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Because studies have not correlated a specific blood level of Prozac with therapeutic results, blood tests are not routinely taken. This is in direct contrast to some other antidepressants. For instance, with at least four tricyclic antidepressants (imipramine, desipramine, nortriptyline, and amitriptyline), blood levels may be routinely taken by some psychiatrists, including myself, because certain levels are needed to achieve a therapeutic window effect, and hence the blood test serves as a guide to the psychiatrist as to the dosage required.

With Prozac, on the other hand, the appropriate dosage, for the most part, corresponds simply to weight and age. Patients of average age and weight (for men that is 150 pounds, mean age 35; for women that is 120 pounds, mean age 35) need approximately 20 mg of Prozac a day, with the very young and very old taking smaller doses. But the average dose is not necessarily the correct one for a given individual. Ultimately, the way a patient feels is the most important determinant of the final dosage, along with the patient’s specific metabolism and genetic factors.

 

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