PROZAC: DOSAGE

What is the usual dosage of Prozac? The standard dose is 20 mg of Prozac a day and 5 to 10 mg for children and the elderly. Dosage must be individualized.

What is the lowest dose shown to be effective, and when is this indicated? Anecdotal reports by individual psychiatrists suggest that the lowest dose that seems to have been effective is 2.5 to 5 mg a day. As noted above, this may be indicated in young children, some very elderly patients, and patients who develop side effects on a standard dose.

What is the highest safe dosage of Prozac, and when is this indicated? Individuals differ, both in their genetic tolerance for a given dose and in the side effects they experience, but in general, the maximum recommended dose is 80 mg a day. However, that dosage has been exceeded occasionally with very overweight patients. Some obese patients nave come out of depressive episodes after being given over 80 mg in select cases where safety has been maintained. Such a dosage is not advised in general because there are potential safety concerns in patients taking over 80 mg a day.

Will a stronger dose get the patient back to the previous level? Usually, what is going on in such an instance is that the patient, after coming out of depression on Prozac, forgets to take the medication or cuts down on the drug without the physician’s knowledge. Sometimes the doctor and not the patient is to blame: a frequent reason for slipping back into depression after an excellent response is that the physician, typically someone who has not had extensive training and experience with Prozac and other antidepressant drugs, takes the patient off the drug too soon. If these possibilities are eliminated and the patient is still losing ground, the dosage should be increased. The problem may be that although the dosage brought the patient out of the initial depression, the level of the drug in the blood did not remain high enough to prevent relapse.

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