Q. I have been suffering with Major Depression and Compulsive Overeating for many years. The depression has been determined to be chemical although I am working through issues in therapy. Who really knows about the eating problem but it is a significant part of my problem. I also have a terrible time making decisions and therefore obsess in my head a lot of the time. I also change me mind all the time and go from one extreme to the other. I've been on Prozac for 10 years on and off. I've tried other things but Prozac has been the most effective. I was on 60 mgs. The problem is that it stops working on the obsessive part of my problem which then triggers my depression. I was recently changed to Effexor 150 mgs. It's not working well on the eating part either but seems to be helping a little bit with the depression. I am so confused. Do you have any suggestions or combinations that have proved to be effective?
A. Your problem does indeed sound very medical - although like all medical problems, it can be aggravated by previous traumas and issues.
It sounds like you may have a number of diagnoses. The OCPD - which I believe is a medical problem treated by high doses of SSRI's (especially Prozac) and generalized anxiety disorder are diagnoses that should be looked at. Almost all the time when someone feels Prozac "stopped working" it's really something else going on, most commonly chronic dysphoria with the BPD. The addition of Tegretol can be amazing if that's the problem.