Today one of my patients asked a question about her medication, an SSRI, and my answers might be useful to others taking similar medication. She was taking fluoxetine, brand name Prozac, for a number of months. Even at a relatively high dose of fluoxetine, she continued to experience significant anxiety. Fluoxetine is ‘activating’ in some people, meaning that it sometimes increases the person’s sense of energy, which can, in turn, increase anxiety. At some point we decided to change to escitalopram, brand name Lexapro, a newer SSRI that has a high potency and somewhat less activation.
Like other docs, psychiatrists receive email surveys now and then asking about different aspects of life as a psychiatrist– about the medications favored for treating depression or anxiety, the fees charged for different types of patient visits, and the amount of time spent at work versus home.
I received such a survey last week, in multiple choice format. Much of it was the same as usual, asking the things I described above and similar questions. But one question made me pause for a moment, and to re-read the question and the choice of answers.