While there are no systematic studies to answer the question of how long to continue fluoxetine treatment, OCD is a chronic condition and it is reasonable to consider continuation beyond 10 weeks in responding patients.
Dosage adjustments should be made carefully on an individual patient basis, to maintain the patient at the lowest effective dose. The need for treatment should be reassessed periodically. Some clinicians advocate concomitant behavioural psychotherapy for patients who have done well on pharmacotherapy.
Long-term efficacy more than 24 weeks has not been demonstrated in OCD. Adults and the elderly: Long-term efficacy more than 3 months has not been demonstrated in bulimia nervosa.
The recommended dose may be increased or decreased. Paediatric population - Children and adolescents aged 8 years and above Moderate to severe major depressive episode Treatment should be initiated and monitored under specialist supervision.
Dose adjustments should be made carefully, on an individual basis, to maintain the patient at the lowest effective dose. Clinical trial experience with daily doses greater than 20mg is minimal. There is only limited data on treatment beyond 9 weeks. Due to higher plasma levels in lower-weight children, the therapeutic effect may be achieved with lower doses see section 5. For paediatric patients who respond to treatment, the need for continued treatment after 6 months should be reviewed.
If no clinical benefit is achieved within 9 weeks, treatment should be reconsidered. Elderly patients Caution is recommended when increasing the dose, and the daily dose should generally not exceed 40mg. Hepatic impairment A lower or less frequent dose e. Abrupt discontinuation should be avoided. When stopping treatment with PROZAC the dose should be gradually reduced over a period of at least one to two weeks in order to reduce the risk of withdrawal reactions see sections 4. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered.
Subsequently, the physician may continue decreasing the dose, but at a more gradual rate. Method of administration For oral administration. Fluoxetine may be administered as a single or divided dose, during or between meals. When dosing is stopped, active drug substances will persist in the body for weeks. This should be borne in mind when starting or stopping treatment. The capsule and oral solution forms are bioequivalent.
Fluoxetine is contra-indicated in combination with irreversible, non-selective monoamine oxidase inhibitors e. Fluoxetine is contra-indicated in combination with metoprolol used in cardiac failure see section 4. PROZAC should only be used in children and adolescents aged 8 to 18 years for the treatment of moderate to severe major depressive episodes and it should not be used in other indications.
If, based on clinical need, a decision to treat is nevertheless taken, the patient should be carefully monitored for the appearance of suicidal symptoms. In addition, only limited evidence is available concerning long-term effect on safety in children and adolescents, including effects on growth, sexual maturation and cognitive, emotional and behavioural developments see section 5. Every little job has felt like one big chore.
On top of all this I have an overactive bladder with lots of pain. Also a hiatus hernia. After reading lots of articles about the side effects of steroids I now feel certain that they have contributed to these problems.
I have an appointment with my GP in just over a weeks time and I feel so tempted to give in and go back on steroids. I know I will be like my normal self after a few days of taking them. However after reading all the comments on this forum I am going to try and resist. My GP knows how much I hate them but does not suggest an alternative.
She just says that steroids are the only thing that works for PMA. Does anyone have any other other suggestions that may work? All suggestions gratefully received folks! Reply Link Cathryn April 22, , It makes me very angry that these drugs are prescribed so wantonly because the body struggles so hard to get over it.
The interesting fact is that your cortisol level is probably fine and your adrenal system is probably working normally. However, the body physically craves the drug, in spite of this. What we need to hear is that those of us who have gotten off the drug and are finally symptom free, must communicate this to this site so we have hope. Reply Link EJ April 19, , 3: I cannot tolerate any of the many prescription medications out there for arthritis…the only thing that worked was Prednisone.
My last 1 mg dose was one week ago, after three years of being on Prednisone therapy. Everything from horrid all-body pain, weakness, and stiffness to upset stomach; lower digestive issues; headaches; dizziness; general tiredness; and sleeplessness have plagued me. For sleep, I find that a good dose 2 pills of Tylenol PM really knocks me out and I can get several hours of needed sleep.
I am delighted to find this website and read all the similar stories to mine. At least I know that I have plenty of company in my misery! Reply Link Cathryn April 17, , It does help to know that I am not alone. Reply Link Andy April 18, , 1: I was a smoker for several years and quitting smoking was by far easier.
The pain is back, the tiredness renders me completely ineffective at work. I feel like I can sleep for days on end. I am moody, achy, tired, headaches, etc. I tried explaining this to my Rheumatologist, and he treats me like I am being over sensitive. In any case, a colleague at work has been on a low dose 2. After 3 attempts to ween off I would get to 3mgs and flare up again. So far I have been okay on 3 mgs. Going down to 2 mgs tomorrow but I have been having awful headaches.
I also have not handled the weight gain very well. I just want to be off these steroids. Reply Link Bonnie April 18, , 6: I started on 80mg in Nov and have been able to taper down to I was hoping the fluid retention and weight gain would go away when I got below 15mg per day.
Reply Link Cathryn April 18, , Please do it slowly or there will be a rebound effect. There are clinics for opiate withdrawal but not for prednisone. It means more slowly of course but it will make the withdrawal easier! Was on prednisone for a year for PMR. After 6 months, the side effects started — severe nausea, dry heaves, terrible anxiety. Tapered off by the end of last month, and now struggling with withdrawal, esp.
My meds manage it but starting about 1 am, I am up and down due to the anxiety. The meds help a little but not enough to put me back to sleep.
Given my extreme symptoms, going to ask my GP for a referral to an endocrinologist. Reply Link mary April 11, , 5: My last dose was March 16th. I have not slept since March 20th and today is April 11th. I requested Clonazepam 0. I was on Mirtazapine 10 years ago for insomnia it took forever to help get me to sleep and it also created a lot of lower back pain.
My doctor and pharmacist feel certain that my insomnia is a result of the prednisone. I am not sleeping at all. I really need some positive reinforcement from people out there who have gone weeks without no sleep because of prednisone.
Has anyone else gone without sleep for weeks like me? And how long was it before you returned to normal? Any positive thoughts would be helpful to me. Reply Link Rachel April 12, , 5: I would have to agree with your pharmacist and doctor that the Prednisone is probably causing your insomnia as I barely slept 6 hours a night when I was on the higher dosage.
Some nights, in order to get to sleep, I would drink some Sleepy Time Tea which sorta helped me unwind and fall asleep. Drinking the tea helped most nights and some other nights it took me a little bit longer.
I also found that going for a walk outside and doing some yoga sometimes helped too. It seemed that the more I tired myself out physically, the easier it was to calm down mentally and get to sleep. It does sound like the Prednisone is still playing havoc with your sleep, however; I do know that it does take time to get it all out of your system especially at such a high dosage.
I wonder if the doctor would allow you to take something a little bit safer like Melatonin if nothing else works? Reply Link Cathryn April 13, , 1: I have never been a good sleeper but once on prednisone, I was wired so tightly. This was 8 years ago. My Doctor put me on Ativan and no I am not advising it, for now I am also going through the withdrawing of Ativan.
It will take 6 weeks and it is not bad at all compared to the prednisone withdrawal. It was great at the time for like you I was a zombie. I was so relieved to have any sleep. In Canada they do.
I wish you luck, for it is difficult journey. Reply Link Holly Robinson April 17, , 1: I developed terrible anxiety and barely hung on. Finally my GP described doxepin for sleeping, which helps. My anxiety kicks in about 1 am and meds helps some but I am up and down til I finally get up. I tapered off at the end of last month and withdrawal for me has been as bad as the side effects, esp.
Reply Link Monica May 3, , 1: I was also given 50mg prednisone for about 8 days for asthma problems no taper. My blood pressure keeps going up and down and I have horrible heartburn.
Can you tell me how you feel now and if any symptoms have subsided? For 25 years i was suffering depression and battled through it by myself not fully enjoying myself or finding life satisfying. Im 45 now and when i first started to take Prozac i didnt know what to expect. At first even two days into taking it i felt better with increased energy levels and generally felt better. Without studying the side effects i noticed numbness of thought detached at times really but i found this relaxing and beneficial.
Members of my family take it and said i was imagining it and that it didnt work that quick,now i know it can and that each person reacts differently to it.
I have had slight tremers in my jaw and experienced slight anxiety after taking it. All in all a price worth taking it has helped me personaly no end.
There is one thing that i would say and recommend though and that is Dont Drink! Ive had to almost give up alcohol and this is one thing i was not keen on if im honest. If i wanted a drink one evening i would not take a pill that day and so far thats been fine.
With alcohol and prozac it made me a bit manic and aggresive so beware. At first i tried to drink a couple of cans,but i found especially at night i would have violent dreams. My partner was quite alarmed as you would expect so now i wont drink at all. I hope the violent dreams will stop now that drinking alcohol with it has ceased. I will let you know how i get on Reading the experiences of peoples reactions to Prozac has been useful and i hope mine have been too. Caroline at June 14, 4: People tend to do good at low doses and then their doctor gives them a higher dose and it screws them up.
I think when my doctor tries to increase my dosage I'll ask him if we can limit it to 20mg. I am a mother of a 2. I had extreme depression for a very long time after my first child that started after she was a year old. She is a "high needs child" who was very attached to nursing every 2 hrs and she neer slept. I was very sleep deprived and extremely depressed and anxious. So much so, that I was always worried that I would snap and hurt her, especially because my husband travels days a week and if I was in any kind of negative mindset, no one would be there to stop me.
I would never have thought about hurting my child, but I could understand what other mothers were thinking when they snapped. I didn't tell my OB bc I was ashamed and bc I was afraid of the side effects of medication. It wasn't until months later after I worked through it alone, that I told her about it.
So, for this pregnancy, she was much more attentive to my mood and observed that I should probably start a low dose of 10mg per day while pregnant. I have been taking it for a little over 2 months and it has definately helped with both depression and anxiety.
I am not numb, but I can pick my battles and have realized that not everything is such a big deal and end of the world. My newborn is 4 weeks now and I am still primarily home alone with her and my high needs toddler, but I am still able to cope with the 2 hr tantrums and keep calm. I am grateful that it has helped and hope it continues to. I did it not only for myself but mainly for the wellbeing of my children. I can already see the effects that it had on my first child.
Giba at July 23, 3: Most thought I was bipolar or malnourished or depressed Or anything else they could think off. Prozac is the first medicine that has worked on me wo Major side effects.
I take it in the morning That way I'm ready to sleep my 9 or 10p. It has changed my life for the better. Evans at July 26, I dont know if the negative emotions are better than none at all Posted by: The effects were fantastic. I felt like I'm reborn. Then he prescribed me 40 mg flunil with migrabeta-tr and zapiz Then everything went downhill. I took the increased dose for around five months before I stopped it myself.
I couldn't do anything and felt very powerless. I became more depressed because of my inactivity then. I got overweight because of eating and sleeping. My rage came out of nowhere. I completely lost my erection. Now it gets better only sporadically!
Fluoxetine has a longer half life they say, but it still freaked me out when I withdrew from it. I now consider myself at the verge of cutting loose of my rage at any time.
Also the depression symptoms keep coming back. Now I have traces of all the side effects mentioned above. But don't go by my saying so, see for yourself. One piece of advice: Get rid of the reason that got you depressed or anxious in the first place because till the time it's not dealt with, there will be a relapse with all your problems no matter what pill you pop Since about 2 months ago, he began sleeping constantly and is laying here right next to me sleeping again after sleeping most of the day today too.
He is still depressed like he was before the prozac. Laura at September 16, 7: It has given me horrible diarreha. I called my doctor today and he is switching me to Prozac! Kathy at September 26, 3: Will it go away? I have to work and cant afford to be this tired Posted by: Heather at October 7, 7: It works really well for me. I'd never swap to another antidepressant.
SSRI's are not an exact science and what works for one person doesn't work for another. I had a nervous breakdown during my first year of uni four years ago.
I was put on effexor and hated every minute. For three months I was manic and paranoid. The withdrawal took forever and was hell on earth. Prozac is a dream compared to effexor. The only thing it does to me is give me upset stomach but I can cope with this.
I started it two weeks ago and it seems to have started working. I've been on and off it now for about 2 years. I'm on 40mg at the moment but think I may drop soon. I feel really happy on it. Therefore, until we learn more, the idea is to take it in the minimum effective dosage and to avoid its prolonged continuous use. I tell my patients to take frequent breaks the frequency and length of breaks varies since each person is unique.
One of its shortcomings of is that it may, in many individuals, not have a consistent effect. This may depend on the time of day it is taken, with or without food, other supplements taken at the same time, the dosage, etc. I have been asked about 5HTP spray that is supposed to be sprayed sublingually.
There are also 5HTP lozenges dissolvable sublingually. I don't have much experience with the use of a spray or lozenge. I read about 5-HTP on your site. I have read elsewhere that you have to take a B complex vitamin with it.
Would a mg B complex be all right? I only would like to take 5-HTP at 50 mg per day. There is no need to take additional B vitamins while taking 5-hydroxytryptophan pills. Safety and toxicity, is there a danger? High doses are toxic I am aware of one instance, thus far, of a toxic, serious, adverse effect. However, in February I met an emergency room doctor who works in Los Angeles and he told me about a patient he had recently treated in the ER.
A male in his late 30s bought 5-htp from Bulk Supplements company. It was in bulk, powder form and the label suggested 50 to mg daily. Apparently the patient took, by mistake, about teaspoon of it the exact amount is not clear which could have been a dose of to mg. He was brought to the ER by his wife after he went delusional, had nausea, diarrhea, hallucinations, and loss of memory.
It took 4 days in the hospital before he returned back to normal. I am disturbed that this potent substance made by Bulk Supplements is sold in powder form in such a way that it would be easy for such an overdose to occur. Some natural products are best sold in a fixed capsule amount in order to avoid such an occurrence.
I suggested that the ER doctor contact the company to let them know of this unfortunate event that could have been easily prevented. The use of L-Tryptophan as a dietary supplement was discontinued in due to an outbreak of eosinophilia-myalgia syndrome EMS that was traced to a contaminated synthetic L-Tryptophan from a single manufacturer.
Because of its chemical and biochemical relationship to L-Tryptophan, 5-HTP has been under vigilance by consumers, industry, academia and government for its safety. However, no definitive cases of toxicity have emerged despite the worldwide usage for the last 20 years. Extensive analyses of several sources of 5-HTP have shown no toxic contaminants similar to those associated with L-Tryptophan.
Use with alcohol Small amounts of wine or other alcohol are not expected to interfere with its benefits. Short term 5-HTP side effects, risks, safety and caution, danger 5-HTP side effects from high doses which could be 70 to mg and greater include nausea and vomiting, stomach cramps, nightmares, and decreased sex drive. Tiredness and sleepiness can occur after several days or weeks of use which may indicate that a break should be taken.
Blood pressure, hypertension Q. I just watched your YouTube video on 5 htp and have a question. I have heard it can raise your blood pressure. Of course the web is full of all this back and forth.
My bp is slightly elevated but i am on meds for it. My doctor doesn't seem to know much on natural ways. Do you know if it raises bp?
I am not aware of its use having a strong influence on blood pressure. Nightmares and vivid dreams 5 HTP enhances dreams and makes them more vivid which can be good or bad. Use less than 50 mg in the evening to avoid or reduce nightmares.
Low libido and interest Serotonin has an inhibitory effect on sexual behavior. Therefore one of the common 5 HTP side effects is decreased libido. This can be reversed when you stop its use. If you wish to enhance the low libido once you are off the supplement, Passion Rx or other sexual herbs can work well for this purpose.
Kidney or liver influence I am not sure what kind of influence 5HTP has on liver and kidney health. Long term side effects, risks, caution, danger Long term side effects are not fully known. When hundreds of thousands of people start taking a supplement that has not had adequate long-term testing, there may be some individuals who have a biochemical abnormality in metabolizing the nutrient that was previously not known.
We don't know the consequences on the immune system, skin, and other tissues of long-term therapy. Heart valve issue I have not seen any studies or reports regarding the use of 5-HTP and influence, if any, on heart valves. However, as time passes and no reports of such heart valve problems are mentioned in medical journals, I am becoming more assured that this supplement does not damage the heart.
Addiction Thus far we have not had any reports of addiction, people seem to stop and go as needed. Alcohol, wine Alcohol is a drug that has unpredictable effects when combined with certain herbs, nutrients, and medicines.
A small amount of alcohol, such as an ounce or two of wine, should not be a danger with a 5-HTP supplement, but we caution against drinking too much. Breast feeding The safety of 5-HTP during lactation and breast feeding is not known. Occasional use by a mother is probably safe. Children, use by a child, adolescents This nutrient can be used by a child but we suggest using the lowest dosage with frequent times off.
Some short term studies have been done showing benefits, but I could not find long term trials My son is 13 years old and has OCD and high anxiety. I take 5-Htp for basically the same thing and I was wondering if it is safe to give a 13 year old teenager? If used at all it is probably best that it be done under medical supervision and only for brief periods and in dosages of 10 to 50 mg depending on weight. Emails I have been giving my 8-year old son 50 mg 5-HTP for the past year.
It was preferable to Prozac that the physician wanted to prescribe. There was a noticeable improvement in his behavior within 2 weeks. For the past 6 months I have given him 25 mg combined with several other natural stress relieving and mood lifting herbs i. John's wort with his morning meal. Suicidal Thoughts And Behaviors In Children, Adolescents, And Young Adults Patients, their families, and their caregivers should be encouraged to be alert to the emergence of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia psychomotor restlessness , hypomania, mania, other unusual changes in behavior, worsening of depression, and suicidal ideation, especially early during antidepressant treatment and when the dose is adjusted up or down.
Families and caregivers of patients should be advised to look for the emergence of such symptoms on a day-to-day basis, since changes may be abrupt.
Serotonin Syndrome Patients should be cautioned about the risk of serotonin syndrome with the concomitant use of PROZAC and other serotonergic agents including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, and St.
Patients should be advised of the signs and symptoms associated with serotonin syndrome that may include mental status changes e. Patients should be cautioned to seek medical care immediately if they experience these symptoms. Patients should also be advised of the signs and symptoms associated with a severe allergic reaction, including swelling of the face, eyes, or mouth, or have trouble breathing.
Patients should be advised to call their doctor if they experience any increased or unusual bruising or bleeding while taking PROZAC. Angle-Closure Glaucoma Patients should be advised that taking Prozac can cause mild pupillary dilation, which in susceptible individuals, can lead to an episode of angle-closure glaucoma. Pre-existing glaucoma is almost always open-angle glaucoma because angle-closure glaucoma, when diagnosed, can be treated definitively with iridectomy.
Open-angle glaucoma is not a risk factor for angle-closure glaucoma. Patients may wish to be examined to determine whether they are susceptible to angle closure, and have a prophylactic procedure e.
Signs and symptoms of hyponatremia include headache, difficulty concentrating, memory impairment, confusion, weakness, and unsteadiness, which may lead to falls. Use Of Concomitant Medications Patients should be advised to inform their physician if they are taking, or plan to take, any prescription medication, including Symbyax, Sarafem , or over-the-counter drugs, including herbal supplements or alcohol.
Patients should also be advised to inform their physicians if they plan to discontinue any medications they are taking while on PROZAC.
Use In Specific Populations Pregnancy Patients should be advised to notify their physician if they become pregnant or intend to become pregnant during therapy. Prozac should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus [see Use In Specific Populations].
Nursing Mothers Patients should be advised to notify their physician if they intend to breast-feed an infant during therapy. Limited evidence is available concerning the longer-term effects of fluoxetine on the development and maturation of children and adolescent patients.
Height and weight should be monitored periodically in pediatric patients receiving fluoxetine. Mutagenicity Fluoxetine and norfluoxetine have been shown to have no genotoxic effects based on the following assays: Impairment Of Fertility Two fertility studies conducted in adult rats at doses of up to 7. However, adverse effects on fertility were seen when juvenile rats were treated with fluoxetine [see Use In Specific Populations].
All pregnancies have a background risk of birth defects , loss, or other adverse outcome regardless of drug exposure. Treatment Of Pregnant Women During The First Trimester There are no adequate and well-controlled clinical studies on the use of fluoxetine in pregnant women.
Results of a number of published epidemiological studies assessing the risk of fluoxetine exposure during the first trimester of pregnancy have demonstrated inconsistent results. More than 10 cohort studies and case-control studies failed to demonstrate an increased risk for congenital malformations overall.
There was no specific pattern of cardiovascular malformations. Overall, however, a causal relationship has not been established. Such complications can arise immediately upon delivery. Reported clinical findings have included respiratory distress, cyanosis , apnea , seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia, hypotonia , hypertonia , hyperreflexia, tremor, jitteriness, irritability, and constant crying.
© Copyright 2017 Prozac for weight loss 40mg *** Did anyone on prozac experience weight loss, and is that go away with time?.