HOW DO WE SWITCH TO PROZAC? 
Ask The Doctor Dr. Leland Heller Biological Unhappiness 
HOW DO WE SWITCH TO PROZAC? 
Question: Dr. Heller, My teenage daughter has been diagnosed with BPD. We have had an extremely difficult year with suicide attempts, two hospitalizations, and an extremely chaotic life at home. I have been reading about you and your research and the Prozac, Tegretol combination. I talked to her doctor about it and he was willing to start Prozac in addition to her other medications for now. My question is how effective is this going to be? Currently, she is on Zoloft (for depression), Abilify (for mood), Concerta (for ADHD) and lithium (for mood). He just decreased the Zoloft to introduce the Prozac because he said he has to decrease it slowly. Is there any hope for the Prozac or does she have to be completely off the other meds or some of the other meds first? We are desperate. Also, she got a rash from the generic Prozac so now we have had to order the “real thing”. Dr. Heller’s Answer: 1) If she’s truly allergic to generic Prozac (fluoxetine), she will be allergic to the brand name as well. If she’s just allergic to one of the chemicals mixed in with the fluoxetine, she may be okay to take the Prozac. If there is truly an allergic reaction to Prozac (fluoxetine), this medication cannot be used. Zoloft (sertraline) is a reasonable alternative. I did a small study comparing Zoloft (sertraline) with Prozac (fluoxetine) 15 years ago:http://pks.947.myftpupload.com/study.htm 2) If the switch is going to be made to Prozac, it can be done right away. There is no need to taper off Zoloft because Prozac prevents withdrawal symptoms. 3) Tegretol (carbamazepine) can be added to the Zoloft. It’s usually not quite as effective as the Prozac/Tegretol combination, but it’s a reasonable second choice. 4) The dosing of Tegretol can be difficult. I usually start with one or two in the late afternoon and see how they do. 5) In general, unstable adolescents with BPD need Prozac (or Zoloft) plus Tegretol until approximately age 22. At this age, the adult brain starts to take over for the adolescent brain. Many of these individuals can successfully get off all medication at that point, but in my experience most unstable adolescents stay somewhat unstable through adulthood unless they’re on medications. 6) Lithium rarely has benefit for the BPD. It’s main use is for suicidality in bipolar. 7) She will still need as needed medications for her episodes of dysphoria (anxiety, rage, depression and despair):http://pks.947.myftpupload.com/dysphori.htm 8) If the cognitive generalized anxiety disorder is also present, her current medications will make her overall condition worse as they trigger that gene. If the GAD is present, BuSpar will need to be added to prevent this complication. All SSRI drugs like Prozac and Zoloft increase that anxiety, and so do stimulants like Concerta (methylphenidate) and Adderall. Good luck!! Dr. H 
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Ask the Doctor Home 
MENU: 
Screening Test “Ask the Doctor” (BPD)Borderline Personality Disorder Annual Updates Biological Unhappiness Disorders & Official Criteria Dr. Heller’s C.V. & Picture How Dr. Heller Got Involved If You Want to See Dr. Heller as a Patient Testimonials Table of Contents for the Book ‘Biological Unhappiness’ How to Order “Life at the Border” Why Read ‘Biological Unhappiness’? Goals AD(H)D and Relationships BPD, Bipolar or ADHD? Suicide What if BuSpar makes me anxious or ill? A Suicide Attempt Per Minute in the US Grandparents raising Grandchildren Information About Children What Signs are there that Someone May ‘SNAP’? TV & Cartoon Characters with Depression & Other Disorders Dr. Heller’s Office Website Dr. Heller’s Lectures Mentally Healthy People Retraining the Brain Today is a Gift Reviews Links Webrings Site Index Home 
Video DVDs now available! You can watch and listen to Dr. Heller in the comfort and convenience of your own home. Provides full explanations and treatment descriptions of Borderline Personality Disorder (BPD) – 90 minutes, other Biological Unhappiness disorders – 90 minutes. Click here to find out more about Dr. Heller’s educational videos. “Biological Unhappiness” “Open this book and it will open your mind. By combining proven medical procedure with hope and inspiration, Dr. Heller has made a significant difference in thousands of patients who had little hope for recovery. “Biological Unhappiness” contains critical information for those who have lost hope.”Zig Ziglar, motivational speaker, author, See You at the Top, Over the Top, Success for Dummies, Raising Positive kids in a Negative World. 
Dr. Leland Heller Dyslimbia Press, Inc. 1713 US Hwy 441 N, Suite E Okeechobee, FL 34972 863-467-8771 Email:
Hours: M-Thu. 8:30AM-5PMFri. 8:30AM-12 Noon*(*During November through April, the office is open until 3PM on Fridays.) All material not explicitly credited otherwise is copyrighted © 1999-2011 Dr. Leland Heller. All Rights Reserved. May not be duplicated without the permission of Dr. Leland Heller or Dyslimbia Press. Biological Unhappiness, BiologicalUnhappiness.com, & Dyslimbia Press are trademarks of Dr. Leland HellerDesigned and/or hosted by the webmasters at: US-Webmasters.com (TM) Start here to find it FAST!(TM)
Skip to content