Meds switch

This may get confusing, so please bear with me.

In a dilemma here. My prozac (20 mg.) has stopped working as effectively as it was at first (been on it for 5 months) and when I visited my doc yesterday for check-up, I told her this and that I have been having trouble sleeping. Also about my major stress/panic incidences since quitting smoking. So she asks me if I want to try Zoloft and stop the Prozac. She also added Doxepin for insomnia. As far as I know these drugs interact with one another because they are different types of AD's....is mixing them safe????

I wonder why she didn't just up the dosage of Prozac instead of cutting it out completely. Argh! I am too afraid to stop the Prozac because it does work and with the Xanax at night it does help. I was able to take .25 in the morning and .25 at night and she says I can still do that in times of stress. I just don't understand ....

Am I going to have to wait another few weeks to feel the effects of the Zoloft because things were BAD I mean B-A-D bad before I started the Prozac. Maybe I'm being overly sensitive about the whole thing.

Anybody got an opinion on which meds are better? I know alot are on combinations.

I am currently taking Prozac 20mg. and Xanax .5 mg.

My doc changed that to Zoloft 50 mg, Xanax .5 mg and Doxepin 25 mg.

Opinions please...

Take care all,
Kimberly.

HI, KTP: I don't know much about various drug combinations. However, I do sympathize with anyone who has to undergo a switch of meds. Hang in there. You will probably get some good answers and information in this forum.

Adieu

Is the doc a family physician or therapist?
If you are concerned talked to the doctor, also talk to your pharmacist.

Your doctor probably didn't think upping the Prozac dose was a good idea, as you already had insomnia.

Luckily, Prozac is probably the easiest SSRI to withdraw from, as it has a lengthy half-life, but as you're going on an alternate SSRI, you don't have to be completely off Prozac before you start titrating up on the Zoloft. That should prevent you from feeling quite as vulnerable to relapse towards depression during the transition period.

That small dose of doxepin is quite safe, being only about 1/8 of the therapeutic dose. Doxepin and two other tricyclics (trimipramine and amitryptiline) have high sedative potential. The low dose is not a concern for serotonin syndrome.

An alternative to the tricyclic for sedation would be trazodone, but having used both for their actions against insomnia, I personally prefer the tricyclic.

Lar

Thanks Lar....

It always makes me feel better when you post your replies. You're so knowledgable and I trust what you have to say.

It eases my mind alot...so tomorrow we make the switch.

I just can't deal with this insomnia anymore. Even when I sleep, I feel like I'm working all the time. Never any rest.

Thanks for explaining about the Prozac. It does make alot of sense and I guess a switch is what is called for in this situation. I have GAD and I have read in several places that Prozac can actually worsen anxiety.

As always...thanks for the info...

Take care,
Kimberly.

Started new meds today. Had to wait until Saturday, and good thing I did because I am sleepyyyyyyyyyyyyy

Wish me luck!

Kimberly.

P.S. My head barely aches. This is new -- have had a terrible headache for weeks.

fyi.. its true. prozac has worsened my anxiety (im on 40mg)

(((((((((((((Kimberly)))))))))))

Wishing you the best on the new medication. I do know how difficult it can be to go off of a medication all the way when it was at one time working. I do hope that this will work out in the long run and possibally help you feel much better than you did.

I know for me, it is quite scary to stop taking a med out of fear of slipping down without it, only I have had some good effects in my past with the switch.

Take care and I do hope the Zoloft replacement will be a good thing for you and help with your insomnia and GAD.

Best Wishes,
Kris

Thanks (((((((KRIS))))))))

So far so good. It has helped tremendously with the anxiety. I do feel much better. I know that once this stuff levels out and my body adjusts it'll be a very good thing (keeping fingers crossed anyway)

The thing is now I'm exhausted all the time. It's sorta to the point where dang, if I wanted this I wouldn't take the meds at all! but I've been there before and I do know that it gets better.

Having some dizziness and headaches but the headaches started BEFORE the switch, so not sure about that. If all else fails, I think I'll discuss it with doc. She seemed mildly concerned since I have a history of blood clots (Pulmonary embolism in dec) and on Coumadin....

It is nice to know that you have support. You're a great friend.

Take care,
Kimberly.