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strawberry17

The Prozac switch or "bridging" with Prozac

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RE; The Prozac Bridge, would a safer method be to take 5mg with your current dose for a week. Then increasing to 10mg for the second week and decreasing your current AD to half current dose. Then just drop the current AD completely, after the second week?

 

So..

 

Week 1: 5mg Prozac + 37.5mg Effexor (for example)

Week 2: 10mg Prozac + 18.75mg Effexor

Week 3: 10mg Prozac

 

The smaller starting dose would allow you to assess how Prozac affects you before going up to the full dose, plus the smaller dose of Prozac during the first week, and smaller dose of current AD in second week, could prevent any complications from too much serotonin (serotonin syndrome, etc).

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jr, I moved your post here, with the accumulated wisdom about the Prozac switch.

 

That method is called cross-tapering and it's the way I've heard some doctors describe they do it.

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I jumped off the Prozac about 2 1/2 weeks ago. Well, I didn't quite jump. I just tapered real fast the rest from about 5 mg. I just went 5 mg. to 2 1/2, over just a few days, then stopped. I've been fine. No problems at all. I really felt I was just done.

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Yes, I'm off Antidepressants anyway :) I'm going to wait on the Xanax. But it does feel great to be off the ADs. It's just been so smooth, except for a couple of bumps that was caused from other things messing with my CNS anyway, that I just felt like I'm ready. I haven't had a zap or anxiety or anything for quite some time. Not even tinnitus. I hope others that try the Prozac Switch have as much success at it as I have.

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Those of you who made the switch to Prozac - were you still having w/d symptoms on your previous AD before you switched, or did you wait until you were completely stable before switching?

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I was somewhat stable at 20 mg of Paxil before I did the switch. I got stuck at 20 mg Paxil during my Paxil taper. Every time I tried to go below 20 I'd get bad symptoms. So, yes, I'd say I got pretty stable at 20 mg before switching. I wasn't totally stable, as I was still healing from the taper from 40 to 20. But only mildish symptoms like tinnitus and feeling out of whack. But not brain zaps and harsh symptoms. I'm trying to recall how I felt but it's blurry :(

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Yes I think I made sure I was stable before I switched.

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Has anyone switched from Mirtazapine (remeron) to Prozac? Or from an AD that was in a different class to Prozac. Am thinking about this but am nervous

that I will still have withdrawal effects due to the different mechanisms of action between Mirtazapine and Prozac.

 

dalsaan

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Switching from Effexor to mirtazapine didn't work for me. I had withdrawals which appeared as moments of rage and suicidal thoughts. It was very bad. I was able to switch between other antidepressants, but they were all ss/snri's. So I suspect the mechanism does make a difference. I wouldn't risk it.

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Prozac is used as a bridge for all classes of antidepressants, including SNRIs. How this works, I don't know.

 

Doctors will substitute Prozac for an antidepressant when withdrawal symptoms appear, so the switch isn't always done when the person is stable but to relieve severe withdrawal.

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I was stable before I did my switch but I imagine this technique would be beneficial to anyone having w/d symptoms on another SSRI.

 

Also, glad to hear your withdrawal went well, Shanti!

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Do you think Prozac or Effexor would be more likely to cause anxiety/akathisia?

 

I'm tempted to ask my Dr for Prozac next week, but I'm guessing that may not be the best course of action. I've been able to switch Paxil->Lexapro->Effexor by just stopping the old one and starting the new one the next day, and had no problems. However, after I fast tapered Effexor and went on mirtazapine I went nuts, so I tried Zoloft for a week, which made me feel overstimulated. Then I tried Celexa for a week, which also made me overstimulated and caused akathisia. Eventally I went back on Effexor, which caused overstimulation/akathisia in the beginning but it eventually got better, although mild akathisia still remains.

 

I suspect I had problems switching from the effexor because I had already fast tapered and was in full w/d mode. If I had switched from one to the other immediately it may have gone smoother. That's why I think if I stay on Effexor until I'm as stable as possible and do an immediate switch, or fast cross taper, things are more likely to go smoothly. Trouble is I don't know if the symptoms I have are w/d or side effects. If they're side effects then it feels like I'm wasting time staying on Effexor when I could try Prozac now. OTOH, if it's w/d then staying put is the best course of action. I'm very impatient :)

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Your system may have become sensitized by all the drug switching and particularly the adverse reactions.

 

Your reaction to a switch to Prozac cannot be predicted. Note that some methods recommend a lower dose of Prozac, which is less likely to cause an adverse reaction or serotonin syndrome when overlapped with your current medication.

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I would be way too scared to try switching to prozac if i was stable incase it induced withdrawal and too impatient to switch if i was in withdrawal - better the evil you know is my motto!

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jr, if you're wanting to come off ADs altogether, it is probably easier with Prozac. It's what I'm currently doing and I haven't found it too bad.

 

Well that's what I think too but I'm afraid it might make things worse. I'm going to hold on Effexor for now until my paresthesia/akathisia and jaw tremors go away (assuming they will eventually).

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Electron

 

I am following this topic as I am in the process of coming off Effexor with Flox. (my abbrev.). Thanks for the encouragement.

It is my goal to get off A.D. meds and hopefully learn to live so I don't require meds. I see you have been decreasing by 2 ML per week.

 

Hi amg.. that would be .4mls. He has usually been cutting the dose by .2 mls. He was able to cut .4 mls this time round because he held for a longer. You are better to keep to a consistent cut for each drop until you get more experience. Try to stabilize where you are for now. Cut sizes vary depending on how our nervous system responds. :)

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Schuyler

 

Thanks for bringing the .2 mls cut to my attention. Yes, I will wait til I stabilize before I consider cutting anything further at this time.

 

Feel pretty crappy at the moment and feel like summer is passing me by and summers are way to short for that. Still have not gone off the property - 8 days now.

 

When I wake in the morning - and I am sleeping well since I went to Flox. from Venfx. (thank goodness for this)... anyway my body feels terrible in the morning particularly.....feels like I have a horrible flu. Headaches have dissipated since I made the switch over too. So, should I look and the improvement in sleep and less headache as a positve due to the siwtch or is this just due to progression period?

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The Prozac is taking effect. That's good.

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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.

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Good question, and the right answer.

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Are there many on this forum who tried to switch to Prozac and failed? What happened?

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You might search for Prozac in the Intros forum and post what you find here.

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I had a quick look. Seems one person failed because she didn't overlap the old with the new. Another failed because they tapered off their old AD too quickly, had w/d symptoms, then tried to stop them with Prozac.

 

I guess it comes back to the advice alto gave in the OP - overlap them for a week or so and do it before w/d from the old AD starts.

 

The majority of people who came up in the search made the transition successfully.

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Thank Electron! I'm glad it's working for you too. I'm still doing fine. In fact, getting better every day. Even in the last month I've had a cortisol injection and tubaligation with anathesia, and all went well.

 

Someone had written to me asking exactly how I did the switch. I'll just paste what I wrote to her in case anyone wants to see clarification of my signature in how I switched. However, check with your doctor.

 

11/22/11 - 20 mg Paxil + 5 to 20 mg Prozac titrate.

12/03/11 - 20 mg Prozac

 

I can tell you that I did it in just a few weeks. I stayed at 20 mg Paxil and started at 5 mg. of Prozac, increasing it 5 mg a week until I was at 20 mg Prozac and 20 mg Paxil. Then I simply dropped the Paxil. Then I stabilized on the Prozac for a couple of months at 20 mg to give my CNS time to adjust. Then you can see my taper from there on my signature.

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In Ontario, Canada seniors (65 +) pay only a $100./year deductible for most prescriptions then after that just pay the processing fee which is just a few dollars. Unfortunately the liquid Prozac is not covered.... so I have informed my doctor of the situation and received a prescription for the 20mg capsules which are covered. I know I saw a formula by a doctor on this site for mixing one's own liquid... can you guide me to it, please. Also, has anyone here mixed the powder simply with water? Is it awful tasting - what else can I mix it with? (Actually I find the liquid Prozac very, very sweet). I will not be getting the caps for awhile so no hurry on this.

 

P.S. Liquid Fluoxetine cost me $80., the capsules with our seniors program will cost less than $5.

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Shanti, thanks for posting your cross taper. Can I ask how you felt when you were taking Paxil and Prozac at the same time? How does Prozac feel? Do you notice it being more stimulating than Paxil?

 

 

First I made sure I was stable and not having rough symptoms on the Paxil, at the 20 mg dose. When I added the Prozac, and even when I was on 20 mg Paxil with 20 mg. of Prozac, I didn't feel any side effects. I think that since I was stuck at 20 mg of Paxil for quite some time, that is a low dose so having the 20 mg of Prozac didn't cause over stimulation and side effects. I think my system did pretty well with the Prozac, and no side effects, thank God.

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amg2012, I've read some people dissolve it in cranberry juice ("Cranzac").

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I'm not a doctor so I can't recommend anything

Yet somehow I trust your advice more than theirs...

 

But you had adverse effects at 75mg Effexor, equivalent more or less to 10mg Prozac. If I were you, I might try 5mg Prozac.

 

I thought 75mg Effexor = 20mg Prozac? Maybe I'm wrong...

 

I'm going to hold on the effexor, at least until my sleep improves, before considering Prozac.

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I'm not a doctor so I can't recommend anything

Yet somehow I trust your advice more than theirs...

 

 

 

I thought 75mg Effexor = 20mg Prozac? Maybe I'm wrong...

 

 

JR That is what I read too in the Icarus Project so I was looking it up again and found that they have a recent second edition 7/11/2012 as I am not sure which edition I read I will look at the new one for some more help.

I think that my reduction from Effexor 150 to 75 mg was too fast and I did not do the brige. I am feeling very dull and losing time (too old to lose time, not LOL). Wondering if I should take more Prozac - I am now at 20 MG (liquid 5 ML).

Perhaps I will find help in this document.

 

It is difficult to interpret and deal with this when feeling so unwell.... any help most welcome!

 

http://theicarusproject.net/advocacy-rights-politics/coming-off-medications-guide-second-edition

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jr, you've shown hyper-reactivity at a higher dose of Effexor. It's up to you if you want to try the higher dosage of Prozac. If I were you, I'd go the more conservative route.

 

The amount of Prozac that might "work" for a bridge is individual. The equivalencies are only estimates.

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the thing with Prozac is that it has a much longer half life, so it is likely to take longer for you to feel good - i would avoid updosing for a little while if you can - you might go too high and will only have to come down again...

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jr, you've shown hyper-reactivity at a higher dose of Effexor. It's up to you if you want to try the higher dosage of Prozac. If I were you, I'd go the more conservative route.

 

The amount of Prozac that might "work" for a bridge is individual. The equivalencies are only estimates.

 

I understand what you're saying. I thought I'd be ok at 10mg Prozac if it equals 37.5mg Effexor, but I think your way is probably better because I don't really know if I'll be able to tolerate Prozac or not.

 

My only worry is that 5mg won't be enough, then withdrawals will start and they might not go away if I updose. But I guess that's the risk I'll have to take.

 

In your opinion, is it better to just go ahead and try ithe switch sooner rather than later, or wait until I feel more stable on the Effexor before jumping ship?

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I don't know, jr.

 

I thought you might say that ;). Well I'm gong to see how I am taking the vitamin B6 for a week or so then go from there.

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JR, from my own experience and some that I've read, updosing with antidepressants does fix the issue of the symptoms, unlike with Benzos that sometimes can be unforgiving. But I can not say this is the case for everyone.

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My experience with taking 37.5 mg. Effexor with the Prozac was not a good idea. Brain fog, extreme fatigue, etc. etc. - I think everyone here knows w.d. symptoms. Today, I took only the equiv. of 20mg. Prozac in liquid and hoping I can find stability here.

Comments, welcome.

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