if the headache and rage were reactions to Lexapro withdrawal from 2 1/2 weeks ago, or Prozac reduction.  

Any advice would be appreciated enormously.

Thank you!

Sara



#107 Altostrata

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Posted 16 March 2015 - 03:26 PM

Sara, you did not allow time to stabilize on Prozac. I responded in your topic http://survivinganti...rawal/?p=139505


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#108 blackrabbit

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Posted 08 May 2015 - 12:19 PM

Hi everyone. This thread is huge so I haven't looked through every page. Just the first three. To save me some time, has *any*one done the prozac bridge with Lexapro? My doctor approved me doing it so I am going to start soon. I am just nervous. 


Current meds: Escitalopram (Lexapro, see below) and Omeprazole 40mg for indigestion

Was put on 20mg Lexapro for 4 years.

Was at 18mg for ~1 week.

4/19/15: 15mg; WD symptoms include: loss of appetite, weight loss, nausea and indigestion after eating, diarrhea, and anxiety. Most of these happen at night.

6/5/15: 13mg; WD symptoms include: tiredness/lightheadedness, indigestion, numbness (emotionally)

7/6/15: 11mg --> 7/10/14: 11.7mg (wanted to taper by 10%)

8/10/15: 10mg; WD symptoms include: anxiety, nausea, GI upset, headaches

9/1/15: bumped back to 10.5mg (back to tapering by 10%); 10/5/15: back to 10mg

11/8: down to 9mg: feeling depressed so far ---> 11/16: bumped back to 10mg :(

1/23: back to 9mg; headaches, "motion sickness" feeling