Day 9... Need some advice

[matt94]

Hey guys

I was put on Fluoxetine 5mg 9 days ago, and just upped it to 10mg a couple of days ago. I thought things were taking a turn for the better yesterday(there were periods of NO anxiety!), but today I've had intense anxiety all day and I'm feeling SO hopeless, frustrated, and desperate. Not even the xanax I was prescribed is calming me down significantly.
I am in a really bad place right now.

I forgot to mention to my pdoc that I tried fluoxetine 5-7 years ago as a child (I'm 19 now) without much success. I hadn't remembered until I drank the stuff! I'm going to call him tomorrow and let him know.

I don't know how I'll make it these next few weeks. Maybe 5mg is optimal for me? I have never been so depressed and overwhelmed...

---------- Post added at 18:04 ---------- Previous post was at 18:01 ----------

The worst part are the obsessive thoughts that never leave. I'm convinced breathing is unnatural and uncomfortable and cannot take a deep breath without tensing and panicking. It's getting worse and worse! Sorry for the negativity...

[ladybug51]

Hey Matt..am on same meds @20mg.
Its takes a while to kick in, am told by Doc 4-6 weeks and/or longer for some.
If you're worried ask questions, go back seek answers.
Am on day 36 and still having issues but am sticking with it.
Its not an easy ride or quick solution...but all you can do is try, and seek help when needed.
Don't apologise for any thing its a hard road we are on.
Hope things improve...for you...:hugs:

[matt94]

Thanks for the reply ladybug :)
It's hard to imagine spending even another day feeling like this, especially knowing that the xanax is doing absolutely nothing...
You are far stronger than I!

Interestingly enough I read a few instances of 5mg being most effective for people.
"The clinically important antidepressant fluoxetine is established as a selective serotonin reuptake inhibitor. This study demonstrates that fluoxetine also interacts with the GABA(A) receptor complex. At concentrations above 10 microM fluoxetine inhibited the binding of both [3H]GABA (IC50 = 2 mM) and [3H]flunitrazepam (IC50 = 132 microM) to the GABA(A) receptor complex in brain cortical membranes. Low fluoxetine concentrations (1 nM) enhanced GABA-stimulated Cl- uptake by a rat cerebral cortical vesicular preparation. At higher concentrations (100 microM and 1 mM), however, fluoxetine inhibited GABA-stimulated Cl- uptake, an effect related to a reduction in Emax. These observations might assist in an explanation of the basis of the antidepressant action of fluoxetine."

Could explain why xanax is doing so little at the moment...

---------- Post added at 18:57 ---------- Previous post was at 18:48 ----------

http://www.dr-bob.org/babble/20060825/msgs/680228.html

"The 5 mg worked for a couple months..and then I had to go to 10 mg for the same effect. I'm at 15 mg now, it seems to be working and absolutely no side effects. Oddly, I went to 20 mg (just for he convenience of taking a 20 mg capsule; Lilly doesn't make 10 mg tablets anymore, so I'm told)-and I had ALL sorts of side effects! So I'll stay where I am.

But I had a friend with panic disorder who paced the living room night and day for months, started taking 5 mg Prozac and poof! she was much, much better. She never needed more than 5 mg. Like I said, seems like the panic disorder folks (like myself) seem to benefit from low dosages of Prozac.

UK Ed used to quote a initial study by Lilly where over 50% of the people in the clinical trial responded to 5 mg Prozac, so it seems like it is definately worth a try."

[anthrokid]

Hey Matt,

I've been on Fluoxetine twice, one in high school (age 16-17) and now (age 19-22). My first time I started on 10mg and went up to 20mg within a couple of weeks, and remained at that dose until I came off (this was for treatment of depression). My second time, I started on the 10mg, and gradually increased to 40mg, which I stayed on for about a year until my anxiety became more managable, at which stage it was reduced to and remains at 20mg (this was for treatment of anxiety/panic disorder). I'm also studying psychology at university and am in my fourth year (honours). So I have an understanding of fluoxetine both from a user's perspective and from a an educational perspective.

Interestingly, literature pertaining to the optimal dose of fluoxetine is controversial. Some literature reports 5mg as being sufficient in 52% of cases, whilst other literature reports 20mg as being the minimun dose required to be effective. What is consistent, however, is that everyone will react differently to fluoxetine, and the optimal dosage will vary from person to person.

Now I'm not sure how much your doctor has told you about fluoxetine, but I'll give you some information anyway. Fluoxetine is an SSRI medication, and tends to have a slower effect time than other medications. Usually, it may take up to 6 weeks to sart noticing the beneficial effects of any SSRI medication, so it is important to stick with the medication for this amount of time unless the side-effects are completely horrible and unbearable, which is usually not the case. Of course, the side effects can be uncomfortable, which can be bothersome. Now with anxiety, our bodies are constantly on 'high alert', meaning that our nervous system is constantly in a high state of activation. In turn, this leads to us being very sensitive to any changes within our body, including the changes medication makes. It is absolutely normal for an anxiety sufferer to feel increased anxiety and discomfort in the first week of starting a medication, or in the first week of increasing a dosage.

The idea, of course, is that within a few weeks of being at a stable dose, side effects should begin to dwindle. After you've had fluoxetine in your system for about a month, there should be noticeable benefits. However, until the stage where you reach a suitable dose, there will unfortunately be unpleasant side-effects whilst your body adjusts.

make sure you speak with your doctor and inform them of how you're feeling and that it coincided with an increase in your medication. They'll assess it from there Given that it's only been a few days since you increased the dose, they may like you to wait a few more to see if it gets better. If not, they may reduce the dose back to the 5mg and see how that goes. Or, they may even decide to persue a different medication.

Hope this helped! Best wishes!

---------- Post added at 14:57 ---------- Previous post was at 14:55 ----------

I will reiterate though, given that you are feeling noticeable worse after the increase in dose, do contact your doctor when you can and enquire as to their thoughts.

[matt94]

Thank you amieekid for all of that information amieekid! I stayed on 5mg and it's been 2 weeks today, wondering if the side effects are just starting to hit me now. I have intense anxiety, some suicidal thoughts, bloodshot eyes and dry mouth.
My pdoc recommended I try 10mg and 5mg alternating days, but I have not psyched myself into that yet.
Everyone is actually telling me to go to the hospital as I have not been coping well with my anxiety. I keep saying "I want to die" and "Please kill me".
I would go to a hospital if I didn't have such bad agoraphobia. I can't even take the car ride there. It would be complete shock to me to be without electronics and the comforts of my home. Plus they would just medicate me, and do little for agoraphobia and such. I might not even want to leave there because of the agoraphobia... I don't want to be stuck.

[Bond Girl]

Things do get better on the fluox - stick with it. I promise you'll be glad you did in a few weeks' time x