FAQ

Common Questions About SSRI Anti-depressants such as Prozac and Lexapro

Being a long-time user of a number of different anti-depressants, I thought I’d list some of the most common questions here regarding them that I know I can answer with confidence. Keep in mind that everyone reacts to anti-depressants completely differently, and relying on someone else’s experience on them is almost useless.

However, there are some general questions I feel I can answer that would help people.

Just a reminder that I’m not a medical practitioner and always consult with your doctor on all of your questions as well. These answer are not intended to be medical advice. I do feel my first-hand experience being on these medications and getting feedback from multiple doctors along the way myself may be able to help people feel more at ease.

Q: How long does Prozac (fluoxetine) take to work?

A: It takes a while (at least a month) to get the full therapeutic effects. I found that many people who have used Prozac, including myself, notice something on the first day or two of taking it, and I feel this is not likely due to a placebo effect, as none of us were expecting it to work in any way immediately.  This isn’t to say its full effects are taking place right away, but that it may begin to start helping in some way.

Q: Does Prozac treat anxiety?

A: In general, SSRIs tend to be helpful for anxiety. This is because anxiety and depression are said to be two sides of the same coin, so to speak. They both stem from a combination of either chemical issues in the brain and/or consistent negative thought loops, and involve distorted ways of thinking. They also often exist together.

When you treat anxiety with an anti-depressant, it often takes the edge off of the anxiety and it makes it easier to deal with. Prozac in particular really almost entirely muted my brain’s tendency towards obsessive thinking, which in turn made it that much easier to get out of any thought loops that were perpetuating an anxious (or depressive) response.

Lexapro or Zoloft did not affect my obsessive thoughts quite in this way. You can feel when you take different anti-depressants that they tend to all work a little differently.
SSRIs can also give you a buffer on your emotions, so your tendency to overreact is lesser as well.

Lexapro (escitalopram) is said to be an SSRI that targets anxiety really well, which for me was a plus since my main problem tends to be my anxiety.

Q: How long does Prozac take to leave your body?

A: I don’t actually know the answer to this, except I do know that Prozac has a longer half life than many other SSRIs, so it stays in your system longer. If you happen to miss a dose, you likely may not feel anything. I used to accidentally miss my Prozac doses all the time and not feel any different, but if I miss a Lexapro dose, I do feel a difference.

For this reason I think that Prozac can be easier to get off of than other SSRIs, as it will leave your system more slowly than others.

Q: Was it hard for you to get off of Prozac?

A: It wasn’t. Even though I was on it for 9 years, I tapered off slowly like you should do. Everyone’s experience in getting of the drug may be different, primarily because the nature of their problem(s) may likely differ from others’.

I did notice some things as my brain was getting used to not being on the drug anymore (primarily a bit more aggression in my personality — not to a bothersome degree). It may depend on how long you’re on Prozac, but I did notice that it took a few months for my system to feel completely back to normal after being on it for so long.

Also, since I’m someone who has a chronic problem with anxiety, things that would normally induce anxiety in me when being off of medication did start to do so again, which resulted in me going back on medication eventually. This likely might not be the case for someone going through something more temporary.

Q: Can you take anti-depressants for life?

A: The simple answer is yes. If you really need them, then the pros of being on the medication long-term will likely outweigh the cons. I know many people in my family who have been on them most of their lives with very little issues.

On the other hand, if you feel you aren’t someone with a truly chronic problem, it would be worth trying to get off them at some point and work on exercising regularly, paying attention to your nutrition, meeting with a therapist, and so on. You cannot underestimate the power of that. There are a great deal of variables that can affect why you feel anxiety and depression, and it takes a lot of trial and error before you can really determine whether it’s something that your brain has a tendency towards naturally, versus something situational or circumstantial that can be worked out over time.

Q: Should I be on an anti-anxiety drug for my anxiety, or stick with an anti-depressant?

A: This is also a difficult question for me to answer as it likely depends on the nature of your anxiety disorder. If you are someone having panic attacks every once in a great while and this is a relatively recent occurrence, you may benefit more from taking an anti-anxiety drug only upon the onset of a panic attack, and not daily. Many anti-anxiety medications such as Ativan or Xanax are very strong drugs and very addictive (along with unpleasant long-term side effects), so it is something you’d ideally only want to take only occasionally and not daily.

I, however, have Generalized Anxiety Disorder and my anxiety, when it hits, tends to be nearly constant for sometimes months. I also have recurring anxiety and depression without necessarily having a trigger. In other words, it’s not the trigger itself that really sets me off — it’s how my brain handles these triggers in the first place (a trigger for me could be something like big life changes of any sort, or anything that my brain is perceiving as a threat at the moment). For me, it makes more sense to have something that regulates my brain chemistry on a daily basis. I believe that people with Generalized Anxiety Disorder can do really well on SSRIs.

Q: Does being on a low dose of Prozac (10mg) or Lexapro (10mg) do anything?

A: This will depend on you and the nature of your issue (and your own body’s reaction to things) — but for me, it certainly does. I’ve been on 10mg and 20mg doses of both Prozac and Lexapro. I found 20mg Lexapro to work better for me. I feel that Prozac is a stronger drug and a 10mg dose of Prozac affected me more than a 10mg dose of Lexapro.

Q: How is Lexapro different than Prozac?

A: I wrote an article on my experience with both here. In a nutshell, Lexapro can be more effective for anxiety than Prozac is, for some people. Prozac seems to be a stronger drug, and can also treat OCD. If your primary problem is generalized anxiety and/or mild depression, maybe you can start with Lexapro and see how it works for you.

It really is a matter of trial and error to see what works best for you. A couple doctors have told me that Lexapro tends to be better tolerated, and I would agree that I have had less side effects on Lexapro than on Prozac. However, I also know a few people who have been on both and preferred the Prozac.

Q: Can Prozac or Lexapro make you anxious?

A: If you find yourself MORE anxious on Prozac or Lexapro, it could be a few things. Either:

1) you just started taking one of the medications and your system is getting used to it, and the anxiety will go away after a week or two.

2) You are nervous about what the medications are going to do to you, and it’s creating anxiety while being on it, or

3) your system isn’t reacting to the medication well. You’ll have to determine what is causing the anxiety and switch to another med if needed.

Q: What’s the best time to take Prozac?

A: Prozac tends to be an energizing drug for some, so for those it is best taken in the morning. I did not get any energizing effects from Prozac and took it in the early evening with no issues. You can start by taking it first thing in the morning and see how that works.

Q: What’s the best time to take Lexapro?

A: Lexapro (as it states right on the bottle) may actually make you drowsy, but I didn’t feel this from Lexapro myself. But for that reason, many medical practitioners will advise to try taking it in the evening first.

Q: I’m having really insane dreams on Prozac. Is this normal?

A: Yes! This is a very common side effect of Prozac. Doctors have suggested taking it first in the morning to potentially help with this as well. I did not have this side effect myself, but I have heard that the crazy dreams can subside after a while of being on the medication.

There you have it — some of the most common questions I see about taking anti-depressants. If you have any other questions or comments, feel free to reach out to me (liz@mylifeinbalance.co). I may add more questions and answers to this article over time to make it even more complete. Best of luck and hang in there!

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