should I change a med or increase the dose?

[FY999888]

Hi,
I am 45 years old male. I had a series of depressive symptoms from the end of 2008. My doctor said it is in the mild to modest range. First I tended to "snap'" out without medicine. In January I gave in and decided to start my medicine. In the last 8 weeks, I am using Prozac 20 mg per day. The result is very puzzling. First three weeks, I had 3 good days and followed by 3 "down" days (approximately) and then after 4 weeks, 5 days of good days and 5 days of "down" days. I almost wanted to withdraw this med and then after 5 weeks, I had almost 2 weeks of good days (feel the med kicks in), unfortunately, 5 "down" days follows again until today. I am really really frustrated. Should I continue 20 mg prozac for a few more weeks to see or evidently this med hasn't taken full effect yet or not fitting me? I am seriously considering changing to another med such as Lexapro or Celexa. Havn't made my mind yet becuase changing med can have other inconvenience. I ever took 20 mg prozac for my anxiety disorder for 10 months in 2007.

Need your help. Thanks so much.

FY999888

[FY999888]

Thanks for sharing the info with me. My question is when you are satisfied with some combination, does your mood stay stable (feeling good) with little fluctuation even under reasonable external stimulus such as job stress, poor weather etc? If yes, then I have some ways to go. Currently it is not that 20 mg Prozac has no effect at all. It does has effect for having many good days but unfrotuanately can't hold it up there. I am sensitive to side effect and mood swing. The drug has been 8 weeks. I am now on the crossroad either incresing the dose or changing it. I hope to get to it with minimum trial.

FY

[Sammich616]

Each change in dose takes at least a month for full effects.  I understand how changing meds can be inconvenient.  I have terrible withdrawls.  However, if a med isn't working, there isn't much sense in continuing.  You may have to try several different meds before you find the rightone.  Each one takes time.  This will not be an easy process, but once you find the right one (or combo of three like me) you will be glad you didn't give up.  I also worked with my general Dr for a while then saw a psychiatrist who worked with me further.  I still see my psych monthly to discuss poblems I am having and adventures in my life.  (I have back problems and recently a stroke) He is very supportive and open minded. =)

[LeftCoastChick]

We can only give you advice and support based on our own experiences, which as all different. we cannot be used as a second opinion - but we sure can be supportive. I think you need to give the med more time, and sometimes upping a med will do the trick, just make sure you are patient, these drugs take awhile.

This is a really fabulous website that answers pretty much anything you might have questions about from a-z:

http://www.helpguide.org/mental/medications_depression.htm

[FY999888]

Thank you very much. I have a psychiatrist working with me. She prefers to increase the prozac dose instead of changing as the first option. I just want to seek a second opinion here because I know there are lots of experts or experienced people on this forum.

Best,

FY

[LeftCoastChick]

The best thing you should do is sit down with your doctor, and talk about the options. If you haven't sought out a psychiatrist yet, I really suggest you do that. Meds won't cure you of depression, but it should alleviate some of it. Talk therapy really helps as well, but a good consult with a psychiatrist should be considered so you can get a proper diagnosis that a family doctor can't really do.