Meds suddenly stopped working…

[Limeslime]

Hi guys, I wondered if anyone else had experienced this and might be able to offer some insight into a solution?

I’m taking fluoxetine 20mg, I’ve been taking it for just over 3 months. This is my second time taking fluoxetine at the same dose, as I also took it in 2020/21 with wonderful results.

My problem is this. Since just after Xmas, I feel this medication is doing nothing for me anymore. Nada. Zilch. The scary thoughts are consuming me, the adrenaline, the fight or flight, the butterflies, the obsessive checking, it’s all came back. Why would the medication have suddenly stopped working after a couple of months?!
I’m wondering whether I need to increase my dosage or change medication completely?

Has anyone else had this, and what solution worked for you?

TIA x

[panic_down_under]

I’m taking fluoxetine 20mg, I’ve been taking it for just over 3 months. This is my second time taking fluoxetine at the same dose, as I also took it in 2020/21 with wonderful results.

...I’m wondering whether I need to increase my dosage or change medication completely?

Unfortunately, antidepressants, especially the SSRIs, may become progressively less effective every time they are stopped and restarted, often requiring higher doses to achieve the previous level of control.

There is a good chance that increasing the dose to 40mg will get fluoxetine working again, though, as with everything AD related, there are no guarantees.

[Limeslime]

Thank you so much for the advice. I’ve spoken to my GP who has increased my dose to 30mg (which I thought was a strange dosage but hey ho)
Is it likely I’ll experience temporary heightened anxiety and other side effects when increasing dose? Do you know how long it might take before feeling the benefits of increasing my dose? I’ve never increased my dose before on any drug, so this is new to me!

[panic_down_under]

Thank you so much for the advice. I’ve spoken to my GP who has increased my dose to 30mg (which I thought was a strange dosage but hey ho)

Increasing to only 30mg initially should moderate the severity of any side-effects, but I suspect you'll need to go up to 40mg to get a good result.

Is it likely I’ll experience temporary heightened anxiety and other side effects when increasing dose?

You may do for a few weeks. They may also be different to those you experienced at the beginning. All you can do is treat the symptoms as they arise.

Do you know how long it might take before feeling the benefits of increasing my dose?

It will be some weeks. How many I can't say as it all depends on individual biology, complicated by fluoxetine's very long half life, up to 6 days for the parent compound and about 16 days for its active metabolite, norfluoxetine, which actually does most of the work. This means it takes up to 30 days just for fluoxetine plasma levels to stabilise after a dose increase (or decrease) and even longer for the metabolite's. How long did it take for the med to kick-in at the beginning?

[Limeslime]

Thank you for taking the time to reply. Initially I felt a bit better quite quickly, i can’t remember exactly how long but I know when I had my 4 week review with the GP I was already very pleased with the results. I wasn’t 100%, but felt significantly calmer than I had done before the drug. I got about another 6 weeks of feeling ok on the 20mg dose before I started to feel it wear off. Now it is doing nothing for me at all, and all of the anxiety and panic has came back. Im hoping increasing the dose will help me 🤞🤞🤞

[panic_down_under]

I know when I had my 4 week review with the GP I was already very pleased with the results. I wasn’t 100%, but felt significantly calmer than I had done before the drug. I got about another 6 weeks of feeling ok on the 20mg dose before I started to feel it wear off.

Which begs the question, did it actually work, or was it mostly the placebo effect? I don't know the answer. It could be either. Unfortunately, you won't know until you've been on the higher dose for a while.