Brief Answer:
explained

Detailed Answer:
Hello and Welcome

I appreciate your concern.

trazodone, has an off label use in insomnia


Prozac (fluoxetine) + trazodone

fluoxetine and trazodone both increase serotonin levels. High likelihood serious or life-threatening interaction. Contraindicated unless benefits outweigh risks and no alternatives available.


trazodone + fluoxetine

trazodone and fluoxetine both increase QTc interval. Potential for dangerous interaction. also exists in this case and requires monitoring

serequal May worsen hypotensive conditions. there is Increased risk of hyperglycemia and diabetes; in some cases, hyperglycemia concomitant with use of atypical antipsychotics has been associated with ketoacidosis, hyperosmolar coma, or death; monitor blood glucose of high-risk patients

In Trileptal

monitoring for notable changes in behavior that might be associated with suicidal thoughts or depression (notify health-care provider immediately if symptoms occur) Please take Caution in performing tasks that require mental alertness.


Bipolar affective disorder is characterized by periods of deep, prolonged, and profound depression that alternate with periods of an excessively elevated or irritable mood known as mania.

Manic episodes are feature at least 1 week of profound mood disturbance, characterized by elation, irritability, or expansiveness

Laboratory tests that may be helpful as adjunct to follow up with these medication include the following:
•CBC count
•ESR levels
•Fasting glucose levels
•Electrolyte levels
•Protein levels
•Thyroid hormone levels
•Creatinine and blood urea nitrogen levels
•Liver and lipid panel
•Substance and alcohol screening


I would not recommend trazodone with Prozac, please discuss other options or monitor closely with your psychiatrist , the other medications also have many side effects but their benefit outweighs the risk at present.
in addition
cognitive behavioral therapy. Yoga and meditation , too have proven benefit
in addition to relaxing exercise. I would also encourage you to join support groups for overcoming your issues.

Psychotherapy may help to decrease relapse rates, improve quality of life, and/or increase functioning, or more favorable symptom improvement.

Electroconvulsive therapy may be useful in selected patients with bipolar disorder



Let me know if you have any query

wishing you best of health

Thanks

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Brief Answer:
explained

Detailed Answer:
hello,

Trazodone and Prozac interaction chances exist, especially with dose increases. I am referring to a condition called Serotonin syndrome. Though your long term use shows that you have tolerated the drugs well so far, having said that the interaction is proven and exists The FDA recently asked drug manufacturers to include warning labels on their products to let patients know about the potential risk of serotonin syndrome


Serotonin is a chemical produced by the body that enables brain cells and other nervous system cells to communicate with one another. Too little serotonin in the brain is thought to play a role in depression. Too much, however, can lead to excessive nerve cell activity, causing a potentially deadly collection of symptoms known as serotonin syndrome or serotonin reuptake syndrome.

Serotonin syndrome symptoms often begin within hours of taking a new medication or increasing the dose of one you are already taking.

In severe cases, serotonin syndrome can be life-threatening. If you experience any of these symptoms, you or someone with you should seek medical attention immediately:

•High fever
•Seizures
•Irregular heartbeat
•Unconsciousness

Serotonin syndrome can occur if you are taking medications, particularly antidepressants, that affect the body's level of serotonin. The greatest risk of serotonin syndrome occurs if you are taking two or more drugs and/or supplements together that influence serotonin. The condition is more likely to occur when you first start a medicine or increase the dose.

You may take anti allergic like levocetirizine and Tylenol to have relief from the cold symptoms.


Let me know if you have any query
Thanks.

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Brief Answer:
explained

Detailed Answer:
Hello,

Trazodone with Prozac at increased doses should have been a last alternative. i.e other safer combinations may have been tried before this. The fact that you haven't had any severe symptoms which I described in my previous answer, shows that you have tolerated it well. However it would be a good idea to discuss with your psychiatrist the options having less severe documented interactions. following are some of the options.

Medications used to manage patients with bipolar disorder include the following:

•Benzodiazepines (eg, lorazepam, clonazepam)

•Antimanic agents (eg, lithium)

•Anticonvulsants (eg, carbamazepine, valproate sodium, valproic acid, divalproex sodium, lamotrigine, topiramate)

•First-generation antipsychotics (eg, inhaled loxapine, haloperidol)

•Second-generation antipsychotics (eg, asenapine, ziprasidone, , risperidone, aripiprazole, olanzapine, olanzapine and fluoxetine, , paliperidone)

•Phenothiazine antipsychotics (eg, chlorpromazine)

•Dopamine agonists (eg, pramipexole)

The XXXXXXX Psychiatric Association's (APA) 2005 guideline watch for the treatment of patients with bipolar disorder noted that medications having the strongest evidence for efficacy for the acute treatment of depression in BPI are the olanzapine-fluoxetine combination, quetiapine, and lamotrigine. Furthermore, there is some evidence that pramipexole may be helpful as an adjunctive agent, although only modest evidence exists for the efficacy of an antidepressant with adjunctive mood stabilizer. Antidepressants in the absence of a mood stabilizer are not recommended by the APA for BPI patients.


Please continue your medication and do not stop them abruptly but do discuss other options I listed on your next visit to the psychiatrist.

Let me know if you have any query
I will be more than glad to help

Thanks

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