Prozac. Is it making me "average"?
April 29, 2006 10:25 AM   Subscribe

I'm on Prozac. It is really working but is it making me into a C grade student who enjoys life, is generally well liked and prefers the simple pleasures to deep analytical thought?

I've been taking Prozac for several months now despite a high degree of personal skepticism of using drugs to dig me out of problems. I'm getting older (don't ask) and have recently started studying at University again. When I was younger I was sharp and alert and I still get brief periods of that now but more often my brain won't gear itself into a higher plane of thought - it is like I am always living in the moment and I can't step out of it and critically assess my thoughts. I feel I've changed from being competitive, complex, creative and moody to become one of those pleasant people who just study to pass, are generally quite sociable and enjoy the simple pleasures. Is it the prozac or am I just getting old? Is there something I can take to override this effect (even for brief periods such as in exams)? Your own experiences appreciated.
posted by zaebiz to Health & Fitness (19 answers total) 4 users marked this as a favorite
I had this sort of thing happen to me on Effexor. I no longer -cared- about things. I didn't get so depressed, but my creative work fell off to nothing, my housekeeping suffered, everything went to 'slack' because I just couldn't be arsed to worry about anything, even things I -should- worry about. It was good in the short-term because it helped me realize I didn't have to stress about everything, but in the end I got off it because, while the new me was nice and all, it wasn't productive.
posted by Rubber Soul at 10:55 AM on April 29, 2006

I took Prozac for nearly two years, (I'm in my forties), and ended up in some serious trouble due to the changes you describe. I was so 'wrapped in cotton wool' that I neglected quite important financial matters.

The only answer for me, when my Dad was thoughtful enough to intervene and drag my arse back to reality, was a change of medication. I look back on that period, (which was 5 years ago), and really can't remember much at all. Very Stepford Wives.

Talk to your Doctor. Anti-depression medications are definitely not 'one-size-fits-all'.

Purely anecdotal, anyone's mileage will vary.
posted by punilux at 10:57 AM on April 29, 2006

Yeah, talk to your doctor. It varies so much from drug to drug and person to person it'll be hard to find a consensus.

If anything, going on antidepressants made me feel like I got back to being creative and complex, not the reverse.

Maybe you're getting a sedating side-effect from it? What you describe isn't the way they're supposed to work, so I'd hit up the doctor.
posted by frenetic at 11:18 AM on April 29, 2006 [1 favorite]

There are so many different antidepressants out there. Definitely talk to your doc about a switch, because what you're describing is not how it's supposed to work. I've taken zoloft at various points in my life and it's always made me more productive, improved my grades, and made me feel more like myself. If that's not happening for you, you are on the wrong antidepressant.
posted by selfmedicating at 11:31 AM on April 29, 2006 [1 favorite]

My creativity, and I'm intensely creative, is deeply bound in my melancholy and depression. On meds, I'm simply not as creatively productive. But a large portion of that creativity was itself melancholy. And I wouldn't have survived to this age without the meds. For me, being alive is worth the price of some creativity. Also, as I've implied, I've also come to question how much true value a lot of what arose from melancholia.

But the most important thing I want to tell you is to try very hard to avoid making judgments about "who you really are". Or, at least, don't jump to the conclusion that your deep, intense, melancholy and often very depressed self is who you "really" are. Because if your mood disorder is biochemical, then surely there's the possibility that who you "reall" are is the person not afflicted by that disorder.

In my case, I spent months and months feeling like I wasn't myself on meds until I had an epiphany one day as I was walking past a schoolyard. Children playing make me very happy, and at that moment I felt very happy about my life and the world. And I suddenly thought about all my values and many of the ways in which I fundamentally see the world and I realized that I am and always have been an optimist, someone who is very open to the beauty and joy of the world. But much of my life I had spent in pain and sorrow and anger and deep depression. And in that moment it finally occured to me that it was entirely possible that the "real" me was the optimistic, joyful person and not the deeply depressed person. From that moment on, I no longer had that sort of identity confusion. Now I pragmatically appreciate that the meds make me functional when I wouldn't be functional, or possibly alive, without them. That's a good thing. And I'm happy that I can be happy about life and the world, which feels, truly, like that's "right" for me. So I gave up those mood swings, those deep, deep melancholias that drove a lot of creative desire. I am less creative. But that doesn't mean I'm not creative at all, far from it. It's a bargain that I think I've come out ahead on. But this is a decision each person has to make for themselves. Just be openminded about how to think and evaluate this.

And, of course, as everyone says, it may well be the case that a different medication will provide you with the therapeutic benefits you're looking for while avoiding what you're complaining. Work with your doctor to find alternatives.
posted by Ethereal Bligh at 11:45 AM on April 29, 2006 [3 favorites]

I'm in my early 20's, but I can identify with the feeling you've noticed. For me, though, Celexa (a usually-well-tolerated substitute for Prozac) caused the unshakable funk—for me, it was that my grades began to slip, and, more importantly, I couldn't muster any sense of hope or yearning, or some design for my future that was the least bit motivating for me. I simply couldn't find an angle that made doing a thorough job of this assignment or that assignment compelling.
But, the whole time my grades were slipping, I felt much better than I had in many many years. No question about that.

My doctor and I finally arrived at a dosage of Prozac that had the same positives as the Celexa had had, but skipped that nihilistatic fog. :-)

So, in short, you're on the right track. You're simply using a "sub-optimal" treatment—a treatment that's somewhat effective, though. Thankfully, most of the experimenting one can do in search of a substitute for Prozac will keep you safely within the bounds of generic-brand—and thus, affordable—medications.
posted by Yeomans at 11:56 AM on April 29, 2006

There are a lot of possible solutions that don't involve dumping the Prozac. You could take less of it on your current schedule. You could take it less often, because Prozac has an incredibly long half life. You could add a different drug.

I take Celexa. By itself, the amount needed to address my symptoms gave me the cocoon-like feeling that punilux describes. I didn't care about anything and had serious memory loss. The addition of Wellbutrin gave me more energy, restored some of my libido, and helped a lot with memory.

Many doctors now consider Prozac something of a 'blunt instrument.' It does work for a lot of people, but so many good drugs have been released since Prozac came out in the early 80's -- it could be worth the effort to try something else. [Many people assume that if one ssri isn't right, then none of them will be right -- that's absolutely not valid.] But see if your doctor has any ideas about a supplementary med. If not, see someone else -- a psychiatrist, not a GP.
posted by wryly at 12:09 PM on April 29, 2006

I'll echo the fact that antidepressants are far from magic bullets. You can tell that from this thread.

As for depression, its known that about 1/3 get better with no treatment, 1/3 on antidepressants, and 1/3 using antidepressents and psychotherapy. Now, "get better" is ambiguous and wierd. BUT, the latter (drugs + psychotherapy) works bests and lasts longest.

So, you might want to try some more couch time and see if you have other issues that might be clouding your drive or simply get some brain coaching to get the drive back.

Or, if you're feeling good -- you might want to try simply halting the drug if you've felt it did its work, you know what depression is to go back on it should you need it, and perhaps your last episode of depression was in fact the last one you'll ever have.

But, the larger point about antidepressants making us artificially happier at the cost of who we really are or at the cost of some edge that makes us more artistic, more driving, etc. is a great one people are making.

Who knows how history might change if a doctor prescribed Osama some prozac? I remember a college lecture where the professor said that Martin Luther was supposed to be a pretty depressed fellow and that history might have been a lot different if he was on some Prozac....

But, yes, try some other drugs also if your doctor think it will help. If cost is an issue for some of the newer ones and if its not an obstacle for you -- go after it. On the other hand, evidence does exist that most of the drugs are equally effective and it's just the side effects (and so compliance) that differ and determine efficacy.

Citalopram supposedly has the fewest sexual libido or performance decreasing side effects if that also might be a problem.

Remember though, ask your doctor about my and most information you get here.
posted by skepticallypleased at 12:41 PM on April 29, 2006

What frenetic and selfmedicating said. I'm 24, and have been on Prozac for about two years now. I'm currently in school to get my paralegal certificate, and my grades are actually better now than they were during my senior year of college (I was on Celexa, which did absolutely nothing for me.) I hate to sound so gung-ho about Prozac, because I do those all those other "recommended things" like getting enough exercise, at least eight hours of sleep a night, and eating well, but seriously, I can still remember what I was like before Prozac, and it wasn't pretty. So yeah, YMMV.
posted by invisible ink at 1:43 PM on April 29, 2006 [1 favorite]

It's called "flat affect." Try another drug. Anecdotally, I'd recommend Lexapro.
posted by radioamy at 1:49 PM on April 29, 2006

I experienced the same effect, being content just coasting along, when I was taking Lexapro. Wellbutrin was a better match for my symptoms. Talk to your doctor, because it sounds like either increasing/reducing your dosage or changing the prescription outright might be what you need. Good luck!
posted by emelenjr at 1:59 PM on April 29, 2006

you might want to try simply halting the drug if you've felt it did its work,

Don't do this. Prozac is known for it's terrible withdrawl effects if you just stop taking it and you're supposed to go off it only under doctors supervision and instructions. It doesn't take long but needs to be done properly. (same goes for changing meds actually, there's usually a change over period). This is well known, your doctor should agree.

I took Prozac for nearly two years. Would have been much less but I ran out about four months in and forgot to fill the prescription, so stopped taking it for about two weeks. Screwed me up totally and set my recovery back by over a year. Don't do it that way.

So it sounds like a trip to the doctor is on order for whatever reason, stopping or changing meds. Do go, it really can be better than you're describing.
posted by shelleycat at 3:56 PM on April 29, 2006

Shelley -- yes, I should clear up that point. You can halt the drug but do it properly. Just because you are have a bout of depression will not equal being on an antidepressant forever though.
posted by skepticallypleased at 6:19 PM on April 29, 2006

really? why bother, then?
posted by mwhybark at 9:52 PM on April 29, 2006 [1 favorite]

Thanks for the great answers. Sounds like a trip to the doctor is in order. The Prozac is working great in other ways - my wife actually likes me now. I think being back at University is allowing me to compare how I used to be so that makes the side-effects more noticeable. I think if I was in a situation like punilux was I would be more worried than I am about it. I think I will buy into Ethereal Bligh's attitude. I do like my new-found optimism.
posted by zaebiz at 10:21 PM on April 29, 2006

Prozac was terrific for my depression, but I had horrible panic attacks. I get good success with a quite small dose of Zoloft - 6 mg; a quarter of the 25 mg tablet. The choice of med and dose are both important.
posted by theora55 at 9:09 AM on April 30, 2006

I gotta wonder if I should add Wellbutrin to my Celexa. I no longer ponder death obsessively, but I can't say I'm exactly a scintillating bit of company these days. I basically run an emotional flatline, not particularly happy, not particularly unhappy.
posted by five fresh fish at 9:39 AM on April 30, 2006

skepticallypleased writes "As for depression, its known that about 1/3 get better with no treatment, 1/3 on antidepressants, and 1/3 using antidepressents and psychotherapy. Now, 'get better' is ambiguous and wierd. BUT, the latter (drugs + psychotherapy) works bests and lasts longest. "

This is a nice bit of statistic, but is untrue. The numbers are much better than this for treatment--the effect size is ~.80, meaning that the average person in treatment does better than 69% of those not receiving treatment. The type of treatment (type of psychotherapy, whether or not the person is on medication, whether they are on both) does not matter. What matters are the general effects of treatment and not the specfici effects of any one treatment. The evidence for this is quite well-established, most recently by extensive meta-analyses of all past treatment studies, and can be read in Bruce Wampold's book The Great Psychotherapy Debate.

As to your specific issue: I'd submit that the Prozac is in fact not working for you. This is something that you are right to evaluate and think about. It might be helping somewhat, but as you take a medication for depression you have to ask yourself how you know if it's working. If the only metric is that you stop wanting to die, or if that's the first and most important metric, then this medication may be working. But as that proximate cause for taking the meds recedes through the success of the treatment, it's crucial to ask what else you require from your treatment. A good therapist can be helpful with this, not because therapy plus medications works better, but because they are trained to help you ask the kinds of questions that will enable you to guage what the next steps are.
posted by OmieWise at 12:12 PM on April 30, 2006

It could of course just because you're getting older, and there are more "distractions" in life.

Certainly when I was a student, the Internet was just getting started, and I considered other things (films, studying) more important than what I end up doing these days. As a consequence, I do find it harder to concentrate, get creative etc. but I just ascribed that to the passage of life, and the accumulation of "failure fear". When you're younger, you are more likely to not be afraid of failure, so consequently will try to do more things.
posted by badlydubbedboy at 4:21 PM on May 1, 2006

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