A timetable for recovery on Fluoxetine / prozac

[panic_down_under]

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.

An 'A' for effort. The rule of thumb is that if 2 SSRIs/SNRIs don't work then the others probably won't and a third failure is pretty conclusive.

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.

That was my experience too. The cognitive, behavioural (CBT, REBT) and mindfulness therapies are the best option...when they work, but sadly therapy doesn't for everyone. The failure rate is about the same as for ADs, i.e. about a third get very good to excellent results becoming essentially symptom free, another third derive enough benefit to make continuing with the treatment worthwhile and the remaining third needn't have bothered.

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.

BZDs work in the moment, but this is a trap because they actually make anxiety and depression worse by destroying brain cells in the twin hippocampal regions just as chronically high stress hormone levels do. They are as bad as alcohol, the most (self)prescribed anxiety and depression 'med', in that regard (see: Boldrini M, 2014; Nochi R, 2013; Sun Y, 2013; Song J, 2012; Wu X, 2009; Stefovska VG, 2008).

CBD oil, but not cannabis because THC has the same negative effect on hippocampal neurogenesis and alcohol and BZDs, may be a better bet as it stimulates neurogenesis.

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

Sigh!

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

Ignorance would be my guess. Often wilful ignorance.

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

No great loss, imo. Gabapentin and pregabalin work well for a few but not for most and given they have the same dependency issues as the BZDs I don't really see the point.

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

Antipsychotics have their place, but they should be among the last options tried and that isn't where you are atm. If consulting a private psychiatrist is doable for a second opinion then that's what I'd be doing. Preferably an old shrink, one that was around before the SSRI/SNRI era so has seen just how effective the older ADs can be.

[davey_b]

I have been feeling a good amount better the last few days, actually nearly a week. I'm now on day 16 of increased dose but I have also been taking l-glutamine for possible leaky gut and it may be a coincidence but I've been feeling better since adding that in. Hope this continues. I'm also working with a therapist and feel my head is a bit clearer I'm able to make some headway with that.

[panic_down_under]

I have been feeling a good amount better the last few days, actually nearly a week. I'm now on day 16 of increased dose but I have also been taking l-glutamine for possible leaky gut and it may be a coincidence but I've been feeling better since adding that in. Hope this continues. I'm also working with a therapist and feel my head is a bit clearer I'm able to make some headway with that.

Sounds promising. Hope it works out for you, Davey.

[davey_b]

Not been feeling as good the last few days but trying to be as positive as I can. I'm only on day 19 of increased dose so probably too soon as much difference. Just frustrating after feeling good for 4 or 5 days last week

[panic_down_under]

Not been feeling as good the last few days but trying to be as positive as I can. I'm only on day 19 of increased dose so probably too soon as much difference. Just frustrating after feeling good for 4 or 5 days last week

Yes, 19 days is not long enough to have much impact and 'snakes and ladders' one step forward, several back responses are quite common. I regard them as good news because it demonstrates that the med is capable of having a positive effect, albeit still only an unstable one. Smooth, linear progressions sometimes turn out to be mostly due to the placebo effect with an inevitable crash from which there is no recovery because the AD was never effective. While this isn't always the outcome it happens often enough to be extra wary about the apparent good progress.

[davey_b]

Yes, 19 days is not long enough to have much impact and 'snakes and ladders' one step forward, several back responses are quite common. I regard them as good news because it demonstrates that the med is capable of having a positive effect, albeit still only an unstable one. Smooth, linear progressions sometimes turn out to be mostly due to the placebo effect with an inevitable crash from which there is no recovery because the AD was never effective. While this isn't always the outcome it happens often enough to be extra wary about the apparent good progress.

Good news then I guess.

[davey_b]

Struggling today. Slept ok last night but feeling hot and sweaty this morning and thinking pretty negatively and feeling like I'll never be better. It's crazy 'cause this time last week I was feeling so much more positive and hopeful about the future, Hoping this doesn't last too long.

[davey_b]

Struggling again today to even get out of bed. Hate feeling this crap! Just want to feel better 😢

[panic_down_under]

Struggling again today to even get out of bed. Hate feeling this crap! Just want to feel better 😢

Unfortunately, you have a long way to go yet, Davey. There are no quick treatments, both ADs and therapy are a long slog. All you can do is hunker down and hang on. The wait is usually worth the misery.

[davey_b]

Unfortunately, you have a long way to go yet, Davey. There are no quick treatments, both ADs and therapy are a long slog. All you can do is hunker down and hang on. The wait is usually worth the misery.

Thanks PDU, I need motivation as I'm struggling to see hope for the future 😢