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I've been seeing my psychiatrist for anxiety, mental ocd, and depression for 16 years now. He has raised my prozac dosage to 140 mg. At 140 mg, I was buzzing, so I took it down to 120 mg. I'm now at 80 mg... I've done this of my own volition. He is 70 years old now.... I'm 42. Is this appropriate treatment or is he maybe getting too old to treat me? I don't know what to do anymore.
I also love him.... after my father died over ten years ago, he told me he was my father figure.
Hello ! Thank you for your question, I’m Dr. Vikas (M.D Psychiatry) and I’ll try to help you today.
The usual dose range of Prozac (Fluoxetine) is from 20-80 mg per day. Maximum dose generally is 80 mg per day.
Higher is the dose, higher are the chances of side effects. I agree with you that doses above 90 or 100 mg per day can be considered to be a very high dose.
There are some doctors who prefer to use higher doses if a patient is not responding to usual dose range provided he or she is able to tolerate the high doses. But still, in my view doses above 90 mg of Prozac should be avoided.
Instead of increasing the dose of Prozac, there are other options like boosting the effect of Prozac by adding other antidepressant like Mirtazapine (Remeron) or switching over to another antidepressant like Venlafaxine or Desvenlafaxine.
So you can tell your psychiatrist that you are not able to tolerate the higher dose of Prozac therefore, instead of prescribing high dose of Prozac, he can consider the option of either adding another antidepressant or switching over to a new antidepressant if you are not responding to Prozac any more.
I hope this helps, please feel free to discuss further if you have any other query.