Fluoxetine 20mg to 40mg increase?

[TinkerbellStarbright]

Hi, please be gentle with me.

backstory: diagnosed with ocd, mainly intrusive thoughts, rumination, maternal ocd after my children were born. Also had many signs of generalised anxiety disorder and social anxiety. One year of CBT.

i started fluoxetine in 2020 during Covid (I’m a nurse) and stayed on until February 2021 when I became pregnant. Had my baby November 2021 and had to go back on fluoxetine after 4 days. Couldn’t stop crying, literally the tears were pouring out of me non stop. Had a really good effect and have been on them since.
Side effects are heat intolerance, sweating, lower sex drive.

recently my hormones have been all over. Suspect perimenopause. Anxiety, intrusive thoughts and depression all worse.

my question is - if I go from 20mg to 40mg will I worsen my side effects? will it help? I really want to (will discuss with my GP) as I know it’s not normal to feel like I do. But I’m also terrified!

Hey,

You poor thing, sounds like you're having a rough time. I'm having a similar time and am desperate for someone to talk to that understands.

I have taken a lot of anti-depressants in my life and I can't say that a higher dose has ever worsened side effects for me. Sometimes being on a higher dose does nothing so they lower the dose again. Obviously listen to your GP if you feel that they understand your needs (I can't say mine does), but being on the higher dose doesn't have to be permanent if you do feel your side effects getting worse! You are in control of how much medication you take.

I hope you're okay!

Thank you so much for the kind reply.

honestly, I’ve lived like this for so long now it’s pretty much my constant state of being 😂

how are you, how are you feeling?

I had a really great nhs therapist who helped massively and she recommended the fluoxetine to me. It’s been a life saver but symptoms are coming back and I’m tired of living like this.

You're welcome doll, I can't imagine anyone being mean to you in this situation but the internet never fails to surprise me!

Anxiety is taking over my life, I'm starting to think about going back to work just so that I can be distracted in the day time from all my intrusive thoughts etc.

Therapy is genuinely the way forward - I've been seeing a private therapist for 3 years now. She pretty much fixed me until I went and had a baby and now it's like I've taken 20 steps back in my mental health journey. Glad Fluoxetine has helped you, I always did like that one, the health visitor is giving me Citalopram I think.

I worked so hard to come off of meds but I feel like I need these meds in my system ASAP so I can start to feel normal again.

Congrats on your baby! I know that being a mom has a serious battering on mental health doesn’t it? It’s very, very hard. Like you I wanted to get off them, but now I’ve pretty much accepted I just need them to get by. A bit like some people are deficient in vitamin d, I need a fluoxetine to keep me healthy. I think I’m going to ring the dr tomorrow and ask to trial an increase.

What do you take now and does it help? Intrusive thoughts are the worst and I’m so
sorry you’re dealing with them

I went up to 40mg a year or so ago also in perimenopause and prescribed HRT. It's been fine I think.

I wouldn’t go from 20 to 40 in one go. I did and the side effects were awful - nausea, vomiting, total brain fog, heart burn, diarrhoea.

It was the mental health nurse who did the increase because of an increase in PMDD symptoms. Spoke to the dr about the side effects and he said he wouldn’t have advised doubling the dose. I changed to 30mg and seen an improvement in my symptoms without the side effects (other than the usual ones - sweating is a horrible one but for me is no different on 20,30,40)

Much more of a battering than I could have expected, I thought I'd be able to cope.

I'm not taking anything at the moment, that's why I'm desperate for SOME kind of medicinal help. The Health Visitor referred me to the mental health team and that's all I know so far, but that for breastfeeding mums that Sertraline or Citalopram are best. I HATED Sertraline so I asked for Citalopram I just hope they come through soon.

If you feel like DMing me so we can talk there I would LOVE that.

How else can I do it? Do they come in 10mg tablets? Or would it be a gradual increase of 20mf and 40mg alternate days?

If it helps any I did one 20mg in the morning and one in the evening, while changing and now I just take them together in the morning.

You get 30mg tablets :)

I was on 40 for about 2 years, I then dropped down and weaned off completely, but things went 'wrong' within a few months and I ended up back on them. I have accepted that I need to stay on them probably forever.

So, I went onto 20, and then increased to 30. I've been on 30 for about a year but I am going to ask to increase to 40 because my anxiety has increased again in recent months.

I've never been given a 30mg tablet, the pharmacy always gives me 20s plus 10s.

They have told me I will be on it forever. been on it since 1999

Different pharmacies maybe do things differently but I definitely get 30mg tablets, have done for over a year now.

Thank you so much for the responses. I have a telephone appt at work tomorrow (so awkward) and I really want to try an increase to see if it helps

I’ve been and collected some 10mg tablets and I’ll be going up to 30mg tomorrow. I’ll let you all know how it goes x

I take 60mg in the morning after breakfast. Been on them for a good while and they work for me.

I never get any side effects from any medication (on a few) so the changes of dosage were fine for me.