Increased fluoxetine dose help

[Aaronc217]

ok i was on 20mg fluoxetine for years and it served me well. One day i had an anxiety fit and it spiraled and just kind of brought it back. My doc said I've probably just built up a bit of a tolerance at this point and an increase should do well. Its been 2 weeks now and I'm still having anxiety if not more and some other side effects.

Is it normal for it to take a long time for an increased dose to take effect or should it be doing something by now. I found the timetable for fluoxetine on here but i didn't know if that was for initial start up or if that includes increasing dosage.

Just wondering if i should stick it out or work on moving on to something else

thanks

[panic_down_under]

ok i was on 20mg fluoxetine for years and it served me well. One day i had an anxiety fit and it spiraled and just kind of brought it back. My doc said I've probably just built up a bit of a tolerance at this point

Were you under greater than usual stress leading up to the "anxiety fit"? If so, it may have been the dose was just inadequate to contain the higher stress levels rather than a tolerance buildup, although this does occur.


Is it normal for it to take a long time for an increased dose to take effect or should it be doing something by now.

Yes, and especially so with Prozac which has a half-life measured in days - ~6 for fluoxetine itself, 16 for its active metabolite which does a fair bit of the heavy lifting - rather than hours so it takes over a month just for plasma levels to stabilize after a dose increase (or decrease).

Also, antidepressants have no direct affect on anxiety/depression in the way say aspirin has on pain. They work by stimulating the growth of new brain cells (http://www.americanscientist.org/issues/feature/depression-and-the-birth-and-death-of-brain-cells/99999) and strengthening the connections between brain regions. The therapeutic response comes from the new cells and interconnections, not the med, and it takes time for these to grow and mature.


Just wondering if i should stick it out or work on moving on to something else

There is a very good chance that increasing the dose will bring your anxiety under control again and as it is the easiest and quickest option I think it is worth giving it another 2-3 weeks or so.

[Aaronc217]

Ok thanks. I think I will wait it out. Really want to get back to normal

[Bike Rider]

I was told by my GP when I increased, to give it 5 weeks or so.

All the best.