View Full Version : Added Prozac to Concerta for PMDD


Scattered
01-18-06, 07:47 PM
Well it appears I have PMDD (premenstral dysmorphic disorder) in addition to ADD, since my ADD meds work great until a week before my period and then I'm irritable, aggressive and generally foggy and ineffective. I tried St John's Wort, but broke out in a rash the next day. I tried Sarafem (same thing as prozac) at 20 mg for three days and I couldn't sleep for half the night and felt totally drugged, heavy limbed, and generally slow -- by the third day I was also moody and irritable. I didn't feel anything like myself and things were going down hill quickly. It took about a week off the stuff to feel normal again. My doctor has prescribed a lower dose to try, but I'm a bit afraid to try it since my last experience was so bad. I've also been researching 5-HTP which is a precursor to serotonin. Anybody got any experience with any of this stuff?

Scattered

barbyma
01-18-06, 08:03 PM
I don't know anyone who's had that reaction to prozac, but I know a few that have not tolerated it -- jitters & paranoia mostly.

There are a bunch of SSRIs to try now. Most people who don't do well on one respond entirely differently to another.

Hope you find one!

caglialoro
01-21-06, 09:19 PM
I totally understand what you are going through.

My DS just started prozac with concerta for his anxiety and adhd. It has been about a week. Well, he was suppose to take 1/4 tablet for 3 days then a 1/2 tablet once a day. I have noticed that he has been more hyperactive and not able to focus. Very jittery, restless all the time. It's really hard to see him like that.

I called his doctor and they want me to lower the dosage to a 1/4 tablet every day. I hope this helps. It has really affected his schooling. He just can seem to settledown to do his work.

I am hoping and praying that the lower dosage will help him. But I am like you, I am scared to even give it to him.

Scattered
01-22-06, 08:36 PM
Thanks for the replies. I decided to try the 5-HTP and have felt great! More relaxed, better able to switch gears, and so forth. this is the third day on it and so far so good, so I'm hoping this is a go.

Barbyma, Leave it to me to have an atypical reaction!:rolleyes:

Cagliolora, It's difficult enough to experment on yourself with this stuff (although I unfortunately don't know a better way) but going through this for your kid must be even harder. I have an ADHD daughter, but my husband's unwilling to try meds although I'm sure she needs and would benefit from them.

Scattered

barbyma
01-23-06, 01:33 PM
My DS just started prozac with concerta for his anxiety and adhd. It has been about a week. Well, he was suppose to take 1/4 tablet for 3 days then a 1/2 tablet once a day. I have noticed that he has been more hyperactive and not able to focus. Very jittery, restless all the time. It's really hard to see him like that.....

I am hoping and praying that the lower dosage will help him. But I am like you, I am scared to even give it to him.
Caglialoro,

During the last 20 years, I've known dozens of adults that have taken SSRIs for depression and/or OCD. Of those that have taken Prozac, I know at least 6 people (that I can think of immediately) that have had similar reactions.

These were all adults and all were so disturbed by these feelings that none chose to continue the med past a week. My father didn't last 3 days :(.

But, every one of these 6 (that I can think of :p) did very well on the very next SSRI they tried. 4 of them tried Paxil next and 2 Zoloft. 3 of the Paxil users and one of the Zoloft are on them for the "long-haul".

My own experience with Paxil was pretty similar and very unpleasant. (I think it's interesting that my father and I had opposite reactions -- he didn't tolerate Prozac, I didn't tolerate Paxil, but he's done well on Paxil, while I love Prozac....)

Sorry for the long message to make a short point. I just wanted to encourage you to try a different SSRI and let you know that you're not alone. The prognosis is good!

Good luck!

Scattered
01-26-06, 08:52 PM
Well, I'm about a week out now on the 5-HTP and thing are going better than they have in a long time. I'm actually getting tons done and feel good. I seem to be able to tackle the scary organizational tasks with less anxiety which not only helps me stop avoiding them, but allows my executive funcitions not to be overrun by my emotional responses. I'm also finding I'm daydreaming less and don't feel I have to be locked in to some high stimulus thought, activity or whatever every second of the day to avoid feeling anxious. It's a very nice way to be! :)

Scattered

Scattered
06-09-06, 02:21 PM
Well, my anxiety level has been over the top and the depression is creeping up a bit too, plus I'm having menstral migrianes. I've decided to give the 10 mg of Sarafem (prozac) a try, since I already have the prescription sitting on my shelf. I did some reading and discovered I should be taking it in the AM not at bedtime -- so hopefully I'll be sleeping better than the last try with 20 mg. Reading back over what I wrote back then, it seems that most of the symptoms could be a result of lack of sleep -- something that always really throws my system off. We'll see. Wish me well.

I guess if this doesn't work, I'm going back to the doctor to see if he'll try something else.

Scattered

Crazy~Feet
06-09-06, 03:17 PM
Are you able to take birth control pills without bad side effects? I remember reading an article about using the pill to intentionally skip periods. I believe the regimen resulted in only 4 periods per year.
Just tossing the idea out there and hoping you find what you need soon. :)

Scattered
06-09-06, 08:19 PM
Thanks for the suggestion but birth control pills are pretty rough on me, plus the fact that breast cancer runs in my family.


Scattered

sloppitty-sue
06-09-06, 10:19 PM
Good luck to you, Scattered! And - YES - I am glad you are going to try the Serafem in the A.M. this time! I know that Prozac can be "energizing" for some when first ingesting. I took Prozac for 8 years, but it eventually pooped out on me.

Now I take Zoloft, along with Adderall, and that has been helpful as was the Prozac. I know that they say that Prozac can take up to (4?) weeks to take effect whereas Zoloft, I believe, is said to only take 7 - 10 days.

My daughter did NOT feel helped with her anxiety and depression when trying Prozac - she just got side effects. However - Zoloft really "cured" her. She had such a positive response from it that it was just like an advertisement. (No antidepressants ever had THAT profound of an effect on me.)

I'd be interested in hearing how it goes for you, Scattered.

Sincerely,
Sue

barbyma
06-10-06, 06:39 PM
I've decided to give the 10 mg of Sarafem (prozac) a try, since I already have the prescription sitting on my shelf. I did some reading and discovered I should be taking it in the AM not at bedtime -- Everybody is different (I'm better taking it at bedtime), but I understand the majority of people do better taking it in the morning.

I hope it works for you! If not, you might try Zoloft or Paxil.

good luck!

Scattered
06-13-06, 11:41 AM
Well, day five and life is looking up!:) I know it's not suppose to work this fast, but I tend to be very medication sensitive and I'm definately seeing an effect. For one thing my house is somehow magically straightening itself up and it is requiring no more effort than usual!:D It's probably too soon to tell but this dosage seems to be agreeing with me. My anxiety has definately backed way off, I'm not irritable or hyper, and I'm tolerating frustrations better while also setting better limits. I'm also sleeping much better which is a relief and some of my obsessive thoughts have also back off.

I'll try this for a month solid like the doctor wanted me to and then see if I need it all month or only the two weeks before my period next month. I'm definately thrilled and hoping this lasts -- I feel so much better and more at home in my own skin and haven't had any more migraines. I really wasn't expecting to get more done, just hoping to calm my anxiety down, but I'm so much more efficient. It really surprised me.

Scattered

Scattered
06-14-06, 08:55 AM
I've had a sore throat and now my nose is all stuffy. The information on Sarafem (prozac) said those could be side effects. Does anyone know if they are tempoary side effects -- I definately think breathing is something I'd like to be able to do a little easier?


Scattered

~boots~
06-14-06, 08:57 AM
I definately think breathing is something I'd like to be able to do a little easier?


Scatteredyep, breathing is good :faint: :faint: LOL

Scattered
06-14-06, 09:04 AM
yep, breathing is good :faint: :faint: LOLDefinately -- it was so bad last night that I woke up two hours early and could get back to sleep. That is not a good thing -- I get very squirely with too little sleep. So now I'm trying to decide if I'm taking my little lavender pill along with my Concerta this morning. Maybe I just caught a cold -- wish I knew.:eyebrow:

Scattered

Scattered
06-15-06, 06:54 AM
Well, here I am up in the middle of the night again -- not a good thing. I'm also finding that I'm very tired all day (wow, wonder if that could be related to not sleeping at night?:faint: ). I think I'll leave off the medicine and just try it in the two weeks when PMDD hits and see how it does then (you're suppose to be able to take Sarafem that way for PMDD). I'm definately like feeling calmer and reacting in a much more measured way, but I need sleep -- I'm falling behind again, because I'm napping during the day (well, trying too -- my kids never really let me fall asleep). I'm also turning into a bit too much of a flat liner -- I don't know if it's the medication or lack or sleep or combo.

I'm also a little worried about weight gain. My weight is good right now, but I've read all these horror stories of Prozac sending your weight skyrocketing in a couple of months time.

Scattered

QueensU_girl
06-15-06, 09:04 AM
Remember that one dose of Prozac lasts one week. (Which is why Prozac Weekly is just really regular Prozac in an 80 mg capsule.)

The Drug Maker, Eli Lilly does not tell us this, though. They want us to buy 7x Prozac Pills per week. (Grrr.)

Prozac's half-life is a gazillion years. ;)

This is Great if a person can't remember to take their pill.

This is Awful if they get into a drug interaction side effect and need it out of their system ASAP.

I understand that the "newer" drug Sarafem (the same drug as Prozac) is taken in only the week (7 days) b4 one's period.

My Point: Prozac can drive up Amphetamine levels, causing the headaches, muscle tension, head-pressure feelings, jaw-clenching that one can get from too much Stimulant accumulation. (This blood level increase has to do with the CYP450 2D4 Enzyme.)

If you start getting side effects (as i mention above) -- You might want to ask your Doctor if this can happen with Concerta (NOT an amphetamine, but SIMILAR chemically -- as it is a type of ritalin, rite?).

Scattered
06-15-06, 12:47 PM
Good information -- thanks Queensugirl!:) I didn't realize all that. Methylphenidate is the active ingredient in both Concerta and Ritalin -- just differently delivery systems. I think I'll definately just take it near the end of my cycle. I'm usually really good the first half -- it's the second half things change (especially the last week and I get tense and irritable and worst of all I get migraine headaches:faint: ).


Actually the jaw clenching, headaches and such are all things I had prior to taking Concerta. Concerta hasn't helped or hurt the jaw clenching but it definately helped the headaches -- except the menstral migraines -- which have been getting worse. I wonder if there is a connection to the Concerta -- I'll have to ask my doctor. Anyway, thanks again for the great information!

Scattered

Crazy~Feet
06-15-06, 01:14 PM
Please don't sweat the weight issue too much just yet Scattered, I actually lost tons of weight on Prozac.

Scattered
06-15-06, 01:42 PM
Thanks Crazy Feet -- thats good to hear. I'm also hoping the since I'm also taking Concerta that won't be as big a problem.

Scattered

barbyma
06-15-06, 02:57 PM
I've read all these horror stories of Prozac sending your weight skyrocketing in a couple of months time.
It's actually more common (or at least that was the word 10 years ago) for people to lose weight on Prozac.

My personal experience was to lose the first time I took it. When I returned to it a few years later, it had no effect on my weight at all. Zoloft made me gain, as did depakote, but everything else made me lose.

It's weird how individual and vast those differences are.

Crazy~Feet
06-15-06, 04:27 PM
It's actually more common (or at least that was the word 10 years ago) for people to lose weight on Prozac.

My personal experience was to lose the first time I took it. When I returned to it a few years later, it had no effect on my weight at all. Zoloft made me gain, as did depakote, but everything else made me lose.

It's weird how individual and vast those differences are.It IS weird! I lost weight my secind time on Prozac and the first round did nothing to me weight-wise. Same with several attempts on Paxil. Odd!

Scattered
06-15-06, 04:46 PM
It's very weird. I'm actually just where I want to be weight wise right now without having to sweat it. I actually gained 6 - 8 pounds on Concerta, because I had been pretty depressed before I started and had lost too much weight. I did a lot of research this morning and there doesn't seem to be any advantage for PMDD in taking Prozac all month long as opposed to just for two weeks, so I'll opt for the shorter time frame. I am so sleepy and I can't figure out if it is the prozac or the fact that my husband kept me up late typing a paper for his class the other night or a combination of the two. Anyway, I'm happy and relaxed (probably a little too relaxed:faint: ) -- I need to get a bunch of stuff accomplished and take a few less naps.

Scattered

Scattered
06-17-06, 05:54 PM
Okay, I'm off Prozac for now but my eye is still fluttering. It does that occasionally under stress anyway, but this is a lot more often then normal and my stress level is down. Tourettes runs in my family, so I'm wondering what's up. It's definately gotten worse since I started Prozac. Anybody know about this side effect?

Scattered

barbyma
06-18-06, 01:26 PM
It sounds like you might be responding a little like I did on Paxil & my father did on Prozac only not as severe.

I do just fine on Prozac & my father on Paxil, btw, so you might try Zoloft or Paxil if you haven't already.

Good luck!

Scattered
06-19-06, 04:11 AM
Thanks Barb!

Scattered
06-22-06, 11:31 AM
I did a lot of research this morning and there doesn't seem to be any advantage for PMDD in taking Prozac all month long as opposed to just for two weeks, so I'll opt for the shorter time frame. Bleh .... so much for my plans. After seeing me yesterday, my therapist told me he thought a good case could be made for taking Prozac all the time rather than just two weeks each months and he wanted me to discuss that with my doctor. He wasn't too concerned about the eye twitching but apparently was concerned about my functioning.:( I got the lecture about how if this was diabetes you'd take your insulin and such when I objected to increasing my med load. Unfortunately, I have tremendous respect for him -- he's a very good psychologist, understands ADD and me very well, and is always straight with me -- so I can't just blow his suggestion off lightly. Like I said, bleh ....

Scattered
06-24-06, 08:11 PM
Well -- so far so good. No side effects to speak of this time around and I'm feeling better -- maybe I just had a cold and not a reaction to the medication -- that would be nice.

I'm also getting more done and am less likely to get stuck on something. Hope this continues.:) Actually getting in the neighborhood of what might be considered normal!:p

Scattered

Crazy~Feet
06-24-06, 08:15 PM
So have you been taking the Prozac steadily? Sad thing about those SSRIs, you have to reach that blood level = therapuetic window for them to be effective.

I mentioned withdrawing from Cymbalta when I started seeing my ADD psydoc and he said maybe, later, but not now. So as far as I can see the combo is "doable", at least for me it is.

Thinking of you,
Crazy

Scattered
06-25-06, 07:01 PM
I was on it for one week -- off for one week -- and now back on for a week. Apparently from what I've experienced and read, when it's not being used for depression but for anxiety issues and such it often works much more quickly -- in a couple of days it was having an effect.

Thanks for the thoughts.:)
Scattered

Scattered
07-05-06, 02:01 PM
Well, apparently my psychologist was right again. :rolleyes: I'm doing very well on the combination of Concerta (18 mg twice a day) and Prozac (10 mg once a day). So many things have improved -- I'm sleeping better, I've stopped obsessing, I'm more relaxed, I'm getting more done -- even on long term projects I've put off, I'm getting along better with my husband and standing up for myself better too, I'm more interactive with my kids and enjoying them more, I've done more socially in the past two weeks than in the preceeding six months, I'm thinking more clearly and have plowed through two pretty heavy psyc books this week, and I'm even better able to regulate my computer time!:) I did still have a mild menstral migraine but just one and one Maxalt got rid of it, so that's an improvement.

Really the only problems right now are that my tendency to miss or forget what people say to me is worse (more like pre Concerta days) and my jaw is kind of tense and sore and I'm having to resist sucking on my lip -- not sure what that is about?:eyebrow: I see my therapist today, so I'll ask him if he's heard of it.

Scattered

Crazy~Feet
07-05-06, 04:15 PM
Yay! Nice to hear you have good news Scatt :). Just an idea on those bothersome effects--ya know me, my 2C is free :rolleyes:--you mentioned some things seem more like pre-Concerta days, and I remembered Vicki used to suck her lip until it was raw pre-Concerta :eek: and I actually had to remove my tongue-barbell because I would rattle the foolish thing until I drove people nuts. Maybe these mouth-involved movements or jaw-clenching are external focusing mechanisms?

Hope you get more good advice from the doc,

Crazy :)

Scattered
07-10-06, 11:51 AM
It does kind of seem like preConcerta days with the concentration, forgetting and such. The sucking thing got worse, so I quit the Prozac until I can talk to my doctor. It stopped being under voluntary control -- which was the pits because things were really going well in other ways -- but suddenly my cheeks were sucking in on the sides and I wasn't doing it.:eek:

Scattered

Crazy~Feet
07-10-06, 12:10 PM
Oh man Scatt! Ya must have felt so...weird.

Maybe Cymbalta will be worth a shot? Its an SSNRI and works for me. Just an idea.

{{{HUGS}}}

Crazy

Scattered
07-17-06, 04:09 PM
Well, I got in to see my doctor and he and my counselor think it is probably a motor tic (they run in my family). He gave me the option of continuing, quitting, or switching to another SSRI. I decided to stick it out a bit -- he said my body might adjust to it. I've found that doing relaxation exercises (deep breathing and such) help. I've moved the time of day to noon that I take the Prozac and that seems to have helped too, especially with the daytime sleepiness. The only time I have trouble with the mouth tic is in the evening when the Concerta is wearing off, other than that I'm doing better on a number of fronts. Less compulsive, less headaches, more even mood, and I'm even getting more accomplished (although there is still room for improvement!;) ). One of the nices things is that several behavior addictions I've struggled with have just vanished into thin air! I guess I fell more OCD spectrum than I realized.:rolleyes:

Scattered

Scattered
07-29-06, 03:41 PM
More problems:( -- I've developed a tic around my mouth (chewing movement) and in my eye lid. I'm in the process of weaning off Prozac. Too bad -- it was really helping, but I don't want to end up with a permant tic or dyskinesia. I wish I knew what was causing it -- the Prozac or the combination of Prozac and Concerta. I wonder if I need to get off Concerta too.

Scattered

Crazy~Feet
07-29-06, 03:52 PM
:( Oh Scatt. What's your next move?

Crazy

Scattered
07-30-06, 01:51 PM
I'm not sure:confused: -- if it doesn't clear up soon -- I guess I'd better try and find a psychiatrist who is knowledgable about this kind of stuff.

Scattered

barbyma
07-30-06, 07:54 PM
Hang in there, Scattered!

Prozac might just not be for you. You can try Paxil or Zoloft (if you haven't already) with little fear of the same problems. Some people just don't react the same to specific meds, as you know...

Scattered
07-31-06, 01:41 PM
Thanks Barb. I'm not sure what I'm going to do. Tourettes runs in my family and I'm wondering if the medication triggered a worsening of motor tics (I've always had a few minor tics that don't bother me -- although they used to drive my mom and husband nuts!:p ). It's rare but Prozac as well as the other SSRI can cause extraprimidal syndrome according to their fact sheet and I definately don't want that!:eek: Maybe I'll try some cognitive behavioral approaches for a while -- fortunately my husband is finishing school soon and my daughter will be entering school, so life should be a mite easier! Here's hoping. I'm a little gun shy about trying any other SSRI although I might have to if the cognitive-behavioral, exercise, relaxation, etc doesn't work.

Scattered

Scattered
09-15-06, 04:25 PM
Well, it's been 5 weeks today and the Prozac should be all out of my system and the Concerta was gone over a month ago -- welcome back to ADD World. It's easy to forget how spacy, forgetful, unmotivated, distractable, and scattered one can really be. And the real kicker is I still have the annoying munching syndrome. Oh well, such is life!:rolleyes:

Crazy~Feet
09-15-06, 05:44 PM
http://i3.photobucket.com/albums/y92/kzrainbow/hugs.gif

What's the next move Scatt?

Scattered
09-17-06, 12:44 AM
http://i3.photobucket.com/albums/y92/kzrainbow/hugs.gif

What's the next move Scatt? :confused: Don't know.

Scattered
10-12-06, 07:19 PM
Well I've decided to occasionally use my Concerta. My doctor wants me to steer clear of Prozac but felt we could carefully reintroduce Concerta. It worked great -- I got so much done, my mind could see how to organize things, and I had better control of my emotions, but ....................... It triggered my tics!:( My counselor actually was discussing EPS (extra pyramidal syndromes) the other day in session, so apparently he thinks it's more than just regular tics. EPS indicates brain damage done by medication.:faint: I wish I knew if occasionally taking Concerta to catch up on my disorganized life and help when the emotions run amok was safe. I can put up with the temporary tics for a couple of days if no permanent damage is being doing. Sure wish I knew the answer. The difference on medication is really dramatic. It's easy to forget what a huge difference stimulent medication makes for me.

Scattered

Scattered
02-21-07, 06:20 PM
This is Awful if they get into a drug interaction side effect and need it out of their system ASAP.

I understand that the "newer" drug Sarafem (the same drug as Prozac) is taken in only the week (7 days) b4 one's period.

My Point: Prozac can drive up Amphetamine levels, causing the headaches, muscle tension, head-pressure feelings, jaw-clenching that one can get from too much Stimulant accumulation. (This blood level increase has to do with the CYP450 2D4 Enzyme.)

If you start getting side effects (as i mention above) -- You might want to ask your Doctor if this can happen with Concerta (NOT an amphetamine, but SIMILAR chemically -- as it is a type of ritalin, rite?).Wow, this is interesting. I was just taking a look at last years medical history and read this again. I had forgotten all about it. It might really explain a lot when it comes to what triggered my tics. While Tourettes runs in my family and I previously had a few minor tics, I didn't have any trouble with Concerta or caffeine until after a couple of weaks on Prozac. Now any time I have any kind of stimulent or am under stress the tics kick in big time. Hmmm -- I should have paid more attention to this post and quit sooner. Driving up amphetamine levels for someone prone to tics on top of the stimulent I was already on sounds like a bad combination.

Belated thanks for sharing this, QueensUgirl!:)

Scattered

Scattered
02-21-07, 06:22 PM
Well I've decided to occasionally use my Concerta. My doctor wants me to steer clear of Prozac but felt we could carefully reintroduce Concerta. It worked great -- I got so much done, my mind could see how to organize things, and I had better control of my emotions, but ....................... It triggered my tics!:( My counselor actually was discussing EPS (extra pyramidal syndromes) the other day in session, so apparently he thinks it's more than just regular tics. EPS indicates brain damage done by medication.:faint: I wish I knew if occasionally taking Concerta to catch up on my disorganized life and help when the emotions run amok was safe. I can put up with the temporary tics for a couple of days if no permanent damage is being doing. Sure wish I knew the answer. The difference on medication is really dramatic. It's easy to forget what a huge difference stimulent medication makes for me.

ScatteredI think I have my answer. The last few times I've tried Concerta I ended up with obvious (not to mention painful) tics for days afterwards and also ended up with a migraine. I'm going to work on things from an exercise, relaxation, and spiritual side from here on out. I'm actually doing pretty well.

Scattered