despreately need reassurance re prozac

[joannap]

i have been on prozac almost 9 weeks (almost 4 on 40mg) and i just don't feel like they are working like they should be.

in the past (i am no stranger to anxiety) i have been on an ssri for 2 weeks or so and then my mood has quickly improved and i have got back to normal living. this time - it has been very different. yes - i have experienced some improvement (my anxiety was through the roof and i could not even be left on my own) but i still feel anxious/depressed much of the time and although i have experienced some better days where i can see light at the end of tunnel - i then start to feel really bad again - like a yo yo effect.

this is the worst breakdown i have ever had so i don;t know if i am expecting too much too soon but my thoughts are concentrated 24/7 on myself even on the days i feel better.

my worry is is that i am on the wrong ssri for me - that if i was on another one i would be improving quicker but THEN i worry that they are doing more than i think and it would be wise to stay on them. i am in very regular contact with my gp - she seems happy overall with my progress.

i do realise that medication is not the answer but my past experience of ssri's is that they have always helped dramatically.

my question is is that how do i tell the difference between an srri that is helping and my recovery taking a long time or whether i need to be on a different medication?

[blueangel]

Hi Joanna - good question, this. I haven't got any personal experience of Prozac, as the SSRIs I've taken in the past are Paroxetine and Citalopram. But, even though they're the same group of drugs, they do all work slightly differently depending on our state of mind, and also our body chemistry. Which have you found was the best anti-depressant for you in the past? It might be worth having a chat with your doctor the next time you see her.

From my own experience, medication has usually taken between 2 and 4 weeks to work with me. It's taken a bit longer for me this time (have been back on citalopram for a couple of months now), and I've also needed a higher dose than before, so I can only guess that my anxiety is worse this time.

You do say that this is the worst you've ever been, so I'm sure that needs to be taken into account as well, but I would have thought that after 9 weeks you ought to be feeling a bit more "level". I know the yo-yo effect is common though, as I've had this myself as part of the recovery process. I notice I'm starting to get better when the good days start to outnumber the bad ones.

[joannap]

thanks for your reply - i have days in a row where i am definitely feeling brighter but then i go downhill again. i keep thinking - this is it - i am on the road to recovery and get my hopes up and then i will feel so depressed/anxious i cannot cope and it has me in tears for hours at a time. i am definitely not as bad as i was in the beginning but still very miserable!

the difficulty is is that i was in such a state before re starting medication - i had had a really bad reaction to a drug for stomach problems and so it made me terrified of taking anything and for some reason i insisted on prozac but i am not sure if it is the right one for me. i have had it once before in the past but not for very long. i have taken citalopram and lustral before - i am just so worried about changing meds unnecessarily - i know there is no guarantee i will feel better on another one but i do feel that after 9 weeks i should be feeling brighter and that my life is still not being ruled 24/7 by anxiety/depression.

[Bill]

my thoughts are concentrated 24/7 on myself even on the days i feel better.

I'm afraid to say this is probably why you're not seeing any real improvement.

I was out shopping today and I felt fine when I stepped out. However, while I was out my tummy started playing up and I just couldn't focus on anything else even though I knew the more I "concentrated on myself", the more my tummy would keep playing up because I was constantly adding fuel for my anxiety to feed off.

I think sometimes it's a bit like the chicken and the egg. If our body plays up, our minds will worry but if our minds worry, our body will play up...and so on....and no matter which come first- the feelings or the thoughts- the cycle starts.

Sometimes it's subconscious thoughts that we're not aware of we're thinking that triggers the cycle but sometimes it can be something we've drank or eaten our tummy doesn't agree with etc etc.

In my case I think it was due to overtiredness together with drinking/eating just before I went out. It was Just a bad day to forget and not dwell on.

Whatever the cause or effect though, I find if I can keep my mind away from thinking about my body then my body will leave my mind alone, and if I can keep my body feeling ok, it won't trigger any worrying thoughts, and I then stand a better chance of keeping relaxed.

I did take prozac once but I found it just like the others - after the side-effects stopped, my mood improved but my anxiety would keep coming back because the causes in my every day life weren't being addressed. Sometimes meds can be like adding a plaster to an infected wound- they can ease but can't cure until the wound is opened and addressed first.

I think I'd ask myself what happens that triggers the anxiety to return and think about how you could prevent the episodes from happening as it could then help you to smooth your rollarcoaster of emotions. The meds would also then stand a better chance of helping to ease your anxiety.:hugs:

[blueangel]

Very good points here Bill - I know from my own experiences that the more you feed anxiety, the worse it gets. We get locked inside our own heads and it's so difficult to break out of this.

Finding the triggers for it seems to be a key thing; it certainly helps me and one of the things that I've learnt from having CBT is that there is always a cause for our anxiety, but we might have to "drill down" to find out exactly what that cause is, as it's often hidden deeply.

I've discovered that one of my big issues is the fear of being abandoned - the root cause to this is that a number of my close family members died when I was young, therefore in my mind:

illness = death = I will be abandoned by everyone (or I will die as well)

This is definitely the root cause for my HA, and also for a lot of my other fears. It's not all of them, as there are other things in there as well, but it can take a while to find out the real reasons for why we are anxious.

For Joanna though - I would go back and have another chat with your doctor. Changing from one sort of SSRI to another isn't actually that big a deal, as they're similar sorts of drugs and there shouldn't be too many problems with side effects, and you might get more relief from your symptoms. Has your GP referred you for any counselling or CBT yet, or is he/she waiting until your symptoms have calmed down a bit?

Take care x

[Pixiedust]

Hm, I was on prozac a few years ago and to be honest they didn't do anything, that was for depression though. I actually felt better after coming off them, but I also know that plenty of people say they do work so...

[joannap]

hi guys

thanks for your replies.

i totally understand what you are saying bill. i have suffered badly on and off since i was 23 with anxiety and am now 36. however - whenever i have been on an ssri - i have felt much better and being able to live what i would call a normal life although yes - i still have a tendancy to worry and be obsessive. i just have not experienced that "lift" this time and my thoughts have not been on myself 24/7 in the past because i have had that "lift" and i know i have been improving.

the last time i was on an ssri - it was for around 7 years - i tried to come off and plummeted so went straight back on. i took a year to wean off this time - during this time i have had an over active thyroid, awful stomach issues (gerd) since last june plus lost one dog tragically to posioning and then another through natural but unexpected causes literally weeks later plus my brothers dog (who i walked) died tragically plus money issues etc.

my doctor is very wary of changing my meds because my anxiety was so high - she does not want me to have a rough time of it and go back there.

i just feel in such a dilemma because i really did expect to feel much improved by now.

[joannap]

i honestly do not think i can even isolate why the anxiety returns - sometimes i think its because my stomach is playing up but then if my stomach feels better - i then feel just as anxious/depressed inside.

my doctor referred me to a counsellor who wanted me to go on an nhs stress pack course. i told her this was not what i wanted - that i felt i needed one to one. that driving a 30 mile round trip on an evening and sitting in a room full of people when i have only been able to visit my own dad twice since xmas - i did not think i could do. i did try last week but got the night wrong and just could not face it the next night so one to one is now being arranged. to be honest - there could be so many causes in my past - i would not know where to start lol and am wary of trying to isolate causes - i can certainly see patterns of behaviour that have happened as a result of things happening in childhood but i need to be able to deal with how i feel on a daily basis in the here and now.

i just cannot understand why the same treatment has not worked like it has in the past. 2-3 weeks on an ssri - i have known pretty much to the day where they have started working and this time - it just feels completely different.

[joannap]

ps - have just read another post where the persons gp told them that prozac is not the drug to use for anxiety/panic?! and he has been taken off his!

[buster_uk1967]

ps - have just read another post where the persons gp told them that prozac is not the drug to use for anxiety/panic?! and he has been taken off his!

Hi Joannap.

I have taken this from the fda website.

Fluoxetine hydrochloride is approved in the United States to treat depression, obsessive-compulsive disorder, bulimia-nervosa, premenstrual dysphoric disorder and panic disorder. In the United Kingdom, it is approved to treat depression with or without anxiety, bulimia nervosa, and obsessive-compulsive disorder.

It seems it is not licensed in the uk for panic disorder but is in the usa????

[joannap]

i would never have labelled myself as depressed but some gp's say panic disorder/anxiety is all part of depression - that it all comes under the same umbrella - very confusing!

[blueangel]

I've just had a quick look at my copy of the BNF (pharmaceutical directory I have to refer to at work sometimes) and the SSRIs that specifically mention panic disorder/GAD are citalopram, escitalopram and paroxetine (Seroxat). However, prozac is definitely one of the same group of drugs, so it must work broadly in the same way as they all help serotonin levels to rise, which is the chemical we get short of when we get both anxious and/or depressed (I think!).

[buster_uk1967]

Hi joannap,

You have not been on in a while. How are you doing?