A timetable for recovery on Fluoxetine / prozac

[davey_b]

What is happening?

Just feel really anxious and worried some days and more relaxed, well less anxious, others.

[panic_down_under]

Just feel really anxious and worried some days and more relaxed, well less anxious, others.

Which is actually a promising sign if the more relaxed, less anxious days are becoming progressively more frequent, Davey. The one step forward, 2+ back shuffle shows the med is capable of working. Linear improvements can owe more to the placebo effect than the med, ime.

[KHPanic]

Hi everyone. This thread has been great for me. I've read the whole thing. The first half a few times. This is my third go around with ADs but the first with fluoxetine. The first two times I was on Paxil but I asked for something else this time because the side effects got a lot worse the second time I went on it and wasn't looking forward to round 3.

Was doing well off everything and then had a really bad panic attack in late December. Started 10mg and went up to 20mg on Jan 5 so I'm at like 5~ weeks? Feeling better but still dealing with ups and downs. Last night I felt like my old self and woke up this morning not feeling that way so kind of down. Worst thing left is slight derealization which is the main source of my remaining anxiety. Gotta love existential anxiety. One day at a time.

[panic_down_under]

The first two times I was on Paxil but I asked for something else this time because the side effects got a lot worse the second time I went on it and wasn't looking forward to round 3.

to NMP,

A wise move. For reasons that are really understood side-effects tend to progressively increase in severity each time an antidepressant is stopped and restarted. They can be different each time too.

Started 10mg and went up to 20mg on Jan 5 so I'm at like 5~ weeks? Feeling better but still dealing with ups and downs. Last night I felt like my old self and woke up this morning not feeling that way so kind of down.

It may take fluoxetine longer to kick-in than the paroxetine did, partly because this is your third time on an SSRI, but mostly because fluoxetine has a very long half-life, about 6 days for fluoxetine itself and up to 16 days for its active metabolite, norfluoxetine, which does most of the work, compared to ~21 hours for paroxetine which has no active metabolite. It takes about a month for fluoxetine plasma levels to stabilize after a dose increase/decrease.

Worst thing left is slight derealization which is the main source of my remaining anxiety. Gotta love existential anxiety.

Derealization is a anxiety symptom so one often reinforces the other which can make it hard to bring under control and it and depersonalization are often the last symptoms to diminish.

[KHPanic]

Thanks for the reply pdu. I was wondering if this being my third go would make it take longer even though it's a different medication. Definitely seems that way.

Fluoxetine has been a lot more mild side effect wise than round 2 of peroxetine. That was miserable. Insomnia and stomach problems lasted a couple weeks. Now mostly just headaches and tinnitus with very low appetite. Don't plan on going off this time so hopefully fluoxetine works well. Seems to be getting there. I haven't had to use any of my Xanax in a couple weeks.

[panic_down_under]

Fluoxetine has been a lot more mild side effect wise than round 2 of peroxetine. That was miserable. Insomnia and stomach problems lasted a couple weeks.

I can't tolerate SSRIs, but if I could paroxetine would be among my last resort meds. It can be a pain in the butt at the start and even worse when coming off it.

Now mostly just headaches and tinnitus with very low appetite.

Acetaminophen, aka, paracetamol is usually effective for SSRI induced headache. SSRIs and other serotonergic antidepressants are mild anticoagulants so aspirin and other NSAID painkillers such as ibuprofen and naproxen, which also 'thin' the blood may become problematic if taken for more than a couple of days. Stop taking NSAIDs if you begin bruising more easily or having nose/gum bleeding.

Was tinnitus also a problem when starting paroxetine?

Don't plan on going off this time so hopefully fluoxetine works well. Seems to be getting there.

Probably a good choice. The chances of an SSRI working drops each time they are stopped and restarted.

I haven't had to use any of my Xanax in a couple weeks.

Sounds promising. But definitely take the Xanax (alprazolam) if you need to as white-knuckling through anxiety is counterproductive. However, avoid taking it just in case as benzodiazepines inhibit hippocampal neurogenesis the mechanism by which ADs work.

[KHPanic]

My old doctor put me on peroxetine 10 years ago when I didn't even know what I was experiencing so I didn't question it. Ive done a lot more research since then and definitely would have asked for something else if I had known at the time. Tapering off was really bad too as you said.

I remember having tinnitus when starting peroxetine too. I was in metal bands throughout my early to mid 20s so I'm no stranger to it. But this has a different frequency. It's lower. Tinnitus from sound is a high ring for me and this is more of a hum. It could be making tinnitus I already have more noticable or altering it. I don't know. Probably just my hypervigilant state noticing it.

As for my Xanax yeah I've been avoiding taking it unless I need to. It makes me really tired but works very well. But as you said I've read it can impede the AD doing its thing. I appreciate all your knowledge. It's good to talk to people who get it.

[KHPanic]

Just wanted to check in. Having a rough few days. Was doing pretty well for all of March. Light depersonalization and foggy brain from the fluoxetine seemed to be fading. Then on Thursday night as I tried to go to sleep my mind was in overdrive and I got really anxious about my meds not working and having wasted the last two months. Ended up taking half a Xanax to go to sleep and have been really sleepy and out of it since. Anxiety is the worst.

[panic_down_under]

Just wanted to check in. Having a rough few days. Was doing pretty well for all of March. Light depersonalization and foggy brain from the fluoxetine seemed to be fading. Then on Thursday night as I tried to go to sleep my mind was in overdrive and I got really anxious about my meds not working and having wasted the last two months. Ended up taking half a Xanax to go to sleep and have been really sleepy and out of it since. Anxiety is the worst.

Indeed it is. I wouldn't read too much into one blip, especially this early in the journey. Everyone has bad days and sometimes it can take a few days to get back into equilibrium. The trick is to not let them get you down.

[KHPanic]

Yeah that's the trick isn't it. I thought I was doing so well and then one bad night brings back all my doubts and anxiety. Gotta build back up. It's just frustrating.