Fluoxetine + Mirtazapine - are these normal side effects?

[turtleonaleash]

Me again - day 6 of Fluoxetine. Background - I took fluoxetine before (60mg.) I went off about a year ago and now I'm starting up again (20mg.) I also take Mirtazapine (15mg) and I have for 15 years. I'm on day 6 of Fluoxitine and I feel lousy - I feel worse than I did before starting the medication. Nauseous, anxious, flushed/warm, sweaty, dizzy, blurry vision, clenched jaw. I know these are "normal" side effects but I can't shake the feeling it's something worse (serotonin syndrome.) I keep telling myself I've taken these medications before with no ill effects, that if it was serotonin syndrome I'd be much more ill, that if it was serotonin syndrome it would be getting progressively worse (these spells come and go), and if it was serotonin syndrome I would have had symptoms on day one (symptoms didn't appear until day 3.) pupils aren't dialated, no diarrhea, I start shaking sometimes but it passes, I've been taking my temperature multiple times a day and sometimes it goes to 99°F-99.6°F but then it usually comes back down. Even though I'm trying to be rational I just can't shake this fear because I'm combining two medications. Every night I'm in tears not wanting to take my Mirtazapine but if I don't I'm awake all night.

[ElleEm]

Hi! I'm sorry you're not feeling well. I guarantee you those are all symptoms of starting up the fluoxetine. I had those exact same side effects. Definitely not seretonin syndrome. Just remind yourself it's the heightened anxiety with starting a new medication. Anxiety is a big fat liar! You are absolutely fine. Sometimes people have a harder time getting on fluoxetine the second time around. Not sure why that is, but it is a pattern. I will repeat again, every side effect you listed is normal for starting fluoxetine. They will subside, come back, and keep subsiding until they're no longer there. Take care!

[Bike Rider]

As Elle has said, all normal side effects, I have had them myself and its the same even if you have an increase in dosage, you go back to square one and start again only not as severe.

My understanding of Serotonin Syndrome is that its not common to get it. I believe you have to really go over the top with the meds to bring it on and your Doctor will know which combination of drugs to use.

Dont fight the meds as they do work, give them time, 12 weeks or so.

[hanshan]

Hi Turtleonaleash - I agree with all the above posts, particularly that serotonin syndrome is quite rare and also your own reasons why you don't have it! Listen to your logical mind, it's your defence against the emotional onslaught of health anxiety. You can be strong. Good luck.

[turtleonaleash]

Thank you all for your reassuring words. I called my Dr yesterday and he said it was virtually impossible that I have serotonin syndrome. It reassured me for about a minute, but then I developed a new symptom - and it's a major TMI one. Last night I was feeling better, I was able to eat a decent meal for the first time in a week - then immediately after I got horrible BRIGHT yellow and painful/acidic diarrhea. My stomach has been sore all night and I didn't get any sleep. This isn't a serotonin syndrome fear anymore - part of my reason for going on this medication again was I was having horrible Heath anxiety about my gallbladder. I've been having epigastric pain for nearly a month now - predominantly on my left side (I know gallbladder is typically right.) The pain also comes and goes and moves around my abdomen. I don't know why but I have it stuck in my head my gallbladder is about to blow and I'm going to have to have emergency surgery. I'm terrified of surgery. I've never had it and I never want to. As soon as I google "yellow diarrhea" the first things that pop up are gallbladder disease. My Dr. Is sending me for an abdominal ultrasound scheduled for August 24th. I'm so afraid they're going to find something. Did anyone else have yellow diarrhea on Prozac??

[hanshan]

If you haven't eaten a decent meal in a week, then your intestines were probably full of liquid gastric and bile secretions that had had no food to work on. Your first proper meal started pushing all that stuff out, so no secrets as to why it was yellow and watery. It all probably needs a couple of days of regular meals to get back to normal. Likewise abdominal pains if you haven't been eating properly.

[ElleEm]

I had that as well! Painful diarrhea that was bright hello. It was because my appetite was virtually gone and there was nothing really to poop out except for a bunch of water. Rest assured, other people have had the exact same things you're describing. You're going to be ok. Keep taking the fluox because as it starts to work, it's really going to ease that health anxiety for you ❤️❤️