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Addendum March, 1989:
Since this book was published, a new AntiDepressant, Prozac (Fluoxetine Hydrochloride) has been released.
Prozac is effective, easy to use, and has fewer side effects than Elavil. Depressed MSers who have not responded to best doses of Elavil, may improve with Prozac.
Treatment strategies are similar to Elavil, but the regimen is simpler. Start with one 20mg capsule each morning and wait two weeks before increasing the dose Some MSers require 20mg twice a day. Maximum dose is 80mg/day.
Side effects:
Mild nausea may lead to modest weight loss. Diarrhea is occasionally troublesome. Insomnia, nervousness and excitement are usually absent or mild. Dry mouth and sedation that accompany Elavil disappear on Prozac.
Unlike Elavil, some patients report improved mood within days of starting Prozac, even though its biological half-life is two to three days and an active breakdown product has an even longer half-life - 7 to 10 days.
Because of its long biological half-life, a given dose may not reach full effectiveness for a month or more.
Warning: Prozac is eliminated through the liver. MSers with Liver Disease should consult carefully with an Internist or a Psychiatrist before using Prozac. There is no accurate information about the effects of Prozac on the developing fetus.
Pregant womwn should avoid Prozac, and all other medications during the first four months of pregnancy. The manufacturer's package insert is the best source of current prescribing information for Prozac.
Continued In 02-06
since August 18, 1999.
