Prozac

[Cammie7]

Hello
Was prescribed 10 mg of Prozac for anxiety extreme stress trying to cope with the death of my sister over two years ago . Every time I fell sick I think the worst things . So Dr prescribed 10 mg Prozac for two weeks and Klonopin for sleep . Now 20 mg a day but the side effects stomach ache anxiety still high crying for no reason . I feel like is this ever going to work ?
Already lost weight no appetite it seems to be some what better today .
Any advice thoughts

Thanks in advance
Cammie

[panic_down_under]

Dr prescribed 10 mg Prozac for two weeks and Klonopin for sleep . Now 20 mg a day but the side effects stomach ache anxiety still high crying for no reason . I feel like is this ever going to work ?
Already lost weight no appetite it seems to be some what better today .

:welcome: Welcome to No More Panic, Cammie,

What you are describing are typical SSRI side-effects. SSRI initially increase serotonin activity and serotonin isn't only a brain neurotransmitter. It has many roles in the body and some organs make and use far more serotonin than the brain does so can be more affected by these antidepressants (ADs) than the brain is. Despite what is often claimed, serotonin isn't a 'feel good' neurotransmitter, it is anything but. Increased serotonin activity often heightens anxiety in the initial weeks. However, the brain, and the other affected organs, will respond after a while by down-regulating serotonin synthesis and expression and the side-effects then usually subside, though they may reoccur for a while after dose increases.

The most serotonergic organ of the body is the gut. It makes and uses about 50 times as much serotonin as the brain, hence the stomach aches. Your pharmacist should be able to recommend an effective remedy to ease the pain until the side-effect diminishes.

It typically takes 4-12 weeks for ADs to kick-in from when a therapeutic dose (20mg for Prozac) is first taken. ADs have no direct effect on anxiety, or depression in the way say aspirin has on a headache, but work by stimulating the growth of new brain cells (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC60045/) (neurogenesis) to replace cells killed, or prevented from growing by high brain stress hormone levels. The therapeutic response is produced by these new cells and the stronger interconnections they forge, not the meds directly, and they take time to bud, grow and mature. For a more detailed explanation see: How antidepressant drugs act (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3025168/).

Prozac (fluoxetine) has a very long half-life, about 6 days for the parent compound, another 16 for its active metabolite which actually does most of the work. While this has a number of positives, it can mean that it is a little slower to kick-in than the shorter half-life ADs, so patience is needed. There are, sadly, as yet no quick fix for anxiety disorders and depression. :weep:

Ian

[Cammie7]

Thank you Ian 🙏