Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Why Is Zoloft Preferred Over Prozac To Treat Depression?
Brief Answer:
all SSRIs work the same
Detailed Answer:
Hello and thank you for your question.
All of the Selective Serotonin Reuptake Inhibitors (SSRI) drugs work equally well for treating depression. However, that said, they do not all work for every person. Most people do not recommend prozac as first line because it tends to have many more side effects than most of the other SSRIs. It also takes longer to start working than the other SSRIs sometimes taking up to 10 weeks to lift a depression. Personally I would usually start an 18 year old on Lexapro or citalopram, since they tend to have fewer side effects than either zoloft or prozac and will start working in a few weeks. It is really a provider preference. For most patients we just have to start a medication, monitor side effects and how well it works and see if we need to change it or modify the dose.
Please be aware that all of these drugs are dangerous if mixed with alcohol. Please try to get him to go to counseling as it can help many of his problems.
Let me know if you have further questions
Dr. Robinson
all SSRIs work the same
Detailed Answer:
Hello and thank you for your question.
All of the Selective Serotonin Reuptake Inhibitors (SSRI) drugs work equally well for treating depression. However, that said, they do not all work for every person. Most people do not recommend prozac as first line because it tends to have many more side effects than most of the other SSRIs. It also takes longer to start working than the other SSRIs sometimes taking up to 10 weeks to lift a depression. Personally I would usually start an 18 year old on Lexapro or citalopram, since they tend to have fewer side effects than either zoloft or prozac and will start working in a few weeks. It is really a provider preference. For most patients we just have to start a medication, monitor side effects and how well it works and see if we need to change it or modify the dose.
Please be aware that all of these drugs are dangerous if mixed with alcohol. Please try to get him to go to counseling as it can help many of his problems.
Let me know if you have further questions
Dr. Robinson
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your response Do you know of this antidepressant called trintellix. My nephew was just put on it He is 22 yrs old now and just finishing up his 4 yrs at university. My sister reports that my nephew did not have any real side effects on this med and within a couple of weeks his mood was already improving.
He is finding it very difficult concentrating on the strategies the counsellor has given him - he has become so flat with his affect that nothing is going through at this point. He really feels she is not helping him and she goes away in 2 weeks for all of August. My plan is to get him into a different counsellor in the next week Maybe it's just her style and approach or maybe he is not ready until something lightens his mood. It's all he's got to get up in the morning and get to his summer job
He is finding it very difficult concentrating on the strategies the counsellor has given him - he has become so flat with his affect that nothing is going through at this point. He really feels she is not helping him and she goes away in 2 weeks for all of August. My plan is to get him into a different counsellor in the next week Maybe it's just her style and approach or maybe he is not ready until something lightens his mood. It's all he's got to get up in the morning and get to his summer job
Brief Answer:
Trintellex
Detailed Answer:
Hello,
Trintellex is a new drug and has quite a few reported side effects. Here is an article that you can read about it.
http://www.madinamerica.com/2014/12/new-antidepressant-shows-little-benefit-significant-risks/
I would stick to one of the more tried and true SSRI drugs for him.
I agree that getting a new counselor may be helpful, but he needs to be on a medication as soon as possible
Regards,
Dr. Robinson
Trintellex
Detailed Answer:
Hello,
Trintellex is a new drug and has quite a few reported side effects. Here is an article that you can read about it.
http://www.madinamerica.com/2014/12/new-antidepressant-shows-little-benefit-significant-risks/
I would stick to one of the more tried and true SSRI drugs for him.
I agree that getting a new counselor may be helpful, but he needs to be on a medication as soon as possible
Regards,
Dr. Robinson
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for all your help. This is a very hard time in our family especially for my son. I just want to make sure he gets on the right medication the first time if possible so he can see there is hope. We have few resources for psychiatrist around here and with university just around the corner- (which he so wants to go) the time clock is ticking.
Brief Answer:
I know how hard this can be
Detailed Answer:
I too have depression so I know there is good treatment out there. Please encourage him to get counseling and to take medications as directed. Medications, counseling and exercise can all help lift depression lift depression and the more of those he does the better.
I hope he is feeling better soon,
Dr. Robinson
I know how hard this can be
Detailed Answer:
I too have depression so I know there is good treatment out there. Please encourage him to get counseling and to take medications as directed. Medications, counseling and exercise can all help lift depression lift depression and the more of those he does the better.
I hope he is feeling better soon,
Dr. Robinson
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello,
I met with my son's Dr briefly today. He let me go over the behaviors he has exhibited the last couple weeks and i stressed that because the fact that my son has never been on any medication and that he is leaving to go to university in 6 weeks I am hoping a antidepressant could be order that would show some signs of working with in 2-3 weeks. This would give him some hope and give us the possible reassure that he might be able to cope in this new environment. I was dismissed from the room after I had my say and 20 min later my son comes out with a prescription for Prozac. Of course my son would be compliant with what ever the Dr says and not know to ask any questions.( This Dr has been his Dr since he has been a baby and we have always told the kids how great a Dr he is)e I am so worried about Prozac and it's side effects. Mostly the increased risk of suicide. I have asked my son to hold off taking the med till my husband and I can discuss with the Dr why he choose this medication over the others and reasons for this one over the other options. We are now running the risk that the Dr will not explain anything to us as our son is the adult and he does not have to discuss this. (but I do know that if my son had cancer I am sure the Dr would sit down with us and explain everything and reasons for treatment etc). The Dr may even discharge as patients from his care as well. This Dr as good as he has been to our children he is not one to be very open to others advise. I am not sure how we should approach this situation. We are trying to get an appointment tomorrow to discuss this with him. Any thoughts? As well the more I think about my son - I believe his anxiety is more of an issue then the depression. I think his anxiety blocks him from making choices and decisions, which then makes him depressed as well. Is there any medication that is an anti anxiety and an mild antidepressant with very few side effects?
I met with my son's Dr briefly today. He let me go over the behaviors he has exhibited the last couple weeks and i stressed that because the fact that my son has never been on any medication and that he is leaving to go to university in 6 weeks I am hoping a antidepressant could be order that would show some signs of working with in 2-3 weeks. This would give him some hope and give us the possible reassure that he might be able to cope in this new environment. I was dismissed from the room after I had my say and 20 min later my son comes out with a prescription for Prozac. Of course my son would be compliant with what ever the Dr says and not know to ask any questions.( This Dr has been his Dr since he has been a baby and we have always told the kids how great a Dr he is)e I am so worried about Prozac and it's side effects. Mostly the increased risk of suicide. I have asked my son to hold off taking the med till my husband and I can discuss with the Dr why he choose this medication over the others and reasons for this one over the other options. We are now running the risk that the Dr will not explain anything to us as our son is the adult and he does not have to discuss this. (but I do know that if my son had cancer I am sure the Dr would sit down with us and explain everything and reasons for treatment etc). The Dr may even discharge as patients from his care as well. This Dr as good as he has been to our children he is not one to be very open to others advise. I am not sure how we should approach this situation. We are trying to get an appointment tomorrow to discuss this with him. Any thoughts? As well the more I think about my son - I believe his anxiety is more of an issue then the depression. I think his anxiety blocks him from making choices and decisions, which then makes him depressed as well. Is there any medication that is an anti anxiety and an mild antidepressant with very few side effects?
Brief Answer:
try to talk to doctor
Detailed Answer:
Hello,
I am sorry this happened and I think it is worth it for you to try and get an appointment to talk to the doctor. Your son would need to be with you or you would need to have him sign a consent at the doctor's office for the doctor to talk to you. Since he is legally an adult the doctor can not talk to you about his case without a signed consent from your son (or him being present).
Just so you understand, though prozac does have more physical side effects than other medications like insomnia and sexual dysfunction, it does not have a higher risk of suicide. All anti-depressants carry that risk. This is because when a person is profoundly depressed and suicidal they may not have the energy or mental faculty to carry out a suicide. When an antidepressant is started the mental clearing and physical energy may improve before the mood and someone that is profoundly depressed and suicidal may then have the energy and mental clarity to carry out their wish.
But please understand, Prozac is not a bad drug. It will treat his depression and anxiety, it has the longest track record of any SSRI and if you can not see the doctor or if the doctor will not budge, it will be okay for him to start the Prozac and because it takes longer to kick in, the sooner the better.
Regards,
Dr. Robinson
try to talk to doctor
Detailed Answer:
Hello,
I am sorry this happened and I think it is worth it for you to try and get an appointment to talk to the doctor. Your son would need to be with you or you would need to have him sign a consent at the doctor's office for the doctor to talk to you. Since he is legally an adult the doctor can not talk to you about his case without a signed consent from your son (or him being present).
Just so you understand, though prozac does have more physical side effects than other medications like insomnia and sexual dysfunction, it does not have a higher risk of suicide. All anti-depressants carry that risk. This is because when a person is profoundly depressed and suicidal they may not have the energy or mental faculty to carry out a suicide. When an antidepressant is started the mental clearing and physical energy may improve before the mood and someone that is profoundly depressed and suicidal may then have the energy and mental clarity to carry out their wish.
But please understand, Prozac is not a bad drug. It will treat his depression and anxiety, it has the longest track record of any SSRI and if you can not see the doctor or if the doctor will not budge, it will be okay for him to start the Prozac and because it takes longer to kick in, the sooner the better.
Regards,
Dr. Robinson
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I am trying to get our son into a clinical psychologist
ASAP for a 2nd opinion. What if he starts on Prozac and then psychologist suggests a different medication how harmful is it to switch to another one? Does he have to ween off Prozac and then restart or can he just switch over and does that cause it's own risks?
ASAP for a 2nd opinion. What if he starts on Prozac and then psychologist suggests a different medication how harmful is it to switch to another one? Does he have to ween off Prozac and then restart or can he just switch over and does that cause it's own risks?
Brief Answer:
seeing a psychologist would be helpful
Detailed Answer:
If he is on prozac for a short time (weeks) only then no wean off period would be necessary to switch him to another drug.
Dr. Robinson
seeing a psychologist would be helpful
Detailed Answer:
If he is on prozac for a short time (weeks) only then no wean off period would be necessary to switch him to another drug.
Dr. Robinson
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
My son has coem home from a 12 hr shift tonight and I asked him if he has started on the prozac He refuses to answer me He wants to be left alone he tells me it is none of my business and to stay out of his business. He got really angry and said I was trying to make him feel guilty I tried to explain where I was coming from - and he no longer wants to talk to me or my husband about anything. He says to stay out of his life. We are too controlling he says. He actually stopped talking to his Dad a couple of weeks ago. Won't acknowledge him at all - those 2 use to be so close. It's devastating to watch.
We found a book in his room today when we were trying to find the medication . He had made a journal entry from yesterday 50 reasons why not to eat and how to make yourself full without eating. He is 139.5 lbs and 5'6" (says that he is about in 53%ile range) He took pictures of himself and recorded all his measurements. He is spiraling out of control and I really don't know what to do This has all come on so fast. Can you help me at all of what we should do here?
We found a book in his room today when we were trying to find the medication . He had made a journal entry from yesterday 50 reasons why not to eat and how to make yourself full without eating. He is 139.5 lbs and 5'6" (says that he is about in 53%ile range) He took pictures of himself and recorded all his measurements. He is spiraling out of control and I really don't know what to do This has all come on so fast. Can you help me at all of what we should do here?
Brief Answer:
must see therapist
Detailed Answer:
I am so sorry you are having these struggles.
If you think he is an imminent danger to himself you can have him involuntarily committed to a psychiatric facility.
He needs medication and counseling urgently.
The best thing you can do is to find someone that he trusts and ask them to intervene to try and assist you in getting help for him.
Someone has to get him into treatment.
You can take him to Emergency to get a psychiatric evaluation done urgently if needed.
I hope you can get him assistance soon.
Dr. Robinson
must see therapist
Detailed Answer:
I am so sorry you are having these struggles.
If you think he is an imminent danger to himself you can have him involuntarily committed to a psychiatric facility.
He needs medication and counseling urgently.
The best thing you can do is to find someone that he trusts and ask them to intervene to try and assist you in getting help for him.
Someone has to get him into treatment.
You can take him to Emergency to get a psychiatric evaluation done urgently if needed.
I hope you can get him assistance soon.
Dr. Robinson
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thankyou for your support
He is 18 now and I cannot make him go .. He refuses any help from me now.
I have found out he cut himself on Wed night before his Dr's appointment on Thurs.
as well I have found out he himself feels he has an eating disorder and borderline alcoholic (according to his comments he left on a secret account he has on his phone) We are meeting a pharmacist friend of our's today and will see if he has any advise and see if he has any connections to get us into get help for him. Our little community is severely lacking many services
We have no family support here so He will not have any one but really that he is close too as he has pushed any friends he did have away and does not trust that anyone cares if they do reach to help him. He has one friend that he knows from school who a yr ago came out of her own ordeal with severe eating disorder - he might listen to her but that is a big burden to put on her if she herself is still recovering.- no? How can you get him assessed if he does not want treatment. Especially in our hospital unless you come in in a crisis they will not help. Not enough services for the need.
He is 18 now and I cannot make him go .. He refuses any help from me now.
I have found out he cut himself on Wed night before his Dr's appointment on Thurs.
as well I have found out he himself feels he has an eating disorder and borderline alcoholic (according to his comments he left on a secret account he has on his phone) We are meeting a pharmacist friend of our's today and will see if he has any advise and see if he has any connections to get us into get help for him. Our little community is severely lacking many services
We have no family support here so He will not have any one but really that he is close too as he has pushed any friends he did have away and does not trust that anyone cares if they do reach to help him. He has one friend that he knows from school who a yr ago came out of her own ordeal with severe eating disorder - he might listen to her but that is a big burden to put on her if she herself is still recovering.- no? How can you get him assessed if he does not want treatment. Especially in our hospital unless you come in in a crisis they will not help. Not enough services for the need.
Brief Answer:
get all the help you can
Detailed Answer:
Please get all the help you can locally, both for him and for yourselves. Seeing a counselor or therapist yourself may help give you and your family some tools to help deal with him. If he becomes overtly suicidal you can call the police to take him to Emergency for an involuntary commitment. This seems drastic but it could save his life if you feel that he is suicidal.
I am wishing that you all get some relief soon
Dr Robinson
get all the help you can
Detailed Answer:
Please get all the help you can locally, both for him and for yourselves. Seeing a counselor or therapist yourself may help give you and your family some tools to help deal with him. If he becomes overtly suicidal you can call the police to take him to Emergency for an involuntary commitment. This seems drastic but it could save his life if you feel that he is suicidal.
I am wishing that you all get some relief soon
Dr Robinson
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
