Fluoxetine/antidepressants

[Cloudd]

Hi. Need your advice/positive experiences...
Couple weeks ago I was diagnosed with severe depression and generalised anxiety disorder so started fluoxetine/Prozac for first time. It’s been 3weeks now, a did a week on 10mg and then to 20mg. I’ve seen an improvement in my mood and energy, from a 0 to a 4, but will this continue to improve over the following weeks or is this the best it’s going to get? I still feel down during the evenings, when did it start to work for you/noticeable improvements? Xx

Hi everyone

Sorry I’ve been quiet over the last few days. It’s been too much to do anything other than the going through the motions as felt exhausted after coping (or not) with the step up expected in my therapy, with DH being away and worries about DD. I’ve regrouped and feel more on an even keel but done very little to progress with my therapy.

@FiloFaxx it may be worth increasing. 40mg is considered the starting dose for anxiety. Adding into the mix your sleepless nights it’s difficult to tease out what is at the root of how you are feeling but maybe it’s worth a trial at 40mg? I had no side effects stepping up.

@Maidenpink I’m sorry to hear about your shunt in your car but glad you are okay. Like you I’ve been thinking about a possible increase up to 60mg as wonder if it might help give me the courage I need to take these next steps in my treatment. I suspect it won’t and I get need to get on with it. I may discuss with my GP to see what they think. Good to hear your bloods are all okay.

@sugarlost I’m glad you had a nice time with your friend. I’m starting to look forward to seeing some of mine. I had to put my friend off last week as it felt too much and reinforced my unhealthy compulsions that I’d be performing to feel safe. Sometimes it’s easier to avoid, my default position which again isn’t helpful but it takes the pressure off until I feel a bit stronger.

Been thinking of you @polelynn. ❤ It's been a bumpy week for you. If you feel your getting back on an even keel then that's good going. You're still progressing, even if you haven't managed your therapy tasks.

Just to share, when I went on Fluoxetine last time I had a month where I thought I'd turned the corner about 8 weeks in on 40mg, then I felt very down and anxious again. I left it a couple of weeks then decided to increase to 60mg. After about 5 weeks at 60mg I was feeling a lot better. I stayed on 60mg for prob a year or so, then I reduced to 40mg which I was fine on for 2 or 3 years. I did feel I piled on weight at 60mg but I wasn't really watching what I ate too. I wonder if I should've gone up to 60mg early on just to try to get on top of this and then come down again after a bit of stability. I really don't know because there are hormonal issues now too. Xxx

@Maidenpink thank you for sharing that timeline. That is really helpful. If everything was staying as it is now I’d be okay to stay on 40mg but I have some big challenges ahead. I just don’t feel ready to tackle some of my fears just yet but suspect I just need to take a leap of faith and push through the unpleasant feelings. Thing is it feels like a huge stop sign is in my way preventing me.

Hi all, hope you don’t mind if I join in the chat. I started taking Fluoxetine about 3&1/2wks ago and have had awful side effects. The worst being massively heightened anxiety with internal shaking/trembling. Symptoms are always worst when I wake and remain with me most of the day. By evening I generally feel better and I am managing to sleep alright. I had quite a good day last Tuesday and thought things were looking up but then Wednesday was truly awful and I couldn’t leave my room. Thursday I forced myself up but had awful diarrhoea (sorry TMI) which was happening in the first week but then stopped and Friday was just meh. Saturday morning was awful but afternoon better and today I’ve felt very flat/quite down. I honestly don’t know where I am with these meds. I now find that although I’m delighted when bedtime comes around, I’m dreading waking up the next day as I don’t know what it’ll bring! Just hoping to touch base with others going through similar, get a little reassurance and offer any support I can x

@BlueVelvetine Hello and welcome to our supportive space. I’ve been on fluoxetine just over 3 months now but the early weeks were hard. My GP had told me to expect an increase in anxiety (which I had) and I felt a sense of life happening to me instead of me actually being part of it if that makes sense. Things settled down around the week 4-5 mark if I remember correctly so it’s probably worth digging deep a little longer. Most of us on here are having good outcomes from the medication though dosage can require adjustment. 20mg is an ideal dose for depression however anxiety usually requires 40mg as a starting point so that might be helpful for you to know. I’m currently on 40mg and my life already looks very different from the early weeks and I may go up further as currently engaged with some intense therapy which pushes me further than I’d like at the moment. I hope that helps. How’s your appetite by the way? I completely lost mine but it did come back. X

Another thought @BlueVelvetine, when are you taking your medication? I’ve found first thing, with a full glass of water, works well for me.

Thanks for the warm welcome @polelynn, I really do appreciate it.
I take my pill about 11am as I’ve read it can be quite activating so didn’t want to take close to bed. I’m also taking half a Lorazepam (0.5mg) when I wake to counteract some of the side effects (shaking/trembling/heart racing). This is working ok but I know how addictive they are and don’t want to go down that path. Thanks for the info about the higher dose for anxiety. I’ll certainly discuss with my GP. I’m really concerned that this may mean back to square one with side effects though. Is this right? In those with severely heightened anxiety at the start of fluoxetine did a dose increase cause the same? I know it’s pretty early days but I’m desperate for some peace from all the internal turmoil. I‘ve a feeling a lot of this is down to peri menopause. Trialled HRT but the side effects from the progesterone tabs were brutal and made my anxiety worse. Anyone have any success with fluoxetine for peri menopause/hormonal issues?
Sorry…a lot of questions…I’ll stop now

@polelynn maybe going to 60mg is what you need to get through this next bit. Sending hugs, it's hard. I'm so stressed with my eldest just now ... too long to explain but it's awful to see your child struggling when you are too and not feel totally responsible.

Welcome @bluevelvetine. ❤ I feel like I could've written your post at about the same stage. I felt like I was losing my mind with the increase in anxiety, my appetite was shot and I had the same tummy trouble. I totally recognise the shift in mood from morning to evening too. It's actually called diurnal mood variation, they think it's partly down to the natural increase in cortisol we all have early in the morning for waking, amongst other things. It can be so marked, I would say to my husband that I wish I could bottle how I feel late at tonight and take it to the next morning with me! So the first few weeks are rough as your body adjusts. It will get better though. As @polelynn says, if you can dig in for the next week or two things should start to improve. These meds take a long time to kick in fully, 6-8 weeks and longer for OCD type symptoms. It's really trying. But you've found us so do come here to share how you feel and get a bit of support and connection at what is a really, really difficult time.

I'm doing a lot better than I was back at 3/4 weeks in but I still have a way to go. Things will get better. Hugs. ❤🤗

Thanks so much @Maidenpink….it’s such a relief to chat to others who have been where I am now and know that it will get better! I feel like a burden to my family just now….failing at life in a way. Not that they aren’t supportive, they are, this is just all coming from me. I suppose guilt is a part of all this. I totally agree with your comment about bottling how I feel in the evening and using it for mornings….completely spot on! Really hoping this feeling goes away soon as it doesn’t set me up for the day particularly well.
I really hope you are doing well now. When did you start treatment if you don’t mind me asking?

I started at beginning of March, similar to @polelynn, 7 weeks at 20 and I'm now about 10 weeks at 40 (I think). I've been on Fluoxetine before too. Interesting you mention peri menopause ... this is what I'm wondering about too. I'm sorry you didn't get on with HRT, I'm in the process of looking into this because my cycle has been awful and the AD doesn't really touch it. And progesterone containing birth control I've tried as a younger woman hasn't really agreed with me so I'm nervous of that. However, the body identical progesterone can be taken vaginally and that seems to be better for a lot of women. There seems to be a lot of different options with the hormones nowadays. Would be interested to hear more about your experience of HRT if you don't mind sharing at some point.

I'll be honest, I am doing much better and for the most part I'm able function and fulfil my obligations. But I'm not there yet and considering the best way forward. Not sure about increasing Fluoxetine in case it's hormonal routes I need to be looking at. X

Hi @Maidenpink, happy to share my experience. My cycle has been pretty erratic for the past 12 months. Last summer I asked for my FSH to be tested and it was still within normal range for my age but a few months ago it was retested and found to be high, indicating I was peri menopausal. A month or so after the test my panic attacks started….I questioned whether HET would benefit me but told no by a newly qualified GP! I was prescribed Trazodone which sent me loopy. It didn’t agree with me at all. I spoke to another GP and obce again broached the subject of HRT. He was open to me trying it as my symptoms and FSH confirmed I was peri. I was given Elleste Duet 1mg. The first 16 days (oestrogen only) were ok but 4 days into the progesterone and I was a wreck. I went back to my GP as couldn’t tolerate it and asked for body identical HRT as have read this is better tolerated. I asked for Oestrogel to allow me to increase dosage slowly and Utrogestan as like you had read these can be taken vaginally hopefully meaning a reduction in the systemic side effects, ie increased anxiety. Dr hadn’t heard of Utrogestan so write to a local meno clinic who called me to discuss a few days ago. She wanted me to try the mirena coil and patch but I’ve said no. I want to try the gel and Utrogestan so she’s agreed and I’m just waiting on the prescription going through to my GP. I will keep you updated on how I get on. GP suggested fluoxetine as said it is considered good for peri menopausal symptoms. I have a friend who has gone through something similar and she has both fluoxetine and HRT (patch) and says that the combination of both is what sorted her out in the end. She is happy, vibrant and feeling great! Xx

HRT not HET 🤦🏻‍♀️

@BlueVelvetine I’m on that HRT combination. Been on HRT around 18 months but in oral form initially. If it weren’t for the pandemic and some work related stuff, I believe the HRT would’ve been enough to keep my mood stable (has definitely helped with my other peri symptoms too). My anxiety really took off in peri, having never really suffered in the past.

In terms of increasing fluoxetine, no I had no side effects at all on going from 20-40mg. I had worried about this aspect too.

@Maidenpink ❤️

Thanks so much @BlueVelvetine, that is really useful to know. And great to hear your friend is thriving on that specific combination. @polelynn has been really helpful with regards to peri and HRT too, so you've landed in just the right place. ❤ I am speaking to the GP next week to discuss next steps re hormonal stuff. I am tempted to try the Mirena because you don't need to think about it once it's in situ but I'm not sure, I know the systemic absorption of progesterone is minimal from it but I'm still wary. I think the way you and @polelynn are taking it might be best and if I do start it it'll be nice to know others on the same.

Regarding increasing Fluoxetine dose, it was in no way the same as when I first went on it but I was very anxious. I increased just when my period was due and as I've said my cycle is dreadful in terms of PMS, so it's hard to know what was what. I suspect it was mostly hormonal as my last spell of PMS was pretty dreadful too. Perhaps if you are starting HRT too you might wait a bit to increase your Fluoxetine so you can figure out what's what.

I'm gobsmacked by how little GPs know about menopause! I've only recently been educating myself about it and I just cannot believe how poor and patchy the support can be. The GP at my surgery that I'm talking to next week has an interest in women's health and seems knowledgeable so I'm really hoping for some sound advice. Xxx

Hi @polelynn, that’s very reassuring to hear of someone on the same HRT combination. Was there a specific reason you changed from taking Utrogestan orally? Did you have symptoms taking it this way? The meno clinic said they don’t advise this as there’s no guarantee it’s getting to where it’s meant to but I’ve read that a lot of meno specialists actually prefer you to administer it vaginally and this is the advice in the rest of Europe so seems like a good option.

I think my anxiety is mostly hormonal but I was also made redundant late last year which hasn’t helped.

Thanks to yourself and @Maidenpink for info re increasing dose of fluoxetine. If the HRT doesn’t completely sort things out I’ll certainly consider this.
Massive thanks to you both as I do feel much better having found this thread. ❤️

I take still take the progesterone element (Utrogestan) orally @BlueVelvetine. I changed from a combined oestrogen/progesterone pill. I initiated the change as though oral was a lot easier and takes up much less space and uses less materials (the pump bottles of oestrogel feel so wasteful), there are more risks associated with oestrogen orally. In terms of the Utrogestan capsules you are usually prescribed this on days 15-26 of your cycle. What I do is start/stop on the same days every month as much easier to remember that way regardless if the month has 28, 30 or 31 days.

@BlueVelvetine I’m sorry to hear you were made redundant. I left a much loved job last year. It’s not easy.

Good to know @polelynn. You've got on okay with oral progesterone then. Top top on your day of the month system too. How did you get on at therapy today? X

@Maidenpink therapy is Wednesday this week which I’m relieved about as this week has not been productive in terms of progress. I got through it though, that’s the main thing.

Yes I appear okay with oral progesterone. I struggled with it when taking the combined oral contraceptive in my younger days and did not get on with the Mirena which I had inserted after my daughter was born. I begged for it to be removed as felt it was a contributor to my late onset postnatal depression. There is no evidence that it can be a contributor but there is a good amount of anecdotal data out there so I was understandably concerned about going on synthetic progesterone again as part of HRT. If anything I’m calmer in that part of my cycle now.

I’m sorry your eldest is continuing to struggle. My daughter had some routine bloods taken this morning to rule out anything medical being the cause of her weight loss and lack of periods but as you know, I’m pretty certain where it’s origins lie.

Yes, hopefully the bloods are all good but I know your concerns lie elsewhere. ❤ One step at a time.

Really interesting about your experience with oral progesterone. Kind of maps mine. I'm curious about your late onset PND. I developed PN illness when my youngest was well into his second year and my eldest was 4. Not the typical months following the birth trajectory. Utrogestan is body identical though, isn't it? Maybe you tolerate that better. X

Thanks @polelynn….I really enjoyed my job so it has been a wrench.

Apologies, I must have picked you up wrong about the Utrogestan. Glad to hear you get on ok with it. I think I will take your advice @Maidenpink and leave increasing fluoxetine until I know whether HRT is going to suit.
Unsure if anyone has also experienced hair loss? I used to have very thick hair and would say I’ve lost roughly 50% in the past year or so….

Maybe a little @bluevelvetine but not like you describe. I know it's common though. Hopefully the oestrogen will help with that. Just to say I've been using Louise Newson's app 'balance' to track my symptoms and read up on menopause. You sound like you're pretty clued up anyway but you and @polelynn (and @sugarlost and @bookcrazy) might find it useful too. I wish I'd started it sooner tbh. X

Thanks @Maidenpink I’ll certainly take a look at that

:( I lost my response by clicking out
Thinking of you all.🧡

Welcome at @BlueVelvetine . Sorry to hear your struggling, I hope your symptoms are relieved soon on the correct meds.20mg caused me nausea first 2 weeks and Loss of appetite....Feeling high and low. On meds since Jan for depression but have anxiety too. Less dark thoughts and coping better but have challenging days.
Try your meds with food if you don't have already. Do you take any vitamins..they could be upsetting your tummy or dairy possibly or side effects of other meds?
I have peri symptoms dry eyes, muscle aches, low concentration, sleep worse than normal, Increased fatigue.
I think peri made my depression worse and Lockdown.
Are you exercising?

@FiloFaxx I hope you can rest...it's so hard being sleep deprived...might you get sleeping tablets? I'm going to finally contact my GP about it but didn't work last time.

@Maidenpink sorry to hear about your daughter, I hope things improve and your less stressed 🙏🏼. I hope your GP appointment goes well.

@polelynn I think it's a good idea to increase your meds again. I hope your therapy session goes well. Please don't push yourself to make yourself feel worse., one step at a time.

I had a difficult day yesterday, had a nap which was good as continued poor sleeping at night and a few tears (good acting) watching a drama but I'm ok. I do question if I'm lying to myself about being ok by myself.

I just want to feel free.. I'm sure brighter days are coming our way 🌱🌿🌼🌾

Wishing you all a restful evening X

Thank you @sugarlost….I really appreciate all the support. I try to remember to take Vitamin D as was severely deficient in this previously. I cycle and walk but there have been many days recently that I’ve not crossed the door as anxiety was just too high.

Sorry to hear about your poor sleep. This in itself is debilitating. Peri menopause has affected my sleep and I must admit that when I trialled Elleste HRT the oestrogen had a big (positive) impact on my sleep. I’ve never had a problem getting over but have trouble staying asleep. I do feel that fluoxetine has helped tho. It’s good you’re able to nap.
Sincerely hope brighter days are coming for all x