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Advice Needed - Change in Medication

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piglet

MyPTSD Pro
Hi All,

I have been told that a change of medication is advisable. I have been on prozac for 6 months. The psychologist recommends a straight switch to somthing that works in a different way. She says a straight switch is advisable instead of a gradual off, then on approach due to my current "crisis". I don't like the use of that term, because it sounds far too serious. However, seeing as my GP also mentioned a change might be in order, it seems that it is inevitable, regardless of the description of the place I'm at.

Question is -what do I change to? Another SSRI? One of the older types? Then there's potential side-effects. I know it sounds ridiculous, but I don't want to be on anything that is going to cause weight gain (other issues there too!). I'm sure I should be thinking of other, much more important side-effects than weight gain, but hey, I'm not exactly my usual clear-thinking self at the moment!

I'm basically right in the shit and could use some constructive advice. :drugs: :crazy-eye :dont-know
 
Piglet, that is a real hard one to advise upon, because every medication works differently with each person, so what is great for one, might knock you for six, or what knocked anothe for six, might be great for you. Honestly, the only thing you can do is chat with your therapist and doctor, see what they both have to say and find the similarities. If they both say different things, then keep poking them about all the alternatives and their opinions on each. The only real way your going to find one that suits you, is trial and error.

Most of the medications have a possible side effect of weight gain and weight loss, because it depends on how the drug interacts with a person whether it depresses them more, thus weight gain, or reduces their depression and they become active / or the medication simply ties up their brain to not eat, hence weight loss. Each person with each medication is really unique, and trial and error is going to be the only way.

The problem with that though, is that each medication generally has a two month lead in time before it stabalizes within your system, straight change or not, hence whilst the new one is going in, the old one will still be withdrawing, so you won't have an accurate analysis of anything that is going to occur within you for 8 weeks.

I will just warn you though, that a straight change whilst understandable in your current situation, is most likely going to still shake you about during the bodily change over period.
 
Thanks Anthony - also for moving the post. I suddenly thought after I pressed the post button "this is not information, this is asking for information - should have put it in one of the chat forums" doh!

I'm wondering if I'll be signed off sick while I adapt to the new meds. Realistically, I'm not really left with much option now, but being signed off again will not go down well with work at all. Also not good for me, as I will feel like I'm letting my colleagues and students down. Yes I know it's not my fault, but knowing and feeling don't hit the same page with me right now!
 
Piglet,

When they started you on prozac... did the stabalize you then cut your dose way back?

I ask because I have been reading a book written by a shrink (MD) explaining how these different meds work. He explains how slowly prozac leaves the body, extremely slow. Way slower than the others. So once you get stable you can cut the dose way back to a fraction of what the original was to keep you stable. If you stay at the high dose your body is constantly building it up in your system and could possibly be causing your increase in anxiety... Where as something like zoloft leaves much faster so you do not run into this problem.

As far as a switch, let me go read. If my memory serves right (it may not) it is not advisable to start a new med for about 5 - 6 weeks until prozac is out of you system, let me go double check and I will come back with the info.

I have been planning to put drug interactions in the info but I haven't done it yet...
 
Thanks for the info Veiled. Have been on 40mg/day for about 6 months with no reduction. However, I've a feeling it's most likely the work situation that has caused the increased anxiety, rather than the prozac!

Found out the name of my new symptom today - fibromyalgia - sore muscles. Not unusual for someone with ptsd apparently. It's so nice to be common for a change! ;)
 
Hey Piglet. Ive never been on Prozac. They have put me on a few other things though. The best thing I was ever on was Paxil. Wow what a drug. The only problem with it is that it made me so carefree that I became an impulse shoper. "oh wow a $300 Car Stereo... My brother would love that" chaching. That and confrontation was impossible on it. My hubby was in Iraq and called threatening divorce cause I was spending so much money and I was like "Okay honey I love you. I'll talk to you later". Wow. I think Im going to try to get put on that again. LOL. I dont know what to tell you though. Its always a crap shoot. And the first 2 weeks your on something are always crazy. good luck though. I hope you get on something that really helps.:wink:
 
OK, I cracked my books out and refreshed my mind on the Prozac. Did a little web surfing... With Prozac a switch in meds is tricky. Totally understandable that your job, which would drive a normal person over the edge, has something to do with how you have been feeling. And I really want to see you feeling better!

But Prozac leaves the body very very slowly, the other SSRIs are not like this one, leaving much more quickly. Since it does this you have it building up constantly since it is not leaving your body at near the rate it is going in. You can run into symptoms you are having if it worked in the past simply because you have too much in your system now. It can take months before it happens or weeks. You may just need to cut your dose way back to as much as a tenth as what you are on to stabilize again and maintain a constant level that will work right. May be worth talking to your doctor about since the change in meds can be risky. Sounds strange but just a big reduction in your dose and not go off may do the trick and make you able handle things better!

It is not advisable to switch to meds, MAOI or other SSRIs and the like when you were taking Prozac since you should wait at least 5 weeks to 8 weeks after completely off to make sure all Prozac is out of your system. If not it could lead to serotonin syndrome. That is a down side of Prozac, the leaving the system so slow. Other SSRIs you could do it in a week or two.

If you do switch just research it and make sure you do it safely! Since the docs tried to play with my meds and switch things up and sending me to the hospital twice I make sure I pull any med they think about inside out researching it first, one of many reasons I hate meds...

And a tid-bit of info not related to what you asked but may be good to keep in mind. Antihistimine cyproheptadine (Periactin) can reverse the effects of SSRIs. A cough suppressant in many over the counter meds, dextromethorphan, has been reported to cause hallucinations if combined with Prozac, and could be possible with any SSRI.
 
Thanks for the info! Will discus options with the doc on Friday. Just got to make it til then! Seriously considering going off sick, cos I feel like crap (more than usual).
 
Piglet, I have no doubt your getting worse, because all this while, you've had no time to actively heal from your past, and all your past is doing is building up new issues now with work, accommodation, finances, etc etc...

I could see long ago that your within dangerous territory, though this employer of yours is certainly making the process much more painful than it need be. If only they knew.... they might make a persons life a bit easier from such trivial aspects of employment in the overall scheme of things.

You hold on and take care of you hey. Please be very careful with med changes, because doctors use patients for trial and error, much of which has already been done and documented, as veiled has outlined from cases already. They still continue to play with patients to see if something changes or other approach works. Not their life, so they don't feel the outcome of their mistakes.
 
Hey everyone speaking of meds.

When I went off Prozack I locked myself in a room for three days becuse I was stark raven mad......But I could not stand it while I was on It.Paxal Ithink thats how you spell it had horible side affects.Sex sucked while I was on that.Lexipro was the best one I have ever been on.But mined you I had to take 20mgs a day.I went cold turkey off of that becuse I kno longer have a docter. Now I am taking a sumplament and love it so far.It makes me hyper
and that can't be bad.Still have to take sleeping pills for my night terrors.But hey what can I say at least I found a solution for a while.Still looking for a doc.The other one moved away.

I have a burning question....Why do some couples team up to rape and kill there children?
 
We all could ask a thousand whys. One thing that has to be accepted to heal is why doesn't really matter anymore. It happens and you have to go from there. If you sit and dwell on why you will be there a long time as there is no answer to how some minds work. Drugs, idiots, and insanity are the easy answers but you still get left with more whys.

I know I have asked why a thousand times, I just had to accept I won't know why, I just know why I developed PTSD. Now I have to address that and learn to control the symptoms. It is hard to move past why, but it can be done.
 
And the winner is......

After consulting a drugs book, My GP has changed my prescription to Zoloft. I'll let you know how the change goes. I have to stop the prozac and then start the zoloft after the weekend.
 
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