What are some of your experiences with Fluoxetine (Prozac)?
May 17, 2014 2:48 PM   Subscribe

I just started taking a 20mg dose of Prozac (generic, Fluoxetine) about ten days ago, and am experiencing a lot of side effects, but no real improvement in my depression and anxiety. What are some of your experiences with this medication, especially in terms of side effects and effectiveness?

I have a decreased appetite, which is good, because I gained a lot of weight over the past year due to emotional eating, insomnia, and severe depression. However, I’ve lost about 4 lbs. in the past week, which I’m a little concerned about. I also have a feeling of internal vibration INSIDE my right leg, from my knee up to my thigh, which feels really strange and has never happened before. I also wake up several times during the night and am unable to fall asleep, and sometimes when I do sleep, it’s not deep or restful. I wake up feeling very agitated, nervous, and tired. I also wake up in the middle of the night feeling weird head stuff; either a buzzing sound in my ears, or numbness in my head. Last night, I felt like there were pins and needles in my head; it was very faint, but it was definitely there.

I talked to my physician and pharmacist about these side effects, and they both were unconcerned, said that these are normal, and that I need to hold out through these symptoms for another week or so, until my body gets used to the medication. I am, however frustrated with how these side effects have been interfering with my ability to do things that are important. For example, I can’t concentrate on anything, so applying for jobs is hard (a lot of my depression is my money issues, unemployment, and living with my parents, who are unpleasant people). I also have been excessively sweaty and get tired easily, so haven’t been able to dance this week, which is a hobby I normally do consistently. I also don’t feel like seeing my friends, because I’m so tired and nauseous. So, I feel like the medicine is just creating more depression and anxiety, since I just feel agitated and can’t do things which would make me happier.

My question is: have any of you ever had similar experiences with Prozac? How long did it take for the side effects to dissipate, and what are some things you did to offset such issues? Also, how long did it take for the medicine to help you feel better? I do feel as though the miserable fog is starting to lift, but very upset with the side effects and worried they won’t go away.

Thank you so much in advance for your answers.
posted by summertimesadness1988 to Health & Fitness (18 answers total) 5 users marked this as a favorite
It took me a bit over a month before the odd effects passed and the real relief from the grey fog came. Stick with it, look after yourself especially carefully for the next few weeks,because you're really even more vulnerable than usual, and soon you'll be in a much better place.
posted by anadem at 2:57 PM on May 17, 2014 [2 favorites]

Also, should add that I'm taking the medicine after a year and a half of serious depression and crying spells. Tried a lot of other things: yoga, therapy, exercise, spiritual counseling, to name a few. Nothing quite worked.
posted by summertimesadness1988 at 2:58 PM on May 17, 2014

The first time that I tried Prozac, I was already very thin and I stopped eating entirely. After a couple of weeks, I panicked, and stopped taking it.
The second time, 15 years later, it made me feel so angry that I couldn't continue, because I was beginning to act hateful to my children.
So, Prozac was not for me. I did well with Celexa and Lexipro for short periods.

You didn't mention if you were in therapy or not but I do want to respond to your added comment, even though my response is unsolicited. After a year and a half of serious depression, you should be on medication and be in therapy. The medication will lift you up out of your fog enough to deal with your issues in therapy. If you do not have therapy, it just hurts too much. A year and a half of chronic depression has taught your brain how to cope in a depressive state. It will take a while before you can reprogram yourself. Keep at it. There is life after being in the deep, dark hole of depression. And once you are out of the hole, you will be able to recognize when you are getting close to the edge and stop yourself before you fall in. Happiness is possible and you can do this.
posted by myselfasme at 3:21 PM on May 17, 2014 [4 favorites]

I had sleeplessness and jittery feelings. They improved when I changed the time of day i took the meds - I think I switched from night to morning, but I could have that reversed.

I seem to recall that 2 or 3 weeks in was when the side effects started to dissipate and my mood started to improve. Both times I took Prozac the effect was moderate at first and increased as we upped the dosage over a couple of months. The side effects did not ramp up or return with dosage increases, once they were gone they were gone.

What you're describing sounds familiar with me and I think it would be worth trying to stick it out for another couple if weeks, if you can manage to cope that long.
posted by Stacey at 3:45 PM on May 17, 2014

In my life, Prozac is the devil. I took it for about two weeks. It gave me such severe insomnia, I got maybe 1-2 hours a sleep a night. It made me suicidal and I ended up in the hospital. Every single flipping time I go to a new psychiatrist they don't believe me that the insomnia was "that bad" and try to put me on it again (because it can help fibro pain). So yeah. Sorry to be a downer, but I wouldn't try it again with a 10000 foot barge pole.
posted by kathrynm at 3:54 PM on May 17, 2014

This, too, shall pass. You need to give it six weeks. I'm sorry it sucks and sorry for the way it sucks, but in six weeks it will suck less than the last 18 months.
posted by DarlingBri at 4:15 PM on May 17, 2014 [2 favorites]

Prozac helped my depression, but caused anxiety attacks. I have had better success with Zoloft and Lexapro. Do stick with it; when it works, it's such a relief, but also be prepared to ask your doctor to try a different prescription.
posted by theora55 at 4:22 PM on May 17, 2014

SSRIs are known triggers for Restless Legs Syndrome, which is really weird but I had this experience on a different one. Iron supplements sometimes help, also magnesium. If you've been eating mostly on an emotional basis for a long time and you suddenly don't have an appetite, it can help a LOT to start actually planning out your daily meals and if necessary setting timers to eat. I'm still working on this but it does help a bunch, and if you've hardly been eating, that by itself may be contributing to your feeling cruddy in all sorts of ways.

If you get self-harm impulses or that sort of thing, I think that's a good reason to stop; if you're just kind of uncomfortable I'd try to stick with it awhile longer because a lot of medications, SSRIs included, the side effects can (but don't always) fade out once you're on them for awhile and your body adapts. If you can make it a month, do--if it still sucks after a month, tell your doctor that. I went through a lot of stuff before settling onto a combination of meds that worked pretty well, and sometimes it still needs tweaking.

Finally, when coming out of long depression, a lot of people do not jump straight from feeling depressed to feeling fine, or even travel a straight line there, there can be sort of an emotional roller coaster, which is why therapy during is also a good idea.
posted by Sequence at 4:27 PM on May 17, 2014 [1 favorite]

Side effects of anxiety and restlessness as well as nausea and appetite changes are pretty common for most antidepressants in the first two or three weeks. In a lot of cases, these particular symptoms are a decent indicator that the medication will work, in that they indicate the medication is having an effect on the patient's anxiety (for some reason, it always seems to get a bit worse before it gets better on medication) and serotonin (most of the body's serotonin is in the GI tract, which is why SSRIs have an effect on the appetite). Most doctors advise giving antidepressants at least a month for the side effects to level out.

You may want to ask your doctor or pharmacist about taking the medication at a different time of day if it is interfering with your sleep.
posted by jaguar at 4:32 PM on May 17, 2014 [1 favorite]

I had headaches, jitters, and a bad taste in my mouth. They subsided over about 2 weeks.
posted by jgirl at 4:40 PM on May 17, 2014

I was prescribed it a few years ago during a breakdown; it is the first prescribed medicine I have voluntarily given up on within a couple of weeks. It was given to me to treat my crippling anxiety and genuinely made things much worse (YMMV). Speaking to my "proper" GP a while later, who hadn't been the one to do the prescribing, he said that Prozac is a mood enhancer, or at least has that effect, so isn't always very helpful under those specific circumstances.
posted by Martha My Dear Prudence at 6:06 PM on May 17, 2014 [1 favorite]

When I went from the starter dose to the therapeutic dose, Prozac made me extremely lethargic, like crazy slow, so that I couldn't leave my house, plus suicidal ideation. Lexapro had the same effect a few years earlier, so the combination of the two experiences made me decide antidepressants are just not for me with my current brain chemistry. I'm a big fan of current psychiatric plus talk therapy treatments for depression, so I only say this because some people really are outliers, and I am one of them ("outliers" is the word the psychiatrist used in the end, actually, because my reaction is apparently pretty dramatically rare).

The medication never made me feel better. I'm not saying this to say that you shouldn't take it, because I think response is dramatically different for different people. But definitely keep in close contact with your doctor on this. Other people's experiences should not necessarily inform yours. I think reactions to these drugs are so highly individual.
posted by sweetkid at 6:30 PM on May 17, 2014 [1 favorite]

I had minimal side effects, but also minimal benefit, for the first month. Then one day, one MOMENT, it was like a switch flipped, and I suddenly had a much better better grip on my depression. For me, it was marked and pretty amazing. I believe it also had the effect for me of helping me to permanently change my way of thinking about things. I began to think of things in the most positive, rather this most negative light. Where before, for example, I might assume someone talking and glancing in my direction was talking about me, and not in a nice way, I became more likely to entertain the thought that there were other plausible, neutral reasons for that person's behavior. This change in how I viewed the world continued after discontinuing Prozac, and indeed, is present today, many years after I last took the medication. I believe I had the best possible outcome from my year on Prozac, and that many, if not most people do NOT have this experience. It is no exaggeration to say that I think it changed my life.

For a well-reasoned discussion about how it seems to work, and how some people do have such an outcome, you might want to read "Listening To Prozac" by Peter Kramer. This was written in 1993, so is probably somewhat outdated, but I found it quite interesting.
posted by thebrokedown at 6:48 PM on May 17, 2014

I took it for social anxiety. Didn't notice anything at all happening for a very, very long time but I had no side effects and continued taking it. One day, probably a year in, I realized I was no longer taking 2hrs preparing myself to leave to the house and after some thought about it I noticed all sorts of positive behavioral changes.

Everyone I have ever talked to about it says it takes a good few months to notice anything. I hope it works for you.

My doctor slowly took me off over a 6month stepdown after I was on it for about 4 years. I took it from about 17yo to 21yo. The changes in my behavior seemed to have stuck and it's been over a decade.
posted by M Edward at 7:46 PM on May 17, 2014

I'm in the weird outlier group with sweetkid. I've been taking bupropion (Wellbutrin) for ages, which helps with motivation & focus, but not so much with the depression. When I started on a beginner dose of fluoxetine, 10mg/day, I had a marked "boost" at first. (Like, "Oh wow, so this is how normal people get to feel! Yay!") I was prescribed it for MDD.

After maybe 3-4 weeks, it wasn't doing as much, and my pdoc upped it to the therapeutic dose of 20 mg/day. Again, I felt a boost at first, but after another month, I realized that I no longer really had the ability to do anything. I became one with the couch. I was also noticing some concurrent anxiety spikes, increased SI, and had really horrible insomnia w/ nighttime anxiety. It was miserable! Like, inside my head, I honestly wanted to do things during the day, and honestly wanted to sleep at night. I could think out incredibly detailed plans for doing the things, but I couldn't move myself off of the couch. At night I felt like I'd downed 3 DoubleShots. It was very unsettling and I felt like I was trapped in my own body.

I tried the 10mg dose again this winter (after being off of it for months) to see if it would help with my usual SAD downturn, and after about two weeks was back to that spaced-out, brain-fog, disconnected-from-the-real-world feeling. It got me through the rough spot in a pinch but I had another "trough" to get through after I stopped taking it. Took about 3-4 weeks for me to level about again to my usual baseline of "blah." YMMV!

One comment I wanted to make, since you're on the generic. A lot of people on forums like CrazyMeds, etc., have reported significant differences in how they felt on generics vs. brand-name. If you keep having negative side effects but otherwise want to see if fluoxetine is a good fit for you, see if you can get a sample of the brand name version and if there's any difference. Apparently some people are more sensitive to the binders, fillers, and whatnot in the generics vs the brand name version. Thought I would throw that out there. Good luck!
posted by cardinality at 12:40 AM on May 18, 2014

I'm just in the middle of adjusting to 10mg Celexa and had a similar "switch flipped" experience. One day doing stuff got so much easier and I have gotten more cruft out of the way in the last two weeks than over the whole winter. The side effects were no picnic (but spoilers - they're at acceptable levels now).

For me the first few days of an SSRI felt like taking a quarter e. I couldn't believe it. Sweatyness, restless bodyparts, desire to jump into the nearest available dopamine funnel (smoking, internet, Civ V), confusedness, feeling wasted and loved-up. Following advice online I started taking the pill around lunchtime when I found it was making me sleepy in the morning. (Trying it at bedtime led to the stuff you describe, frequently waking up, fitful sleep.) Noonish or slightly before seems to do it. My pills aren't marked by days so I write the date on the strip in case I forget if I took one.

Next phase, some traits and tics I habitually keep under control popped up again, such as oversharing, and I made one real faux pas (an evil twin couldn't have done better). In hindsight I was really detached in that moment so I've been watching that. None of this stuff really matters now that the "switch flipped". If anybody had told me I would savour 90% my interactions with people every day, I wouldn't have believed it. But suddenly I stopped being geared to "avoiding" and found myself "approaching" again - time, people, problems, moments. I'm writing a lot more and keep better contact with family and friends.

Now with a streak of mania or bipolar it seems you would need to be really careful and there are different medications for these. Some nights I only seem to need 3-4 hours of sleep now. I started getting addicted to amazon and ebay all of a sudden (dopamin, comparing ALL the products, etc) and there was that epic night where I spent like half a months salary, I did not give a shit it felt so good. What I'm saying is I suspect neglected feelings, such as wanting stuff, can come back with a bit of a vengeance when one gets better. To me the whole thing feels a bit like remembering how to drive. I can't second all the above posters enough in being in contact with someone to talk to for helping with the process.

Even though it took long to start working for me, I can maybe say there were early signs of it starting to work. For example, making a connection to people in little everyday interactions, which surprised me. Are you seeing any of those?
I think I had the luck of running into a bunch of serotonin-producing occasions. For me it was music, old friends turning up, someone booking a flight to visit me, starting a vegetable garden from seed and watching things grow.. and I think I could feel the drug amplify them. My SSRI theory is that you need to give it some serotonin to work with - after all it doesn't make serotonin but makes the amount you currently have get used multiple times. (If I understand this right.) It would follow that you can speed that process along by exposure to nice things.

PS. I'm writing about Celexa in response to your question because I believe the result is similar to Prozac - increased serotonin and they're both SSRI's. But obviously YMMV
posted by yoHighness at 11:07 AM on May 18, 2014 [1 favorite]

It caused such horrible relfux, my esophagus ended up swelling. I was switched to Cymbalata and do much btter now.
posted by FunkyHelix at 12:31 PM on May 18, 2014

The therapeutic benefit of SSRIs is actually not so much due to the drugs themselves as to the tolerance the body builds up to them over time, and for a therapeutically effective dose of fluoxetine that typically takes about one to one and a half months. Until your body does build up its tolerance, you get to experience the direct effects of the drug and these are indeed weird and unpleasant.

If the process feels bad enough that you don't think you'll cope with it, talk to your doctor about reducing your dose somewhat and ramping it up as you acclimatize. That will make you take longer to get the therapeutic effect you're after, but might lower the intensity of the direct effects to the point where you're willing to put up with them.

Other SSRIs come on much faster: about two weeks for Sertraline (Zoloft) and paroxetine (Aropax) so explore those possibilities with your doctor as well. You'd probably want to be off the fluoxetine before starting another.

Personally I found that fluoxetine turned me into a shuffling dead eyed zombie, paroxetine made me twitchy and frightened and angry, and sertraline worked just fine. Everybody's response to these drugs is different, and if your doctor thinks an SSRI is a good option for you it's certainly worth switching drugs within that class if the one you're using doesn't suit you.

Discontinuing any SSRI is best done by tapering the dose down over a couple of weeks - suddenly stopping them generally feels pretty awful.
posted by flabdablet at 1:32 PM on May 18, 2014

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