The Ups and Downs So Far...Need Advice

[JustForToday]

Hi Everyone,

I'd first like to say that you all on this site have helped me keep going so far on the fluoxetine. I am a recovering opiate addict that suffers from severe Post Acute Withdrawal Syndrome (PAWS) as well as recurring depression. Over the last 2 years I have been so constantly up and down (a lot from the PAWS) that I am so desperately trying to pursue anything that will help stabilize me to have a normal life. I have a great Christian support group and do NA...and that side of it really helps. I know opiates are not the answer but still I think I need help medically. Hence the reason I have taken Fluoxetine now for the last 34 days...

My journey so far is as follows:

Week 1: Days 1-3 no bad side effects really, day 4 felt very good but this subsided on day 5. Days 6 and 7 were an absolute nightmare, extreme anxiety and depression worsened. Could barely do simple tasks. No appetite, nauseous, etc.

Week 2: Days 7 through 10 were a struggle, not as bad as Days 6 and 7 though. Day 11, I felt great but these feelings changed on Day 12-14 as I also had another hellish experience and was bedridden the whole weekend with constant negative thinking, anxiety, worsened depression, etc.

Week 3: I slowly started to feel better on Day 17 and then Days 18 through 20 were absolutely awesome. I could function completely at work, had no anxiety, I almost felt a little too good, possibly manic. But nonetheless I really felt the medicine working. I know my natural self without the medicine wouldn't have felt this way. However, on Day 21 I started to just feel 'so so' again.

Week 4: I continued to have a 'so so' week consistently, was able to function but definitely not feeling normal or anything like I did on Days 18-20. Just could 'push through the day' if that makes sense to anybody.

Week 5: Days 31 and 32 were extremely hard...felt very anxious and sub-conscious around people. Also very hard to function at work as simple tasks seemed so overwhelming. On Day 33 I felt ok but still not feeling like my true self. I am currently now on Day 34 as I write this and feel 'ok' but still not great...

My question to you all is do you think I should stay on the Fluox? I really really felt it working on that Day 18-20 period...I am just hoping I could feel half of what I felt then consistently...like I said I knew I felt a little too good and know that isn't the norm.

I am hoping Week 6 I start to level out and feel better...but again maybe I shouldn't be on this medicine but I am so desperate to just feel normal...any suggestions would be greatly appreciated. It is just so hard to have any confidence in myself when I am so up and down all the time... Thank you all so much.

[anthrokid]

It sounds like you are on the right track and have some great support in place at the moment. I just really want to congratulate you for the efforts you've taken so far to overcome addiction. It isn't easy, and you should be proud at how far you've come.

Fluoxetine is an SSRI, and as such it can take a while to work. Usually people will notice more steady changes around the 6-8 week mark. Some people notice changes earlier, and others later. You've already noticed some differences, particularly those two great days. Keep in mind that even on fluoxetine you will still have good days and bad days. Even someone who doesn't suffer from depression or anxiety or withdrawal will have good days and bad days. Try to measure it instead in terms of how you would react before starting fluoxetine. Are you having more good or okay days now than you were beforehand? If so, then stick to it. If not, perhaps have a chat with your doctor and see what they think :) Remember, always consult your doctor before stopping the medication. Like I said, fluoxetine can take a while to work, and it would be a shame if you stopped yourself just short of it working.

[JustForToday]

Thank you so much for the response A...I will repost around the 6 week mark to see how I am...will continue taking for now.

[cuphalfempty]

Hi,
Don't be disappointed if it takes you longer to feel better. I expected week 6 mark to do the magic and when it didn't happen I was beating myself up over it, thinking that I must be doing something wrong. I am now on week 9 (or 10?) and I am definitely feeling better. There comes an awful day sometimes, but they are rarer than before and easier to deal with. It's a process...

Hope you feel good very soon :).

[Davit]

You mention opiates. The high that comes from opiates is actually from dopamine and the withdrawal is dopamine so I'm surprised you were given an SSRI instead of a tricyclic mood stabilizer. (trimipramine)

SSRIs take two weeks to work and on average six weeks for full effect. I use morphine for extreme pain and I was an Ativan Addict. SSRIs only make me sick. Tricyclics on the other hand work instantly. Stay on the SSRI unless you are sure it isn't working. There are other options. Ups and downs are no fun.

[JustForToday]

cuphalfempty, thank you so much for your insight...I know I have to hang in there no matter what. Today is Day 35 and was absolutely an awful day...but you know what, I almost am through it :) So tomorrow will start week 6.

Davit - thanks for the info. I have actually probably used opiates a total of 8-10 times in the last 3 years. Each time I have done it, it was out of desperation to get out of the depression I face. My doctor thinks I might have a depression issue to go along with the PAWS...but I know even staying mostly clean for 3 years has not let my brain heal completely. I know each relapse supposedly sets you back to Square One. (So therefore, I do believe I still go through PAWS)

Bottom line is I am so ready and willing to do anything to get out of this hellish cycle I have been in the last 3 years, will keep you all posted. Thank you for your support.

[Davit]

One other thing you should know, moderate alcohol and drug use does not kill brain cells, it temporarily stops neurotransmitters from doing there job. An overdose stops neurotransmitters that control vital organs. Heart stops, no blood goes to the brain and unless oxygen can get to it cells start to die. When you can't remember because of drugs or alcohol it is because neurons in memory did not work. I have used more Morphine than that in the last five years.

Real depression is a chemical imbalance and calls for meds to correct it. SSRIs work slow because they don't build Seratonin, they keep you from losing it and their sedating effect allows you to rebuild stores of it and other neurotransmitters. Calcium can do the same thing as Seratonin but not as efficiently but it does have a calming effect. The best though is tryptophan. A glass of warm milk, have it with a banana for the potassium. Or an apple if you prefer.

[anthrokid]

Looking forward to hearing how you're coping at the 6 week mark. Good luck!

[JustForToday]

Well today is day 42 (the last day of week 6) and...I am HAPPY TO REPORT I have had SEVEN good consistent days!!! Starting mid day Easter Sunday (Day 35) I began to just not feel as bad and felt like I could actually function.

I have been really trying to exercise hard as this helps me...I felt so awful on Easter Sunday morning but after I forced myself to go on my run...I started to feel so much better. I have still had ups and downs this past week, but they were so miniscule compared to what I have went through previously. I don't feel awesome all the time, but I do feel normal, and a lot of the time I have felt great this past week!

I am just so thankful to God right now...there are still so many issues I am working on (I am such a mess without him) but I know it is progress not perfection. Thank you all so much. And I know if tomorrow I start to feel bad, I just have to keep trusting and have faith. I will report in another week...thank you all so much again!

[anthrokid]

This is really fantastic to hear! I'm happy that you're finally seeing more positive results than negative - that's a sure sign that this is working for you. Whilst you have still had ups and downs, what you have said is spot on - they were minuscule compared to what you were experiencing before. You may not feel awesome all of the time, but you are now starting to feel more 'normal' and are having days where you feel you can function a lot better, and that is great progress :) It's also great that you've been able to exercise more and have identified that this helps you feel better as well. Looking forward to the next update.

[JustForToday]

Now on Day 55 and feeling better and better each day! I did have a few really bad blip days a week ago...but I just hung in there and they passed. Just very thankful right now. Life is no way perfect, but I feel as though I can at least face each day...one day at a time. Praying it stays this way.

[anthrokid]

:yesyes:

[pollynewsome]

hi Justfortoday i am now week seven! Up until now been horrific! Side effects from hell.. However i have had a much better day today.. Best yet.. Had a moment about an hour ago.. really dizzy and that made me a bit anxious but ive calmed myself down and its settling a bit now.. ive read the betterdays diary and so far that has been spot on. My doc wanted to increase the dose but i have decided to stick to 20mg until i reach the 12week mark and then if i still not right may consider uping dose.. Keep up the good work and keep us posted.. x

[JustForToday]

Hey Pollynewsome, so glad to hear you had a much better day! How are you doing now? The side effects early on can be absolutely awful. I would definitely stay on the same dose till around 12 weeks and then go from there. I am now on week 11, and honestly had a rough week ten (I ran a marathon last Sunday and it completely drained me physically/mentally and also going through some PAWS) but I will post again at the end of week 11...hoping for a better week this week ;) Keep it simple and take it easy :)

[pollynewsome]

Hi JustForToday.. another good day.. Blood pressure was low which doc said could cause the dizzyness..otherwise.. much better. Wow a marathon good on ya.. Keep going x

[pollynewsome]

Day from hell yesterday .. boo however just a blip onwards and upwards.. you ok?? x

[JustForToday]

Hey, how are you doing now? I had a much better week this week. Life is in no way perfect, but can at least face my struggles one day at a time. Today starts week 12 for me! Hope you are doing well.

[pollynewsome]

hi justfortoday.. at the moment not good.. im approaching week 9,, and all the side affects i had in the early stages are back! shaking,jittery,internal tremors, anxiuos.. So a bit fed up to say the least. Trying to keep busy but its just there!! Glad your much better.. keep going.. im at docs tomoz cos my blood pressure was low last week so gunna mention how rubbish i feel at mo.. hope its just a blip:) keep you posted! x