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Anxiety and Stress Disorders

Prozac for OCD

08/08/2007

Question:

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.

Answer:

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.

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Response by:

Nicholas A Votolato, RPh BCPP Nicholas A Votolato, RPh BCPP
Assistant Professor of Pharmacy
College of Pharmacy
Assistant Professor of Psychiatry, Emeritus
College of Medicine
The Ohio State University