In Practice

A practicing doctor's views on psychiatry and contemporary culture.

Prozac for the Long Term?

Prozac for the long term?The New York Times science section today features an essay on the long-term use of antidepressants. The lead refers to the sort of question I introduced in Listening to Prozac: how do medications shape identity? But most of the piece concerns the biological effects of taking the drugs for years. Read More

Yes, But

If the medication works, and continues to work, I'm not sure what else there is to ask for. Yes, it would be good if we knew for sure that these meds were completely safe over the long term. But even life itself is not completely safe over the long term! I'd just be happy to *have* the long term, myself.

And, of course, faster acting, more effective drugs.

Brain Changes

I would be interested to hear about more studies that look at long term brain changes that remain after a drug has been discontinued. I have read that there is some evidence that for anti-anxiety medications, for example, that the anti-anxiety effects may last after the patient stops taking the drug. I personally have had experience that leads me to believe there is some truth to this postulation. I began taking Paxil 10 years ago for extreme social anxiety. The drug literally changed my life even though I had zero expectations that it would do so. I really thought it would not work and did not believe a chemical imbalance was to blame for my anxiety. It seemed too simple and I berated myself for not being able to help myself without drugs. Now I am just so grateful I found Paxil and although it was HORRENDOUS to get off of, I stopped taking it 5 years ago. Since then, my social anxiety has remained greatly diminished without the Paxil. I took nothing for years and now take a very low dose of Zoloft to deal with some work stress. I don't believe I will ever go back to the level of anxiety I felt before I began Paxil. Whether it is due to experiential chemical brain changes ( positive reinforcement) or chemical changes from the drug itself, Paxil saved my life.

a different animal

I enjoyed hearing about the lowering of anxiety from becky but would like to mention that there is an antithetical difference between anxiety and depression. Depression effects parts of the personality that anxiety doesn't. Emotional delusion, paranoia,and acute low esteem of self and others. There is always the question of a correct diagnosis-for example is it just anxiety,does depression come with it..A.D.D.- O.C.D. Chances are if there's anxiety there is at least melancholy,which can be compensated for via a proactive self knowledge.In my opinion if it goes higher then melancholy then crucial parts of the personality start to be affected.Anxiety may need to be put in its place every few years or so (with medicine)-chances are it will build itself back up over time.Good luck, sincerely DAVID

I think there should be long term studies without question

My best friend has been on and off anti-depressants, including Prozac since her early twenties. I've watched her personality change, sometimes for the better, more often for the worse, depending on your perspective. I do worry, especially with her doctors varying the depressants frequently what the long term life effect will be. She is now 47. I do know, whenever she was in *talk therapy* she fared much better even if it seemed to take longer. I do not feel any drugs should be prescribed without talk therapy but unfortunately that's the way it is as talking to a patient is time consuming and expensive.

Long term

Hi

I think a long term prozac is good for health and it is give power of defending diciease.

And when the drugs stop working.........

I've been on anti-depressants and anti-anxiety meds since a traumatic period in the early 1990's. I've pretty much tried them all. Prozac was one of the early ones and was very effective...for a while. I started at 40mg, went to 60mg finally to 80mg until it was clear it wasn't working anymore.

For the past three years I've been under a great deal of financial stress which is about to come crashing down on me. My new prescription drug program has such high co-pays that I had my doctor switch me to generics. Back came Prozac (at 40mg) and for 3-4 months it worked. But it's not working now. Neither are the generics for panic attacks. I assume it's because my situation is becoming critical and my stress levels are so high, that this accounts for the lack of effectiveness. He originally gave me Valium to sleep (10mg) He pulled me off it when I hit 40mg with little effect and put me on some old tricyclic antidepressant to sleep. It works: it will knock me out for 18 hours and then I'll be depressed and lethargic for the rest of the day, so I try not to take it. But in the last month, I've been up two days straight twice and three days straight once. I took it after those 3 incidents and it "worked".

I guess what I'm asking is that after long-term use and coupled with clinical depression with multi-year bouts of extreme stress, will ANYTHING really "work"?

I would probably worse if I were off my meds completely, but I'm not in very good shape with them.
I should add for reference that I'm a very driven person, was a 6 figure executive until the company I was with for 12 years collapsed, and have been unable to obtain meaningful employment for the last 3 years. The money has run out and we're looking at homelessness within 6 weeks or so. So I'm not feeling real great about myself right now.

My psychiatrist just tells me to get a job and exercise and I'll feel better...and writes me more scripts. I went through a suicidal phase, but it passed and I couldn't leave my wife alone to deal with this mess.

I don't know if any of this is making sense. If I'm asking a question you can answer in there somewhere, please do. Otherwise, I apologize for this lengthy monologue of questionable value.

Re:And when the drugs stop working.........

Horrible story. You have my sympathy. Really, though, you might be in better shape if you find SOME kind of work. Sure, it's depressing to be subjected to such a downturn as you've described. Perhaps the notion that work would provide you with enough income for shelter (obviously much more modest than that to which you're accustomed) would help your spirits. I know that is not easy, though. We all know that you are not alone in experiencing this kind of "series of unfortunate events".

Have you found the Lord? Your

Have you found the Lord? Your words make my heart so sad. The Lord Jesus Christ is more than enough. He is all you need.

GET RID FROM NON PURPOSE PILLS

In my point of view, people should avoid taking pills on a regular basis,Specially sleeping pills because it will definately effect on your health and when you really need the pills it won,t effect on ur body so that would be the dangerous situations for you,and those people who have a dipression problem, they have to get control on their nerves, try to avoid pills and handle your mental stress by your seleves and just get rid from all the pills.

PROZAX VERSUS STRESS

I have been takng prozax 7 years gained huge amount of weight and still suffered bouts of sucicidal thoughts,I recently stopped all meds and had a mild stroke .As a survivor of rape and child molestation for years I believe I have ptss and have not had the help needed now in my late 50s I am still a train wreck.

re

Tiffany, I am so very sorry for what you've gone through. I had a horrible childhood with abuse as well. (Not as bad as some)

I have been off prozac for about 6 months.....life is not easy....

Drugs never work-really

Yes, drugs help to make the patient "feel better" but never to empower the patient to deal with their own emotions directly and effectively. The way drugs are administered is to keep the patient dependent on them not unlike the illegal drug pushers. Having troubling emotions? Here take a pill. That is the attitude of many psychiatrists and of course the drug companies. I don't believe we will hear a commercial on the evening news any time soon that says, "have you taken responsibility for your emotions today?" Drugs such as Prozac serve only one purpose: to impair the patient in their ability to grow and deal with their emotions and thoughts.

Pro Prozac

Only persons with severe depression know what it means to live with the symptoms. I much prefer a productive life dependent on Prozac than one hopeless one without it. Been taking it for about 14 yrs. now. In my opinion, the quality of my life is 95% better. I do think about the possibility of quitting it eventually but am afraid old symptoms will return. Could someone advise about the correct and responsible way of getting off Prozac?

Thanks.

long term prozac

I have been on prozac for 20 years and have begun to be concerned about the long-term effects, especially whether I can function without the drug. I want to gradually go off the drug just to see if I can function without it. I would like feed back from anyone who has gone off the drug after this length of time.

I stopped taking Prozac cold

I stopped taking Prozac cold turkey after a few years.my psychiatrist warned me that it would come back worse 5 months later, but I didn't listen because I'm stupid. Sure enough, after almost half a year my symptoms returned worse than ever. My crying spells were out of control, I couldn't function, I was a different person. I should note that I was subbing weed for the pills unbeknownst to my Dr (doubt that had much affect on anything other than the delay in my realization of needing treatment but who knows it's WEED), but once I moved out of the house for college and was no longer smoking I realized how messed up I was. I nearly committed suicide, I'm just glad I had to stop smoking because I probably wouldn't have noticed the pills not working until it was too late. It's taken me a month to get back to a relatively normal state and those weeks I had to wait for the meds to kick in again was hell, just as my doctor had warned me. Panic attacks, suicidal thoughts, cutting were suddenly daily occurrences. Now, my depression had been bad before, but this was exponentially worse.
The most frustrating part is why. The reason I stopped taking the pills in the first place was because I listened to everyone who didn't understand depression, saying "deal with it, medicine is a quack you don't need it, the government just wants your money maaaaan." I also worried about my personlity being altered, but i now realize on the medicine i'm a much much better version of myself. So dumb of me to stop taking it. But some people CAN go off of them and be fine in some cases. Definitely not me though, as I'd been depressed my entire life.
Overly long story short, just do what your doctor says. S/he went to medical school for years and years. You did not. Internet commenters did not.

REPLY FROM WIFE OF LONG TERM PROSAC USER

Dear I stopped taking Prozac cold,

I read your comment and feel your pain. Have you considered getting some professional and spiritual counseling to help you get the the bottom of the reason for your depression? I think both would help you long term. Psychiatrist prescribe drugs to treat issues. Psychologist go back in your history to find out what caused the problem and resolve it. LCSW's take the problem from the front end and help you learn skills that will help you change your behavior. My daughter, who was killed was getting her masters degree in social work at the time of her death, and my youngest son has said he's thinking about getting his degree in psychology.

Many years ago, when every doctor around was prescribing Prozac, because it was being touted as the wonder cure all, there was a doctor (Dr. Sterling Ellsworth, PhD--psychologist) who made this statement to me, "Prozac is just a band-aid for the wound. If a person wants to get to the bottom of their problems and fix them, they must engage in therapy to find the cause." That always stuck with me, as it made a lot of sense. I am in no way personally or professionally connected with Dr. Ellsworth, but I do highly recommend him, simply because I witnessed how he helped other members of my family, and he did get to the bottom of the problem. Dr. Ellsworth does therapy sessions via Skype/phone as well. I know that it's hard to find a good therapist, so you can read a little about Dr. Ellsworth and contact him at the link below if you are interested. He lives in Oregon.

http://drsterlingellsworth.com/index.html

You can also ask members of your clergy and people you respect for a referral to a good counselor.

I, like others on this forum, am just sharing my experience about Prozac. I offer my suggestions because of my life's experiences, not in any way do I try to take the place of a doctor. I have learned a lot from reading about the experiences of others, and have shared my experience with the drug in order to possibly help others. It is my personal opinion that Prozac is just what Dr. Ellsworth called it, "A band-aid for the wound." My husband has never gone back on it, thank goodness, and I'm happy to report that he is functioning so much better than he ever has. I cannot say what's best for you or others, but for us this was definitely the best decision!

Stopped prozac cold- we are

Stopped prozac cold- we are the same. person.

I think we all know the

I think we all know the effects of long term use of Prozac by now. Prozac is causing addiction, it's a sad certainty. I don't see how this drug can help as an antidepressant since it lead the people into addiction, where are the real benefits? There are countless examples at Narconon with people that have been used antidepressants for years, maybe we should learn something from that.

You've obviously never taken

You've obviously never taken the drug yourself.

Narcan is used to revive

Narcan is used to revive individuals who have overdosed on narcotics....NOT antidepressants; and the two terms should not be confused.

WHATEVER

We have long believed whatever we choose to believe. The studies are for those who care and read. Most just want results and without effort.
Very little specialized study or knowledge is needed to know what is obvious: many drugs are not organic and our body will struggle with them. Duh.
Sorry I am over 50 yrs old and tired of the same ol retarded approach.
Maybe the capitalists are doing it all on purpose since they know they can get away with it!! Rationalizing away the side affects for the sake of the cash. Ya think??
You cannot protect people from themselves. Open the gates and let her rip.

I have to agree with the

I have to agree with the first poster here.

pikavippi

Long term use of Prozac

I have been on Prozac for about 12 years and was originally prescribed it to help control my PMT. I look upon it as taking a vitamin pill daily. I like the way I am on it. I am totally in control of my emotions and feel it has restored my equilibrium. I don't worry about the long term effects but to be perfectly honest, if I like the way I am whilst taking it, then I'm prepared to keep on taking it. I went to my doctor recently because I was worried that it prevented me from addressing certain problems in my life but the doctor told me it didn't work that way and not to worry. My attitude to taking Prozac is "if it ain't broke, don't fix it". I only take 20mg per day so I don't feel I am overdosing on it. I just feel it's replacing some chemical that was missing before and now I'm fixed.

long term use of PROZAC

Hi EdwinaI read your input on Prozac with interest
I was prescribed it in 1994 20 years ago now .I have taken it daily 20 mg halved so 10 mg a day.
I too like the way I am on it I am also in control of my emotions on it.
I am 75 years old, retired now doing paintings in my art studio plus enjoying relationships and volunteering.From an early age 1940`s/50`s I spent my life hiding,afraid to speak up and participate....If you went to a psychologist in those days you were considered fit for the lunatic asylum.plus the only medication was alcohol.I TRIED RELIGION BUT NO ONE ANSWERED!
I have always been a nervous oversensitive,intelectualindividual and wondered what was wrong with me in my dealing with lifes ups and downs.(UNFOUNDED FEARS and DREADS plus chronic shyness)
I remember NOT going into my university common rooms as I couldn`t hold a cup of coffee up to my mouth without shaking/trembling and spilling it all over.A psychologist said I was probably a hypersensitive and probably I need medication to calm my sensitivity down which Prozac has done so well.I too don`t worry about the long term effects at my age I THINK and FEEL great on my dosage.No more terrified feelings meaning I couldn`t go out into the world.
Before PROZAC I used to use alcohol to calm my horrors but realised that was the route to damnation.
I HOPE THIS INPUT MAY HELP OTHERS
tHANKS FOR SHARING EDWINA!
BEST WISHES
Al

Hi Al, Just wanted to say I

Hi Al,
Just wanted to say I had to look up my previous post that you replied to and found that it was from 2011! Nevertheless, I am still on Prozac and my feelings about it have not changed. Another recent visit to the doctor and she suggested that maybe I should now wean myself off it after all these years. Well, I'm not. I still feel good taking it and so I shall continue taking it. It hasn't turned me into a zombie or anything like that so I won't be taking her advice.
I love your comment about trying religion and now one answered - so true! The only person who can help you is you and you seem to have done a wonderful job of getting on with your life with a little help from Prozac and and a lot of self-help.
Keep up the good work Al and lovely to hear from you.
Best wishes,
Edwina x

Prozac

Thanks so much Al & Edwina for saying it like it is! I started Prozac 22 years ago. Attempted to
go off several times ( because of believing some of the ridiculous comments above). Each time I
would after a couple months go back to a person I didn't want to be. I am on only 10 mg now & am in
my 70's. I am very healthy, attend 5 exercise classes a week & love to hike , travel & spend time with
grandchildren. And I love life. Yeah! Prozac or any anti-depressant that works for you!

long-term prozac use

Why are we waiting for young scientists in need of quickie publications in the first place? How about a government-mandated study by older scientists who can focus on groups already in their fifth, tenth, or fifteenth years of treatment? These people are everywhere. Interview them. Try withdrawing them from the drug (if they are willing) and observe the results. As someone who has taken this substance for six years now and is currently in withdrawal for one month, I can tell you that my head has been buzzing like a defective neon sign well after the damn stuff has supposedly left my body. I don't know how my brain chemistry has changed over these six years, you don't know, my doctor doesn't know, and Eli Lilly doesn't know, either.

LONG TERM USE OF PROZAC

I have just finished reading all of your comments. I came to this site trying to learn more about Prozac. My husband had thyroid cancer 13 years ago, and consequently, had his thyroid gland removed. He was an emotional basket case afterward. Prozac provided a solution to crying spells and depression, which isn't uncommon after the thyroid gland have been removed (my advice is don't do that unless you have no other choice; they'll never tell you about the resulting problems). Many have problems like this. He has taken Prozac ever since then. He'll start with the minimum dose. When that dose taps out, he'll increase the dose. When the maximum dose taps out, he goes off cold turkey and starts at the minimum dose again. Crazy, but it works. It is extremely difficult for our family when he goes off. We have two minor children still at home and hiding behind the piano is a good idea when my husband goes off Prozac. After about a month, he'll start on Prozac again at the minimum dose. When he's going off Prozac, he's easily irritated, short fused, and has explosive outbursts. In short, difficult to live with and that's putting it nicely. His anger is vented at me initially when he goes off, then transfers on to our children, and others. His recent decision to go off Prozac, which he always goes off cold turkey, and I have no idea why was because he wanted to see if he could get more energy. My husband has been taking "Seven," Exfuze dietary supplement. "Seven" is a juice drink with Gac, Acai,Goji, Noni, Fucoidan, Mangosteen, & Seabuckthorn, which is touted to be a "cure all" for many things. He was taking it for relief of knee joint pain resulting from 30+ years of playing soccer, which he said it did help with that. He thought it might also help replace the Prozac. This is a never ending battle. I haven't known if his taking the Prozac long term is the problem or if the lack of having a thyroid gland was the problem. After doing some research and reading the comments here, I am convinced he is having a long term Prozac usage problem. I would be very interested in having him participate in a study of the long term effects of using Prozac if anyone hears of one and wants to pass on my contact info. I will say that he took St. John's Wart for a brief period before he started on Prozac (can't take St. John's Wart until Prozac is completely out of your system, cause they work in a diametrically opposite way), and he seemed to have more energy and act more normal on it. Do any of you know if it has long term side effects or dependency issues as well? It appears to be safer. My 27 yr. old daughter was killed in 2006 in a horrific road construction accident, (a CAT 740 entered into the oncoming traffic and drove over her car). My LCSW counselor told me the "medicine" route would be quicker, but that the therapy would work as well, and I could choose. I chose the latter and was in therapy for a year. Five years later, I am very glad I went that route, because I'm of the opinion that Prozac is just a band-aid for the wound. I had to work through my pain. I still have some painful moments, but I know I am healing and getting better and have come a very long way from where I was--I still have occasional crying moments, but they were multi-times daily on the front end. After my daughter's death, I was diagnosed with chronic PTSD and adjustment disorder with depressed mood by a psychologist, who I saw as well. I figure if I can survive this, I can survive anything. This may be helpful to some of you who are wondering which route to take drugs or therapy regarding your own issues. I know there are some mental illnesses that require some drugs, and the benefits outweigh the side effects, so it is worth it, but I think oft times drugs are prescribed, when another route would be better in the long term. BTW, I was given a prescription of Prozac too by my primary care physician, which I elected not to take. Good luck and "well" wishes to all!

thank you

Thank you for sharing your story. I wish I could give you a big hug and I pray to have people in my life such as yourself.....

I could not stop reading your

I could not stop reading your comment. But wow, it like you have been battling giants all your life and still have hope for a positive outcome after all. Thank you for sharing your pain whit us.

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Peter D. Kramer is a psychiatrist and author. His books include Against Depression and Listening to Prozac.

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