Hello All:
Allan Netick wrote:
>I too have taken it (Prozac) for 2 years or so. ALso I don't get the
>buzz (faster thinking and movements) that I did before. I just got a RX
>for 10 mg pill once a day in the early pm along with my other capsule.
>Haven't tried it yet. Supposedly people take up to 80 mg /day.
>Interactions of Prozak with other drugs, ESP Eldepryl are matter of
>concern. Let me try another spe+ 11lling: Deprenyl? Selegeline.
>Whatever.
Right you are Allan in considering the interaction between Prozac/fluoxetine
and Eldepryl/selegline.
The text below is taken from An Examination of Medications both Commonly and
Occasionally used in Treating Parkinson's Disease by Neal Slatkin, MD:
SELECTIVE SEROTONIN RE-UPTAKE INHIBITORS (SSRI) ANTIDEPRESSANTS
PROZAC (FLUOXETINE), ZOLOFT (SERTRALINE), PAXIL (PAROXETINE) AND OTHERS
Depression is more common in Parkinson's disease than in other chronic
illnesses of similar severity, probably due to an alteration of
neurotransmitter levels in the brain, including the levels of serotonin and
norepinephrine. Depression in the Parkinson's patient can worsen virtually
all symptoms of the disorder, which in turn can deepen the patient's
depression, causing a vicious circle of physical and mental impairment.
Often, in order for a patient to get maximal benefit from anti-parkinsonian
medications, the depression must be treated.
The selective serotonin re-uptake inhibitors (SSRI) antidepressants appear
to
work by raising serotonin levels in the brain. While they cause few of the
side effects associated with the older generation antidepressants, they are
much more expensive. Parkinsonian signs often improve following treatment
with SSRI antidepressants as depression resolves. In selected patients, SSRI
antidepressants may have a more direct effect in relieving certain symptoms
of Parkinson's disease by potentiating the effects of dopamine.
SIDE EFFECTS OF SSRI ANTIDEPRESSANTS
+ Nausea, diarrhea, headache, sleepiness, loss of appetite, fatigue and
problems having an ejaculation
+ Prozac and to a lesser degree Zoloft, can cause tremor, insomnia and
anxiety.
+ If taken in the morning, Paxil and Zoloft can cause excessive sleepiness.
+ Note: On occasion these medications can actually worsen the symptoms of
Parkinson's disease or cause a sense of physical restlessness.
CONTRAINDICATIONS
When combined with Eldepryl (selegiline), these medications can uncommonly
cause a severe syndrome characterized by increased rigidity, jerking
movements of the arms and legs, agitation, confusion, restlessness, fever,
shivering and sweating ("serotonin syndrome"). The simultaneous use of these
medications and Eldepryl should be discussed with your physician.
Margaret Tuchman (54yrs dx 1980)
