Q. I AM CURRENTLY ON 20 MG PROZAC AND HAVE BEEN ON IT FOR AT LEAST 9 YEARS. I ALSO HAVE THE PRESCRIPTION, SERZONE 100 MG. AND WAS TAKING THAT ON A DAILY BASIS. I TOOK ONE PILL A DAY OF EACH. FOR THE LAST TWO OR THREE YEARS, I HAVE BEEN MUTILATING MYSELF. NOT SO DRASTIC AS CUTTING MYSELF, BUT SCRATCHING MYSELF TO OPEN WOUNDS. THESE ARE ON MY ARMS, ANKLES AND SCALP. IT HAS BECOME AN OBSESSION. THE DOCTOR I SEEN FOR THE PRESCRIPTIONS I'M ON IS A REGULAR PRACTITIONER. I WONDER IF I SHOULD SEE SOMEONE BETTER ADVANCED IN MY TREATMENT. ALSO, COULD MY MEDICATION I'M ON NOW BE CAUSING THESE PROBLEMS. MY AGE IS 60 YEARS OLD, AND AM MARRIED. MARRIED BUT UNHAPPILY. PLEASE GIVE SOME SUGGESTIONS.

A. I cannot guarantee you a better marriage or social situation, but adequate dosages of medications should take care of the self-injury. How much Prozac to take is the real question. There are frail 60 year olds, and robust 60 year olds. The former may need only 40 or 60 mg/day, the latter for sure needs 80 mg/day. Talk it over with your doctor. If your general practitioner is uncomfortable with higher dosages of Prozac, go see a psychiatrist.