Re: Restarting fluoxetine
Originally Posted by
IrishLondon
I came off them over 2 months, with my last dose 10mg every other day.
Tapering off by missing doses might be a worthwile with short half-life ADs such as the SNRIs (particularly duloxetine) and paroxetine, but is pointless with fluoxetine because of its very long half-life, about 6 days for fluoxetine itself and up to 16 days for its active metabolite norfluoxetine which actually does most of the work. Missing a dose every second day would have made almost no difference to the med's plasma levels. Cutting the daily dose would have after a week or so.
My GP restarted me on 20mg fluoxetine which I’ve been taking for a week now. But my god, my anxiety is so intense.
It might have been better to start back on 10mg for the first 2-3 weeks, but whether dropping back now is worth doing is debatable. Perhaps try 10mg for a day or two to see if it makes a difference. If the 20mg is in capsule form dissolve the contents in a measured quantity of water or fruit juice (but not of grapefruit) and drink half one day, the other half the next. The mixture will keep for at least a week when refrigerated.
Has anyone been through restarting after one month off? Do I have to go through all the initial side effects again?
You may get some of the initial side-effects but it shouldn't take as long for the med to kick-in as you still have some in your system from before you quit. The rule of thumb is that it takes about 5 half-lives for a med to be metabolised and eliminated, so around 30 days for fluoxetine and 80 for the metabolite.
Im finding it a real struggle and i’m not sure whether to continue
I'd be asking the GP to prescribe something to ease the anxiety until the initial spike diminishes as bio-feedback mechanisms kick-in to reduce serotonin output.
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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.