Jump to content

How long should I give it


Recommended Posts

Sorry to post another question about medication. I’ve been on fluoxetine for 8 weeks, increased from 20mg to 30mg just over a week ago. The thing is over the past month I’ve had way more bad days than good days, I feel it’s not working for me this time and my GP wants me to stop abruptly and start taking escitalopram 7 days after stopping. I’m not sure how much more anxiety I can take so now I’m scared to continue and scared to stop. I’ve recently started therapy so will discuss there also but what you you guys think? Have I given it long enough as my gp seems to think? The only days I have good days is when I’ve taken 0.5mg lorazepam in the morning. I know this is not good but I need to be able to function for my daughter. I am taking it more days than I would like but it seems to be he only thing getting me through at the moment. My gp isn’t concerned about addiction saying we can taper when an antidepressant actually starts working for me. I’m obviously concerned about addiction but I’m only taking 0.5 when take it when she said I can take up to 4 x that amount. I am not sleeping well and have no appetite due to anxiety.

Anyway, what are your thoughts on the fluoxetine, surely I should be noticing a little improvement by 8 weeks?

Edited by Black
Link to comment

I think 8 weeks is generally enough time to start seeing some improvement, some people do wait a little longer, but if you aren't really saying ANYTHING its probably worth switching.  
I switched from fluoxetine to citalopram about 15 years ago (and then escitalopram which is almost the same 5 years ago).  For me the citalopram/escitalopram was better than the flouxetine, and the transition went pretty smoothly.  I did a cross taper, slowly going down on the fluoxetine and up on the citalopram (like one week at 75% flouxetine/25% citalopram, next week 50/50, third week 25/75, then finally 100% citalopram).  However in my case the fluoxetine was still somewhat effective so there wa reason to stay on it during the transition.  In your case if its not giving you any benefit, stopping now probably won't change much.  Also, fluoxetine has a longer natural half life so it kind of naturally tapers anyway.  Its understandable to be concerned, but your doctor is trying to help you, its probably best to trust their judgement, the OCD is going to make you nervous no matter what approach. you take in all likelihood.

I also have some experience with benzo's, though in my case it was clonazepam.  I too took a low dose (I think it was also .5mg) for a couple months after experiencing some acute panic attacks (one of the reasons I switched SSRIs if I recall correctly, its been awhile, it all starts to blur together, lol).  I wasn't a huge fan either both for the addictive potential and for the fact it general made me feel kind of blah (though it did help dampen the anxiety).  I transitioned off them before too long, my doctor would give me a small prescription to have on hand in case of acute panic, but not enough to get fixed on, like a I think a week supply at most?).  I would use them occasionally, more often at first but less and less over time.  I think my last prescription refill was about 5 years ago before I moved to Japan, I still have a few but who knows if they even work anymore, lol).  I don't think its too risky to keep using a low dose short term to help keep the anxiety at bay while you try and find an SSRI that really helps.  I'm sure you are keeping an eye out for any troubles and your doctor will keep an eye out too.  

Hopefully you have good luck on escitalopram, I know I have.

 

Link to comment

Thanks so much for this, I really appreciate you taking the time, so lovely of you. That does make me feel a bit better about the switch. I know when Prozac worked for me last time I felt a lot better by this time and certainly not worse so yes I think it’s right to switch also ocd is making me doubt. 

Link to comment

Hi Black

I'm sorry you're struggling still :( 

This is my opinion, so feel free to ignore it! But I think that meds for most people only do so much, they take the edge off anxiety or improve mood, but for most people the bulk of their experience will have nothing to do with meds and everything to do with compulsions.  If you're doing lots of compulsions then taking meds will not counteract that.  

I know you are seeing a specialist but do you have any access to self-help in the meantime? Books (e.g. Break free from OCD) or have they set you any homework etc?

I can't really comment on whether you should change meds or not, but my advice is don't pin too much hope on medication (although I know you had a positive experience last time).  CBT is what will really help and you can be doing that any time, every day, you don't need to wait until you see your therapist.

Hope you feel better very soon x

Edited by gingerbreadgirl
Link to comment
1 hour ago, gingerbreadgirl said:

Hi Black

I'm sorry you're struggling still :( 

This is my opinion, so feel free to ignore it! But I think that meds for most people only do so much, they take the edge off anxiety or improve mood, but for most people the bulk of their experience will have nothing to do with meds and everything to do with compulsions.  If you're doing lots of compulsions then taking meds will not counteract that.  

I know you are seeing a specialist but do you have any access to self-help in the meantime? Books (e.g. Break free from OCD) or have they set you any homework etc?

I can't really comment on whether you should change meds or not, but my advice is don't pin too much hope on medication (although I know you had a positive experience last time).  CBT is what will really help and you can be doing that any time, every day, you don't need to wait until you see your therapist.

Hope you feel better very soon x

Good advice thankyou. It was brainlock that helped me most last time along with the meds but neither seem to be helping much at the moment. I’ve only had one session so not a lot of homework set yet, just relabelling, accepting and refocusing. I’ve been doing my own exposures but again don’t seem to be moving on from crippling anxiety. I feel exhausted, not sleeping well at all and depression is creeping in. I have another session tomorrow so hopefully that will help. I’ve restarted yoga and have just done a 4 week mindfulness course so I feel I’m working really hard but not getting anywhere. It’s the anxiety that is the worst part for me, I know they are stupid thoughts and know to agree with them which I can do in the moment (most of the time) but then there is just this generalised and constant anxiety ? I just feel like the meds should be doing something rather than nothing. I’ve been given quetiapine and zopiclone for sleep but each have only given 2-4 each on a bad night, have a new one to try tonight as I’m not taking quetiapine again, I feel it’s made me worse particularly in the mornings.

Link to comment
2 hours ago, gingerbreadgirl said:

But I think that meds for most people only do so much, they take the edge off anxiety or improve mood

Thats interesting, for me the medication experience was more direct.  Before the drugs the intrusive thoughts would get stuck, I couldn't dismiss them like normal people could.  Once I started taking the drugs it felt more like before I had the OCD, the thoughts would occur less often and when they did it was easier to dismiss them (though still not like my pre-OCD days).  For me the SSRIs helped my brain function more "normally".  My parents described it to me later as if I was back to being my old self once the medication kicked in, not 100% of course, but much much better.  Its hard for me to say whether they also had a direct effect on my anxiety or mood, by reducing the intrusive thoughts significantly my anxiety went down and my mood improved anyway, but its possible they also helped with that, though I've definitely still experience some extreme anxiety while on the medication, so its not full proof in any case for me.
Of course everyones experience with these type of drugs is different so I am sure that for others the effect is more what you describe.  Its too bad that we can't dial in these kind of treatments to be more similar for everyone and have better success rates.

Link to comment

That's interesting Dksea I didn't realise meds could work in that way.  Do you think it's possible that the frequency of the intrusive thoughts decreased because you were less anxious about them? (As obviously the intrusive thoughts only bother us because we pay attention to them). 

Link to comment

I think also when you treat he anxiety medically the intrusive thoughts decrease with the reduction in anxiety. For me anyway.

I should add I increased from 20mg to 30mg of fluoxetine a week ago so that may be impacting on how bad I’ve been feeling.

Still in two minds about what to do. I might just give it until the weekend ? 

 

Link to comment

Have you tried some natural, no side effects, alternatives like exercise? It creates fresh serotonin.  I just exercise, I don’t do meds because in my study of evolution I found that exercise played a key role in mental balance.  Also don’t use caffeine. 

Link to comment
2 hours ago, Handy said:

Have you tried some natural, no side effects, alternatives like exercise? It creates fresh serotonin.

Please stop suggestion serious mental illness can be cured by just exercising, this is not true.

Edited by dksea
Link to comment
19 hours ago, dksea said:

Please stop suggestion serious mental illness can be cured by just exercising, this is not true.

There is no cure for OCD & I never suggested this cures OCD. However every person on every OCD forum says exercise makes them feel better & it’s mechanism for doing so is well known. I first learned about it from Andrea on the forum years ago. 

Link to comment
1 hour ago, Handy said:

I never suggested this cures OCD. However every person on every OCD forum says exercise makes them feel better & it’s mechanism for doing so is well known.

First, its doubtful that every person on every OCD forum has said anything the same.
Second, you suggested it was an alternative to medication.  While exercise has health benefits in general and likely some positive effect on mental illness, it is not equivalent to taking medication.  OP could certainly engage in exercise, we all should engage in healthy levels of exercise, but its not going to be something to replace either CBT or medication.

Link to comment

I do a lot of exercise by the way lol. A lot! It helps in the moment and for 30 mins afterwards but doesn’t stop the obsessions. That’s my experience anyway

Link to comment
6 hours ago, Handy said:

There is no cure for OCD & I never suggested this cures OCD. However every person on every OCD forum says exercise makes them feel better & it’s mechanism for doing so is well known. I first learned about it from Andrea on the forum years ago. 

Just to clarify, I have never said that excercise cures OCD. I don't understand what thing Handy learned from me. 

I think that exercise is important for maintaining physical fitness and helpful for health in general. I also think that exercise can be a great hobby, for example I love to play tennis and jogging, doing these sports makes me happy.

Link to comment
4 hours ago, dksea said:

First, its doubtful that every person on every OCD forum has said anything the same.
Second, you suggested it was an alternative to medication.  While exercise has health benefits in general and likely some positive effect on mental illness, it is not equivalent to taking medication.  OP could certainly engage in exercise, we all should engage in healthy levels of exercise, but its not going to be something to replace either CBT or medication.

:goodpost:

Link to comment
1 hour ago, Andrea said:

I think that exercise is important for maintaining physical fitness and helpful for health in general. I also think that exercise can be a great hobby, for example I love to play tennis and jogging, doing these sports makes me happy.

Absolutely agree!  Good general health is beneficial for mental health, but its not going to solve your problems either, just make them possibly easier to handle.

Link to comment
  • 2 weeks later...

Just wanted to update incase anyone was reading this. So I stuck with the fluoxetine in the end and exactly 9 weeks after starting and 2 weeks after increasing the dose to 30mg, it finally kicked in. Such a relief! I stopped the lorazepam without any issues at all and have now done 3 sessions of therapy which is going well. I honestly feel almost back to my old self but will stick with the therapy. Thanks for all the support when I really needed it. 

Link to comment

And for anyone trying fluoxetine it really can take a while to kick in and it’s worth considering adjusting your dose if it’s not working for you after several weeks. 

Link to comment
14 hours ago, Black said:

Just wanted to update incase anyone was reading this. So I stuck with the fluoxetine in the end and exactly 9 weeks after starting and 2 weeks after increasing the dose to 30mg, it finally kicked in. Such a relief! I stopped the lorazepam without any issues at all and have now done 3 sessions of therapy which is going well. I honestly feel almost back to my old self but will stick with the therapy. Thanks for all the support when I really needed it. 

Thats great to hear! Thanks for sharing the update.

Link to comment

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...