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Prozac and psychosis


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I can not help you with this one, but I will be very interested to hear the responses to this thread.

A person quite close to me, who was not psychotic at all, developed SEVERE psychotic symtoms when put on SEROQUEL,- an ANTI psychotic!  I am on this drug myself.

She told me, that her psyc told her,  that this was not unheard of by any means.  She claimed that the psyc said that he had had this happen with antidepressants!

So, there may be a link. 

I have not really looked into the matter though.

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what a kawinkydink.  (not trying to trivialize, its just the word that popped into my head)  i had been on prozac for about two months (so maybe finally the 8 week mark when the medicine kicks in) and this past week was hell for me.  i may have kind of upset the balance by taking like three mg of klonopin, and then running out and not having any to take, but i was definitely agitated all week.  the week before i had been working, but the temp assignment ended, so basically i had now way to distract myself and it felt like my intrusive thoughts were cranked up a notch.  it all kind of climaxed yesterday with me going crazy for a bit, and breaking three family picture frames.  yeah it was fun.  i'm feeling a little bit better today - and got my pdoc to call in some ativan - but i basically felt almost as bad as when i first had ocd 12 years ago.  just kind of a constant anxiety, undistractablity (now i'm making up words) that i couldn't get rid of.  i see my pdoc tuesday, and i think the ativan might help (i stopped taking the prozac - i was just at 20mg) but teh experience definitely has thrown me back to zero and made me a little scared. 

prozac was kind of weird.  i had been off lexapro for a month and a half, before i started it in july, and for the first couple of days i felt immediate relief.  like feeling good for brief periods of time when i had never felt that way for a couple of years.  then that kind of went away - got more depressed, then got feeling a little better with touches of that really good supercontent serotonin feeling for a couple of days, then the downward spiral starting last saturday.  i think as it is the most "activating" ssri it can maybe jumpstart some of the bad episodes like your or i experienced.  not sure if they're caused by the same thing or what, but my pdoc called prozac a 'dirty drug' in the sense that it effects more than serotonin, so i'm thinking that maybe by tweaking the norepinephrine a bit it set me off.  i don't think i'll ever know for sure, i just hope i don't go through a similar experience like that again in teh future. 

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Before I was put on Prozac, I wouldn't say I was going through a psychotic episode but I did indeed have psychotic tendencies. There was a girl in my head then but she was more like separate thoughts of mine. Then when I went on Prozac I developed full-blown psychosis; developed extreme paranoia, delusions, heard voices, had disordered thinking, and the girl in my head became real. I am now on Risperdal. This whole thing started to get worse, however, basically a few days after I started Prozac and I know it takes at least a few weeks for SSRIs to get in your system. So it might've been a coincidence, but my question is this; can Prozac cause or worsen psychotic symptoms? Would someone who was never psychotic in the first place have a chance of developing psychosis on Prozac?

hmm, its a pretty rare response, but people with "unwakened" psychotic disorders and bipolar disorder can experience a negative reaction to ssri's.  This can include a manic reaction and/or some psychosis. 

Having said this, there are a lot people with schizoaffective disorder who take an ssri/anti psychotic combo - just look at symbyax (prozax and zyprexa in the same pill).

Increased anxiety during the first few weeks of an ssri can aggravate responses to stimulus - eg panic, anxiety, mania, psychosis.  Normally benzos are prescribed to help you through the first few weeks.

FYI I am prescribed 60mg paxil/900mg seroquel to treat OCD with major depression, GAD, Panic Disorder and residual psychosis.  I find the combo works well for me. 

Talk to your dr about your response and options.  A couple of possibilities are:

- the prozac might mellow out for you at the right dose

- ssri's arent for you. A NARI could be better eg reboxetine.

- you might be better off on a tetracyclic anti depressant like tolvon or remeron (very calming)

- you may react well on an atypical anti psychotic alone, with a mood stabiliser or whatever

- a different ssri might be better for you eg paxil or lexapro.  Prozac is probably the least selective of the newer ssris. Lex is the most selective (eg dirty vs clean). In many patients the additional effects are helpful, but not for everyone. 

Good luck, seek medical advice and post your progress.  Hope this helps a little.

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Thanks for the replies. I don't have much trouble with my psychosis at the moment since the Risperdal is doing its job, but I was just curious as to if the Prozac was causing this. My suspected diagnosis is somewhere along the lines of schizoaffective because I've had negative and some mild positive symptoms for about a year now, and the Prozac just worsened it. But I'm also on the lowest dose possible (10mg). I was just wandering if psychosis was a possible side effect.

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Thanks for the replies. I don't have much trouble with my psychosis at the moment since the Risperdal is doing its job, but I was just curious as to if the Prozac was causing this. My suspected diagnosis is somewhere along the lines of schizoaffective because I've had negative and some mild positive symptoms for about a year now, and the Prozac just worsened it. But I'm also on the lowest dose possible (10mg). I was just wandering if psychosis was a possible side effect.

<{POST_SNAPBACK}>

Yes. I witnessed it with a family member firsthand with another SSRI (celexa) starting at 5mg.

scream_phoenix,

Was your OCD pure obsessive?

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