I’ve been asked a few times about my experience with the anti-depressant Fluoxetine so I figured I might write a blog starting from the beginning for anyone who is taking it for the first time and feeling a bit nervous.
Keep in mind this is my experience, not medical advice; it could be different for you.
So, where to start … you’re feeling a bit generally rubbish, not sure what’s going on, and you’ve finally made the realisation that perhaps depression or anxiety is the root cause.
If you’re still unsure, you can take this test here to check.
Ok, you’ve taken the test, and you are pretty confident you’ve got a bit of a glitch in your mental health matrix.
What’s the first step?
Call your Doctor
Make an appointment to go and see your GP. Don’t keep putting it off; go and do it. The relief you get from putting your hand up and taking the first step by reaching out is the very first step in helping yourself toward better mental health. There is no shame; you are not defective or abnormal; this is a very common thing to do.
Going to the Doctor
Ok, so you’ve got an appointment now, and you’re in the waiting room. Naturally, the dr is running behind schedule, and you are not sure what to say, how to say it or what type of questions you’ll be asked. Will they chuck you in a suit and send you off in a van? I don’t think so … well, that’s never happened to me.
More likely, the doctor will call you in as usual, and they’ll ask you to answer a series of questions about your state of mind over the past 14 days. This test is a bit of a gauge where you sit on the depression/anxiety scale and will inform the rest of the chat you have.
I’ve been asked about my lifestyle, stress levels, trauma history, engagement in talk therapy, regularity of exercise, nutrition and how I relax. I am very versed in all of these self-care maintenance techniques, but sometimes, like recently, I’ve been triggered back into an episode of depression and anxiety.
My doctor is always very supportive, keen to hear me out and has a very holistic approach, I’m very grateful for this, and it took me years to find her.
If your doctor isn’t really easy to talk to or doesn’t quite vibe with you, then find a new one.
How it feels to have the depression diagnosis
It can be a strange feeling, being diagnosed with depression for the first time. For me, it was more of a relief than a feeling of failure. I finally had a name to put to all of the shit feelings, and I could make a bit of sense of it. There are approximately a trillion Facebook groups you can join, including our unique and supportive group for women here , many books to read, and articles to search on the web. Take this as a learning opportunity.
Bit of a disclaimer on Facebook groups: practice caution with these. I jumped straight into a Prozac/Fluoxetine group when I was very first diagnosed, and I think it was a mistake to do so. All it did was dial my anxiety up to a billion because there were a LOT of conflicting messages and negative comments in the group, which made me quite disheartened and scared about what might happen to me.
I raised some of the concerns voiced in the group with my doctor. She cautioned me that the people happily living on Fluoxetine are not on dedicated anti-depressant Facebook groups; they’re busy living their lives. I think she was 100% right about this. If anything, find some supportive local women’s groups and start there – like our group (Unpacking Women’s Mental Health) mentioned above.
Taking the very first Fluoxetine pill
I was started on a low dose of 10mg once per day for two weeks, and then this tapers up to 20mg per day. The capsules only come in a 20mg minimum, so you have to take half a pill instead when you’re in your first two weeks. Both times I’ve noticed a sense of calm on the first day I’ve taken the 10mg (within a few hours). Everything I have read says it takes days or weeks to feel any noticeable change, but this was not the case for me. Placebo? Who knows. Who cares? I felt better.
The first 2 weeks on Fluoxetine
During round one on Fluoxetine (I have been on and off it twice now), I felt exhausted for the first week and all but lost my appetite. I ate very little and ended up losing a few kgs over the first month.
The feeling is not zombie-like, it’s not a feeling of being in any way out of control, drunk, high, nothing like that; it is like someone is lightly sanding away the rough edges, and things become a little more pleasant, manageable, and life becomes much less dumb. There is no euphoric feeling, and the sun doesn’t grow a smiley face, and the clouds don’t sing songs to you as you skip down the street. It is just a better version of everyday life.
Sleep is atrocious for me in the first two weeks, awake through the night, tossing and turning, wondering if it’s worth it (it is). Sweating in the night, weird dreams and frequent wake-ups are all part of the bedding process. I recommend using a sleep rescue remedy to get through this, I still use it now, and it works wonders. This is it here.
I didn’t notice it so much in the first round, but I had a headache for almost a week straight in the second round, which was not ideal, but I used Panadol, and it eventually went away. No more headaches after that.
Long term use of Fluoxetine
A noticeable change is that the negative self-talk slows right down and eventually all but disappears for me. This is gradual, but certainly, within a couple of months, I feel very free of that annoying voice in my head. I feel a lot more relaxed in social situations and willing to spend time with people I otherwise wouldn’t. This helps me in my work, friendships and being a part of family gatherings. I also feel like a much more patient mother when I am taking Fluoxetine; the inclination to “lose my rag” is much less because the significant mood swings just aren’t there.
Sleep goes from rubbish to fabulous. Mind you, I also stopped drinking alcohol this time around, so I can’t confirm whether the huge sleep improvement has been from Fluoxetine alone, probably a combination of the two. On a side note, alcohol is a sure-fire way to ruin your sleep, and if you also want to cut it out of your life, the book – Mrs D Goes without by Lotta Dann was a game-changer for me.
How long do you need to take Fluoxetine?
The first time I took Fluoxetine was for six months. I decided to come off them after doing a lot of work in therapy and self-care, starting this blog (it is an excellent outlet for me), and I felt I was ready to face the world without the pills. You can read a bit more about this time here.
When I go back and read that blog now, it mentioned how I lost motivation, which was one of the reasons I stopped taking it. That isn’t true for my second round; I was in such a pit before going back on the medication that my motivation was still very low. When I think about it now, I am not sure that it ever returned after giving up the medication the first time.
I don’t think that part had anything much to do with the medication in high insight. The answer to this question is going to be different for everyone. I know some people who have been on it for 20+ years, some for five years and some who jump to it in times of crisis and take it short term. That is up to you and your doctor.
What is Serotonin Syndrome?
This was one of the things I was most terrified about before I started Fluoxetine (thanks, weird FB group). I will give you a little rundown of what it is:
Serotonin syndrome occurs when the level of a chemical in the brain, called serotonin, gets too high. It is a known adverse reaction associated with some medicines or herbal supplements that increase serotonin.
Key points about Serotonin Syndrome
- Serotonin is a chemical produced in the body. It is needed for nerve cell and brain function.
- Serotonin syndrome occurs when the level of serotonin gets too high. This may be caused by the use of some medicines or herbal supplements that increase serotonin.
- Symptoms of serotonin syndrome can range from mild (shivering and diarrhoea) to severe (muscle rigidity, fever and seizures).
- Milder forms of serotonin syndrome may go away within a few days of stopping the medicines that caused the symptoms.
- Severe serotonin syndrome needs hospital admission and can be fatal if not treated.
You can read more here.
I didn’t get this.
It sounds scary.
I don’t know what the stats are, but it is something to be aware of and make those close to you aware of them so they can keep a lookout for the signs. I don’t say this to scare you, but you should inform yourself of all the risks.
What happens when you come off Fluoxetine
For me, this was not problematic at all; I waited a month or so after I felt ready and took one every second day for a week and then stopped altogether. As I mentioned earlier, though, I am on the lowest dose (20mg), so I imagine this could be quite a different experience if you are on a higher dose. Again, your doctor will advise you what to do here, and you need to consult with them before making changes.
Once I stopped taking them, the monkey mind was back within a couple of weeks. It’s when I noticed that I had one, and I had lost it in the first place because it was so obvious when it returned. This was the single worst part of being off the meds for me. Mind chatter, oh and anxiety, that came right back as well. I think once you have experienced living with much less of it, the return is not cool.
Fluoxetine and the changes to your body
- Very quick relief from constipation/diarrhoea, which I attribute to the lowering of anxiety. You can read more about anxiety and it’s links to Irritable Bowel Syndrome here.
- I yawn, a lot, it’s a weird side effect. Yawning all the time, even in my gym class. They must think I am so weird yawning on the challenge tracks.
- Weight gain. This is probably the most annoying side effect and if it didn’t exist I am sure 99% of the world would take Prozac. The best way to tackle this is to manage your diet and exercise routine while on medication. Being mindful and proactive is the easiest way to manage it. This can be hard becuase you don’t care as much.
- My circadian rythm changed quite noticeably. I was very tired all the time before starting on this second round of Prozac but this time I have been staying up later to colour in, but also waking up later too. I usually sleep around 9 hours per night uninterrupted now.
- The medication reduces the need for me to want to cover up my anxiety with alcohol. I am sure it has had a hand in the ease at which I kicked the daily wine habit a month or so ago.
My conclusion about Fluoxetine
For me, this is a little bit of magic to help me maintain balance in my life. It isn’t something that works as a stand-alone. As well as unbalanced brain chemicals, I believe that depression and anxiety are little warning signs from your body that something in your life isn’t quite right. Anti-depressants alone won’t fix that.
You also have to do the work to get to the bottom of the feelings and set yourself up for a happy life.
I am going to give you two lists here. The standard list will help you fight depression, and my special list will help you fight depression. I have come to think of the second list as very important. Based on my life experience.
Take from it what you will, and I hope this has been helpful to you.
Standard to-do’s (they work, but you have probably heard them before)
- Stretch (yoga)
- Eat nutritious food
- Practice Gratitude
My special list
- Toxic relationships can cause feelings of depression. Get out ASAP.
- Strained relationships with children, espcially young children, can cause feelings of depression. See a Dr if you feel this way ASAP.
- Hating the job you do everyday can cause feelings of depression. Do something that sets your soul on fire. Take a risk.
- If you are not satisfied with where you are in your life this can cause feelings of depression. Change it. Life is all about choices. You don’t have to sell your house and move country (unless you want to) but start with manageable changes.
- If you have been abused as a child. Get the therapy, read the books, do the work to heal. It won’t go away on it’s own.
- If you have been in an abusive relationship with a partner/ family/ anyone. Seek help. Trauma stays with us until we reconcile it.
- If there is some weird and wonderful thing of interest to you and you would like to learn more about it, like: hypnotherapy, tarot cards, energy healing, sound baths, light healing, whatever… explore and try the thing. Why not?
- Do not give a shit what anyone else thinks. This is your life and you only have one. Do what you need to do to enjoy it.
- Don’t wait to take action. Do it today.
Take care out there, and I hope to see you in the group.
Feel free to pop any other questions in the comments.