Prozac alone for severe panic/anxiety

[LolaS]

Have had anxiety for over 2 decades. 6 months ago, I developed constant panic. From morning to night, I have a racing mind, chills, hot flashes, have no appetite, vomit at least once a day and can't concentrate at school or work. Did all tests (blood work, etc) and nothing was found.

Went to see psychiatrist a 5 weeks ago who put me on 5 mg of Prozac for 2 weeks, then 10 mg for a week and 20 mg for 2 weeks now. I also take .25 Klonopin 4 times a day. None of this has had an effect on above panic state at all. Now, he wants to add Zyprexa (anti-psychotic) to the mix and up me to 40 mg of Prozac. I am scared of the Zyprexa. I'm not psychotic and I have a family history of diabetes.

My question is if anyone has had success with only Prozac for severe anxiety? I'm ok with a higher does of Prozac and getting off the klonopin like the doc wants, but I want to avoid Zyprexa if possible. If you have taken Prozac in combination with some drug, which one was it? Also, what dosages?

[Bike Rider]

Hi LolaS, I am on Fluoxetine (Prozac) and have been for about 5-6 weeks at 20mg, I have had no bad side effects and now I think it is starting to kick in and do its job, I hope.

It is a slow acting med and takes time to work and you have only been on it for 5 weeks building up to 20mg, so give it a bit longer to see what happens.

[Mermaid16]

Hi Lola! I don't take Prozac, but take other anti depressants. I have been taking Olanzapine 2.5mg at night for just under a month. I take it also for severe anxiety. I am writing to tell you of my experience with it. The term antipsychotic is scary. When I was first prescribed, I didn't take it for at least a week. I went back to the psych complaining how bad the anxiety was and he said to take the olanzapine. I was so scared to start that he said I can sit in the waiting room and take it, if I wanted to. Of course I didn't though. I have had mixed results with it. Some nights I can take it and I feel calm wash over me within an hour and it is a pleasant feeling. Some nights I can take it and if I have been worked up before hand, it does absolutely nothing. I might feel tired, but still panicky. The main thing I don't like about it, is that the next day, my anxiety is still there. Then I don't really see the point in taking it. I have booked another psych appointment for a second opinion (it has taken me about 6 weeks on the waiting list). So I am going to see what this one suggests. I feel that I am over medicated and that is causing problems. I take four meds and the old doc added another one to it last week, which I haven't taken as yet, because I think it is too much. My situation is probably very different to yours, but thought I would give you some advice so you can make an informed decision. I take Valium also and the antipsychotic is probably put in there so you can reduce the klonopin. I guess it comes down to how much you can bear the anxiety. If you can get through with the Klonopin and Prozac, then I think that is a great option, otherwise you may have to consider the Olanzapine. There is a Forman on here that will give you some info on it. Good luck with everything. Tracy xx

[PunkyFish]

Have had anxiety for over 2 decades. 6 months ago, I developed constant panic. From morning to night, I have a racing mind, chills, hot flashes, have no appetite, vomit at least once a day and can't concentrate at school or work. Did all tests (blood work, etc) and nothing was found.

Went to see psychiatrist a 5 weeks ago who put me on 5 mg of Prozac for 2 weeks, then 10 mg for a week and 20 mg for 2 weeks now. I also take .25 Klonopin 4 times a day. None of this has had an effect on above panic state at all. Now, he wants to add Zyprexa (anti-psychotic) to the mix and up me to 40 mg of Prozac. I am scared of the Zyprexa. I'm not psychotic and I have a family history of diabetes.

My question is if anyone has had success with only Prozac for severe anxiety? I'm ok with a higher does of Prozac and getting off the klonopin like the doc wants, but I want to avoid Zyprexa if possible. If you have taken Prozac in combination with some drug, which one was it? Also, what dosages?

I have taken Prozac for about three months now. First at 20mg and then about five weeks ago, my dosage was increased to 40mg. Before the Prozac I was a mess, my anxiety was sky high, my mind was racing with really stupid thoughts that I shouldn't of been worrying about, I could not function normally, I was crying a lot and had become depressed. I would say for me personally it took about two months for my anxiety to begin to lessen and my thinking pattern to turn into somewhat normal. The last two weeks or so my anxiety has been very low. I still do get anxious sometimes but I'm able to control it. People are always going to have a little bit anxiety in their lives but when it gets to a point where it effects your daily life and it becomes to much. I've gone from being a nervous wreak to a calm person, I can feel I can deal with things a lot better.

My doctor told me that it can take anywhere from 4-8 weeks for Prozac to take effect. It was only when my dosage was increased to 40mg that it began to help for the panic. In my first 4-6 weeks on the medication I was highly anxious on times and this is a common side effect. With this sort of medication you can sometimes get worse before you get better. It's defiantly best to have a chat to your doctor before you make any decision.

[Ronan23]

Would anyone recommend starting off with 10mg of Prozac? I've previously been put off SSRIs because well, they hit me like I've drank 20 cups of coffee at once.

[MyNameIsTerry]

Would anyone recommend starting off with 10mg of Prozac? I've previously been put off SSRIs because well, they hit me like I've drank 20 cups of coffee at once.

Yeah, you can start on any dose and work up. You are right to think this way if side effects are an issue, you are more likely to succeed getting on them.

My GP started me straight on the therapeutic dose of Citalopram and 2 days later it hit me really hard and he was calling the Crisis Team in. What many GP's do is start at half that dosage to ease people in.

What may be an issue for you is whether this med is licenced in your country at the dose required. If it is, it shouldn't be a problem but something to be aware of is that some manufacturers overcharge on the smallest dosages as they don't really want to sell them. That may put a doctor off.

If you can't get them at half the dose you require, you can split any pill with a score line down the middle as it means it's homogenised. Many pills without such lines can be split too, but you have to check into that. And never split a timed release pill as it can result in overdose, never split a capsule (it's likely there to prevent irritation in the throat or stomach so what's inside passes further first) and never split something with an enteric coating as that's needed to bypass the stomach.

I'm telling you all this because you mentioned you were in Thailand on the other thread and I have no idea what their policies are. In the UK our NHS don't have an official guidance policy on pill splitting so GP's are wary of it and prefer to work with manufacturer dosages but psychiatrists are fine splitting pills. Plus they do it in the US and in Germany anyway.

You could ask your doctor about the 10mg, it's a sensible idea. If that's even too harsh, the splitting option is another way to build up. Another member did this with Sertraline as she was very afraid to take meds and her GP went with even smaller dosages by splitting the pills just to get her going and it worked fine for her.

If you have a drug licencing body over there, it should list all licenced versions on there so you could check it out.