Thank you for the replies to the questions and the added information. It helps a lot. I believe I can now be of help with this issue.
I can imagine how frustrating and worrisome this situation must be for you. I'm not sure why your daily dosage has been increased over the 20 years, but I assume it is because the depressive and or anxiety symptoms would slowly increase. And so each time this would happen or become significant, the dosage was increased. The upshot is that you are now taking the high end dosage of Prozac.
The situation you describe does not seem that you are really referring to a symptom of memory loss as much as anxiety reactions to stressful situations. Similar to a panic reaction where a person can't remember things. As opposed to a decline in remembering things at all. If there is also memory loss, forgetting things you need to do and where you put things and that you left the stove on, etc. more than the normal cognitive wear and tear of life as you go through your 50s, it might be the Prozac or it might be aging. That would be hard to discern given how long you've been on the medication.
One side effect that is most likely Prozac induced: Prozac is known to reduce sexual desire and performance. This is a very common side effect and you are taking higher end dosage of it.
Okay. So we have anxiety issues and possible memory loss and definite sexual side effects. All of this point to a serious conference with your prescribing doctor. It may be time to switch to a newer SSRI than Prozac. Viibryd is a new SSRI that has come on the market and the clinical trials created a lot of "buzz" because there were hardly any sexual desire problems reported with it. The early reports from patients is positive in this area.
Changing medications is always a chancy proposition. So the discussion needs to focus on risks and benefits. However, at this point, it seems the benefits of Prozac are severely compromised by its side effects and the risks of new medications whose effects on you are unknown may be worth taking.
You might also consider adding a behavioral component to your treatment for your depression and anxiety. While behavioral treatment requires more effort from the patient than medications and is not as quick acting, it doesn't have the side effects nor withdrawal symptoms of the medications. If you would like to introduce a behavioral treatment, feel free to ask me another question about it. Just write “For Dr. Mark” at the beginning and everyone will know it’s for me.
Okay, I wish you the very best!
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