QUESTION:
Dear Dr. Heller,
My psychotherapist has recommended I change from Prozac to Celexa, citing it works
faster (shorter half-life?) and would be better for deep depression. I will ask my
regular MD about it-I do not have a psychiatric MD. Thanks...
ANSWER:
I haven't found Celexa to be more effective than Prozac, in fact the opposite is
true. The short half life has nothing to do with effectiveness, and is more of a
hassle when you stop medication. Temporarily converting to Prozac is often
needed.
When I have a patient in a "deep depression" I always look for the BPD with chronic dysphoria (anxiety, rage, depression and
despair). This responds dramatically to Prozac, and if necessary the addition of
Tegretol a week later. The
screening test I use for my
patients will likely be of use to you in making all the medically treated diagnoses.