Antidepressants - increase dose or change medication?

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I’m on a moderate dose of fluoxetine just now. Scope to increase if required.

Over the last few weeks or so, I’ve felt that they’ve stopped working. I was doing fine, but now life seems so flat. I can’t enjoy anything, don’t look forward to anything, don’t get excited about anything.

I’m looking at my DH and feel like he’s being off with me (with thoughts like how he seems distant, isn’t cuddling/kissing me as much etc) but I suspect it’s me who’s off.

I honestly wake up in the morning and cannot be bothered at all. It feels like there’s concrete in my legs. I’m overeating, staring off into space, wanting to be alone as much as I can but also feeling lonely…it’s miserable.

In your experience, is it better to increase your current medication, or try something new? I’ve never had any other medication and I’ve been on my current dose for about a year.

I would probably increase - it's much easier to do that than wean off one type and then have to start another gradually especially if you're only on a moderate dose. I've never found anything less than the max dose (or more than the max dose) works for me.

I am currently in the same situation although I’ve been on my antidepressants (sertraline) for over 20 years after lots of hospitalisations and a very difficult late teens/young adulthood.
I had been well and functioning as a wife and mother and employee and then over the last couple of years I’ve gone to pieces.
I’m already slightly better than I was after lots of help from psychotherapy service but had a psychiatrist appointment recently where it was suggested that I could change meds. So wonder if it’s worth changing medications or increasing doses at all? Or just going the slow route with the psychotherapy?
will be interested to see what other people have experienced.
have you discussed this with your GP or psychiatrist OP? What are their thoughts?

@mynameiscalypso Yeah, that’s what I expected. It seems so counterproductive to reduce my current dose, although I completely understand why it’s necessary. Can I ask what medication(s) you took?

@Doesitmatteranyway What dose of sertraline are you on?
I haven’t had any discussion with anyone (it’s just the GP for me, I don’t have any input from psychiatry or mental health teams), so I’ll probably phone them on Monday. Even that feels like a huge task right now, but I know it’s essential.

I'm currently on the max dose of escitalopram but was on sertraline for many years too.

Since my appointment with psychiatrist I’ve been doing a bit of reading as she suggested I think about it. Anyway it seems with some swaps you can stop one drug and move on to the next and with others you do have to taper and restart new drug more gradually. It depends on the class of drug that you are stopping/starting.
I know it’s scary and also difficult to motivate yourself when you aren’t well but I think it would be worthwhile talking to GP about it. They will have experience of titrating these meds and will be better to guide you. In the end you might decide to do nothing and pursue other ways of improving your mood but it’s good to know what your options are.

Sorry just saw you’d asked me about dose - I am currently on 125mg day (scored tablets that I have to break) it’s a funny dose because of some other meds that I take. But there is room for increase. My dose has gone up and down over the years and it was always helpful but now seems to be less helpful

I would agree with PP that you're better to try increased dose first. That will be much quicker and easier than weaning off one and starting from scratch with another.

Hi Op. Whenever I have got to the point that i feel that my meds are not working, my doctors and psychiatrists have always recommended increasing the dosage first (and sometimes adding additional meds to the mix) to see if it makes a difference before jumping to another med. Sometimes that's all it takes. You've been on fluloxatine for a year already so you know that your body can handle it, maybe (hopefully) you just need a bit more to really make a difference. I was on fluloxatine for a long time and it was great until it got to the point I felt it wasn't doing anything for me and i was going backwards. I had reached the highest dosage by then so the professional view was that it was indeed time to try different meds. I'm currently on the highest dose of venlafaxine plus 200mg of Sertraline. Sadly I've reached the end of my venlafaxine journey and adding in Sertraline hasn't helped at all so it's back to the drawing board for me. I really wish there was a magic machine that could just tell us what med and dosage will be perfect for us - the trial and error nature of it all is so exhausting. Anyway, I really really hope that whatever next steps your doctor does recommend makes all the difference for you and the clouds start to lift very soon. Big hugs xx

Thanks everyone, I’ll speak to them about going down the increase route instead of changing the medication.

@SnackQueen Thanks for sharing your story. I’d love that magic machine to tell me what medication and dose was right for me too! Hope you’re able to find the right combination for you soon. 💓

Hi op it seems that the best option is to max out the sertraline. I am currently on max dose of citalopram and GP added Mirtazapine in November but I am struggling with the side effects so, wondering what my next options are.