Starting fluoxetine after trying St John’s Wort

[Mrsmitchell1984]

So day 2 of not being on any form of antidepressant and feeling strangely fine. Probably the calm before the storm. But trying to enjoy feeling relaxed for a bit before I have to go on fluoxetine again - which I know will be a rollercoaster ride.

Hope everyone is doing ok xxxx

[panic_down_under]

I have to go on fluoxetine again - which I know will be a rollercoaster ride.

Cross that bridge if you come to it, Sally. Anxious mind are very adept at latching onto such fears and delivering the whole catastrophe to us if given half a chance. Starting at 10mg and upping the dose at 10-14 day intervals until you reach the initial target dose will help reduce the severity of any side-effects.

[Mrsmitchell1984]

Yes you are right - if you look for side effects you are more likely to get them.

I actually slept last night - which was brilliant. I did wake up a few times but managed to get back to sleep. What a massive relief. I haven’t taken the ant histamine drug yet though.

It is now day 3 of wash out period of St Johns Wort. I think if I continue to feel ok during the nights then I may even wait until Monday (the full 7 days) until I start the Fluoxetine.

I did have some worries creeping in this morning - one was a bit embarrassing but I feel like I have lost the sensation to feel the need to pee. Then I am thinking what has this St Johns wort done to me has it affected my nervous system so bad that it has switched some nerves off. I am not going to google losing the sensation to need the toilet as I am sure I will hear some horror stories that will make it worse. Also, if you know any bad things about this, please don’t tell me. However, if you know good things - such as you never lose this sensation or an anti depressant can’t do that to you- then please let me know that. I’m trying to rationalise that even if I have lost this sensation for life that at least I will be able to overcome it in the long run. I’ll just make sure I go to the toilet at certain intervals of the day.

I also don’t feel tired at all- even though I slept last night. There is no feeling of fatigue at all-even when I was barely sleeping. I am starting to think just what is this St Johns wort I have been taking??? I bought it from a reputable health food store which vigorously checks all of its products (Holland and Barrett) so it’s not as if I have taken something dangerous like a drug. All of this could equally just be caused by anxiety and not the supplement at all. Can a heightened sense of yourself cause you to not feel the need to sleep- yes I guess it could, just like the reductions in appetite- as your body is in a stage of running away from something - it switches off the unnecessary need for food. The lack of sense of tiredness too could be explained by the body shutting down that mechanism because tiredness is put on the back burner when you are running away from a monster. But the sensation to pee? Can that be overridden too?? I actually drank 2 pints of water before I went to bed last night so I could feel the sensation - but all I felt was a pain. I don’t know- time will tell I guess. I don’t think worrying about it will help anyway- I should just do what CLAIRE weeks says and float past these things- as fear and worry about them will just enhance the adrenaline release.

Sorry for the long message today. I will post an update later.

[Mrsmitchell1984]

Just had the urge to wee- so ignore all the above 🤣

[Mrsmitchell1984]

panic down under- I just wondered if you think it would be better to wait 2 weeks before I start Fluoxetine rather than 1 week- or should 1 week be enough?

[panic_down_under]

Then I am thinking what has this St Johns wort done to me has it affected my nervous system so bad that it has switched some nerves off.

TCAs are sometimes prescribed in small doses to children and the elderly to prevent bed wetting (SSRIs can have the opposite effect). There are anecdotal claims SJW may do the same.

I bought it from a reputable health food store which vigorously checks all of its products (Holland and Barrett) so it’s not as if I have taken something dangerous like a drug.

They are drugs and can be as dangerous as any pharmaceutical. The FDA used to have a dedicated site for reporting adverse affects from alternative medicines. It made for disturbing reading until the FDA was ordered to shut it down following pressure from the industry. The problem is that there is little regulation in many countries. Anyone can invent their own formulas and market them, with absolutely no formal expertise required. To compound the issue much of the raw materials now come from China where there is no regulation worthy of the name. The herbal extract might have come from a multi million dollar facility using state of the art equipment, or some guy with nothing more than a couple of plastic buckets and a bottle of solvent. Even the big companies can get it seriously wrong as was proven by the Eosinophilia–myalgia syndrome disaster of the late 1980s/early 1990s (which could well have claimed me as a victim). And even if the product is pure and exactly as claimed on the label, it might still kill for most of them have never been rigorously tested to confirm they act as claimed. For decades beta-carotene was promoted to smokers as a lung cancer preventative. When science finally tested the claim it was found to greatly accelerate lung cancer onset. How many thousands/millions? died prematurely because of that!

</rant>

I just wondered if you think it would be better to wait 2 weeks before I start Fluoxetine rather than 1 week

I don't think it's necessary. By the seventh day there will, at worst, only be barely detectable levels of hypericum left in your system.

[Mrsmitchell1984]

Thank you Panic down under. Your information is just incredible and helping me so much!

Does the sensation to go to the toilet come back again once SJW gets out of the system - I felt a vague twinge this morning - I hope it has not gone forever. It probably seems like such a silly worry.

I am still doing ok without any anti depressants - apart from I have this feeling of I think it is emptiness inside of me. I feel like I can accept the weird anxiety symptoms - which I think is part of the way forward. But emotions and feelings are so hard to shake off. Maybe I should just accept them and carry on? Then I won’t need any form of anti depressant?

[Mrsmitchell1984]

I suppose it’s just a feeling of introvertedness or lack of enjoyment in things - feeling like you can’t lose yourself in something. You have the feeling that there is always something stopping you from relaxing.

[panic_down_under]

Does the sensation to go to the toilet come back again once SJW gets out of the system

It should do, especially as you've only been on it for such a short time.

Having reached that 'wonderful' time of life when having to get out of a nice warm bed at least once during the night to pee I wish TCAs worked better than mine does even at its maximum dose.

But emotions and feelings are so hard to shake off. Maybe I should just accept them and carry on? Then I won’t need any form of anti depressant?

Acceptance is one part of the cognitive/behavioural/mindfulness therapies. If therapy is an option it would be worth pursuing, imho. While it wasn't the answer for me, it has been for many and some of the tools taught are valuable even if meds are more effective.

[Mrsmitchell1984]

Wow Panic Down Under that is really helpful - you are helping me so much at the moment.

Have you tried not drinking too much before bedtime - leaving it at least 2 hours before bed?

Felt annoyed today as a colleague at work was speaking about how too many of her friends have been on anti depressants for so lung and it has made them worse. But for me my experience as different. I was on fluoxetine for 4.5 years. Yes I probably did have some anxiety back and the odd depression but it was mild and I think the anti depressants will help me cope with it.