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enriquegm82

Optimum dose of Prozac for OCD

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Hello

I am currently cross tapering from Paroxetine (Paxil) to Fluoxetine (Prozac) for OCD.  Right now I am taking 20mg Fluoxetine and 30mg Paroxetine.  The idea is to stop Paroxetine and to increase dose of Fluoxetine to 40 or 60mg.

Could you share with me, in your opinion, what is the optimal dose to treat OCD symptoms?

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For me, prozac does not help me with OCD.  I used to be on desipramine and anafranil.  Anafranil worked a little, but not enough to continue on it after a few months.

Right now I think for me it is the combo of meds I am on that helps the most.  But everyone is different, so YMMV.

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2 hours ago, melissaw72 said:

For me, prozac does not help me with OCD.  I used to be on desipramine and anafranil.  Anafranil worked a little, but not enough to continue on it after a few months.

Right now I think for me it is the combo of meds I am on that helps the most.  But everyone is different, so YMMV.

What is that combo that you take?

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34 minutes ago, enriquegm82 said:

What is that combo that you take?

See my sig below. 

I was saying YMMV and everyone is different because no one has my specific cocktail (AFAIK) with the meds at the doses I take.  I was just saying it was my cocktail.  I'm sure others have different cocktails that work for them also.

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Higher doses of SSRIs tend to be needed for anxiety disorders like OCD. 40-60 mg sound about right, perhaps even 80 mg may be needed depending.

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Melissa

What the naltrexone used for?

I have read Doctors that use it to counter "poop out"

 

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6 hours ago, mikrw33 said:

Higher doses of SSRIs tend to be needed for anxiety disorders like OCD. 40-60 mg sound about right, perhaps even 80 mg may be needed depending.

FWIW, I was on 80 mg/day and there was no change for me.  I am now on 10 mg, and no changes.

I know though that all meds work differently and while one med doesn't work for someone, it might work for another person.

 

5 hours ago, 300.3 said:

Melissa

What the naltrexone used for?

I have read Doctors that use it to counter "poop out"

 

For me, the naltrexone is used to counter the voracious appetite that I have as a side effect from a former med, in which it never went away (I was on a med that caused a voracious appetite, and when I went off the med, that side effect never went away).  Which is why I need the naltrexone now.  It calms down the massive eating.  It isn't a diet pill or a pill that suppresses appetite and hunger ... you still get hungry, but it controls whatever part of the brain has to do with eating ... so ie with me, without this med my appetite would soar out of control, and I would not be able to control what I'd eat.

It is used for other reasons also (smoking and alcohol cessation also), but this is how it works for me.

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10 hours ago, melissaw72 said:

For me, the naltrexone is used to counter the voracious appetite that I have as a side effect from a former med, in which it never went away (I was on a med that caused a voracious appetite, and when I went off the med, that side effect never went away).  Which is why I need the naltrexone now.  It calms down the massive eating.  It isn't a diet pill or a pill that suppresses appetite and hunger ... you still get hungry, but it controls whatever part of the brain has to do with eating ... so ie with me, without this med my appetite would soar out of control, and I would not be able to control what I'd eat.

It is used for other reasons also (smoking and alcohol cessation also), but this is how it works for me.

 
 

Yep. There's a diet pill, Contrave, which combines bupropion SR (Wellbutrin SR) with naltrexone extended-release. I tried it and didn't really have much luck with it—it came nowhere to being as effective as phentermine. I've never tried the Qsymia (topiramate + phentermine combo) diet pill, which is said to be more effective than phentermine alone, but I apparently get kidney stones no matter how much water I drink any time I take topiramate, so I can't take it.

Just curious @melissaw72, how effective is the naltrexone on its own for you? I'm having appetite problems myself, and am trying to figure out ways to control it (have been researching natural supplements on examine.com, some seem to be promising, but I know better than to place a lot of trust in natural supplements...) Do you take it in the morning or night or when?

Edited by mikrw33

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1 hour ago, mikrw33 said:

There's a diet pill, Contrave, which combines bupropion SR (Wellbutrin SR) with naltrexone extended-release.  I tried it and didn't really have much luck with it—

My pdoc happened to bring this up in conversation last appt, and he said there was only a tiny bit of naltrexone and wellbutrin in it.  So I can understand why it wouldn't work.  I'm sure it works for some people though.

1 hour ago, mikrw33 said:

Just curious @melissaw72, how effective is the naltrexone on its own for you? I'm having appetite problems myself, and am trying to figure out ways to control it (have been researching natural supplements on examine.com, some seem to be promising, but I know better than to place a lot of trust in natural supplements...) Do you take it in the morning or night or when?

I am on 150 mg of naltrexone (50 mg 3x/day), and it really works well for me.  Anything lower than 150 mg/day, it isn't enough to help ... the voracious appetite comes back with a vengeance.  BTDT. 

 

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4 hours ago, melissaw72 said:

My pdoc happened to bring this up in conversation last appt, and he said there was only a tiny bit of naltrexone and wellbutrin in it.  So I can understand why it wouldn't work.  I'm sure it works for some people though.

2

It has 8 mg/90 mg naltrexone/bupropion, respectively, per tablet, and up to 4 tablets are taken daily (on a titration schedule), with 4 tablets yielding only 32 mg naltrexone and 360 mg bupropion (almost 400 mg). So yeah I guess that is a tiny dose of naltrexone, compared to 50 mg or more.

4 hours ago, melissaw72 said:

I am on 150 mg of naltrexone (50 mg 3x/day), and it really works well for me.  Anything lower than 150 mg/day, it isn't enough to help ... the voracious appetite comes back with a vengeance.  BTDT. 

 

I think I may ask my pdoc about trying naltrexone. It seems like I asked her about it in the past for dissociation, but she said it tends to cause liver problems. I may end up having to push for it, depending. Or maybe ask for an alternative, if there are any. Thanks for your input! :) 

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19 minutes ago, mikrw33 said:

 

I think I may ask my pdoc about trying naltrexone. It seems like I asked her about it in the past for dissociation, but she said it tends to cause liver problems. I may end up having to push for it, depending. Or maybe ask for an alternative, if there are any. Thanks for your input! :) 

You're welcome!

(bold)  I didn't know naltrexone could be used for dissociation.

I hope everything works out.

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