Taking 20mg citalopram with 10mg Prozac

[Gavjbrown]

Just wondered if anyone has any experience of taking the 2 together.

Basically the wife has been on citolapram 20mg for approx 2/3 years. She's been going through a difficult 8 months and due to citalopram only having a half life of 35 hours I'd rather her dose not be increased to 30mg.

Instead introducing 10mg Prozac that has a half life of between 7-9 days could possibly be better?. Also when she is at the point of tapering citalopram in the future, increasing Prozac and decreasing citalopram would possibly be easier to come off due to Prozac having one of the longest half life's.

And advice and thoughts guys.

Regards Gav

[Bigboyuk]

Hi Gav as with any meds prescribed we aren't drs I would run this by your Gp in the first instance! Even if the have been prescribed together still run this by your Gp Hope your wife improves and aboard to NMP Cheers

[panic_down_under]

She's been going through a difficult 8 months and due to citalopram only having a half life of 35 hours I'd rather her dose not be increased to 30mg.

Firstly, welcome to No More Panic, Gav

Why not? What difference do you think half-lives make?

Instead introducing 10mg Prozac that has a half life of between 7-9 days could possibly be better?.

I don't see how.

Also when she is at the point of tapering citalopram in the future, increasing Prozac and decreasing citalopram would possibly be easier to come off due to Prozac having one of the longest half life's.

It may do, but despite the impression given by Dr Google and even support groups like NMP, most people don't have a really difficult time quitting antidepressants. Anyway, your wife could switch completely to fluoxetine just before beginning to wean off meds, or now for that matter.

I can't see the point of taking two SSRIs at the same time, plus, as I understand it, NHS GPs couldn't prescribe them even if they wanted too, and not many would.

[Gavjbrown]

Well the half life makes a massive difference to withdraw effects when coming of them. Paroxetine has a half life of about 20-23 hours so in theory your beginning withdrawal everyday. . I can tell you it's a very lengthy process to come of it without withdrawal symptoms( over a year using liquid form).Totally awful compared to Prozac 7-9 days hl.

Thank you both for the welcome and wishes to the wife.

Regards Gav

---------- Post added at 20:53 ---------- Previous post was at 20:49 ----------

Try coming of paroxetine (seroxat) quickly. It's one of the worst and most surgeries won't subscribe it. There's also been court cases over it in the States.

[panic_down_under]

Well the half life makes a massive difference to withdraw effects when coming of them. Paroxetine has a half life of about 20-23 hours so in theory your beginning withdrawal everyday. . I can tell you it's a very lengthy process to come of it without withdrawal symptoms( over a year using liquid form).Totally awful compared to Prozac 7-9 days hl.

Yes, paroxetine is one of the two hardest antidepressants to discontinue because of the short half-life and the lack of an active metabolite, but this is much less the case with the other SSRIs and the relative longish half-life citalopram even less so.

Anyway, increasing the citalopram dose won't significantly worsen any withdrawal issues when your wife stops taking it. It is weaning off the last few milligrams when most of the problems occur, not the reductions at upper end of the dose range.

The other thing to be considered is whether fluoxetine will actually work. While all SSRIs are generally equally effective, one, or two usually work better than the others for an individual.

[Gavjbrown]

Thanks for the advice. Yes I understand it's more about the percentage drop at later stages than the the larger mg drops at a higher dose. The later stages are whar really took the time with seroxat. I had to use a 1ml syringe and hardly fill.

[MyNameIsTerry]

Gav, the Cit half life easily covers her until end needs to withdraw. If it really was hard, you can pill cut or switch to Fluoxetine.

That's normally the case with Ven standard or other short half life meds. But bare in mind that Sertraline & Duloxetine are also fairly short but aren't considered as hard to come off.

Whilst it's true it's like starting withdrawal each day, which is a concern I understand as I'm on Duloxetine, bare in mind it takes a further half life to get from 50-25% (assuming a standard calculation) and you've taken the next dose long before then.

I think we also have to consider the dosing schedule was developed by the manufacturer so perhaps they have already taken that into account. Consider how Ven standard has to have a split dose regime to get around this but Ven extended release is taken like the others.

[Gavjbrown]

Hi Terry, thanks for explaining in more detail about half life. She's switched to fluoxetine now so we'll see how that suits.

Regards Gav