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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10643
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I am a 29yr old male who suffers from polar and bad social

Customer Question

Hi there,
I am a 29yr old male who suffers from bi polar and bad social anxiety I take 50mgs of serequel also just started 40mgs of Prozac not long ago,and feeling very depressed and paranoid and more anxious all day long I can't really eat I'm that anxious.
I can't get in contact with my phsyc and I'm struggling.
If I up my dose of serequel I feel spaced out should I up my dose of prozac I'm scared I will feel worse.
Can you help please ?
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

*This website DOES NOT constitute treatment and only provides information and advice. For treatment (therapy and/or medications) you must go to a licensed professional in your area.

Hello and thank you for your question. I am sorry that you are experiencing these symptoms, I can understand how distressing this can be for you. Unfortunately if you increase the dose of the Prozac, this could very well make you Bipolar Disorder worse as antidepressants often make symptoms of Bipolar Disorder worse if there is no mood stabilizer or atypical antipsychotic present. While you are taking Seroquel with the Prozac, your Seroquel is at a low dose, so that dose most likely is currently not sufficient for you (an efficient dose would be at 300mg or higher for most people) or would not be sufficient if you increased the Prozac. The best option for you would be to talk to your doctor about a medication change when you can as clearly the side effects of Seroquel are too bothersome, so it would be better for you to remove that medication and possibly try another atypical antipsychotic such as Ziprasidone, Lurasidone, or Olanzapine. Or you can try a mood stabilizer like Lamotrigine, Lithium, or Depakote. If you respond well to one of these medications than the dose can be increased to an effective level which can stabilize your symptoms. So as for right now, I would not recommend increasing the Prozac as that could cause you to go into a Manic episode.

Customer: replied 1 year ago.
Ok great yeh funny you say that I upped my dose to 40mgs Prozac and have felt worse ever since. Yeh I find it hard to see my doc as I do 12 hours shifts and no time to see her. But I'll set go
Back down to 20mg and mayb up my dose of serequel 15mg at a time. I really need something to help I hate feeling anxious and paranoid. Is there anything I can take for severe anxiety and paranoia?
Expert:  Dr. Z replied 1 year ago.

Paranoia and anxiety are two different things, so you may be using the terms interchangeably by mistake. Anxiety is when you feel stressed and worried/fearful in situations that you know you shouldn't, but yet you still do. Paranoia is a delusion, false belief, when you feel worried/fearful and stressed in situations that believe are true no matter what any one else tells you...as an example you truly believe people are following you or spying on you. So if you are just talking about anxiety, then your doctor can prescribe you a benzodiazepine (e.g. Alprazolam, Clonazepam, or Lorazepam) as these are very effective in lessening anxiety symptoms and will not interfere with your other medications or your Bipolar Disorder. But if you are talking about true Paranoia than the only medication for that would be the atypical antipsychotics like Seroquel

I know it is difficult to see your doctor, but it is important to find the right regimen that significantly lessens your symptoms with minimal side effects, and that will take some trial and error with your doctor. Hopefully you will be able to see her soon in regards ***** ***** medication adjustment.

Expert:  Dr. Z replied 1 year ago.

I hope this answers your questions and gives you some guidance on this issue. Please let me know if you have any questions or concerns as I am happy to assist and support you regarding this issue.

*Please do not forget to leave a positive rating. Thank you.

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