Fluoxetine augmentation options

Question

Asked for Male, 48 Years

I am taking Fluoxetine for the past 10days, today onwards on Flutop LA once a day dose. So far I didn't see any improvement in MDD or OCD. Knowing my experience with SSRIs (tried all) for the past 1 year I think I need augmentation. Taking medication for Blood Pressure so SNRI isn't the best option. I think Bupropion also can disturb my blood pressure control. I am a pre-diabetic but blood sugar is in control without medication with diabetic diet. So I am looking for an augmentation option that helps in MDD + OCD while not having side effects of hypertension or hyperglycaemia. I also tried CBT sessions but didn't help. What are my medication options now to augment Fluoxetine? What is your opinion about Mirtazapine ? What other options I should go for? Thank you

Answers (2)

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Dr. Yasir Hassan Rather

Psychiatrist 15 yrs exp Srinagar

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Greetings ! Keeping all your history in consideration the best and safe medication as augmenting agent are 1) lamotrigine , but it needs slow and gradual titration and may show results after some weeks. 2) And the other option among antipsychotic medication is small doses of aripiprazole which is very weight neutral and will not cause impairment in blood sugar. These options are very safe condsidering your prediabetic state and hypertension. But its better you consult a psychiatrist online or in person , so that he can prescribe you these medicines as they need to be taken under strict supervision of doctor.

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Please Do not try to self medicate your self. Take professional help.

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Dr. Rayees Ahmad Wani Neuropsychiatrist 13 yrs exp Srinagar · Accepted Answer

Dr. Rayees Ahmad Wani

Neuropsychiatrist 13 yrs exp Srinagar

I think you should try maximum dose of fluoxetine (80mg). U can augment with second generation antipsychotic medications with least effect on metabolic profile (eg aripiprazole) after consultation with a psychiatrist. U can also try CBT ( by another therapist).