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Mental Health  (Expert Forum)
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Withdrawing from prozac
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD) , bipolar disorder , dementia , electroconvulsive therapy (ECT) , learning disabilities, memory, obsessive compulsive disorder (OCD) , panic , personality disorders, phobias , post-traumatic stress disorder (PTSD) , schizophrenia , stress , transitions, and work problems.

Withdrawing from prozac

by H3Alba, Jul 11, 2009 06:13PM
My 15 year-old daughter has been on 20mg of prozac for approximately a year after experiencing a traumatic incident that led to a major depressive disorder.  I have been researching online for a conservative titration schedule to d/c prozac.  I have not found one. Most suggest reducing the dosage by half every couple weeks.  I am not comfortable with this as I have been a witness to this many a time and never seems to work.  

by Roger Gould, M.D., Jul 13, 2009 02:50PM
To: H3Alba
You have already received some excellent advice.  I would recommend reading over a three-week period.  Cut the dose down in half the first week.  The second week pick the low dose every other day.  The third week take the same dose every third day and then stop.  I'm assuming you will do this in consultation with your doctor.
Member Comments (3)

by Jaquta, Jul 11, 2009 07:20PM
The doctor here provides advice on tapering programs and medication(s).
Have you discussed this (your concerns and desire to discontinue your daughter's medication) with her doctor?  You could potentially do more harm than good if her depression hasn't resolved.  Has she had counseling to talk through the trauma?

The taper you mention does seem extremely conservative.  Maybe a more structured taper would be appropriate?

I can understand your concerns but please don't let your fears affect your daughter.  She may have doubts about herself and her ability to discontinue the med (or to function without it) so support her and encourage her and be patient with her.  Perhaps everything you've already been doing.  Just be careful.

J

by Paxiled, Jul 12, 2009 02:42AM
Keep in mind that Prozac is different from the other medications you read about.  Prozac stays in the body for a long time, and takes a month or two before any withdrawal would be noticed.  Therefore, you won't see much information about Prozac withdrawal because if it happens it happens somewhere down the line, and would probably be misdiagnosed as a relapse, not withdrawal.  Whereas, with all the other ssris, they have a very short half life, meaning they leave the body very quickly, in a matter of hours.  It is believed this is one reason the body has such a hard time adapting to their absence, and withdrawal begins even before you're done tapering off them.  Your psychiatrist is the person to discuss this with, but psychiatrists, including, I'm sure, Dr. Gould here, will tell you Prozac doesn't have the same withdrawal problems as other ssris.  Whether that's true or not, again, your daughter wouldn't notice until a month or two has passed.  Either way, titration with Prozac won't affect the body that much in the short run, so it can be done with much less immediate difficulty than, say, Paxil or Zoloft or Effexor.  
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