QUESTION:
Dear Dr. Heller,
I have been taking 20mg Prozac per day for the last eight years. For the first six years it was a "life saver", but over the past couple of years it does not seem to be working, and lately my depression seems worse. Can I increase the dosage? I did not have any side-effects from the 20mg.
ANSWER:
It depends on what your diagnoses are. If you have BPD (borderline personality
disorder) the addition of Tegretol will likely get you out of your depression in
approximately 3 hours. If you've lost your "zest for life" the addition of
Wellbutrin will bring your levels of noradrenaline and dopamine back into balance with the
higher serotonin levels from Prozac.
Raising the dose rarely works for simple major depression that has been stable for a long
time. If the BPD is present raising the dose can improve the unprovoked mood swings,
chronic anger, emptiness, boredom, emotional pain, rejection sensitivity and unhappiness.
Some people with what I call "fractured enjoyment" (f.k.a. "depressed
personality disorder") experience improvement with higher doses. Panic and obsessive
compulsive disorders can respond to higher doses as well.
