Doctor upping Prozac 20mg to 40mg NERVOUS!!

Hi,

I've been taking fluoxetine (Prozac) for 4 weeks now after years of being on Lexapro. I had minimal side effects in the beginning. A week in was very very tired, no energy. Also had no appetite, nausea, and diarrhea (sorry, TMI). My doctor prescribed me Zofran, which helped greatly. Also he gave me permission to up my Klonopin from 1mg a day to 1mg 3x a time if needed. My GI issues resolved, still tired but began letting up. Now in the last few days of week 4 I'm finding myself depressed (which is not my main issue, I have PTSD and panic which sometimes results in a mild depression for a day or two) and my anxiety is high. My doctor just returned my call and would like me to go from 20mg to 40mg. I was instructed that if I experience any adverse effects to call them immediately....made me more nervous! New meds and dosage changes trigger my anxiety. I'm terrified. I'm afraid doubling the dose will make my anxiety and depression worse.

Has anyone had to up their Prozac dosage from 20mg to 40mg after 4 weeks?

When upping the dose did you experience the start up side effects all over again?

Did upping the dose help? If so, how long?

Did upping the dose make things worse?

Is going from 20mg to 40mg a big jump?

I'm sorry for so many questions. I get so panicky about meds due to past bad experiences. I'm scared to feel worse than I do. Guess I'm looking for a little hope from anyone who has been through this.

Thank you!

Thank you :)

I'm in tears right now I've got myself so worked up, anxious, and upset. I expected to have relief by now, not still battling and looking at a dosage increase. Just scared of the possible reaction.

KW,

You should not have the profound effects like during a start up. A bump in dosage may cause some s/e's...but then again, you may have none!

Be sure and use your coping skills and positivity to get you through the next few days....

Hopefully this increase will be what you need to get you to a therapeutic level on your Rx, and on your way to feeling your best soon!

Keep us posted on your progress and we will keep you in support! :)

S.C.

ft27-i strongly disagree with you that prozac is a gentle ssri. its one of the strongest there is. problem is there is no 25 or 30 mg but jumps to 20-40 and for some thats too big a jump.

Hi

I am currently taking Prozac and had no problems switching from 20mg to 40mg I actually went up to 60mg and have found it to be a good medication.

Hibee

Thank you :)

I started with Lexapro (1st AD) in November of '08 after my stillborn son followed by 2 miscarriages. I felt a huge change in just 2 weeks. My anxiety was nearly gone, I could function, I wanted to do things, I had my life back. Unfortunately, in December of '13 my doctor decided it was time to move on, I wasn't receiving any benefits. I had a scare that my cancer returned in my ovaries after beating cancer earlier that year. Had a breakdown.

I switched to Zoloft. It was a nightmare!! Lost 25lbs because I couldn't eat, physically sick, horrible depression, panic attacks that would last 4-5 hours with Xanax not even touching them, hallucinations, thoughts of harming my kids. I was living in hell. I gave it 6 weeks, just kept getting worse.

Tried Cymbalta and Celexa afterwards. They did nothing but make me angry, irritable, and have no patience. Didn't help with anxiety at all.

Went back to Lexapro hoping it would work again, but it didn't.

Now here I am 4 weeks on 20mg of Prozac. It's been a ride. Physically had alot of GI issues. It's let up. Had some good days, felt hopeful. Had some days where my anxiety and panic were running rampid. Some days I've felt sad.

My doctor gave me 3 choices:
-Since its only been 4 weeks keep on the 20mg a bit longer
-Go up to 40mg
-Try something new

I'm terrified to try something new. I've got 4 weeks in on Prozac, I don't want to give up...maybe it will work, maybe it needs more time. I'm scared to go up because what if it heightens the depression and anxiety I've been having the last few days. I'm confused, lost, and frustrated. No one in my life understands.

I should mention last week my best friend found her 27 year old brother deceased. I spent last week with them, helping anyway I could. Showing was Friday, funeral was Saturday. It was hard. I can't help but wonder if it triggered me, I also found my sister deceased 20+ years ago. I know what it's like to have those images. What pain she will carry. What this does to a family. I couldn't help but have thoughts that I could be like her brother, not dead, but having demons so horrible they never let go. He was a veteran with severe PTSD and anxiety along with a brain injury from service. He lived with horrible demons.

I just don't know what to place this on and where to go from here. There's no real right answer, it's all a gamble.

Post Edited (kwilson) : 5/10/2016 9:37:14 AM (GMT-6)

Thank you Larry :) I appreciate the positive story, gives me hope!

I understand your anxiety a bit more now; you're so right when you say ADs are a gamble. Upside is you're still early in the game, and it sounds like the Prozac has been at least marginally effective. You're dealing with the trauma of your friend's brother's death, and all of its attendant triggers. When we're dealing with anxiety and depression we always look for the worst possible outcomes, thus I'm not surprised at your anxiety as it relates your friend's brother. It's easy to picture the same outcome, even though the situations are entirely different.

Depression and anxiety are life long struggles, and those who understand, understand, those who don't, don't. Articulating the fear of loss of control that a bad drug reaction can prompt is impossible to people who haven't experienced it before. I'm not surprised that no one in your life understands - it's part of the burden we bear. Nonetheless, we always find a way to plod forward, sometimes we do it for us, and sometimes for others, but we always do it.

The chance of you freaking out on Prozac is minimal. If it's going to happen, you'll catch it before it gets weird. After all, you've been through that before. I'd also suggest, that if it's going to happen, it would have happened already.

Prozac, like Lexapro, isn't going to be a panacea. I still have bad days (on Cymbalta), but they're not crippling. If I had to choose one thing that Cymbalta helps me with, it's perspective. I'm able to use better judgement when it comes to my illness.

I've had to deal with a couple of bodies lately too. Weird how traumatic it is - still get the odd nightmare. Oddly enough the book "Smoke Gets in Your Eyes" about funerary practices helped mitigate that anxiety.

Not sure how this post got so long - guess I relate to your situation more that I thought, except for the ovaries part. ;-)

Hang in there kwilson

yes i have taken prozac -for 3 months. it worked well but i couldnt tolerate any dose higher than 20mg. every one reacts diff to each dosage. it did take longer to kick in than zoloft did but it worked quite well. one great thing about prozac is its a snap to quit. no withdrawals at all . i also agree prozac has a safe proven track record. i decided to stop to see if i could go with out a ssri. i would take it again if nessesarry

super20dan, did you experience heightened depression and anxiety when starting Prozac? I feel that I shouldn't have these at the 4 week mark, thought it would of appeared sooner. A lady at the ER seemed surprised that this started now at 4 weeks.

No, I woke up with severe anxiety. I still haven't gone up to the 40mg, I'm scared it's going to make this worse.

I do however have some hope *fingers crossed* I have an assessment this afternoon at 12:30 with our hospitals Behavioral Health Institute. I will get to meet with a psychiatrist's nurse practitioner. Figure out a course of treatment, get my questions answered about my meds (ER wouldn't offer any advice last night), and hopefully avoid the end of July wait to be seen by a psychiatrist. This is also to get me into a 5 week outpatient group treatment program. Hope it goes well, I felt very defeated and hopeless last night leaving the ER.

I also have an appointment today with a holistic physican to come up with a treatment plan.

My counselor was concerned and happened to call me last night while I was at the ER and is squeezing me in tomorrow for a session.

I just need to feel hopeful. I need to take back the power over my anxiety. I need strength. I feel like a weary soldier who has been on the battlefield far too long. This anxiety and depression has taken over everything...my mind, my body, my heart.

Thank you for thinking of me and checking in. It means alot. It's nice to know there's someone understanding and supportive.

^^ this.

For sure. :) :) :)

Well, I did some looking at my calendar and I've been off by a week. This past Tuesday was actually 5 weeks on Prozac. So looks like I'm coming up on my 6 week mark. Kind of has me worried because I'm still not feeling the greatest, but I will say Wednesday night I did get up the courage to go from 20mg to 40mg.

Wednesday I was a mess....I cried alllll day and was very anxious. By the time evening rolled around I was in a zombie type state. I looked in the mirror and didn't recognize myself. My eyes looked empty. I felt nothing. It was like I was hollow.

Thursday I was INCREDIBLY angry and irritable. I couldn't even stand myself. I've never felt such anger before without reason. Honestly, I was a little frightened. I had about a 2 hour period following my session with my counselor where the anger disipated, but it returned. I should also add my husband joined me on my session. That's progress :)

Yesterday (Friday) I thought I was FINALLY having my "light switch day". I was feeling so hopeful and excited about my future. Seeing a light at the end of the tunnel. Best mood I had been in in a very long time. Visited my neighbor, caught up on the phone with some friends, and went for a walk. Everyone i talked to said I sounded so different, so positive.

Then today came. Have felt anxious all day, irritable, depressed, spent most of my day in bed binge watching on Hulu. I'm so frustrated, to have such a great day and a sigh of relief thinking Prozac is for me, then to today where I'm backtracked. I'm not sure what to think. Prozac has had me on one heck of a roller coaster and I feel like by now it should be getting easier. I hope these last few weeks haven't been for nothing. The thought of starting over just makes me feel more bummed. I feel like I should feel better.

Good news:

My first day of the 5 week Intensive Outpatient Therapy was yesterday and went great! I almost bailed, but forced myself to go. There were moments I was a little irritated with one particular member, but over all a good experience. I plan on sticking with it as long as I can get out of this funk. The way I feel today, is not a mood that I will willingly show up at 8AM Monday morning.

I FINALLY was able to secure an appointment with a psychiatrist on July 19th...hopefully someone cancels before then.

Again, thank you all for your support, advice, and kind words. Hope you all are doing very well!

Post Edited (kwilson) : 5/14/2016 7:06:35 PM (GMT-6)