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Suggest Dosage For Prozac

Posted on Tue, 12 Sep 2017

Question: I love a long history of panic disorder. 4 months ago I had a major relapse. For more than 20 years I have been on 20 mg. of prozac. At times of relapse I would go to 40 and add something to sleep and a benzo for a while. This time the psychiatrist added ambien for sleep and klonopin, but did not change the prozac dosage. A month later my GP insisted I go back and change to an antidepressant that does not cause anxiety, he believed the prozac was contributing to my anxiety after 20 years. The psychiatrist change me to celexa. When the psychiatrist later tried to add effexor and risperdone I saught a 2nd opinion. The current psychiatrist maxed out the celexa at 40 mg. After a total of 11 weeks, 5 at 40mg it was clear the celexa was not helping. So 2 weeks ago i did a 4 day cross taper of 20 mg of celexa and 20 mg of prozac. I also did a genesight genetic test to determine which antidpressants are best for me. I got the results today that showed prozac among the best meds for me and celexa as much less effective. I've been on the 20 mg of prozac for 2 weeks along with klonopin 1.5 to 2 mg and ambien cr for sleep. Psychiatrist wants me to start 40 mg of prozac tomorrow. Do you feel this is too quick of an increase?

Answered by Dr. Alexander H. Sheppe (20 minutes later)

Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

An increase of Prozac from 20mg to 40mg is not too fast or too high. Prozac 20mg is a starter dose -- a therapeutic dose is normally 60mg or 80mg -- so this increase is appropriate in getting you closer to a therapeutic dose. Prozac is much more effective and safe than a benzo or Ambien, so this course of action is wise.

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Follow up: Dr. Alexander H. Sheppe (1 hour later)

Seems pretty quick. Just 2 weeks at 20 mg. for panic disorder. Have never had to go about 40. I know the klonopin and ambien are both much worse in the long run, just seems a quick jolt. I work full time and am afraid of additional panic attacks while working.

Answered by Dr. Alexander H. Sheppe (17 hours later)

Brief Answer:
Followup

Detailed Answer:
It is not a quick increase, this is standard and should not cause you any problems.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers

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Above answer was peer-reviewed by : Dr. Arnab Banerjee