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Steven Olsen
Steven Olsen, Therapist
Category: Mental Health
Satisfied Customers: 1765
Experience:  More than twenty years of expertise in counseling, psychological diagnosis and education
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Had a severe reaction to wellbutrin plus and ER visit - now

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had a severe reaction to wellbutrin plus and ER visit - now am on ativan and prozak 20mg... i feel like the ativan isn't working any more how long will it take for the prozac to kick in?

The simple answer is that the Prozac will take about 2 weeks at minimum to show some benefit, and most people experience more significant symptom reduction in 4-6 weeks with 8 weeks being full effect. It is, rather a slow process.

Prozac works by increasing the availability of serotonin which reduces anxiety and worry (as well as depression). Ativan is a benzodiazapine, which increases a chemical called GABA, which tells your nervous system to stop sending messages, particularly fear based messages. The Ativan is very dosage dependent, very fast acting, and if you are not getting any relief you may wish to talk about dosage with your doctor as usually this medication is highly effective. You may just not be taking enough.

I would recommend a revisit to your prescribing doctor as at least one of these should be giving you relief. And, in all likelihood, the dosage is simply not adjusted to your metabolism. Steven

Customer: replied 5 years ago.
Do you think its a bad thing to increase the ativan? I have now been taking these meds for a week, so it seems I have another week to go for prozac relief. I'm taking 1mg of ativan every 8 hrs. This all began from the wellbutrin reaction, I was never this fearful, I can barely eat, and get unbelieveable anxious attacks.
The typical start dose for Ativan is 1mg per day, but if no response occurs it is common to raise that to 2-3 in some cases. You are suffering, clearly, and I see no reason to hesitate to ask for a reevaluation of the dose. The medication will be removed (tapered) in most cases as soon as the prozac begins to work, so this will not be a long term dose. I would not be reluctant at all to see your doctor. Clearly this is not working as it should and it is common to go a bit higher in dosage. Steven
Customer: replied 5 years ago.
I'm actually taking it 3 times a day, 1MG dose. Would they increase the dose or increase the times taking it?

As you are already at the upper limits of the usual dosage they most likely, instead of increasing the dose further, will change to another chemically similar medication. These include Valium, Xanax and others. There are many, many others in this class of medication, and I know you are in distress, but please try not be too discouraged.

Even with all the neuroscience at our disposal, dosing and choosing the right medication is still very hit or miss. But, in retrospect, I doubt they will increase the dosage. They may increase the initial dosage and taper it later in the day, but more typically at this point they will try another medication as you seem resistant to this particular brand. Steven

Customer: replied 5 years ago.
It was helping at first and then it started to taper of effectively. When they gave it introvenously at the hospital it obviously worked very well. I was originally prescribed xanax with the wellbutrin but it wouldn't last long and it would completely knock me out. I've been on medical leave from work and am hoping to return next week so I don't know what will allow me to be functional.
You appear to build up tolerance very quickly. That does happen. However, there are many, many choices in this category and you probably only need the medication for a few weeks until the Prozac kicks in. But you do need to see your doctor face to face at this point as the medication you are taking is not working; it is at an upper dose threshold and there are other choices. Not all work the same and not all cause the extreme "knock out" that the Xanax did. But there is no other way, sadly, to find out except to try them. But often in the process, by knowing what does not work, a good alternative can be found. Steven
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