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We don't know why, but anti-depressants often lose effectiveness after a period of years. It is called "poop-out". Sometimes increasing dose will help, but if 50 is not working, you likely need to change medications. 50mg is safe, but won't help work any faster. You just may need more due to "poop-out. We have no idea why this happens and it can happen anytime, after many years. You are correct about half life covering a missed dose now and then but not a great idea to skip. If you are improving and uncomfortable with just idea of dosage, don't worry. 60mg is not uncommon. If you are concerned because you are having side effects, then cut back and consider changing drugs and have MD research "poop-out" (that is the technical term for it). Not all non-specialists are aware of it. If improving, trying hanging in there. My best hunch-you need to change medications. Even something very similar is likely to work. You haven't hurt your brain. I have seen people on a drug for long periods and then reduce or quit it have more problems resuming it. Again, no harm done and changing medications is likely solutions.
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I seem to be improving on the Prozac. I've had a lot of anxiety (well prior) to this also. This episode bgan with a panic attack. I still feel fearful and anxious and wondered if it could be the antidepressant at the higher dose, Depression itself can cause this to occur also correct?. Also, generally how long does it take to get to remission? I'm beginning my 8th week. My doc. thinks the Prozac sees to be working coming from where I was to where I am. Also why then increase the 40. Do doc's like to up the dosages? , Iincreasing the amount will or won't expediate this process? I think my situation was due to two low teraputic doses. Wasn't as compliant as I needed to be. Now I'm in this mess. Also how easy is it to change medications when your on prozac?
Sorry kind of asked the same question over again about dosage amounts. Will the fear , panic and anxiety resolve over time? Afraid to take 50 but will do it if it helps.
Not difficult to change medications, but if it working, better not to. Prozac will treat panic, not cause it. Relapse do to too low of dosage (including panic) is indication you need medication. If it is still working, hang in there. Anxiety panic often take a higher than typical (20mg) to treat. MD's actually tend not to increase dosages as often if they should (in my experience). It will expedite things if you need the higher dosage and are not responding optimally at 40 mg, which is very possible. It usually takes a few weeks (2-3) at therapautic dosage to feel better (not great, but should notice difference). It may be now you need higher dose
Many times the fear after panic attack is fear of having another panic attack. Counseling helps that fear greatly. Don't worry about 50 mg or even if MD pushes to 60mg.
Okay I'll be a good patient and go to 50. DOn't want to be a numbed out zoombie (want my life back.)
Prozac typically does not sedate or make feel "zombie-like". I would let doc psuh to 60 if needed and if not feeling better after 3-4 wks aat top dose, conside changing. Changing drugs oftens involves a souple weeks of worse before get better.