Worried about needing to increase or switch antidepressants

[norwichbroad]

I have been on fluoxetine for 3 years (had never needed antidepressants before that). I started on 20mg and it made an amazing difference to my mood and ability to function in day to day life. I had very few side effects either.

After about a year it was increased to 40mg as I started having anxiety symptoms as well.

The mental health issues began because of several different stressful situations that were (and some are still ongoing) happening in my life. Most of these are beyond my control at the moment.

In the last couple of months I have noticed that I'm not feeling much of anything. I feel like I'm going through life on autopilot and not able to engage fully with the world or people around me. I avoid feeling painful emotions because I'm concerned I don't have the resources to deal with them. I feel very weary and tired. I have some volunteering responsibilities that are strongly aligned to my interests and that I should feel passionate about, but honestly right now I often feel like I don't care (even though deep down I do) if I miss deadlines or don't show up. At times I am struggling a bit to concentrate at work.

I'm already on a medium dose of antidepressants and I feel like this - I'm worried about how I can feel better. Could increasing the dose help? but then I'd be on a high dose and where do I go from there? Or is there any benefit in exploring changing antidepressant? I'm concerned about that too as I know often side effects can be bad and I was fortunate enough to basically have none with fluoxetine, and what if a different medication isn't as effective for me?

You might find it helpful and it seems the logical first option as you’re already on it.

full disclosure- I had a nervous breakdown and increased dosage didn’t help. Now on vortioxetine which works differently.

but I was on fluoxetine for 15+ years so it might be that it just didn’t work for me to simply increase the dose.

thanks @EmmaEmerald. Any suggestions on how to broach the topic with the gp?

I would tell your GP what you've said here.

I can't see why they'd object to increasing your dose. It is less faff than trying something new. Are you worried they'll object to you trying an increase?

If it's reassuring, I've been in treatment for years and found they're happy to accept my suggestions. Only time they've suggested a switch was during a particularly bad insomnia phase when I was asking for diazepam. They wanted me to try a more sedating SSRI but once I pointed out that I didn't want to gain more weight, or feel sedated during the day, they accepted that and gave me about 10 diazepam for "emergency use". (Being awake for three nights straight is horrendous and the reason I did such an awful paint job in my last home, lol).