Question:

This is my medical history: back in 1994 to 1996, I was on and off Prozac three times. The first time was because I’d been depressed for a long time, from age 16 to about 25. It worked great, it really turned me around. The second and third time was to help me get through stressful situations I was in. It helped those times too, just not as quickly or as noticeably as the first. I was med-free for 1997, 1998, and 1999 and was doing OK. In May 2000 I crashed. It was anxiety more than depression though. I tried Prozac for the fourth time and it didn’t seem to help. During a brief hospital stay I switched to Effexor, and it helped alleviate the depression, but made me sleepy. My psychiatrist added Wellbutrin last winter, and I didn’t feel cured, but I was functioning OK. The Effexor was still making me sleepy, so I replaced it with Celexa. First 20mg/day, now 30mg/day. I’d been on Celexa for 11 weeks now along with 100mg/day wellbutrin. My depresion has gotten worse over the last few weeks. I use Clonazepam a few times a week when the anxiety gets rough, which seems to be getting worse. I’m anxious all the time, I feel kind of out of breath, I feel my heart pounding sometimes, I sleep a lot, feel sad, and cry more often. My psychiatrist doubts that Celexa is making me more depressed, but I’m not so sure. I’m looking for a little advice here. Should I withdraw from Celexa and Wellbutrin and cleanse my system and start over somehow? I really miss how Prozac helped me the first three times, and maybe I could go back to it, but I’m afraid my system has become immune to it somehow. Why isn’t the celexa helping at all? Should I try another SSRI or am I now immune to all SSRIs? Dammit dammit dammit I hate this. What should I do? Michael.

Response:

- Hide quoted text — Show quoted text – > This is my medical history: back in 1994 to 1996, I was on and off Prozac > three times. The first time was because I’d been depressed for a long time, > from age 16 to about 25. It worked great, it really turned me around. The > second and third time was to help me get through stressful situations I was > in. It helped those times too, just not as quickly or as noticeably as the > first. > I was med-free for 1997, 1998, and 1999 and was doing OK. > In May 2000 I crashed. It was anxiety more than depression though. I tried > Prozac for the fourth time and it didn’t seem to help. During a brief > hospital stay I switched to Effexor, and it helped alleviate the depression, > but made me sleepy. My psychiatrist added Wellbutrin last winter, and I > didn’t feel cured, but I was functioning OK. > The Effexor was still making me sleepy, so I replaced it with Celexa. First > 20mg/day, now 30mg/day. I’d been on Celexa for 11 weeks now along with > 100mg/day wellbutrin. My depresion has gotten worse over the last few weeks. > I use Clonazepam a few times a week when the anxiety gets rough, which seems > to be getting worse. > I’m anxious all the time, I feel kind of out of breath, I feel my heart > pounding sometimes, I sleep a lot, feel sad, and cry more often. My > psychiatrist doubts that Celexa is making me more depressed, but I’m not so > sure. > I’m looking for a little advice here. Should I withdraw from Celexa and > Wellbutrin and cleanse my system and start over somehow? I really miss how > Prozac helped me the first three times, and maybe I could go back to it, but > I’m afraid my system has become immune to it somehow. Why isn’t the celexa > helping at all? Should I try another SSRI or am I now immune to all SSRIs? > Dammit dammit dammit I hate this. What should I do? > Michael.

Hi Michael,  I’ve been on Prozac 4 different times, always coming back to it because it seemed to work the best. The way my pdoc explained it was that my brain became "bored" with the Prozac, and it didn’t work. It seem to give me a different "feel" each time I took it.  I’m not offering this as medical advice, only what *I* would do in your situation. Since the Celexa isn’t working after this long and the dose of Wellbutrin isn’t terribly high, I’d get an appointment ASAP and request another med, something "like prozac" (another SSRI like Zoloft or Paxil). When Prozac petered out on me, I started Wellbutrin and Zoloft, and feel excellant. I think it’s more or less trial and error, but don’t wait too long, your Celexa should have kicked in by now. I don’t know if your immune to SSRI’s, but Prozac died on me, and another worked fine. I’ve had many anti-depressants that may have well just been sugar pills because they did nothing, so don’t feel it’s just you. Good Luck, Dave —