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Real bad problem, help

I have to get off prozac 20mg, I've taken for 15 years, due to having 3 stents put in 2 weeks ago and now am taking plavix 75 mg which is a blood thinner and interacts with prozac making the plavix less effective. I need to taper off the prozac and not sure how. these docs do not know about everything, all the doctors knew I was taking these meds the cardiologist said to take the plavix for 2 years even if I took nothing else. I feel like I have to be my own doctor, I found this out by studing the meds and talking to the pharmacist. If I keep taking the prozac my chances of having a heart attack or stroke increases. Most types of antidepressents affect plavix. What to do?

I looked it up poochie, that sucks. the good news is, you shouldn't have to wean off of Prozac, as you do with other ADs. It has a long half life or something like that. I'm on 40 mgs.

Ask your pharmacist or Doc if there is something you can take to take the place of Prozac, that doesnt interact negatively with Plavix.

:hug::hug:

call your local pharmacist. You will be pleasantly surprised to discover how much he/she knows.

We have to be our own best advocates, always informed and educated. I like my neuro and PCP but feel "It's my body and we work as a team", in the end no one now what and hos as much as really concerned and involved us. They get really busy and don't have all the answers.

Had a wheelchair repair guy here who in the end wasn't really helpful. In the end I ended up problem solving as It's me who can't walk and is so dependent on my chair and do know it and this life very intimately.

This is not easy, wheelchair guy is not one of my favorites (We've had previous encounters). I had to hold my ground dealing with this petty tyrant know-it-all and he maybe interpreted strength and assertiveness as rude. Jerk.

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.

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.

I thank everyone for your help, I really don't know what to do, I have tried going off prozac before, due to ms, I get suicidal so I have to be on something and this works so good for me. I will talk more to my doc about it, I have no choice to take something and the plavix, this is vert worrisom, which it shouldn't be, the doctors should be up on this, and they should communicate, and believe me, I will tell them that

If SSRI drugs increase bleeding risk, how does that differ from Plavix which makes platelets less sticky? SSRI's make blood cells smaller?

I've taken 10mg Prozac for about 1 yr now. Started it after reading it helps some with MS which, I assumed was due to a less stressed brain cause we know stress can damage brain but, the fact you say it's also a bleeding risk makes my wheels turn. Perhaps it helps blood get into tiny areas?
Interesting.

edit type.o

does it have to be plavix? i take pradaxa but i'm being tx'd for a fib.
i'm also on tamoxifen for brst CA and have a limited option for antidepressants because they can interfere with it. i've been on a lot of alternatives. some work, some don't.

i've ultimately found something that works for me.
i wonder if a psychiatrist (md) can help answer those Q's in your case?