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Thread: Hello again! Advice and support needed

  1. #1
    Join Date
    Mar 2020
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    66

    Hello again! Advice and support needed

    Hi
    I posted last time a year or so ago on here and found the timetable thread to be a lifesaver!
    So I stayed well for a year, going back to work on a covid ward, coping with homeschooling and lockdown and I genuinely thought I would never be in this place again.
    2 weeks ago I woke with anxiety and here I am still struggling 2 weeks later.
    So I was taking 40mg fluoxetine and suffered sons extreme side effects at the beginning. I had no intention of stopping taking it.
    But as per my normal pattern, I felt so well that I just kept forgetting to take it and thought well OK that's a way to wean off or reduce the dose. I'm so annoyed with myself.
    Some weeks I maybe only took it on 2 days.
    Then bang, anxiety starts and depression kicks in.
    I spoke to the GP and she said to go back to 40mg straight away so I did.
    Now although I'm nowhere near as ill as last year I am experiencing the extreme mood swings, the anxiety first thing on waking and then the tearful low mood until it slightly lifts in the evening.
    I just wandered if anyone can offer some advice, some light at the end of the tunnel.
    Is it likely that the fluoxetine will need to settle again considering I hadn't fully stopped taking it?
    I'm really struggling to know I will get better.

  2. #2
    Join Date
    Jan 2017
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    3,555

    Re: Hello again! Advice and support needed

    Quote Originally Posted by KayMK View Post
    So I was taking 40mg fluoxetine and suffered sons extreme side effects at the beginning. I had no intention of stopping taking it.
    But as per my normal pattern, I felt so well that I just kept forgetting to take it and thought well OK that's a way to wean off or reduce the dose. I'm so annoyed with myself.
    Some weeks I maybe only took it on 2 days.
    While fluoxetine can be a little more forgiving of missed doses than other SSRIs these meds don't work if they are not taken. Even worse missing doses frequently will increase the risk of them not working at all at any dose. These are meds than must be taken daily, every day, with only very occasional fails. Sorry, but there is no way around this. There is a slow-release once a week version available if that helps, but it still needs to be taken every week, week after week.

    Is it likely that the fluoxetine will need to settle again considering I hadn't fully stopped taking it?
    I'm really struggling to know I will get better.
    Antidepressants don't directly ease anxiety (or depression) in the way say aspirin eases a headache. They work by stimulating the growth of new brain cells (neurogenesis) and it is these new cells and the connections they forge which provide the therapeutic response. Your infrequent dosing seems to have stopped this process and it may take some weeks to restore it. It takes about 7 weeks for new cells to grow and mature, though they may begin producing some positive responses a week or two earlier. How .long have you been back on the 40mg dose?
    __________________
    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
    Join Date
    Mar 2020
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    66

    Re: Hello again! Advice and support needed

    Thanks for your reply. Hope you are well.
    Its been 2 weeks since I started taking them properly every day.
    I'm suffering with such swings in mood. Very low and tearful and then by the evening it's lifted slightly.
    GP has mentioned changing them to another drug but I'm not keen as these have always worked in the past.
    I'm so furious with myself for not learning last time as it took a good 8 weeks to be feeling better.

  4. #4
    Join Date
    Jun 2013
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    2,026

    Re: Hello again! Advice and support needed

    Don't be furious with yourself - these things happen, and it happened. It will all work out... Be kind to yourself. Maybe some part of you didn't really want them? But that part now knows it needs them.
    __________________
    All manner of thing shall be well... (Julian of Norwich)

  5. #5
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    Mar 2020
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    Re: Hello again! Advice and support needed

    Thankyou. Lesson learned though, I will not be coming off them again.
    You live and learn I suppose

  6. #6
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    Jan 2017
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    Re: Hello again! Advice and support needed

    Quote Originally Posted by KayMK View Post
    Thanks for your reply. Hope you are well.
    I am, thanks for asking.

    Its been 2 weeks since I started taking them properly every day.
    I'm suffering with such swings in mood. Very low and tearful and then by the evening it's lifted slightly.
    These are fairly typical responses to what you've been through. The problem with fluoxetine is that it has a very long half-life, up to 6 days for fluoxetine itself, plus up to 16 days for its active metabolite which actually does most of the work so it can take a while for it to become active. It takes up to a month just for plasma levels to stabilise to a steady state. But that half-life also has advantages. If you'd missed doses with the other SSRIs which all have much shorter half-lives you would soon have been deep into withdrawal.

    GP has mentioned changing them to another drug but I'm not keen as these have always worked in the past.
    Given that fluoxetine was working well before you began skipping doses I think that might be jumping the gun. I'd wait to see if you respond, but that is going to take a while, unfortunately.

    I'm so furious with myself for not learning last time as it took a good 8 weeks to be feeling better.
    We are contrary creatures. It is what makes us human. Never repeating mistakes might make our lives easier, but kicking over the traces rebellion and just sheer crazy bloodymindedness can be soooo good for the 'soul'. I suspect we'd lose more than we gained if we wised up. Who wants to be a timid robot! But don't go tempting fate a third time, okay? My navy friends tell me big waves come in threes and it's the last one that usually sinks you!
    __________________
    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.

  7. #7
    Join Date
    Mar 2020
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    66

    Re: Hello again! Advice and support needed

    Well I'm on 18 days of taking 40mg every day properly.
    Pretty much following the same path as last time, waking at 3am with anxiety and not managing to calm it much until the afternoon, by which point I feel gradually more normal until bedtime and I'm feeling normal. I remember typing last year that I go to bed one person and wake another.
    Very tearful still and mood is low. I must be driving my family round the bend asking them if I'm ever going to feel better.
    The difference I have noticed this time is that the anxiety is not as desperate, I'm not sure if that's because I hadn't stopped the medication completely.
    It amazes me how every time I'm ill I think I'm gonna be able to conquer this beast quicker and it always takes longer.

    My thinking seems a bit clearer the last few days, I'm able to reason with myself and talk myself down quicker. Hope this continues.
    Then I get moments when Im genuinely terrified that the meds won't work and I will never get back to myself.
    It's a bumpy road!

    There are things I've learnt though that I think have helped this time, clearing my schedule, no plans and no pressure helps and not feeling guilty about that. I've been doing some breathing and meditation techniques too.
    As much as possible ending the day thinking positively.

    Kerri x

  8. #8
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    Mar 2020
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    66

    Re: Hello again! Advice and support needed

    24 days in!! Wondering how long before I stop counting the days!
    Still feeling brighter and calmer by the evening. Even managed to read my book a few nights.
    But oh my god the mornings!
    The despair and crying is starting to get boring now! It's so frustrating because I wasn't even depressed before and now it seems to be my main problem.
    Coupled with the lack of sleep, no appetite and its pretty hard to make it through the day.

    This morning I had a very strange sensation of my body vibrating when I woke up. Every time I tried to go back to sleep it started again. So 4am is pretty much my pattern for waking.

    The ups and downs are the hardest to grasp because I'm so desperate for a concrete example of getting better.

    It's so strange to go back and read my old posts, like I'm giving myself advice from the past!

    Anyone else around the same sort of time as me?!

    Trying to keep positive that better days are coming x

  9. #9
    Join Date
    Mar 2019
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    165

    Re: Hello again! Advice and support needed

    Hi Kay, I am 8 weeks on fluoxetine now but 4 weeks of that into an increase to 40mg and feeling very similar. Waking up every morning with a feeling of dread, OCD is still bad throughout the day but I am much calmer by the evenings.
    I’m feeling at the end of my tether as I have already tried escitalopram which pooped out after a couple of months then did 2 years on venlafaxine which never really made me feel like my old self. I’m also on quetiapine and mirtazapine which I also reduced at the same time as my fluoxetine increase so I suppose I have the withdrawal from that complicating things a bit. I just want to feel like me again and really hope this time the fluoxetine will help me 😞

  10. #10
    Join Date
    Mar 2020
    Posts
    66

    Re: Hello again! Advice and support needed

    Hi Jo
    Isn't it just bizarre that feeling of improving by the evening and then waking up back to square one!
    You would think I would be used to it, I've been here a couple of times, but I never get used to it.
    I've only ever taken fluoxetine and it's always worked eventually so I'm hopeful but god it's such a long proccess.
    Have you read the timetable thread?
    I literally read it every day. It's what got me through last time.

    I'm the same, desperate to feel back to myself. Ive read that these ups and downs mean the medication is working.
    It took me a good 8 weeks to feel better last time but every day I worry I'm never going to find myself again.

    Are you managing to work or anything?

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