Question:
I have been on Prozac for over two years now and have done exceptionally well, except that I required high doses. I not only have major depression with borderline personality disorder but also obsessive compulsive disorder.
When I reached the 60 mg level of Prozac, there was notable change. At 80 mg I was like a totally new person. However, after about a year at 80 mg I suffered a relapse and my dosage was bumped up to 100 mg. again with good success. I have been on 120 mg. of Prozac for the last 8 months and just recently suffered a serious relapse in my depression and other symptoms. I have been taking 140 mg of Prozac for a week and finally the intrusive suicidal thoughts are disappearing. I have also read that some patients do require high dose treatment and can successfully be treated on doses as a high as 200 mg. per day (divided doses throughout the day).
I have been searching for more information on high dose Prozac and it is difficult to find. If you have any information or can direct me to articles which deal with the use of high doses of Prozac, I would greatly appreciate it. I do not ever want to be taken off Prozac. It took me 12 years to get to this point and I tried many other types of antidepressants. Prozac worked a miracle for me.
Thank you for reading this.
Dr. Heller's Answer:
As you’ve experienced, 80-100mg of Prozac usually does miracles for those with the BPD combined with obsessive compulsive disorders.
The suicidal symptoms you’ve described are likely due to BPD dysphoria (anxiety, rage, depression and despair). Prozac reduces the frequency of dysphoria episodes but not their severity. The addition of Tegretol 200mg should be a miracle 3 hours later. If not, you may need a 3mg dose of Risperdal to get you out of your dysphoric spell.
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