Prozac vs Zoloft

[nurseandie]

recently stopped taking ProzaC BECAUSE IT SEEMED TO LOOSE ITS EFFICACY..{oops} I'm a psych RN and noticed a lot of Pristiq being ordered. I thought I'd give it a go. It's been about 3 and1/2 wks. The regular G.I. probs have gone away.  The bizaare side effect I now have is like a psychotic break.  I cant talk because I cannot remember what I have said sentence to sentence. I become aware that I am rambling to the poor other person. I dont even remember what i have just said. Its like I have been dreaming and come awake. I even have opened my eyes and seen my hands moving doing whatever dream I am into. So now the big question I was on Prozac, the highest dose for 30 years. It seemed to stop working in my coctail of psych meds. I told my PC I'd like it so Ive been on it for almost 4 weeks and the nodding off and rambling on are getting worse. So the BIG question is should I go back on Prozac that I know at least what I am saying and doing, or go on Zoloft which is the mosr prescribed psych med there is? If anyone has anything to help PLEASE respond. Thank you.

[Paxiled]

To add to nursegirls excellent advice, Pristiq is prescribed so frequently because it's newer and still on patent, and so it's being pushed by the pharmaceutical company reps more than long time generics such as Prozac or Zoloft.  Those docs probably have drawers full of free sample of it.  This is how it goes, unfortunately.

[nursegirl6572]

Sounds to me like you are choosing meds for the wrong reasons.  You wanted to try Pristiq because you saw it being Rx'ed a lot where you work?  I'm SURE you can understand how that would not be a good reason.  If you were taking an AD for anxiety (the Prozac), Pristiq would have actually not been the best choicem as it can be quite activating.  I'm sure you're not having a psychotic break...sounds more like it is affecting your memory and increasing anxiety.

The other thing you did wrong was deciding, because the Prozac lost some of its efficacy, that d/c'ing it was the answer.  Did you discuss that with your doc, or just decide that on your own?  Did you taper or just stop taking it cold turkey?

I know you're very knowledegable, but PLEASE, there is a good reason why we don't have "MD" after our names.  PLEASE don't make these rash decisions without REALLY thinking it through and discussing it with your doctor.  NEVER use info or trends from your employment as a guide, or factor in deciding YOUR care and treatment.

There would have been a lot of other options that would have made sense, including adding a second med instead of d/c'ing the Prozac, to sort of "jump start" the Prozac again.  You're allowing your professional knowledge to affect decisions about your own care, and that's ALWAYS a bad idea.  I know, I've done it myself...us nurses are good for that.

Please rely on your doc for guidance.  You need to have a pow wow with him, and soon, to see how you should proceed at this point.  You're probably going to need to be tapered off the Pristiq before anything new is added.  Restarting the Prozac may or may not be helpful, it also may be difficult.  A LOT of people experience an odd intolerance to a med that once helped them greatly without side effects, on subsequent courses of treatments, which is why it's better not to try to d/c and start back up again.  You would have probably had a few more obvious options at this point had you not stopped taking the Prozac.

How about other SSRIs?  Ever tried Zoloft?  Lexapro?  Those are two meds with good track records of success in treating anxiety.  They both have helped me tremendously.  What is the disorder you have anyway?  When were you diagnosed?

Very best to you, I hope you (and your doc) figure something out soon!

[mammo]

Having been on Prozac for 30 years I'm sure your body  built up a tolerance to it and it was no longer working.  But did you wean off of it as you introduced the Pristiq?  If not you may be having with withdrawal from the Prozac combined with the side effects of starting a new medication.  Or it may just be that Pristiq is not for you.  Talk to your doctor about these side effects, they're pretty scary and you need to know what to do at this point where medication is concerned.  What works for one may not for another.  I wish you all the best with this.

[drifter0213]

with meds it's always trial& error i take zoloft 50mg/day for anxiety and depression i took prozac in '94 and it was not for me people respond differently to meds what might work for me might not work for you. i would discuss this with your doctor :)