Does my AD need increasing ?

[BlahBlahBlahhh]

Started on Fluoxetine 20mg daily, 12 weeks ago. Have suffered with low patches ever since I can remember but they had become closer together and for longer periods. Within a month of starting medication, the side effects disappeared and I felt like me again, upbeat, positive, energetic. I told my GP before starting ADs that everyone who knows me sees me as a lively, positive, cheerful person and nobody would believe I suffer with depression if I told them. I said that most of the time I feel like I am living on a happier level than most but when I dip, I feel so so low. He thought it best to refer me to a psychiatrist to rule out bipolar as he said starting on ADs if you are bipolar can cause manic episodes and is therefore not the right course of treatment. I went back to my GP after 2 weeks and said I really don't think I am bipolar and I would really like to start ADs as I was so fed up with feeling low, which was when I started the Fluoxetine, felt 100% better and cancelled psychiatrist. I went back to my GP after 6 weeks for a review and said I felt like me again. He said I should stay on meds for 6 to 9 months then come back to start weaning off of them. Over the past few days I have felt unmotivated, tired but not able to sleep and generally low but without the usual emotions related to my depression...kind of flat as apose to the very upbeat feeling I was having if that makes sense ? Does that mean the Fluoxetine 20mg isn't working as well and needs increasing or was I having a low level mania after starting which has died off ? (Felt slightly excitable and very happy and energetic for past couple of months which has been great). Don't want to stop meds as I've felt so happy and stable in mood. I know people have reported on here that ADs don't change who you are or stop you completely having ups and downs but they just generally level things out which is what I have felt on the whole but this is the first time I have felt 'flat' since stating them...not sure if it's PMT which I suffered with terribly before. Thanks for any advice/words of wisdom from those also on medication x

This might be useless because I was on Citalopram (for depression) not Fluoxetine

But -
When I started on them (it was either late October or early November, it's slightly hazy in my head) I felt absolutely awful, really hopeless and miserable

They started kicking in after a couple of weeks, and within about 4-6 weeks (December) I felt happy. Not just on an even keel happy, but really over the top happy. At the time, I thought 'wow this drug is a miracle'. Looking back, I think artificial is a good word to describe it. It certainly wan't real happiness. It was an artificial high, and I was very much right at the beginning of getting better

But then that high wore off. The real miserable, hopeless feelings didn't come back, but I started feeling flat because the high wasn't there any more. By the time I had been on them 3-4 months, I felt much better than I had in October. But again, looking back i definitely wasn't better at all. I was getting there but very slowly. I was still dog tired (sometimes sleeping 14-15 hours straight), little appetite, the flat feeling and disconnected

I don't think I was 'better' (back to my old self) until about April/May time, when I actually often felt genuinely happy and comfortable, on an even keel.

I absolutely think that the anti-depressant worked and it was largely responsible for getting me better, but it didn't work in a straightforward 'get a little better week by week' way, it created basically this but with an extra dip between the peak and the cafe

Anyway, that was a long winded way of saying - maybe you're experiencing someting like i did? An initial happy feeling which wears off after a while?

How long did you feel happy for? The reason I ask is because most psychiatrists say megalomania doesn't last more than a week if it does its mania and believe me there is a big difference between mania and normal for one thing psychosis must be present. So if your up period lasted more than a week I would say it's doubtful it was hypomania more just you were feeling better and now your not.

Thanks for your responses, I couldn't post response yesterday as the site kept crashing. I'm glad you said that Crawling, I didn't think it was mania but it just concerned me that I felt so exhilarated after a month of taking meds but it did last for 7 weeks so as you say unlikely to be mania. Raven...your diagram sums it up...looks like I'll have to settle for the reasonably priced cafe over tea at the Ritz ! Oh well, I'll take that over the lows any day ...probably TMI but My period started this morning and I feel a bit more 'lifted', maybe if I wasn't on the ADs I'd have had really bad PMT this month but just felt flat instead. X

Sorry just realised I meant hypomania not meglomania.

I should know what the definition of a megalomaniac is but googled it last night to make sure....no, don't think I'm one of those...my children might aliken me to Hitler at times though x

I have taken sertraline long term (Fluoxetine didn't agree with me) I can totally relate to what your saying.

When I started my a/d's initially I felt great, happy, upbeat & motivated. Then after a while I just settled down in to a flatline mood state where highs & lows aren't as obvious. In my mind that was better than the deblitating moods I had before.

Thats one of the reasons I'm weaning myself off them now (been on them for 12 years) I'm not suggesting you should stop taking yours but I would definately explain how you feel to your gp. Maybe you do need an increase of perhaps a different a/d?

Thanks Badger, as it's early days (12 weeks in) maybe I'll give it a bit longer and see how it goes, one other thing that I've noticed is initially my appetite went but now I'm eating quite alot and also having very vivid dreams at night, I'm sure it's not unusual, it's nice to talk to others with similar experiences though x