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Thread: Second time around...

  1. #1
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    Second time around...

    Hi everyone,
    I have done really well throughout Covid lockdown but recently I felt the anxiety start creeping back (mainly in the context of subtly increasing health anxiety based on 'veins on my head' and therefore of course imminent explosion of circulatory system... ) and so I spoke to the doctor today.

    I'm going onto Prozac for the second time - never noticed til today the threads mentioning it 'doesn't work' a second/third/whatever time. Any experiences to boost my confidence a bit? I think it's about 5 years since I came off it - may even be more, might be less. Time has warped for me as I work from home!

    Racking my brains to remember whether I ended up taking it at night or in the morning. I have a feeling I switched to morning as the tiredness took several hours to kick in. Any bright ideas?

    Anyway - hi again fellow fluoxetine peeps.


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  2. #2
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    Re: Second time around...

    Quote Originally Posted by Speranza View Post
    I'm going onto Prozac for the second time - never noticed til today the threads mentioning it 'doesn't work' a second/third/whatever time.
    There is good evidence that ADs, especially the SSRIs, become progressively less likely to work each time they are stopped and restarted, but the chances of fluoxetine working for a second time remain fairly high. However, the initial side-effects may be more severe and/or different than last time and you might need to take a higher dose to get the same response.

    Racking my brains to remember whether I ended up taking it at night or in the morning. I have a feeling I switched to morning as the tiredness took several hours to kick in. Any bright ideas?
    SSRIs are more likely to trigger insomnia but some do find them sedating. Taking fluoxetine at a specific time of day to negate sedation may help for a week or two while plasma levels are in flux, however, it has a very long half-life, up to 6 days for the med itself, plus up to 16 days for its active metabolite, norfluoxetine (which does most of the work), so once plasma levels stabilize it shouldn't matter when you take it.
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    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

  3. #3
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    Re: Second time around...

    Thanks, that's really interesting as I only know one person on Prozac long-term - everyone else I know seems to have had it for a few months and that's what the GP spoke about yesterday. I suppose nobody wants to be medicated needlessly but it's something to think about...
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  4. #4
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    Re: Second time around...

    Quote Originally Posted by Speranza View Post
    I suppose nobody wants to be medicated needlessly but it's something to think about...
    Most guideline recommend people take their first AD for 9-12 months before weaning off and up 18-24 months the second time. Given the poop-out issue I think there is a good case for staying on the med permanently if there is another relapse. Fwiw, I decided to stay on ADs permanently after needing to go back on them for the fourth time and I've been taking my current AD continually for nearly 26 years. My brain hasn't turned to porridge yet. I'll probably remain on it for life provided they keep making it. It might even protect against dementia.
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  5. #5
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    Re: Second time around...

    That's really interesting.

    One of the main effects for me was slowing down my thoughts, which was very restful. My entire life, I've been aware of thinking several thoughts at once, and one day on Prozac I suddenly realised I was only thinking one at once, and that this must be how it was for most people. Sooooooooo restful! My brain gradually speeded back up off Prozac though.

    I have wondered since if I have ADHD but it's very hard to get a diagnosis at 60... I've always just assumed I have 'ME-syndrome' - ie, I'm me!

    Thanks for your input.
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  6. #6
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    Re: Second time around...

    Quote Originally Posted by Speranza View Post
    One of the main effects for me was slowing down my thoughts, which was very restful. My entire life, I've been aware of thinking several thoughts at once, and one day on Prozac I suddenly realised I was only thinking one at once, and that this must be how it was for most people. Sooooooooo restful! My brain gradually speeded back up off Prozac though.
    Interesting. Can't remember anyone reporting this type of response before. ADs strengthen the connections between the non conscious parts of the brain and the areas that manifest consciousness and decision making which may enhance the latter's ability to dampen down 'chatter' better.

    I have wondered since if I have ADHD but it's very hard to get a diagnosis at 60
    Might be, but it could also be a mild form of bipolar mania. Something to ask a psychiatrist or psychologist about if you ever get the chance.
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  7. #7
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    Re: Second time around...

    No low mood and no mania... just lots of thinking!!
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  8. #8
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    Re: Second time around...

    Good luck with restarting fluoxetine, Speranza. I haven't had any problems myself with restarting an SSRI after a break of 6 years but it depends on the individual, I suppose. I've noticed a slowing down of my thoughts too and I don't have any mania!

  9. #9
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    Re: Second time around...

    Thanks. I just assumed it would be a logical outcome of the drug. Certainly very restful!
    I see from my old threads that this is actually my third time! (Shows what a state I was in second time!) But last time I was only on 10mg which worked a treat, perhaps that's why this time she has started me on 20. A few days in, placebo effect kicked in almost immediately (hey, I'll take that!) head slightly achey but so far nothing like the awful headaches I had first time.

    Anxiety is all about the racing thoughts so... here's hoping!
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  10. #10
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    Re: Second time around...

    I would take the placebo effect too!

    It sounds positive, Speranza so go with what suits you and not what it says on the tin! Racing thoughts are exhausting and any respite is very welcome.

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