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I recently started taking 40mg of fluoxetine daily again. I didn't go from a lower dose to a higher dose, I just started taking the full dose. And for the past few days I've been feeling depressed and like I'm going to burst out crying at any moment. I've also started a new school which probably doesn't help any. Are these common problems? Any advice would be welcome.
Hey Aloysius,
Welcome to the forum. It may have helped to know if you were prescribed it for depression or anxiety, why you didn't start at a lower dosage to get your system reaccustomed to SSRIs, and I'd be interested to know if you were prescribed any similar medications previously (I note that you stated that you were taking it again). From your mention of school, I assume that you are a teenager.
From https://www.drugs.com/sfx/fluoxetine-side-effects.html
Psychiatric
Antidepressants may have a role in inducing worsening of depression and the emergence of suicidality in certain patients during the early phases of treatment. An increased risk of suicidal thinking and behavior in children, adolescents, and young adults (aged 18 to 24 years) with major depressive disorder (MDD) and other psychiatric disorders has been reported with short-term use of antidepressant drugs.
Major Side Effects
You should check with your doctor immediately if any of these side effects occur when taking fluoxetine:
depression
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* ANTIDEPRESSANTS INEFFECTIVE FOR ADOLESCENTS
http://www.gizmodo.com.au/2016/06/so...ren-and-teens/
A discouraging new study concludes that most antidepressants are ineffective for children and adolescents, and may even be harmful in some cases. But the researchers caution that the low quantity and quality of clinical trials are obscuring the true effects of these drugs.
For the new Lancet study, researchers analysed 34 trials involving over 5000 participants aged nine to 18. Out of the 14 antidepressant drugs scrutinised, only fluoxetine (AKA Prozac) was more effective at relieving the symptoms of depression than a placebo. Shockingly, venlafaxine (branded as Efexor-XR in Australia) was actually associated with an increased risk of suicidal thoughts and attempts when compared to a placebo and several other antidepressants. Patients found that imipramine, venlafaxine and duloxetine had such negative effects that they were likely to stop taking the drugs.
“The balance of risks and benefits of antidepressants for the treatment of major depression does not seem to offer a clear advantage in children and teenagers, with probably only the exception of fluoxetine,” noted study co-author Peng Xie of Chongqing Medical University in China.
In light of these findings, the researchers recommend that children and teens who are taking antidepressants be monitored closely, regardless of which drugs they are taking, and especially at the beginning of treatment. The researchers stopped short of suggesting that children be taken off their meds; previous research has shown that withholding antidepressants from children and teens can be dangerous.
But the researchers caution that the true effectiveness and risks of these drugs remain unclear due to the disturbingly small number of clinical trials, many of which are flawed. Selective reporting of findings in published trials and clinical study reports were also blamed.
Indeed, there appears to be some selectivity at play here, and no small amount of reporting bias. Of the 34 trials analysed, 65 per cent were funded by pharmaceutical companies. The researchers ranked nearly 30 per cent of the trials as being at high risk of bias, 59 per cent as moderate and just 12 per cent as low.
“Without access to individual-level data it is difficult to get accurate effect estimates and we can’t be completely confident about the accuracy of the information contained in published and unpublished trials,” said lead author Dr Andrea Cipriani, who works out of the University of Oxford. “It has been widely argued that there needs to be a transformation of existing scientific culture to one where responsible data sharing should be the norm.” Cipriani said that scientists should be given access to raw clinical trial data in order to validate and replicate existing findings.
Publication bias in pharmaceutical research is a known problem. Back in 2004, biotech giant GlaxoSmithKline not only failed to show treatment effectiveness for off-label use of the anti-anxiety drug Paxil among children and teens, it also failed to note a possible increased risk of suicidal tendencies in this age group.
But Big Pharma doesn’t deserve all of the blame — the current publishing model is likewise culpable. It’s easier to publish positive results than inconclusive results, leading to yet another form of publication bias. As Cipriani and her colleagues rightly point out, something has to change.
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Because you haven't been taking it for long, you could discontinue it abruptly (cold turkey) without tapering off, but not suffer from withdrawal symptoms.
Previous relevant post/s:
DEPRESSION; TEEN: See http://anxietyforum.net/forum/showth...785#post223785
DEPRESSION: http://anxietyforum.net/forum/showth...510#post216510
There are herbal, and non-herbal antidepressants that you could be trying, such as a recommended brand of St. John's Wort, (Kira, Jarsin, or Perika brands are standardised, with sufficient hyperforin balancing their hypericum content, from vitamin / health stores, or Google supplies; takes up to 6 weeks to reach maximum effectiveness) or 5-htp or SAMe, which work quicker. They are not known to cause depression.
Your prescriber may not be aware of the above information *, or just be unconcerned as to your fate, knowing s/he is covered by insurance, by remaining within the prescribing guidelines, and would be likely to try you out on another SSRI like sertraline / Zoloft, or a SSNRI.
View: ANTIDEPRESSANTS / ANXIOLYTICS (ANTI-ANXIETY MEDICATIONS) at http://anxietyforum.net/forum/showth...657#post225657
40mg Fluoxetine is a lot to start on.. I'd hate to think of the side effects, so it sounds like you're doing really well!
I would consult with your physician and explain to him/her your symptoms and concerns.