5 weeks on fluoxetine, feeling very low

[TheRivieraKid]

Thanks for your post Laura - really appreciate it

Piano - it could be that you're super-sensitive to the drug and that a 10mg dose will have the same effect as someone else who has a 20mg dose - that might be all you need in the end, or you may need to up the dose later on. Everyone's different and that's what makes treating anxiety/depression so difficult, as there's no hard and fast "cure" as such. So keep in touch with your GP and see what they recommend

I went to see my hypnotherapist today who I did some EMDR work with, had a good session but feel quite anxious this evening - this quite often happens to me after mental exertion.

I am however comforting myself with the fact that I'm now into Week 3 of taking the drug - talk about counting the hours

[Emphyrio]

Hang in there Piano - just give it some time

I've heard quite a few people talking about 'therapeutic doses' on this site, but I wouldn't say that one size fits all. I have a couple of books about OCD - one of them (Tormenting thoughts and secret rituals by Ian Osborn) states on page 99 that:

A few people with OCD respond to ultra-low doses of medication. I have patients doing well on just 2 milligrams a day of Prozac

I would argue that there is no reason why low doses could work for other disorders too.

I also found an interesting article at http://www.lef.org/magazine/mag2003/...ffects_01.html

Meanwhile, troubled by the reactions I saw, I searched the medical literature for explanations. I found more than I anticipated. A study published before Prozac's® approval showed that just 5 mg helped 54% of patients, while 20 mg-the recommended dose-helped 64%.6 In other words, quadrupling the dose only improved efficacy 10%. To me, this meant that 5 mg was a reasonable starting dose, yet doctors were told to start everyone at 20 mg, even the 54% who needed only 5 mg! I was shocked and appalled.

It essentially mentions that some people need 80mg of prozac to feel better whereas others only require 2.5mg - response to medications can vary "4 to 40 fold" between people. Although I would discuss any dose related queries with a doctor, its certainly something to think about.

[Piano]

Emphyrio: Thank you so much for the quotes on doses! And thank you for reassuring me, it helps a lot.

RivieraKid: So you are getting EMDR? I really want to try that!

Iggy: Meeting for coffee would be lovely but a bit difficult And it would have to be decaf, I can't drink anything with caffeine because of the fluoxetine. I tried once and my anxiety was awful...

[Iggy131313]

heehee yep Piano, Im on decaf too! I tell you what we will have a virtual decaff tomorrow.

Im now going to try and sleep.

Night night. xx

[Piano]

Night night
Sending you warm thoughts

[Amandala]

I want to thank you all again too... I guess we are all around that 5 week area, a few more days until 6! The days seem better but the mornings are still pretty shaky. I know I am supposed to increase to 40mg once I level out but I am so scared of having to start over! I finally bit the bullet and am going to see a new psychologist next week. I dropped my old one a few years ago because she was too "pill pushy". My regular doc had changed my cymbalta to prozac but I don't think he's too comfortable playing around with it too much. Glad to hear everyone is still hanging in, for better or worse
I'm in the US but I'd love to join in for some decaf

[Tufty]

Hi Prozie gang,
I've been on Prozac for 22 weeks and wanted to say that you've shared some great advise on this thread.
In summary -
I took 20mg daily for 4 weeks,
40mg daily for 4 weeks (8 weeks),
20mg every 36 hours for 8 weeks (16 weeks),
20mg daily for 2 weeks (18 weeks)
10mg every 36 hours for 4 weeks (22 weeks)
so I've played around with lots of doses and agree whole heartedly with what emphy say's above. I changed the dose with my GP's agreement and each time I increased the drug I had intolerable side effects, I changed from 20mg every 36hrs to one a day because I was feeling well and was finding it difficult to remember to take it every 36 hours but after 2 weeks on 20mg daily the panic, shaking, diarrhoea, nausea, electric shock feelings etc were back - hence I reduced it down even further and have continued to improve.
I guess I'm sensitive to the medication - I've tried other anti d's and Prozac is the one I tolerate the best. Most people will be fine on the 20mg daily but if you're not I'm proof that lowering the therapeutic dose can work. One size does not fit all - we all have different metabolisms and brain chemistry and it sometimes takes a while to work out what will work for you. It's not all down to size either - I know people on 60mg of Citalopram who are underweight and have no side effects - I'm defo not underweight and couldn't take 20mg
I'm going to change to 20mg 3 times a week in a couple of weeks, simply because I'm currently opening each 20mg capsule and throwing half the contents to get the 10mg dose and that's a hassle (and not exact). That still gives me 6.6mg a day which as emphy quoted works for 54% of people.

In hindsight I wish I'd started at the lowest dose and increased very slowly- it takes about 25 days for Prozac to reach it's steady state - but wanting to get better asap (like the rest of us) I was impatient.
Hang on in there everyone - you will get better - i improved loads at the 8-11 week mark.
Love Sam

[Piano]

Thank you Samhar!

Today I was so depressed that I called my dr. He said we will have to discuss upping the dose next week (6 weeks mark). He also said we might have to change medication.

Please give me some encouragement

[Tufty]

Were you suffering with anxiety or depression or both before starting the Prozac? I only ask because I didn't feel depressed before starting them, that started about 5 weeks later but it maybe that the anxiety was masking the depression. Do you keep a chart/diary of your symptoms Piano?

[Piano]

I was not suffering from depression, but I had a terrible anxiety (which has calmed down).
Yes I am keeping a diary of my symptoms. It seems that I get depressed every day, it lasts for about 3 hours. It started around the 5 week mark.