Prozac works just has good on 20mg as 40mg so why take the hike to side effects , OCD that's a hole new ball game Prozac at 60mg is used and luvox at even higher. I took Prozac for years at 20 mg and tried 40mg I few time but made me hungry ands sexless , I soon swooped back down to the magic 20mg . But I was taking it on its own I have never been given a combo in England not used unless scits , you get a mood stabilizer with an ad if bipolar but only 1