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Thread: A timetable for recovery on Fluoxetine / prozac

  1. #721
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    Re: A timetable for recovery on Fluoxetine / prozac

    Quote Originally Posted by losin View Post
    I think it's 12 weeks. The only thing I can think of is I've been eating a lot of junk food over the past week.
    While there is growing evidence that the gut and its microbes can have a significant impact on mental health, I don't think eating junk food for a week would make a huge difference.

    It looks like 40mg fluoxetine may not be enough. If the current state continues then you basically have 3 options, increase the fluoxetine dose to 60mg, add a small dose of *buspirone (Buspar) - if you can get your GP to prescribe it which may not happen as the NHS is apparently not a fan - or switch to something else. If switching then I'd suggest either citalopram (Celexa), or one of the TCAs such as amitriptyline, or imipramine. Citalopram has a reasonably good record for working when another SSRI has pooped-out, but personally I'd try a TCA. Your GP would probably prefer to follow the NHS guidelines and prescribe either venlafaxine, or mirtazapine, but they'd be toward the bottom of my list.

    * buspirone is a GAD specific med which works for some, but not most, however, it has a proven record for boosting the effectiveness of serotonergic ADs and reinvigorating those which have pooped-out. It may also ease some SSRI side-effects such as sexual dysfunction.
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  2. #722
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    Re: A timetable for recovery on Fluoxetine / prozac

    hello, after a long break.so i stop prozac and i'm on 20mg of deroxat.the change was drastic after a month. I have started to live again.I think that the withdrawal that I made from deroxat was too fast.after 3 months of deroxat more motivation my doctor decided to increase to 30 mg.i really hope the 30mg will work and hope not to change the antidepressant.here I hope you are well

  3. #723
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    Re: A timetable for recovery on Fluoxetine / prozac

    Quote Originally Posted by velia View Post
    hello, after a long break.so i stop prozac and i'm on 20mg of deroxat.the change was drastic after a month. I have started to live again.I think that the withdrawal that I made from deroxat was too fast.after 3 months of deroxat more motivation my doctor decided to increase to 30 mg.i really hope the 30mg will work and hope not to change the antidepressant.here I hope you are well
    This is very good news. Finding the antidepressant which works best with individual biology can sometimes take a while but when the right med is found it can almost magically change lives.

    Long may this last and thanks for letting us know!
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  4. #724

    Re: A timetable for recovery on Fluoxetine / prozac

    Just wanted to say thanks to everyone on this thread. I've read it from the start over the last 24 hours.

    I've been on flu for 14 years. First at 20mg, then after a depressive episode I went to 40mg in 2014 and I've been really down since the summer and tried a load of things but was basically struggling with suicidal thoughts so I upped my dose to 60mg 10 days ago. Really in the thick of side effects at the moment but know I just have to push through and view each day as one day closer to being better.

  5. #725
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    Re: A timetable for recovery on Fluoxetine / prozac

    Quote Originally Posted by davey_b View Post
    Just wanted to say thanks to everyone on this thread. I've read it from the start over the last 24 hours.
    to NMP, Davey,

    You read all 73 pages? Wow! That's some dedication!

    I've been really down since the summer and tried a load of things but was basically struggling with suicidal thoughts so I upped my dose to 60mg 10 days ago.
    I hope you cleared it with the prescribing physician first. Some can get awfully stroppy if you don't allow them to think it was their idea.

    Really in the thick of side effects at the moment but know I just have to push through and view each day as one day closer to being better.
    Very true. It is a matter of taking each day as it comes and rolling with any punches. Unfortunately, there are no shortcuts.
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  6. #726

    Re: A timetable for recovery on Fluoxetine / prozac

    Thanks PDU.

    I started CBT a couple of months back and talked to my doc then about upping my dose but we decided to see how the cbt went. I know all the theory from it but my brain is just so frazzled and wired that I'm struggling to implement it so we've upped my dose. Last week was actually pretty good but really crashed over the weekend.

    Had a tough day yesterday but took a 5mg diazepam last night and slept better so feeling less all over the place so far today. I fit the common pattern of being bad in the morning and getting better as the day goes on and at times in the evening I feel like I'm fine but then wake up in a bit of a mess in the morning.

  7. #727
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    Re: A timetable for recovery on Fluoxetine / prozac

    Quote Originally Posted by davey_b View Post
    I started CBT a couple of months back and talked to my doc then about upping my dose but we decided to see how the cbt went. I know all the theory from it but my brain is just so frazzled and wired that I'm struggling to implement it so we've upped my dose. Last week was actually pretty good but really crashed over the weekend.
    While some begin to experience side-effects within an hour or two of taking a higher dose, a delayed reaction tends to be more common, especially with fluoxetine because of its very long half-life. Unfortunately, the side-effects may also linger for longer for the same reason. It takes about a month for fluoxetine plasma levels to restabilize to a steady-state after a dose increase (or decrease).

    I fit the common pattern of being bad in the morning and getting better as the day goes on and at times in the evening I feel like I'm fine but then wake up in a bit of a mess in the morning.
    I have the opposite, imo worse, pattern, coming out of the blocks in the morning all bright eyed and bushy tailed ready to conquer the world and then fading as the day progresses. Such is life.
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    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

  8. #728

    Re: A timetable for recovery on Fluoxetine / prozac

    Quote Originally Posted by panic_down_under View Post
    While some begin to experience side-effects within an hour or two of taking a higher dose, a delayed reaction tends to be more common, especially with fluoxetine because of its very long half-life. Unfortunately, the side-effects may also linger for longer for the same reason. It takes about a month for fluoxetine plasma levels to restabilize to a steady-state after a dose increase (or decrease).



    I have the opposite, imo worse, pattern, coming out of the blocks in the morning all bright eyed and bushy tailed ready to conquer the world and then fading as the day progresses. Such is life.
    Pretty much the same as me, fine in the morning, starts building up mid morning peaking after lunchtime and staying at that level rest of the afternoon and evening. Starts to tail off after 9pm. Had Fluox added to my mirt about 12 months but made no difference so tapered off them, not sure the mirt does anything either but it did give me an appetite for the time in my life! Trying to avoid going down the antipsychotic route but that may be inevitable.

  9. #729
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    Re: A timetable for recovery on Fluoxetine / prozac

    Quote Originally Posted by spectrum123 View Post
    Fluox added to my mirt about 12 months but made no difference so tapered off them,
    What was the highest fluoxetine dose taken?

    not sure the mirt does anything either but it did give me an appetite for the time in my life!
    Mirtazapine is more a powerful antihistamine than antidepressant which mostly eases anxiety by sedation.

    Trying to avoid going down the antipsychotic route but that may be inevitable.
    You're a long way from needed to consider antipsychotics. There are other SSRIs, TCAs, SNRIs, other ADs and possibly even MAOIs. NICE guidelines recommend antipsychotics not be prescribed for GAD and Panic Disorder:

    https://www.nice.org.uk/donotdo/do-n...n-primary-care

    https://www.nice.org.uk/donotdo/seda...panic-disorder
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    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

  10. #730

    Re: A timetable for recovery on Fluoxetine / prozac

    Quote Originally Posted by panic_down_under View Post
    What was the highest fluoxetine dose taken?



    Mirtazapine is more a powerful antihistamine than antidepressant which mostly eases anxiety by sedation.



    You're a long way from needed to consider antipsychotics. There are other SSRIs, TCAs, SNRIs, other ADs and possibly even MAOIs. NICE guidelines recommend antipsychotics not be prescribed for GAD and Panic Disorder:

    https://www.nice.org.uk/donotdo/do-n...n-primary-care

    https://www.nice.org.uk/donotdo/seda...panic-disorder
    Fluox max dose was 60mg per day (12 months) with 45mg mirt, I had been on this previously to starting the Fluox.

    Over the last 25 years, I've done of the SSRI's Citalopram, Escitalopram, Fluoxetine, Fluvoxamine, Paroxetine, & Sertraline. SNRI's Duloxetine & Venlafaxine. Along with Mirtazapine, Propranolol, Hydroxyzine. None have been particularly successful.

    I've also done 3 rounds of CBT, 2 rounds of counselling, all that did was help me recognise what was wrong but did nothing to stop the daily cycle.

    Bezo's obviously work, although 2mg of diazepam barely manages 2 hours then parachutes you straight back the where I was prior to taking them. Lorazepam does work for 5-6 hours and doesn't drop off rapidly. It is though for emergency use only.

    I did have 7 days of Trifluoperazine years, which worked but are limited the same as BZD's.

    They won't consider the older AD's like TCA's or MAOI's (no real explanation why)

    Gaba drugs are on the NHS naughty step, so they are out.

    The MH consultant has left the next route as the antipsychotics as mentioned above.

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