Posted by JohnL on April 6, 2000, at 3:17:34
In reply to augmenting prozac, posted by Andy on April 6, 2000, at 0:06:00
> Hi all: Ive been taking prozac for several years and it doesnt work as well as at first. Tried increasing dose but that made me sick. Was wondering if anyones ever added tryptophan or 5-htp (same thing) to the prozac and it worked better. Any other suggestions that I can ask my Dr about Id appreciate.
> AndyAndy,
This isn't an easy one because there are so many choices.
A survey of pdocs indicated that addition of low dose, like 600mg, was the most common approach. Other common approaches include adding Wellbutrin, adding a low dose tricyclic like Nortriptyline or Desipramine, adding Ritalin or Adderall, adding Bromocriptine, adding Buspar. On and on. Or 15mg Remeron at bedtime. A more novel approach is to add 25mg to 50mg Naltrexone. A search in Dr. Bob's Tips will provide more info on Naltrexone, as well as other augmentation approaches. Addition of Lamictal can be effective too. Sometimes just a simple switch to a different SSRI will do the trick.
Unfortunately there's no easy answer and no way to predict in advance what will or will not work for you. But the choices abound. Sorry I don't have a more concrete answer for you. But of all the augmentations I have tried, I found the tricyclics and the stimulants to have the greatest potential. My pdoc and my GP use additions of a tricyclic or a stimulant more than anything else, followed up by Lithium. But of course, the new side effects of whatever you try will be a factor as well.
I've also tried SJW with Prozac and found the combination well tolerated. Better than either alone. I've also tried 5HTP with Prozac. But one must be careful with dosing to avoid serotonin overload. The right small amount of 5HTP (perhaps 35mg-50mg once or twice a day) can be very helpful, but if it's too much you will know because you'll actually feel worse, agitated, and perhaps get diarhea. It's tricky to find the right dose of 5HTP, and dangerous if not done conservatively. So be careful if you decide to get adventurous.
poster:JohnL
thread:29042
URL: http://www.dr-bob.org/babble/20000401/msgs/29053.html