What if I can't tolerate even the smallest pill size of the medication?

Occasionally patients are very sensitive to medications and cannot tolerate even the lowest dosage that comes in pills.

Many of the pills can be broken in half to allow for lower dosages. There is also a liquid form of Prozac that has allowed many patients to gradually increase the dosage to therapeutic levels. Often, if patients can start at very low dosages (e.g., 1-2 mg/day) and very slowly increase the dose, they will eventually be able to tolerate the medication. This technique has proven so successful for many people that there is now a "fan club" of those helped by this approach. Many patients have been able to use liquid Prozac. For example, one woman who was started on Prozac at 20 mg/day complained of very bothersome side effects such as increased anxiety, shakiness, and terrible insomnia. She also felt it had made her OCD worse.

In addition, she had horrible side effects from even 12.5 mg of Anafranil, and later with low dosages of Seroxat and Lustral. She then started 1-2 mg/day of liquid Prozac that she had heard was good from other patients whom she met over a computer bulletin board. She felt no side effects, and over a period of a few weeks, she again got up to 20 mg/day without the previous side effects that she had felt on this dose in the past. She continued to increase the Prozac to 60 mg/day over a couple of months, and her OCD gradually improved quite dramatically. Thus, careful and gradual increases in dosage with liquid medication may allow some medication-sensitive patients to reach therapeutic levels.

The information is sourced from an article written by : Michael A. Jenike, M.D.Chairman.

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