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Prescribed prozac to treat dysthymic disorder. Is it safe to take celexafor smaller dosage?

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have a case study for a class and I need help with an answer....
XXXXXXX is a 45-year-old female of average height and weight. Her family physician prescribed the SSRI anti-depressant medication Prozac to treat to her dysthymic disorder. Her initial dosage was 20 milligrams per day, which helped her somewhat. Two months ago, you and her family physician agreed that she should increase her dosage level to 40 milligrams per day. She has taken 40 milligrams for 2 months, and her depressive symptoms have completed subsided.

While in the waiting room of her family physician, XXXXXXX learns that another patient, XXXXXXX is taking Celexa, which is also an SSRI anti-depressant medication. XXXXXXX is nearly twice Jane's size and several inches taller, but only needs 20 milligrams of his medication per day. XXXXXXX decides she wants to change her medication to Celexa so that she can take a smaller dosage.

Which of the four aspects-absorption, distribution, biotransformation, or excretion-Jane is experiencing?

Posted Mon, 6 Aug 2012 in Mental Health
Answered by Dr. Ashish Mittal 1 hour later
Thanks for your query.

I understand your concerns. Choice of medicne in this case depend on factors other than absorption, distribution, biotransformation, or excretion.

Following information will help you in understanding of this case:
-Although both celexa and prozac are SSRI but they are different medicines and so their dose is not same.
-Prozac effective dose range is 20-80mg per day. Celexa effective dose range is 10-20mg per day. So, roughly celexa 20 mg is equivalent to 80 mg of prozac.
-Apart from that every person do not respond to SSRI. Response rate is usually 60-70%. So, it is not good to change SSRI on which you have responded.
-Choice of medicine is a complex decision and depend on many factors like: Illness, symptoms profile, weight, other medical morbidities, history of treatment response, mental status examination of patient, tolerability of medicine and side effect profile of medicine.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
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