Prozac

[awc]

Sorry. First time on this forum so not sure how it works. Have already posted this as 'reply' to other medication-related posts, but also here as a new one. Could see how to search past posts for topics. Anyway...

With reference to Prozac, I've been on 20mg for just over 6 months. Its definitely made me able to engage with CBT treatment more effectively but there is a lot of underlying anxiety / adrenaline and intrusive thoughts can still be pretty bad.  I am seeing my GP Friday because although i don't take medication lightly or particularly willingly, I am not sure 20mg is enough to be of real benefit. Any thoughts...? Thanks

[taurean]

  Hi awc, welcome. 

As I posted on another thread  from consultation a few years ago with my psychiatrist :

  On 18/01/2019 at 10:40, taurean said:

What I learned from the psychiatrist was she said one needs to be on at least 40mg per day for it to have an effect for her OCD patients, presumably udging from her observations of her patients.

This may be an indicator awc. 

But we all react differently to meds which does make things difficult. 

[awc]

Thanks. Really appreciate the advice. 

A

[dksea]

Hey AWC, welcome to the forums.  I used Prozac for about the first 10 years of my now 25 year OCD journey.  During that time my dosage went up and down quite a few times based on my symptoms and other life situations.  In my case there were little to no side effects so it wasn't an issue.  Hopefully that would be the same for you.  However, as Tauren points out, when it comes to OCD meds we all react differently.  You won't know how effective it is until you try.  Its also worth notting that, in general SSRI dosage for OCD tends to be higher than dosage for Depression.  40mg is the middle range dosage level for Prozac, so it would  not be at all surprising if you need to go a little higher to get maximum benefit.  If you are able to tolerate a higher dosage level and it helps you lead a better life, seems like it would be worth exploring.  Most likely you'd increase incrementally and see how things go, you probably wouldn't jump to 40 mg right away, possibly going to 25 or 30 depending on what your doctor believes is best.

As another personal example, i'm currently taking Lexapro.  Last year, after things had been going well for a long time, my doctor and I decided to try a lower dosage and we went down 5 mg.  Things continued to go well so 9 months ago we went down another 5mg.  Unfortunately over the next few months my anxiety and OCD symptoms began to increase, slowly at first and then noticeably.  After awhile it became noticeable and problematic enough that we decided to go back up by 5mg.  Since then things have settled back in to normal.  So for me, for whatever reason that dosage level was the right one.  Going lower just wasn't quite enough.  Dialing in that ideal dosage is just trial and error unfortunately.  And it may change over time.  Maybe in the future I will be fine on a lower dosage or maybe life stresses will contribute to needing a higher dose for awhile.  The thing is to be aware of your own situation and work together with your doctor to do whats best for your own well being.  And of course, do the CBT work, thats the most important overall!

[awc]

Thanks for taking the time to reply. Your point about keeping up the CBT is so important.