Fluoxetine for 3rd time

[panic_down_under]

I don't see the value in staying on 20mg. Imo, your GP should be thinking of increased the dose to probably to 40mg after a couple of weeks on 30mg. The alternative is to switch to another AD. Citalopram (Celexa) and the very similar escitalopram (Lexapro) have a good record for working when another SSRI has failed.

Does your GP know about the agitation and the suicidal thoughts? If not s/he should. Also ask for something to ease the anxiety. White-knuckling it is counterproductive.

[Ayresstew]

The thing is I’ve never been suicidal until this time on fluoxetine I had 4 terrible days out of a month where I thought I couldn’t carry on. I never had that before but I think the doctor just assumed because I was depressed it was that instead but some of the intense symptoms actually scared me so maybe after all this time my body just doesn’t want that in me anymore. Probably the mirtazipine just gave me relief of some symptoms. Before I finished fluoxetine I was drinking heavily last time maybe that didn’t help but I definitely experienced severe reaction to it for a good 6 weeks

[Ayresstew]

I actually think I’ve had a bad reaction to it now I’m looking back through I think I need to come off. How long do I need to taper before I could go on citalopram

[Ayresstew]

I’ve been on citalopram about twenty years ago which worked really well Only on them for 2 years but could I be in the same situation worse side effects and not work So frustrating

[panic_down_under]

I actually think I’ve had a bad reaction to it now I’m looking back through I think I need to come off. How long do I need to taper before I could go on citalopram

You don't need to taper off fluoxetine. You GP will probably recommend an overnight switch, or a short cross-taper. That way there is no time lost.

Correction: When switching to another SSRI, SNRI, or serotonergic TCA fluoxetine should be stopped for 4-7 days to allow plasma levels to halve before beginning the new AD.

I’ve been on citalopram about twenty years ago which worked really well Only on them for 2 years but could I be in the same situation worse side effects and not work

There is no way of predicting what will happen, but, as per my previous post, citalopram has a good record of working when another SSRI has quit.

[Ayresstew]

Thanks for your help I will probably go on citalopram again. Does that take quicker to get stable in the blood. Doesn’t take as long as fluoxetine to kick in I think

[panic_down_under]

Does that take quicker to get stable in the blood.

Yes. Citalopram has a half-life of about 35 hours so plasma levels will typically stabilise within 7-8 days. While it has 2 active metabolites the data indicates they don't contribute much to the med's efficacy.

Doesn’t take as long as fluoxetine to kick in I think

Usually not when starting from scratch, but the switch will have some delaying effect.

[Ayresstew]

Hi I’ve been of fluoxetine 3 days and haven’t started escitalopram yet. I’m already getting withdrawals is this possible with the long half life

[panic_down_under]

I’m already getting withdrawals is this possible with the long half life

Yes, it is possible because there is more to withdrawal than just chemistry. Psychology is at least as important. What are the symptoms?

[Ayresstew]

Hi , been getting racing thoughts and a drop in mood even though I wasn’t feeling good. Jittery and more anxiety. Maybe it was doing something but I’m starting escitalopram tomorrow I’m anxious because the fluoxetine is in my system