Any Doctors / Nurses - Fluoxetine Overdose! How bad???

[Ispywithmycynicaleye]

DP has taken between 2 and 4 tablets of Fluoxetine (20mg each) a day for around 5 days thinking they were antibiotics. We just discovered today they are my adult DD's antidepressants she left behind after she moved out!!

He is adamant he doesn't need medical attention despite feeling awful! He has had numerous panic attacks all week, including 2 today, burning hot fever, chills, shakes etc. Should I be worried with it being an overdose over nearly a week or will he be ok now he stopped taking them and the side effects will get better?

Call 111

He needs to go to A&E now to be treated for Serotonin Syndrome. Fluoxetine has a very long half life, so he will reach peak blood concentration by tomorrow/day after if he stopped taking them today.

You should phone 111, so that they can take a medical history and give advice.

Not a doctor or nurse , but I do know that people can take up to 80mg of fluoxetine a day, so that's not overdose territory. Though obviously if prescribed this dosage would be built up gradually.

Why did he feel the need for antibiotics? Could this be linked to the fever/chills etc?

60mg is the max dose. Call 111 for advice to be safe.

@OliverBabish, 80mg is the max dose. But I agree that medical advice should be sought.

Initial infection was from a broken tooth, that's why he was using up what he thought was antibiotics. He is completely refusing 111.

I phoned them on tuesday night after he had severe panic attacks and sudden fever, chills, his skin was all blotchy red. I was beside myself thinking he caught sepsis from the tooth infection. It so happens thats also the day he took 4 fluoxetine tablets.

111 was a joke, the woman kept pushing me to say it was covid related. I told her I was really worried he developed sepsis from his tooth infection. In the end he was called back by a dr who said DP was referred to the covid investigation centre because he had covid symptoms!! Dr was surprised to find out it was over a tooth and said there was no mention of that at all, just that he received the referral stating DP most certainly had covid and a test needed to be arranged!!

He is much calmer now, but is still burning hot and sleepy.

@Noodle765 can I ask what serotonin syndrome is? Is it a bad thing?

@KittytheHare 80mg max, this could be a good thing? Out of the 5 days only 1 day he took 4, the rest were 2 or 3 tablets except today was only 1 because he realised this morning.

I'm going to let him sleep on the couch for a while, I'm going to stay up and keep an eye on him. I can hardly find anything online about what to look out for, most sites about Fluoxetine overdoses redirects me to a page saying invalid site!

I am livid. I told him ages ago to see the dentist but he kept putting it off!

I should add, he did see the dentist yesterday and had the broken tooth removed. She never prescribed antibiotics saying the infection will come out itself. That's why he stupidly took more.

He needs to seek medical advice. And after that he needs to learn about proper use of antibiotics and antibiotic resistance.

I once took a whole pack of fluoxetine with other stuff, it was fine, but I'd be worried about the tooth.

I appreciate that @EspressoExpresso but he is refusing. Tbh he is being totally irrational about it but he has been really anxious and having panic attacks the last few days, I dont want to make him worse. I totally agree about the antibiotics, I believe he has learned his lesson. The hard way.

I've told him to sleep and I'll keep watch. I bloody hate this! He actually hates taking tablets of any kind. He wouldn't even take painkillers for his broken tooth even though it must've been agony!

@TheWashingMachine I'm so sorry to hear that. Thanks for sharing it to reassure me, I hope you're ok now.

Is he taking any other medication either prescribed or over the counter? Has he had any alcohol? This may increase the effect.

Although 80mg is the max daily dose that's usually very slowly increased from 20mg. He seems to he suffering quite severe side effects so if it was me I'd take him to A&E for review.

Ignore him and call 111.

He's not taking any other prescribed medication but has been taking painkillers the last few days for a persistent headache he describes as bad as a migraine. He said the headache has been constant for about 3 days now. I am so worried, what little info I found online seizures were due to a prozac overdose (not sure if this is what he has).
He is refusing any medical intervention including me phoning for advice. I told him earlier I was worried about seizures etc and he said he is fine! Bloody infuriating!

Serotonin syndrome is potentially fatal. Ignore your husband and seek medical advice.

When did he stop taking them?

Info here

www.healthline.com/health/serotonin-syndrome#complications

I have bern on these meds a long time and for me, even a gradual increase has an effect. The headaches are quite possibly that.

This suggests treatment is to stop taking it but I'd honestly go to A&E or walkin or whatever - or call - to see if he can get anything to help.

Might your pharmacist be able to help? They know a lot, mine is fab.

It could be an infected tooth but surely the dentist would have seen if it was badly infected.

Headache and temperature are obviously also Covid symptoms. If he has been going out of the house then Covid is also a possibility. I would suggest a test to he sure.

@Reinventinganna only info I could find about symptoms online was severe anxiety and seizures. DP has it in his head that 'they' will take our kids away if they find out he self medicated on what he thought was his old left over flucloxacillin. He has already had 2 big panic attacks today I'm scared I'll make him worse.

I did think about phoning while he slept for advice without giving his details but after phoning 111 on tuesday only to be pushed and coerced into saying its covid (which was so bizarre!!!) I just dont see the point. I've phoned 111 before and never experienced coercive hard sales tactics forcing you to say it's one particular condition before!!

@Lindy2

It could be an infected tooth but surely the dentist would have seen if it was badly infected.

Headache and temperature are obviously also Covid symptoms. If he has been going out of the house then Covid is also a possibility. I would suggest a test to he sure.

@Lindy2 it was an infected tooth. The dentist confirmed it. She never gave him antibiotics telling him now the tooth was out the infection will come out by itself. He doesnt have covid

@LunaHeather thanks for the link I'm going to read it just now.

It’s important that you get medical advice. As it could be potentially serious and he is still out of sorts I’d call 111 or you may be able to get some advice from a 24 hour pharmacist but either way it’s important you get personalised advice from a professional. I hope he’s ok.

Are you sure the paranoia isn’t a side effect of the overdose?

@Ispywithmycynicaleye
The max daily dose is 60mg according to BNF
bnf.nice.org.uk/drug/fluoxetine.html

"Symptoms of poisoning by selective serotonin re-uptake inhibitors include nausea, vomiting, agitation, tremor, nystagmus, drowsiness, and sinus tachycardia; convulsions may occur. Rarely, severe poisoning results in the serotonin syndrome, with marked neuropsychiatric effects, neuromuscular hyperactivity, and autonomic instability; hyperthermia, rhabdomyolysis, renal failure, and coagulopathies may develop."

If he has averaged not more than 300mg over the last 5 days then it is unlikely to be physically harmful but he may feel pretty rubbish due to the side effects/withdrawals from suddenly stopping