A timetable for recovery on Fluoxetine / prozac

[KayMK]

Mornings have always been worse for me. Most days Im feeling better by the late afternoon and some evenings lately I have gone to bed feeling almost back to normal.
It's such a strange feeling going to bed one way and waking up another.
I'm naturally normally an optimistic person so when I go to bed feeling OK I tell myself the morning is bound to be better but it generally isn't.

[panic_down_under]

Mornings have always been worse for me. Most days Im feeling better by the late afternoon and some evenings lately I have gone to bed feeling almost back to normal.

Most people have times of the day when anxiety, and/or depression are at their worst. For me mornings used to be pretty good with PD becoming gradually worst as the day progressed.

I'm naturally normally an optimistic person so when I go to bed feeling OK I tell myself the morning is bound to be better but it generally isn't.

One day soon you should begin to see a sustained improvement in your mornings. The naturally optimistic usually respond better to treatment too.

Have you been on 20mg for 7+ weeks, or were you on a lower dose for the first week, or two, Kerri?

[KayMK]

Thanks for your support. I really appreciate these messages.
I'm the crazy person who went straight back on 40mg without consulting the Dr and then had a big crash of side effects at the end of week one. I did think about reducing the dose a couple of weeks ago but decided that as I had come that far I could persevere on. I know I'm noticing improvements now so it's just a case of staying strong I suppose.

[panic_down_under]

I'm the crazy person who went straight back on 40mg without consulting the Dr and then had a big crash of side effects at the end of week one.

Ah, yes. I should have remembered that.

I did think about reducing the dose a couple of weeks ago but decided that as I had come that far I could persevere on. I know I'm noticing improvements now so it's just a case of staying strong I suppose.

I wouldn't change anything yet. Fluoxetine is often slow to kick-in and especially so when it was taken before. Unfortunately, there is no way of speeding up the process.

[KayMK]

Ha ha yeh that big mistake is hard to forget!
The improvements are slow and frustrating but I can feel a shift. Just a gradual feeling of being able to cope a bit better. I'm on social isolation lock down now with 2 kids and a grumpy old dog so I'm banking on that medication to see me through!

[Dhen1503]

Hi
I keep reading all your posts on this forum and they have really kept me going.

This is the second time I have taken 20mg fluoxetine after a 6 month break. I came off it with doctors advice as I was feeling great. However my anxiety has crept back since christmas and I ended up with a doctors appointment on 17th February who reinstated 20mg fluoxetine and insisted it would work as well as last time. I dont recall any side effects first time. This is my 5th week on 20mg fluoxetine second time around. I have and still am suffering side effects including no appetite at all, nausea, headache, reflux and heart burn, strange thoughts, increased anxiety, trembling, hot flashes and sweating, lack of urination despite drinking pleanty. I am having to force myself to eat. I have yet to see any real improvement of my anxiety although I do feel more normal in the evenings compared to first thing in morning and throughout the day when I feel terrible and anxious. I have been off work for a month and still dont feel ready to return.

I have also been attending group therapy sessions which haven't really helped so I am going to request one to one councelling.

This coronavirus outbreak has only added to my anxiety as I live with my parents who are both in their 70s and mam has multiple underlying health conditions such as type 2 diabetes, lupus, asthma, the list goes on.

Just after advice and reassurance that things still have a chance to improve.
Thank you and good luck to everyone!

[KayMK]

Hi
Sorry to hear you are struggling. It's so tough isn't it.
I'm like you I read these posts and it gives me hope. I still felt pretty bad around 5 weeks and it was about that point that I found this forum thread and it was a lifesaver. 5 weeks feels soooo long doesn't it. I just couldn't believe I wasn't back to normal by then. Although the doctors tell you to give it a couple of weeks I think we can see by all these experiences on here that it takes much longer.
All of the side effects you have I had too.
My appetite is returning. Still not eating much in the morning but Im actually fancying certain foods now which is a massive improvement.
So mornings are the absolute pits still but they are getting easier. I'm a couple of weeks ahead of you so take some hope from that.
Although Im still feeling pretty unmotivated and mildly anxious it's much improved from 5 weeks.
Are you taking anything to help with the side effects and heightened anxiety?
All this news of the virus can't be helping anyone's anxiety.
Keep us updated how you are getting on.

I have been signed off for another 4 weeks today. I just need to conquer these mornings.
X

[Dhen1503]

Hi Kay
I'm on nothing but fluoxetine. I'm not really keen on taking a cocktail of tablets when these worked so well last time on the same dose. I thought side effects were improving but heartburn and really bad headaches have returned along with the other side effects. I forgot to mention before insomnia is another side effect I'm struggling with. Two nights ago I took my tablet before bed instead of in the morning but have felt I'll since. However this could also be due to my fear and anxiety over coronavirus.
All the best
David

[panic_down_under]

I'm on social isolation lock down now with 2 kids and a grumpy old dog so I'm banking on that medication to see me through!

Try and get out if you can even if its only a walk to the corner of your street and back when few people are about. I'll trade you the grumpy dog for the snoring sheep that has recently decided to sleep under the cabin I'm renting.

[panic_down_under]

I dont recall any side effects first time. This is my 5th week on 20mg fluoxetine second time around. I have and still am suffering side effects including no appetite at all, nausea, headache, reflux and heart burn, strange thoughts, increased anxiety, trembling, hot flashes and sweating, lack of urination despite drinking pleanty. I am having to force myself to eat.

Side-effects can be more severe the second time on an AD and you may also need to take a higher dose to achieve the same level of response too.

The side-effects are fairly typical of SSRIs. Nausea, reflux and heart burn are caused by fluoxetine's affect on the enteric nervous system (ENS), the mini brain which controls the gut. Serotonin isn't only a brain neurotransmitter. It has many roles in the body and the brain is only a minor user, less than 2% of of the body's serotonin is made and used by it. The most serotonergic organ is the ENS+gut which makes about 50 times as much of it. The gut can therefore be more affected initially by SSRIs/SNRIs and some TCAs than the brain. The usual otc remedies are usually effective.

The side-effects should begin to diminish as the body responds to the increased serotonin activity by down-regulating its synthesis and expression.

headache, hot flashes and sweating

Another of serotonin's roles is in mediating blood vessel tone, constriction and dilation, which trigger these side-effects. Any of the common painkillers should ease the headache, but paracetamol, aka acetaminophen, is a better longer term option than the NSAIDs - aspirin, ibuprofen, naproxen, etc - as SSRIs are also mild anticoagulants.

Two nights ago I took my tablet before bed instead of in the morning but have felt I'll since. However this could also be due to my fear and anxiety over coronavirus.

It was most likely the anxiety. Fluoxetine has a very long half-life, about 6 days for fluoxetine itself, plus up to 16 days for its main active metabolite which does most of the work, so minor changes in when the med is taken are unlikely to have any affect.