Just started taking these

[No Imagination]

I'm told you need to take them straight after or during a meal but does it need to be at the exact same time each day? I've been taking them straight after breakfast so far but if I have a bad night the time I have breakfast sometimes differs so is it a big deal if there's an hour or two difference from one day to the next?

Thanks.

[MyNameIsTerry]

No, you will be fine.

I've varied both Citalopram and Duloxetine by hours with no issues. Both of these have much shorter half lives than Fluoxetine and longer half lives mean slower distribution so it's less of an issue.

What you may find is that your own anxiety causes you to worry or feel anxious for the variation but it certainly won't be the med itself.

It's best to keep it around the same times and have a good routine more so when you are still new to them. But the odd hour or so isn't going to make a difference so get some rest and recover from the bad nights.

[No Imagination]

Cheers bud. I wanted to get into a routine taking them early on with breakfast and doing it that way but then when you have a bad night it can screw with that a bit. I've just started them for anxiety (day 4) so here's hoping for a positive difference!

[No Imagination]

Just sat eating breakfast and a feeling of what I can only describe as dread washed over me for a good minute or two. Ordinarily even with my anxiety I wouldn't feel like that at random, could this be the effect of this medication? I've had 4 days worth and today's was day number 5.

[Roman]

Yes, definitely. Stick with it! I'm on day 24 and having some times when I feel a bit more normal. Apparently it can take up to 4 to 6 weeks to work. My morning anxiety is pretty bad and I feel a little calmer at night.

[MyNameIsTerry]

Yes, if you start to notice new symptoms when you start these meds, it's likely they are the reason.

Each day it is building up in your blood plasma until it reaches steady-state. For this med, it takes just over a month.

[Panicer]

Hi No Imagination

I'm on day 35 of taking Fluoxetine 20mg for anxiety, the first time I've ever taken any AD and I've definitely felt strange at times over the last few weeks. I've also unfortunately some times felt more panicky or for longer than before I stated taking the pills. Week 3 & 4 were probably my worst.

However as Terry has said above these feelings are probably down to the medication, rather than my illness. I can also say that I'm just now getting periods of the day where my anxiety has almost completely disappeared, which feels wonderful. (I've been really bad since September 16) I take my pill in the evening after eating but whenever suits you is fine as long as you take them every day. They really do seem to take some time to work properly and some people on here suggest it's up to 12 weeks to get the full effect.

I've been trying to post my journey everyday on this thread http://www.nomorepanic.co.uk/showthread.php?t=157003&page=25 It's partly a diary to remind me how I'm doing but it's also been really useful to hear updates from others going through the same journey. Good luck with yours

[MyNameIsTerry]

Hi No Imagination

I'm on day 35 of taking Fluoxetine 20mg, the first time I've ever taken any AD. I've definitely felt strange at times over the last few weeks. I've also unfortunately felt more panicky at times than before I stated taking them. Week 3 & 4 were probably the worst.

Yeah, the side effects ramp up again around that mark from what I've read.

I've seen a fair few threads by people saying they've hit that wall but they get through the other side and it reduces. Hang in there, you are about through the period now.

I know what you mean, I've only been on Citalopram & Duloxetine and both made me much worse until the side effects went. Duloxetine was much worse due to the adrenaline ramping my anxiety up far beyond anything I had experienced.

[Panicer]

Thanks Terry

It's always good to hear from others that we're not the only ones going through something. I've read the same advice from others on being ready to expect bad days but that the good days should soon outweigh the bad. I'm hoping in another couple of months I'll be back to my old-self :)

[No Imagination]

Thanks for the all of the replies. It's great to get feedback from people who are going through or have been through the same or similar things. Much appreciated.

[Roman]

Stick in there No Imagination. I had my first semi normal day yesterday after 26 days and I'm ecstatic that things seem to be turning a corner hopefully.

[No Imagination]

I'm on day 8 of these now. Not much fun is it :weep:

I've had anxiety for a good 10 years but never tried medication. The last few weeks were pretty bad for me so it was decided it was time to give some medication a try.

Right now I feel as bad or worse than I did a couple of weeks ago. Sleep is all over the place, when I'm able to get some, not much appetite, weird random things happening that never used to happen, lightheadedness. I have health anx as well as General and this is making it all worse because of course you feel ill and you end up worrying about that. On top of that I had or believe I have something wrong with me anyway, which is what prompted the bad week in the first place. My GP says no but I'm not so sure.

What a nightmare this all is :weep:

Family are great, which is the one positive thing in all this.

[Panicer]

Hi No Imagination

Well done for sticking with the pills, if you can get to about 30 days I think you should start to notice an improvement, I did but it seems to be up to 12 weeks to get the full effect. I know where you're coming from with the health and General anxiety, as I have the same problem. Any unusual feeling could set me off an a catastrophising what if cycle. However a therapist said to me recently when you get weird body feelings such as a tremor, pain, lightheaded etc and you're feeling anxious at the same time that's simply anxiety, when you get one without anxiety that's just physiology. Something has just stuck with me about that and as soon as as I feel something unusual my anxiety rises but then I immediately say to myself "weird feeling + anxiousness, raised heartbeat, sweating etc = just plain old anxiety, you can safely ignore it and relax again" and it really seems to have started working for me :) It might be worth giving it a try?

[No Imagination]

Thanks bud. Yeah I know it's not a quick process by any means. It'd just be nice if I could sleep ok for example or if I didn't feel quite as lousy! Ten days ago I thought I was having some kind of breakdown I was so exhausted so I suppose it's unrealistic to expect too much too soon.

[No Imagination]

Managed to get some real sleep which was nice but that was the last of my temazepam sleeping pills so not sure if that will be repeated tonight! Anyone used Nytol at all? I've got some, figured it was worth a try.

[No Imagination]

Not a great day today so far. Got some sleep but only about 4 hours or so. I have pre-existing issues - some kind of vertigo that's there all the time and feels like lightheadedness usually with occasional full dizziness and over the past 6 months numbness in my feet and occasionally hands. I wake up every morning with pins and needles in both feet, as soon as I get out of bed and walk around it goes away. Anyway I think it must be circulation related but my GP won't have it because I'm not old enough (38) and seems to think it's just anxiety but I really don't see how it can be as baffling as anxiety can be sometimes.

Anyway, today I've been pretty lightheaded even for me and I was a couple of days earlier in the week. At the the same time my feet and legs have felt weak and fatigued despite not really doing much. So of course in my mind this is just further evidence that there is actually something wrong with me beyond the anxiety. I know lightheadness is one of the side effects of this but as I already have it it's difficult to distinguish between that and what I already have simply being worse and as it's coinciding with with whatever is happening with my feet and lower legs you start to worry of course.

It doesn't help that I'm taking some propranolol as well at the moment and of course I keep thinking if I have something wrong with my circulation should I be taking a beta blocker. I try and convince myself that all of it is anxiety and side effects of the meds but I just don't believe it. So not only do I feel crappy physically I feel crappy mentally as well. Fed up of this :weep:

[panic_down_under]

I have pre-existing issues - some kind of vertigo that's there all the time and feels like lightheadedness usually with occasional full dizziness and over the past 6 months numbness in my feet and occasionally hands. I wake up every morning with pins and needles in both feet, as soon as I get out of bed and walk around it goes away. Anyway I think it must be circulation related but my GP won't have it because I'm not old enough (38) and seems to think it's just anxiety but I really don't see how it can be as baffling as anxiety can be sometimes.

It could be anxiety, the symptoms are not inconsistent, but it could also be low BP, or a nerve issue. Fluoxetine could be making some of the symptoms worse, both by heightening anxiety and as a direct affect.


So not only do I feel crappy physically I feel crappy mentally as well. Fed up of this

Unfortunately, all part of the rich tapestry of life on antidepressants at the beginning. They can be gawd awful medications which *no one in their right minds would take...with only one redeeming feature, when they work they can greatly improve quality of life.

* though apparently some do in the mistaken belief that they will be even better than 'normal.' :weep:

[No Imagination]

Yeah it could be anxiety, I just don't feel it is. There's other things as well, legs and arms get tired quickly, legs and arms held in one position start to feel tingly quickly as well so again I just keep coming back to circulation related but the doc and actually another doc both say no. My BP is fine as far as I'm aware although the recent propranolol may lower it of course but last week at the docs it was 110/70 sat down and then 120/80 after I stood up apparently so good I think. I've actually got to go for a nerve conductivity test the week after next so maybe that will uncover something, it'd be nice to get an actual answer for once as opposed to we don't know but it's probably just anxiety. Not that I want anything to be wrong with me of course! Ironically I'm not someone that goes to the docs regularly even with the health anxiety side of things, before the issues with my feet I hadn't been for a few years.

[No Imagination]

Well another lousy day really so far. It's not so much the anxiety side of things for me it's mostly the physical symptoms I have that are bothering me. If I could shift them I'd feel alright to a certain extent I think. But if I could shift them I wouldn't be on this medication at all I suppose as I'd be a lot less anxious than I am. Unfortunately if I can't deal with the physical part of this I don't know if I can deal with the anxiety.

[No Imagination]

Well, two better days really. Yesterday the physical side of things was fine and so was I even managing to get an almost normal night's sleep. Today was ok again, had some tension this afternoon where I felt agitated and I couldn't stop moving my legs for some reason even when sitting still. Nothing too bad though. No idea what to expect tonight as the last two nights have been about one hour sleep two nights ago and then about six or seven hours last night, so completely different. Feeling a bit of agitation again now so maybe the former unfortunately but we'll see.

[No Imagination]

Does anyone know what the situation is regarding taking this with Amoxicillin antibiotics?

[panic_down_under]

Does anyone know what the situation is regarding taking this with Amoxicillin antibiotics?

There are no listed interaction issues, but anxiety levels may, repeat may, be affected by the immune system reaction.

[No Imagination]

Ok thanks.

[No Imagination]

So a bit of an update as I haven't posted in a while. I'm just over three months into them and I feel as though I've been making progress...until yesterday when I came crashing back down again :weep:

The last few months haven't all been plain sailing but it definitely felt like I was moving forwards and was able to be more active than I have in a long time. Whether that was down to the Fluoxetine, the beta blockers, the counselling, a more positive attitude or a combination of all of them I don't know but it was better.

Yesterday however things took a turn for the worse for some reason. I've had a few periods of intense sweating on the meds but yesterday took it to a different level, in fact I'm not even sure if it was the same thing or something different. My skin suddenly felt weird all over my body, almost like a burning sensation but not quite. Legs, arms, back, nether regions the works. Never felt anything like it before. It seemed to last for about 30 mins but went away and came back a bit during that time. It completely threw me to be honest especially as I have been doing so well recently. As a consequence I felt off all day yesterday. Then after a few hours sleep I awoke to feeling quite shaky, managed to drop back off to sleep after a while only to wake up feeling the same way again not long after. This repeated a few times. I'm still feeling off now and whilst I know that some of it is likely to be anxiety the whole thing has left me baffled really. I'm basically as bad (in a different way) to how I was three months ago. I was hoping that yesterday was some weird blip but the fact I'm feeling off again today isn't filling me with confidence.

It's so frustrating to feel as though things are on the up only to get slapped back down again.

---------- Post added at 13:27 ---------- Previous post was at 13:08 ----------

I think what makes it worse is that whilst I try and put everything down to anxiety, I just don't believe it. So that increases the worry further :mad: :weep:

[panic_down_under]

I'm just over three months into them and I feel as though I've been making progress...until yesterday when I came crashing back down again

Are you still on 20mg fluoxetine?


I've had a few periods of intense sweating on the meds but yesterday took it to a different level, in fact I'm not even sure if it was the same thing or something different. My skin suddenly felt weird all over my body, almost like a burning sensation but not quite. Legs, arms, back, nether regions the works. Never felt anything like it before.

It sounds like one of the common adrenaline surge symptoms, but the beta-blocker should be stopping it. The dose may need to be raised.

[No Imagination]

Yeah still on 20mg's of Fluoxetine, which seemed to be working ok.

---------- Post added at 14:05 ---------- Previous post was at 13:46 ----------

The thing is for three months I've gradually felt better without question. Then all of a sudden things are happening that I've never really had in over 10 years with anxiety. I can't understand it.

[panic_down_under]

Yeah still on 20mg's of Fluoxetine, which seemed to be working ok.

This is not the impression I'm getting. For starters, you shouldn't still need to take the beta-blocker if fluoxetine was working well.

As for the burning sensation, if it continues I suggest you see your GP just to rule out a direct physical cause. If you haven't had a physical including bloods in the last year or two, now would be a good time. It probably won't find anything out of the norm, but one of the big traps with anxiety disorders is that anything unusual tends to get blamed on the disorder and not treated on its merits.

[No Imagination]

Well I started taking the beta blockers a few days before the Fluoxetine. I was told by my GP to allow up to 6 months for the Fluoxetine to work and reading here it seems an absolute minimum of three months is needed. So on that basis I didn't see the sense in stopping the beta blockers until I had some sense of where I was on the Fluoxetine.

Up until this week it felt as though I was making progress. I was doing a lot more, doing things I haven't done in years, doing new things and not really feeling any anxiety or certainly nothing noticeable. All of a sudden either this has been turned on it's head or something else is going on.

I had blood work done a few months ago and it was normal.

---------- Post added at 14:06 ---------- Previous post was at 12:37 ----------

I mean, can they work for three months and then stop working? Is that possible?

[panic_down_under]

I was told by my GP to allow up to 6 months for the Fluoxetine to work

If it takes 6 months to get a response then it probably isn't the med, but just the lowering of anxiety as part of the normal waxing and waning cycle.


I mean, can they work for three months and then stop working? Is that possible?

Yes, antidepressants can quit working after just a few months. Mirtazapine is notorious for doing so, and the SSRIs are more likely to than SNRIs, TCAs and MAOIs, but will usually work for at least a couple of years.

However, I don't believe this is what has happened here. It is more likely you just need a higher dose. Some of us do. Also have you been under greater stress than usual lately? If so this could have overwhelmed the current dose.

[No Imagination]

Just spoken to the GP and he says to up the dose to 40mg. He'd have preferred 30mg but apparently there aren't 10mg tablets?

---------- Post added at 13:08 ---------- Previous post was at 12:42 ----------

Probably a stupid question but if I took one tablet and then two the next and then one the next and then two and so on would that be the equivalent of 30mg's because of the length of time these take to work or would it cause problems by leading to an imbalance?

[panic_down_under]

Just spoken to the GP and he says to up the dose to 40mg. He'd have preferred 30mg but apparently there aren't 10mg tablets?

10mg tablets are available internationally. I don't know about the UK.


Probably a stupid question but if I took one tablet and then two the next and then one the next and then two and so on would that be the equivalent of 30mg's because of the length of time these take to work or would it cause problems by leading to an imbalance?

Because of the very long fluoxetine half-life this won't be a problem (I don't advise it for other ADs). However, it can lead to mistakes and I suggest you only do it for a couple of weeks before going up to 40mg. You're probably not going to get much of a boost from 30mg anyway. Plus, with antidepressants it is probably better to be a little over than under medicated.

[No Imagination]

I'm just going with 40mgs. If I could get the 10mgs here in the UK I may have gone up to 30mgs initially but as I can't it seems like it's better just to go up to 40mgs and hope for the best.

Thanks for taking the time to reply to all of this buddy. It's good to have advice from knowledgeable people, even more so when you're not necessarily thinking straight.

[worriedsoul]

My brother went from 20mg to 40mg and noticed a dramatic difference in a few days

[No Imagination]

So a bit of an update as I haven't posted in a while. I'm just over three months into them and I feel as though I've been making progress...until yesterday when I came crashing back down again :weep:

The last few months haven't all been plain sailing but it definitely felt like I was moving forwards and was able to be more active than I have in a long time. Whether that was down to the Fluoxetine, the beta blockers, the counselling, a more positive attitude or a combination of all of them I don't know but it was better.

Yesterday however things took a turn for the worse for some reason. I've had a few periods of intense sweating on the meds but yesterday took it to a different level, in fact I'm not even sure if it was the same thing or something different. My skin suddenly felt weird all over my body, almost like a burning sensation but not quite. Legs, arms, back, nether regions the works. Never felt anything like it before. It seemed to last for about 30 mins but went away and came back a bit during that time. It completely threw me to be honest especially as I have been doing so well recently. As a consequence I felt off all day yesterday. Then after a few hours sleep I awoke to feeling quite shaky, managed to drop back off to sleep after a while only to wake up feeling the same way again not long after. This repeated a few times. I'm still feeling off now and whilst I know that some of it is likely to be anxiety the whole thing has left me baffled really. I'm basically as bad (in a different way) to how I was three months ago. I was hoping that yesterday was some weird blip but the fact I'm feeling off again today isn't filling me with confidence.

It's so frustrating to feel as though things are on the up only to get slapped back down again.

---------- Post added at 13:27 ---------- Previous post was at 13:08 ----------

I think what makes it worse is that whilst I try and put everything down to anxiety, I just don't believe it. So that increases the worry further :mad: :weep:

So after about a month with nothing else happening, I find the situation repeating itself today :weep:

Similar thing to last time, I awoke with a slight tingling sensation throughout my body, not actually unpleasant or anything just there. Could have been a slight tension in my muscles throughout my body but it didn't feel horrible and I didn't feel anxious. Fast forward a few hours and I have a CBT session and I get the same sensation as a month ago while I'm in the car on the way to the session. I tried not to let it get to me and actually it came and went quite quickly. I got to the session and was sat waiting for 5 mins, no real issues but as soon as the session started it kicked off again. My session lasted for an hour and I had 5 or 6 waves of it throughout the session but I continued on with it anyway.

After finishing I left and it didn't happen again for 30 mins or so but then once again another weird wave throughout my entire body, even inside my mouth. It has now happened another couple of times. This has to be adrenaline surges right? I've had anxiety and panic attacks for years but never felt anything like this and it's unsettling. I also had a serious sweat on each time it kicked off, which is more like a typical blast of anxiety/panic to me.

Could the medication be changing how the anxiety itself feels somehow? I feel like I'm making progress but 'new' issues arising don't help with that.

[panic_down_under]

I got to the session and was sat waiting for 5 mins, no real issues but as soon as the session started it kicked off again. My session lasted for an hour and I had 5 or 6 waves of it throughout the session but I continued on with it anyway.

Did you tell the therapist about this and if so, what did s/he say?


This has to be adrenaline surges right?

Most probably. Trialling a beta-blocker would confirm it.


Could the medication be changing how the anxiety itself feels somehow? I feel like I'm making progress but 'new' issues arising don't help with that.

I suspect it isn't really a new issue, that it has always been there but that you were more focused on other anxiety symptoms occurring at the same time. The other symptoms may be less evident now which is allowing you to notice this more. And with each 'surge' you become ever more vigilant. This is something you and your therapist probably need to be focusing on now.

[No Imagination]

Thanks for the reply buddy.

Yeah I told the therapist and we based the session around what was happening so in that sense it was probably useful for her to see me at that exact point in time.

I am already using beta blockers. I take 40mg a day of Propranolol 4x10mgs. In so far as I didn't get a racing heart they appear to have worked at least in that sense.

It is definitely something new, whether it's simply a more exaggerated version of something that's happened in the past I don't know but the actual physical sensation is something I've never had before, with anxiety or panic attacks.

Is it possible that in taking the fluoxetine your body reacts differently to anxiety?

[Bike Rider]

[QUOTE=No Imagination;1677627]Just spoken to the GP and he says to up the dose to 40mg. He'd have preferred 30mg but apparently there aren't 10mg tablets?

---------- Post added at 13:15 ---------- Previous post was at 13:08 ----------

Propranolol does slow the heart down, which helps with anxiety and it does help relieve other physical symptoms of anxiety too.

This is why it is a banned substance for sports. But used for exam nerves or best man speeches etc.

But I found that it did help me with the other physical effects, even if my heart wasnt racing and if you do any sports, you may find your performance down because of them.

[No Imagination]

Thanks for the reply.

Yeah I think it's certainly possible that it could be anxiety. Let's face it anxiety can do all kinds of things to us. It was simply that it was a new sensation that made me wonder if it was just anxiety or something else. I've had anxiety for over 10 years and panic attacks within that period as well and this was different to those, not necessarily worse just different. But of course anxiety can throw new things at us and well all know that only too well. I'm also mindful of the fact that I'm a month into an increased dose of fluoxetine so potentially this could be having adverse effects as well. What a pain in the arse the mind is eh.

[No Imagination]

So Fluoxetine and alcohol...I stopped drinking months back when all of this started and I went on my meds. I want to know what the situation is with alcohol and Fluoxetine and also propranolol if possible before I start drinking alcohol again. It's not a big deal for me either way really.

For people looking in that are just starting out on these, I can't promise that you will get better but it has helped me. I've been doing things I haven't done in years. You will get side effects and they are annoying but I came out better the other side.

[hopelesspanda]

Hi no imagination,

I'm very glad to hear that Prozac has worked for you and you've improved. I am just now on 6 and a half weeks for severe anxiety. I am wondering, if you don't mind sharing, what types of things it enabled you to do?

I have moments where I feel more capable but as soon as they leave me I feel that I won't get better :( thanks xx

[No Imagination]

Hi no imagination,

I'm very glad to hear that Prozac has worked for you and you've improved. I am just now on 6 and a half weeks for severe anxiety. I am wondering, if you don't mind sharing, what types of things it enabled you to do?

I have moments where I feel more capable but as soon as they leave me I feel that I won't get better :( thanks xx

Hi,

Sorry for not replying sooner but I haven't been on here for a while.

What type of things has it enabled me to do? Well I went from being almost a recluse that struggled to get out of the house for any period of time without it feeling like a major ordeal, to being out for hours on end day after day after day. I've been able to go to sporting events with 20/30 thousand people in attendance without an issue, not as a one off but regularly, even going early on sometimes and spending more time there. Go to bars/pubs and be ok. In fact, if I have quieter days when I haven't much going on I notice it and tend to find things to go out and do. So completely different really. I even had to give the eulogy at my Grandfather's funeral a few weeks ago and coped without

It's not a magical cure or it hasn't been for me. I still experience anxiety on occasions - the reason I'm on here today is because I just had a big anxiety attack for some reason. But even with that going on I've often just carried on with whatever I was doing and that has to be in part down to the medication as well as the CBT I'm getting as well of course. For example I'm writing a positive reply to you whilst experiencing some anxiety!

Six and half weeks in I wasn't as improved as I have been over the last few months certainly so you aren't there yet by any means. In fact at that point I was still experiencing issues with the meds and side effects anyway. But gradually I did start to improve, at first I didn't even notice it but then you kinda do. Like you I had shorter moments of feeling more capable, probably at the same time period you are at now. But then those moments became longer and suddenly I realised I was looking forward to the following day before I would head off to sleep. I hadn't felt that way in a long time and it hit me that I was generally feeling more positive.