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Ask Dr. Ed Wilfong Your Own Question
Dr. Ed Wilfong
Dr. Ed Wilfong, Psychologist
Category: Mental Health
Satisfied Customers: 1528
Experience:  Twenty-five years treating all ages; Specialities: psychopharmacology & diagnosis, MMPI-2, testing.
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This is for Dr. Wilfong. I just increased my Prozac amount

Resolved Question:

This is for Dr. Wilfong. I just increased my Prozac amount with my doctors encouragement from 40 to 50 mgs. I am 8 weeks and 4 days into treatment with progress. The doctor believes the higher dose will help improve faster. I'm concerned about taking higher doses of Prozac. I've been on the drug for 18 years at about 20 mgs. when I became sloppy with taking it. (Missed doses, perscribed 30 mgs during a high stress time and would take it inconsistantly, etc thinking I had a lot of theraputic room with half life on Prozac.) However, this is one reason I may have relasped. Doc said if I'm uncomfortable with 50 I could resume 40. Not sure what to do here. Also, I have one additional question. Why after 18 years on PRozac would I go to such a severe relaspe when the drug became less in my system? Is my brain chemistry dieased? Was it side effects from reducuing the dosage? How does this work?
Submitted: 5 years ago.
Category: Mental Health
Expert:  Dr. Ed Wilfong replied 5 years ago.

Dr. Ed Wilfong :

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.

Dr. Ed Wilfong :

Thanks for asking for me.

Dr. Ed Wilfong :

I am not online every day. If you go to my profile, you can address questions directly to me. I will be automatically notified if you respond to this.

Dr. Ed Wilfong :

Dr. Wilfong

Customer:

Dr Wilfong,

Dr. Ed Wilfong :

I am here

Customer:

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?

Customer:

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.

Dr. Ed Wilfong :

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

Dr. Ed Wilfong :

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.

Customer:

Okay I'll be a good patient and go to 50. DOn't want to be a numbed out zoombie (want my life back.)

Dr. Ed Wilfong :

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.

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