Real bad problem, help

mrsD · 12-03-2011, 07:47 AM

This is the official reason for the interaction:

http://www.drugs.com/interactions-ch...5-360,1115-648

SSRI drugs also increase bleeding risk:

This is another search using Lexapro as a substitute:
http://www.drugs.com/interactions-ch...13-565,705-360

It explains the bleeding risks.

Wellbutrin may be an option for you since it does not affect serotonin. However, metabolism of Wellbutrin is affected, so lower doses may be used. (but the doctor may refuse to give this anyway with the interaction):

http://www.drugs.com/interactions-ch...05-360,440-203

So 3 separate reasons for 3 separate antidepressants combined with Plavix.

Tapering down with Prozac takes time, since it is a long acting drug in the body. Some doctors allow tryptophan OTC to help with this. But I don't know if that will affect the Plavix as well.

SallyC · 12-03-2011, 09:12 AM

This is what I heard, but I haven't tried to come off of Prozac......and when I came off Paxi, 4-5 yrs ago, Doc replaced it with Prozac and I had no withdrawal sx from Paxil.

Perhaps if you start another AD, you will not have any trouble?

Quote:

Discontinuation syndrome
Several case reports in the literature describe severe withdrawal or discontinuation symptoms following an abrupt interruption of fluoxetine treatment.[24] However, various studies have shown that the side effects of the fluoxetine discontinuation are uncommon and mild, especially compared to paroxetine, venlafaxine and fluvoxamine, probably due to the relatively long pharmacological half-life of fluoxetine.[24] One of the recommended strategies for the management of discontinuation syndrome with other SSRIs is to substitute fluoxetine for the original agent, in cases where tapering off the dose of the original SSRI is ineffective.[25][26] The double-blind controlled studies support this opinion. No increase in side effects was observed in several studies when the treatment with fluoxetine was blindly interrupted for a short time (4–8 days) and then reinstated, this result being consistent with its slow elimination from the body. More side effects occurred during the interruption of sertraline (Zoloft) in these studies, and significantly more during the interruption of paroxetine.[27] In a longer, 6 week-long, blind discontinuation study, an insignificantly higher (32% vs 27%) overall rate of new or worsened side effects was observed in the group that discontinued fluoxetine than in the group that continued treatment. However, a significantly higher 4.2% rate of somnolence at week 2 and 5-7% rate of dizziness at weeks 4-6 were reported by the patients in the discontinuation group. This prolonged course of the discontinuation symptoms, with dizziness persisting to the end of the study, is also consistent with the long half-life of fluoxetine in the body.[28] According to a 2007 summary report of available evidence, fluoxetine has the lowest incidence of discontinuation syndrome among several antidepressants including paroxetine and venlafaxine. [29] See also SSRI discontinuation syndrome.

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