View Full Version : Can someone help me with my queries about depression medication??
Hi all,
I have posted in the health anxiety forum before on here many times as I have been feeling so ill/rough for 2 years now and have been convinced something more serious is wrong, but the doctors just keep saying it is depression/anxiety. I am also now receiving counselling.
I am on 40mg Fluoxetine, but I had a few concerns I hope someone can help me with?
I started off on 20mg about a year ago, and when I was still feeling rough/ill the doctors decided to up the dosage to 40mg.
I am still getting told by the doctors that I am in good health, but I was starting to wonder about my medication (Fluoxetine) because I felt like I wasn't feeling any different on 40 to how I was on 20 (and how I was on 0 to be honest) so I said to the doctor about maybe lowering to 20 again. She said to do this I need to take alternate dosages of 20/40/20/40 for 6 days and then drop to 20mg from then on.
But I have now started to worry: what if 40mg had been making a difference but I'd not really noticed it? What if on 20mg I now start to feel even worse? I don't know what to do - whether to stick to the 40 I have been taking or drop to 20 - maybe it won't make much difference?
What sort of side effects could be experienced from dropping dosage? Is 40 down to 20 a big jump? Since doing the 40/20/40/20 thing I have also woken up yesterday morning with an agonising sore throat and chills, but could this be related or not?
I am still feeling rough and tired constantly and this has caused me in turn to feel depressed. I really am at a loss of what to do, as when I spoke to the doctors, they almost made it sound like it was "upto me" if I decided to modify my dosage, and have not suggested any alternatives.
Thanks for any advice!
Prozac is an SSRI which takes a while to work and a while to stop working. You are unlikely to notice a daily difference if you are upping or lowering the dose. After a year it's maybe time to consider a different med, there are lots out there. I wish you all the best.
Baggs
How long have you been on 40mg for?
Also, when did you start reducing your dosage? The reason why I ask is because fluoxetine has a long half life (4-6 days for the fluoxetine, up to 16 days for the active metabolite) so it would usually take a few weeks after changing the dosage to notice a difference.
Fluoxetine has some of the mildest withdrawal symptoms out of all the antidepressants, supposedly. I've 'cold turkeyed' off 20mg twice in the past with no withdrawal symptoms that I'm aware of. However, some people seem to be affected badly by withdrawal symptoms. I would personally give the 20/40/20/40 dosages a bit more time - 6 days sounds a bit short, I'd give it a few weeks personally.
Perhaps the fluoxetine just isn't for you? It worked for me twice before, then the third time I took it, I experienced horrible side effects. There are plenty of other antidepressants out there, though its often a gamble as to how people react to them. But certainly there are newer SSRIs than fluoxetine, and supposedly they are better tolerated.
Hi, many thanks for the replies, much appreciated.
I think I have been on 40mg since about March maybe? There or thereabouts. I started reducing (the 20/40/20/40) last week, but maybe I should give it a bit longer than 6 days. I was worried that dropping to 20mg might have caused some side effects as I woke up yesterday with a shocking sore throat and headache, chills etc, but I suppose this is probably more likely a virus. Also, as you have both said, Fluoxetine doesn't seem to cause withdrawal symptoms.
I would like to maybe try something different, but it's hard to know what to do, I feel more ill than depressed. And the feeling of illness has gradually made me become more down and low. I am signed off work (and unemployed) and have had to make many, many visits to the doctors over the past year to get new sicknotes, and each time I go I mention about how I am still taking the anti-depressants, but they've never once suggested trying anything else :(
I feel so pathetic, got so much going on healthwise and never feel like I can tell the doctors all about it (got the extreme tiredness, headaches, no energy - and also got this annoying bunged up feeling that I've had for a long time now and I have to keep swallowing all the time) Likewise, I can't turn up at A&E or something like that. Is there anywhere I can go or anyone I can see who I can just list all my issues and things going on - I suppose the obvious answer would be the doctors but they just seem to want to get you in and out of there as soon as possible!
I share a lot of the same symptoms as you do - over the past year I've tried 3 different meds, including prozac for the third time (which worked yet had really bad side effects which I didn't get before) and have felt weak, agitated, tense, had painful muscles, occasional spells of tiredness etc.
I don't think that fluoxetine is the right medicine for you to be honest. You should have noticed a difference at least. Of course you can go to 60mg but I really don't think it would help you. There are several other SSRIs you can try which are much newer and are better tolerated.
I would go back to your doctor and explain exactly how you feel. I'd write it down beforehand if its easier for you. I pretty much would be assertive and say that you've been feeling bad for a while now and that you don't want to continue like this. If the GP doesn't do anything I'd make an appointment with another GP.
Have you had a blood test out of interest? For low thyroid etc? If you haven't I'd ask for one just for peace of mind.
Thank you for the response, sorry I am a bit late in replying.
I hope you all had a good Christmas and New Year?
You may remember last time I posted I was doing 20/40/20/40 dosages of Fluoxetine on alternate days. They initially suggested doing this for 6 days but I did it for a little longer, and a week or two ago began taking 20mg per day. I'm not sure if it's just me looking for things to notice but I find I have been so so much more tired in recent weeks, and have began having naps again during the day - something I had cut out and resisted, but have now gone back to as, silly as it sounds, I can't stop it. I just think "Oh I'll just lay down to relax" and then I'm asleep. Cutting out this sleep is something my counsellor put a big push on, and I am not sure if it could be because of the medication drop, or because I went home for Christmas and my routine changed - I was not going for my walks, I was staying in bed later, etc.
I went to the doctors before Christmas with this horrible sore throat type thing, which also cause an awful pain in my right ear whenever I swallowed. He said it doesn't look bacterial and should clear up in a few days, but if not, to go back straight after Christmas. It did seem to go over Xmas day, but then came back, then went, then came back again. And I still have it now. So I went to the doctors the other day to see about this and she checked my throat and inside my ear, as the previous doctor had done before Christmas. She said there was nothing suspect wrong and I just have to "leave it". In both appointments I also mentioned my anti-depressant medication, and suggested the possibility of changing to something else, or asking what the next steps were. Both doctors said I should continue with the Fluoxetine for the time being. They said it should not cause me any side effects at all. Yet I have spoken to a few people I know on online chat and they have said that I should come off the medication totally, as it does more harm to your mood and energy levels than good. One girl I know said she started taking them as the doctors thought it might help with her symptoms and she said she felt totally devoid of energy whilst being on them. Obviously though these are not professionals, so it is hard for me to know what to do.
What I do know is that along with the tiredness (seems pretty extreme right now but maybe that's because I have gone backwards on my behavioral activation work/routine) and the headaches, I now have this pain in my throat and ear and I have been told to just 'get on with it' pretty much. It's just another thing to bring me down and make me feel sorry for myself. I wish I was stronger. I wish I was one of those people that could just get on with things, but I can't seem to. I've never felt so constantly tired and uninterested in doing anything.
With regard to your last point, Emphyrio, I have had many, many blood tests over the last 2 or so years that I have been feeling like this. It was June 2011 when I was told I have an underactive thyroid, and when they put me on the medication (took a while of trying different dosages to bring my levels to 'normal') I thought that would be the end of it - ie - I thought that was the reason I felt so ill and tired all the time. But it doesn't seem to have done anything. Other than that I have been given the all clear on everything for all the blood tests I have had.
I just feel so lost at the moment. I am now doubting whether I should have dropped from 40MG, or maybe it's actually making no difference but because I chucked myself out of my routine over Xmas, I am now feeling it?
Happy New Year all
I do feel for you as your symptoms are very real and perhaps do have a biological cause - or perhaps they are caused by the depression and fluoxetine maybe is not the rights meds for you. Either way it is not uncommon (unfortunately!!!!) for some GP's to fob you off. Try reguster with another practice if you can.best of luck to you!
Hi, if you are convinced something is wrong despite implying you are not feeling as bad as you used to, and you suffer from health anxiety, then it does not seem to be a question of your medicine dose.
It seems that the health anxiety is still chuntering along and you are starting to pick up on it. Your own fears are growing as you convince yourself there is something wrong with you, over and over again. Your subconscious is listening to these fears and it believes them because it's heard them so many times.
In other words, your subconscious is learning to behave as though something is wrong, even though it doesn't know what the problem is.
You can experience side effects from reducing a dose so follow your doctor's advice. I think that there is a limit to how much medication does for us as it does not eliminate the core problems, it simply manages the symptoms. If the core problem is persistent, it's only logical (Captain) that it will increase in strength and eventually overcome the effects of the medication.
In my opinion you should switch from counselling to CBT as you need to change your thought and behaviour patterns. Anxiety is a biological process which is started by your thoughts, therefore you need to fix the way you think.
What ever is going on here, ncfcfan85, You most definitely are NOT pathetic. most people who have been suffering prolonged tiredness, headaches would have no energy. It's an incredibly frustrating time for u. Everyone has made good suggestions & observations here.... It would certainly be worth seeing your doctor, or a different doctor if you have lost faith in yours. Make notes about how long your symptoms have persisted and the nature of them. Hopefully then together you can work something out. I do know what you mean about them hurrying you out of the door. In my experience, an early morning appointment seems best. The surgery is at its quietest and my doctor seems most receptive then too. Also, I think it's possible to ask for a "double appointment" as we'll which would give you more time
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