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Tuesday, January 27, 2015
Anxiety and Stress Disorders
Prozac for OCD
I have a question. I am new to this site. I had been on Prozac for about 9 years and it was wonderful. It almost totally alleviated all of my OCD symptoms. Well, I was incredibly stupid and thought I no longer needed medication and weaned off of Prozac last October. Needless to say, my OCD came back full force (worse this time around) in March of this year. I honestly thought I was going to die. Well, after a try on Lexapro which made me tired and more depressed I went back on Prozac. I started on 20 mg eight weeks ago, went up to 40 mg six weeks ago, and now have been on 60 mg for 2 1/2 weeks. The last time I was on Prozac 40 mg the entire time. Well, I am really scared. Sometimes I feel like I am feeling better and at other times I feel awful. I know increasing the dose brings increased anxiety, etc., but should I wait with the 60 mg for an extended period of time or do you think Prozac is not working for me this time? I want this to work again so badly. I know the meds work because it worked for 9 years. I also know I can feel better because I did feel great. Please help me.
As the evidence shows, in general Prozac is effective in OCD. The dose that is required is less clear. There is evidence that it may take a longer period of time than the 2 1/2 weeks before you see the expected benefit. If side effects are getting in the way, work with your physician to see if the lower dose for a longer period time would be helpful. If you are doing reasonably well on 60mg, stay the course and try not to be too discouraged. It is still early even with a previous response. I also never underestimate the usefulness of behavior therapy as an adjunct to the Prozac. This can also be discussed with your physician.
Nicholas A Votolato, RPh BCPP
Assistant Professor of Pharmacy
College of Pharmacy
Assistant Professor of Psychiatry, Emeritus
College of Medicine
The Ohio State University