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Re: back to Prozac maybe low dose » porkpiehat

Posted by Jay2112 on February 20, 2022, at 19:54:08

In reply to back to Prozac maybe low dose, posted by porkpiehat on February 18, 2022, at 12:10:31

> I was thinking about trying a low-dose of prozac. I took it in the 90's so I was taking either 20 or 40 mgs.
>
> I find celexa/lexapro less deadening but it makes me more prone to impulsive anger at low doses. Getting the dosing time is problematic too.
>
> Big question is how it will react with the Lamictal. The Celexa/lamictal combo seems to intensify side effects of both and create more compulsiveness.
>
> Also I used to get EXTREMELY suicidal if I had anything to drink on Prozac (especially the next day). Now this only tends to happen if I increase my klonopin dose or move some of it to the daytime.
>
> I'm reading that prozac definitely has a GABA response so I'm wondering if this is the same phenomenon. I don't want the suicidality to get worse.
>
> Anyway, just spitballing...Anyone have similar lamictal experience or a similar prozac vs celexa experience?
>
>
Hi porkpiehat,

Well, I have had much experience with Prozac, as well as Celexa. All I have to offer is my personal experience, but will try to add in additional thoughts. Do you have a diagnosis, or can you mention what symptoms are most prevalent for you? Do you have any problems with mania, in particular dysphoric, a 'dreadful' type of mania? You mention being suicidal...have you ever tried an antipsychotic?

From the literature, Prozac does seem to affect GABA at medium to high doses. I believe this is why Prozac was effective with me, at the 40-60mg dose level. I imagine, in your case in particular, alcohol may have severely curbed GABA levels, and left you with the high norepinephrine and serotonin levels Prozac produces, possibly causing your suicidal response. (IMHO,etc)

Celexa is very serotonin selective, much more than Prozac, and does not have any real effect on GABA, norepinephrine, or any other neurotransmitter. Lamictal, the NMDA agonist, may or may not produce a bit of a flattening effect in a combination with Celexa.

Possibly, try starting Prozac on its own, since you had a positive response before? IMHO, I would start at the 40mg dose that you responded to before, as it is the medium to higher doses that produce the GABA stimulation.

My *major* concern, of course, for caution is with your suicidality. IMHO, an antipsychotic that you have tried, and has reversed suicidal feelings would be best to have on hand. Mostly, though, getting medication advice from your pdoc about your suicidal feelings is most important.

Please be safe, whatever you do.

Jay


Humans punish themselves endlessly
for not being what they believe they should be.
-Don Miguel Ruiz-


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poster:Jay2112 thread:1118655
URL: http://www.dr-bob.org/babble/20220128/msgs/1118696.html