The title of today’s blog is What is Prozac Poop-Out and What Can You Do About It? Now, before you accuse me of making up a silly term, I want to let you know that this is a clinically known and accepted term that is used by the psychiatric profession. What I am going to do in this blog is tell you what Prozac poop-out is, what causes it, how often it occurs, and most importantly, how you can deal with it.
Prozac poop-out is a phenomenon where a person’s antidepressant simply stops working as well as it once did, causing a relapse of depression symptoms. Although this phenomenon is most commonly referred to as “Prozac poop-out,” it can actually occur with any SSRI. As one client told me, “I had been taking the antidepressant Celexa for two years. I felt great. Then one day it stopped working?”
Here is another version of Prozac poop-out that many have experienced. Sandy was taking the SSRI Effexor for depression. It worked, and by the end of for six months her symptoms decreased to the point that I she decided to taper off the drug. Then four months later, she felt her symptoms returning. But when she went back to the Effexor, it no longer worked. She felt no relief from any of her symptoms.
While the true incidence of Prozac poop-out is uncertain, some studies suggest that 25 to 30 percent of people will notice a decrease in effectiveness of their antidepressants over time. No one really understands the cause, but the leading theory is that the receptors in the brain become less sensitive to the effects of the antidepressant. This is akin to the body building a tolerance to alcohol or drugs over time.
If you experience Prozac Poop-out, the first thing you should do if you notice Prozac poop out is schedule an appointment to talk with your doctor. She will want to know if there is any stress happening in your life that could be contributing to your depression.
In addition to lowering stress, there are several strategies that have been tried to help people deal with Prozac poop-out Some of these include:
Increasing the dose of your particular medication.
Switching to another SSRI or a drug from a different class of antidepressants –
Lowering the dose or taking a drug holiday for a period of time, hoping that the medication will again be effective.
Augmenting treatment with a second drug such as a mood stabilizer or an antipsychotic.
Adding in either psychotherapy or counseling.
Adding in lifestyle changes that may help with depression.
This last strategy brings me to the point of this blog. In my video, “It Takes More Than a Pill to Heal From Depression,” I said the best way to treat depression involves using a holistic approach, involving physical self-care, mental-emotional self-care, social support, spiritual connection and lifestyle habits. While medications can be a useful tool in this system, one should never rely exclusively on them, because one day they may stop working.
On the other hand, when you work with the lifestyle approach first, you have a distinct advantage, as many lifestyle habits such as exercise are as effective as drugs in treating mild depression. Does this mean that I am against medication? Absolutely not. I have seen medications like Prozac and Luvox help people with obsessive thoughts. And if these or other medication stop working, this does not mean you can’t try a new medication to replace the old one. But antidepressants often take 4-6 weeks to work.
Thus, while you are waiting for the antidepressant to kick in, you can practice the numerous self-care activities that I write about in my book Healing From Depression and teach on this website. And if the new drug doesn’t work, you will have already made progress in your depression recovery.