Anyone done the same with fluoxetine?

[leenalou]

Hi
Long term sufferer of anxiety/ panic here been on fluoxetine for many years, to cut a long story short about 2 weeks ago I woke up with a panic attack yes I'd been a bit stressed and worried but because I'd been anxiety an panic free since around January it took me by surprise. It was then I realised that I'd not been taking my meds (20mg fluoxetine and 10mg propranolol) as its so easy to forget you need them when you feel good, anyway I'm back taking them regularly now since 23rd October but I feel like I have a lot of the side effects again is this even possible wouldn't they still be in my system to some extent think I went roughly 6-8weeks without them I know they won't be at the therapeutic level I'm used too but surly they can't be out of the system all together. I'm having high morning anxiety which seem to level out as the day goes on, disturbed sleep waking up in the early hours with the anxiety after only a couple of hours sleep, nausea and no appetite all very similar to start up effects just wondered if anyone had done the same or similar that could offer some support or reassurance that this is not going to be another 6-8 weeks to even out again.
Thank you for reading
Selina x

[MyNameIsTerry]

As far as the drug itself goes it takes about just over 4 weeks to reach steady-state in your blood plasma. This is because of the long half life of this particular med. Compared to one like Citalopram which takes just over 7 days or Sertraline at just under 7 days due to their shorter half lives.

When coming off if you stop taking it the drug will continue to be eliminated at the same rate as it does when you are taking it. However, because you aren't adding more to it each time to keep it stable you are are working on fully eliminating it and this takes about the same time as it does to reach steady-state.

That sounds like it's back to square one for you but there are some things to consider which may make it easier for you:

- you were on for many years so your body long ago learned to tolerate the drug itself and the higher levels of Serotonin it triggers (more Serotonin actually working for longer rather than creating new)

- whilst you will have eliminated the drug itself, the down regulation process which is is the 2nd stage of the drug and the main aim for treatment may take a bit longer to right itself. This is something I'm less sure of but what I do know is down regulation doesn't start at the same time a med reaches steady state, I can't remember which med it was but in one study of a shorter half life med it took a month for that (and I'm pretty sure this was one of the 1 week steady-state style SSRI's). So, I'm thinking Fluoxetine may take longer than that month to work on this but I can't be sure. If it does take longer it suggests it tskes longer to restore your receptors to what they were before you started. And maybe the years on it could impact this?

(Remember when we start these drugs they are primarily working on forcing more Serotonin to stay in the "space" between the sending & receiving receptors. The sending receptor also reabsorbs it back and this is what down regulation slows down, it's like a shower head getting furred up in that respect.)

So, maybe it's not all bad news even though you are going to start the initial stage of the process again which is where the Serotonin is being kept in high volumes in the "space" and even this is supposed to be less harsh on a long half life drug like this one.

I hope you feel better soon. I've struggled getting onto both meds I've tried and I rmember just how hard it was.

[leenalou]

Hi Terry
Thank you for the reply and information
What a fool I am knowing this could have been prevented if I'd have been more vigilant about taking my meds, I know how harsh the side effects can be so I suppose I better get ready to ride them out.
Let's hope it doesn't take as long this time.
Thanks again Terry

Selina x

[leenalou]

Well just an update, I'm on day 18 of back to regularly taking 20mg of fluoxetine, morning anxiety is still high and lasts to around mid morning when it starts to ease, afternoon through to evening seem pretty good at the moment. I go to sleep as soon as my head hits the pillow but wake around 3am with the anxiety again. I'm hoping that because my afternoon and evenings are levelling out that it won't be long before my morning's do the same as morning anxiety sucks!

Take care everyone
Selina x

[leenalou]

Typical me got my days wrong today is day 21 so three weeks done, with this med and its side effects, sleep is worse anxiety yesterday was all day didn't seem to let up on the afternoon either wish they would hurry up and level out I need sleep!! You would think I would be used to this by now as its not the first time it's happened. Still I suppose I can be reassured the meds are doing something as the side effect are seeming to change on a daily basis here's to starting week 4 tomorrow x

[leenalou]

Day 25 today and feel yuk!
I have a full on cold, still not sleeping past 2-3am and waking with tingling heavy arms and adrenalin.
Afternoons/evenings seem to be ok with minimal anxiety and an increase in appetite nausea is on and off but is easing.
Can't remember how long it took for sleep to return to normal last time but I wish it would hurry up, I think my problem is I'm worrying about it too much but it's hard not too.
Anyway I suppose its on with the show x