Women's Health Tip of the Day

Prozac Weekly

If you take Prozac, but find it difficult to remember every day, you may want to ask your doctor about Prozac Weekly. It contains the same active ingredient as Prozac -- fluoxetine hydrochloride -- but in a concentrated dose (90 mg) that you take only once a week. The idea is if you take a pill once a week, there's less chance of forgetting it, and you don't have a constant reminder of your depression.

(Note: A person must be stabilized on 20 mg of Prozac daily before starting Prozac Weekly.)That's not to say you should go running out to get a prescription for Prozac just because its convenient. In our next tips, some pros and cons of antidepressants...

Pros of Antidepressants

In our last tip, we mentioned the availability of Prozac Weekly, a once-a-week medication for the treatment of depression. That's not to say you should go running out to get a prescription for Prozac just because its convenient. (And it's not hard to do -- Prozac is one of the most widely prescribed medications in the country.) While antidepressants may be necessary for serious cases of depression (for example, to prevent suicide), they aren't for everyone. As with any mood-altering drug, you should carefully consider the pros and cons before taking them.

The pros, assuming the medication works, are obvious -- you feel better. From there, you might be able to help improve your mood naturally -- for example, by getting more exercise, eating a good diet and getting more sleep. Best case scenario, these changes may enable you to stop taking the medication and still keep depression away.

Cons Of Antidepressants

In our last tip, we mentioned that while antidepressants may be necessary for some cases of depression, they aren't for everyone; you should carefully consider the pros and cons before taking one. On the positive side, an antidepressant can help you feel better fairly quickly, but remember, everything has its price.

Antidepressants often produce bothersome side effects. The most widely prescribed choices -- SSRIs (selective serotonin reuptake inhibitors) including Prozac, Zoloft, Celexa, Paxil and Luvox -- can cause nausea, difficulty sleeping, drowsiness, anxiety, nervousness, weakness, loss of appetite, tremors, dry mouth, sweating, decreased sex drive, impotence or yawning.

More importantly, once you start taking an antidepressant, it can be very difficult to stop. Withdrawal effects can range from mild symptoms such as dizziness or nausea to more debilitating effects -- severe anxiety or what some describe as "shock wave" sensations in the brain. For these reasons, weaning yourself off of, or "tapering," an antidepressant must be done gradually. Worst case scenario, withdrawal effects are so severe (or so similar to the original mood disorder) that the person continues to take the drug, creating a vicious cycle.

Ultimately, it's up to you. Anyone with depression wants to feel better, and antidepressants can seem like an easy answer. (And for some, they are the best answer.) Just be sure you know what you're getting into.

Find out more information. http://www.prozacweekly.com

-- Anonymous, February 20, 2002

Answers

Hi Saro,

This is important info but I would like to add to it by suggesting that really in-depth info about ssri's has mostly been kept from us by the drug companies and, by extention, by the medical profession.

The side effects from these drugs (as well as the side effects from withdrawl) can be devestating. For example, there are cases of folks started on Wellbutrin for smoking cesation by well-meaning physicians who have ended up in psych wards with their lives nearly destroyed.

I believe that these drugs can be actual life savers in some cases, but they are, at this point, heavily over perscribed and usually under monitored. I think this crisis relates somehow to our culture's lack of self responsibiliy as well as the medical field's inherent arrogance. We so often look for quick cures, for unhappiness, for whatever.

At any rate, anyone interested should take a look at this website: http://www.drugawareness.org/home.html

-- Anonymous, February 21, 2002

Dad has been on Zoloft (low dose, 25 mg) for about 5 weeks. I was told it might not really take effect for 2 months, but I see no improvement at all. On the other hand, he's in pretty bad physical shape, and I agonize over what side effects might be resulting from his combo of drugs and which he might safely delete from his regime. He's 90 years old with lots of other complications, so the doctors haven't had much to say about it. It also means I can try something for a few months before trying something else for a few months - he doesn't have that much time.

I am, however, considering pulling the Zoloft. With a dose of only 25 mg any idea if he can go cold turkey, or maybe every other evening? The pills are too small to cut down.

-- Anonymous, February 21, 2002

>might not really take effect for 2 months, but I see no improvement at all.

why even bother?

I think a lot of doctors are too overworked to make good decisions and to carefully monitor their patients. Drugs can be lifesavers, but there are too many around that can have adverse interactions when combined. Or, their main effect is to drain the patient's wallet.

-- Anonymous, February 21, 2002

"why even bother?"

Because he's that close to being dead without some improvement along the way, and he doesn't have much way left.

For instance, I can't get food into him AND get him marginally washed during the same time period.

If I knew how much longer his heart would hold out it would be an easier decision whether to bother continuing treatment for his other life-threatening conditions.

Right now, just trying to figure out how I might take him off the Zoloft.

Act of desperation, really.

-- Anonymous, February 21, 2002

Hi Brooks,

From what I know about discontinuing use of ssri's, it seems to be always safer to wean gradually. Every other day for at least several weeks, then down from there is a common approach. By rights it should be your father's doctor who is advising you on this but I know from personal experience that too many of them don't seem to be aware of the often dire side effects of instant withdrawl.

I, like you, would be questioning why on earth your father was prescibed this drug in the first place. He's 90, has a number of health issues; it's not unreasonable for him to be somewhat depressed given his condition. He's lucky to have you.

-- Anonymous, February 21, 2002

cat, he was prescribed because I asked his doctor for something. And Doc said if there were problems after 2 weeks to just stop. It's all a mess, and I don't know if I'm hurrying my dad's demise or not. It would destroy him to put him into a nursing home or hospital for the rest of his days. Meanwhile, he can barely breathe or get around. He's not ready for hospice, just really debilitated. He needs to eat. He needs to agree to being washed occasionally. His muscles are severely atrophied because he isn't moving around, and he's not strong enough for PT. And I need all of this to be less difficult for him emotionally. For all the medical improvement he had made this fall, there wasn't any corresponding improvement in stamina, so I was looking for a magic pill. The doctors aren't silly enough to try to cure him at his age, just trying to make him more comfortable. Just isn't happening.

Meanwhile the cats are making out. The home health aid loves cats. Since dad wants to be left alone, she's finding ways to amuse the kitties.

-- Anonymous, February 21, 2002

BrookS you have my continuing best wishes. I wasn't trying to be sarcastic. It's just that when my father was dying last year at this time, the doctors were giving him tons of drugs and not being careful about how they were reacting. I'm sure he died a few weeks sooner than he needed to because of their carelessness.

-- Anonymous, February 21, 2002

Meemur, I'd never think you were being sarcastic over something like this. There are just so many self doubts right now about what to do or not do. I really do appreciate the support of absolutely everyone here.

-- Anonymous, February 21, 2002

Brooks, how hard for both of you.

I recently started dealing with issues around my aging father. I'm the oldest and the only daughter (Mother died 7 years ago) so it seems to fall to me. At any rate, I was feeling some confusion and angst over the whole thing so I visited a therapist a few times. She gave me a list of books to read. I'm finding reading these to be extremely helpful. One in particular "Your Best Is Good Enough: Aging Parents and Your Emotions" by Vivian Greenberg. The library had a copy. Reading about the subject has helped me be more realistic about my expectations for Dad, helped me be clearer about healthy boundries for both of us, as well as helped me to feel less isolated about it all.

-- Anonymous, February 21, 2002

I might be in a better mood on "mood menders" but I just can not "give up" my own full falcuties. (Course I may SPELL better, hey?)

My heart goes out to you with your father..so sad... and that is a great link.

-- Anonymous, February 21, 2002

I'm sure mood-menders would not help spelling at all. Just make you not care about it.

Maybe I could use some. I have a lot of stress...and I spell well.

-- Anonymous, February 22, 2002

cat, thanks for the reference, I'll check that one out.

-- Anonymous, February 22, 2002