Starting Prozac after my old meds were (unknowingly) making anxiety worse

[laurandisorder]

Hey team,

I have missed you guys!

I'm an antidepressant veteran from way back. I first started on Zoloft (2 years), then Effexor (2 years), then Lexapro (2 months - not for me!) and I finally got prescribed Edronax also known as reboxitine. It was prescribed for major depression and eating disorders. I have been on this medication for 8 years and I started suffering from anxiety and panic attacks (eventually diagnosed panic disorder) 6 years ago.

What a learning experience the past few months has been. Little did my psychiatrist or I realise that the medication I was taking (not FDA approved in the States) was doing little to treat panic and anxiety. In fact with side effects like tachycardia (my resting heart rate used to be 120pm) and anxiety itself, it was actually exacerbating the problem. So I have tapered down off the Edronax over the last 6 weeks and I get to start Prozac soon.

I'm quite excited about this new medication adventure and I would love to hear other people's experiences with fluoxetine. Positive or negative (I'm not a hypochondriac!) I'm very hopeful at this stage that this may finally be a solution I have been looking for. I specifically declined Aropax, as my partner used to take it and it didn't seem like any fun at all to withdraw from.

I'm a little bit dubious about the month to come. It has been a long time since I haven't been medicated at full dosage and efficacy. I just hope that it doesn't interfere with work or university too much! The only potential side effects j am worried about are weight gain (once an anorexic...), vivid dreams (I already experience sleep paralysis and night terrors) and the suicidal ideation. I may need to drop by for support a little bit more.

Anyhow. Any feedback would be appreciated. I'd love to hear your experiences.

[Ritch]

Prozac was the first medication I was tried on, it was the only one available on license when I was seventeen so it was either Prozac or nothing.

Unfortunately prozac like your previous medication made my struggles worse and It wasn't a very positive experience. It increased my anxiety and the severity/frequency of my suicidal ideation. With that being said I have seen many people across various forums say that prozac has helped them a great deal so I am hopeful it will treat you well.

Keep us posted

[Exactice]

Day 39 of Prozac 20mg a day.

From all the reading, Prozac is a hit or miss, This is my thread with Prozac http://anxietyforum.net/forum/showth...on-to-the-next!

I will say there is a 2 week hell period with the side effects. But if you can manage and fight through them, it starts to get better. I can say I am finally stabilized. My anxiety is under better control now. My thoughts and feelings are much more positive and stable.

Give it a whirl but dont ignore the side effects if its to much talk to your doctor. Some people, its just not for them other people have had great success!

Good Luck and keep us posted!

[soManyProblems]

Prozac (fluoxetine) is a very good SSRI, according to head-to-head trials which compare one SSRI with another. The two SSRIs that consistently win in head-to-head trials most often are Prozac and Lexapro (escitalopram).

Your choice to avoid Aropax (Paxil, paroxetine) is probably wise. I have been on Paxil for over a decade and it has served me well, but it has terrible withdrawal, it is not actually an SSRI (it is an SNRI), and it should be taken twice daily. That said, some people do like Paxil. I know several psychiatrists and none of them (none) will start patients on Paxil, but some people do like it. Every drug seems to have its little fan club.

Anyhow, Prozac and Lexapro are the two SSRIs that seem to possibly be better than others. In theory, I prefer Lexapro. Lexapro has a much shorter half-life and no active metabolites. Prozac and Lexapro are both "true SSRIs", unlike Paxil, because they both have at least 10-fold selectivity for serotonin over norepinephrine.

Prozac is not as "pure" as Lexapro because Prozac binds to serotonin 5-HT(2C) receptors, but this tends to calm anxiety. Also, this effect may not be clinically relevant at all.

Prozac is generally regarded as a more stimulating SSRI, more likely to cause insomnia and less likely to cause weight gain. Lexapro is regarded as a very neutral SSRI - I personally find Lexapro sedating, but some people report insomnia.

Good luck, and good choice. Prozac is a fine drug.

[laurandisorder]

I'm on day #5 of Prozac now and it hasn't been too bad.

The absolute WORST day was the last day of withdrawing from my old medication (I had to have three days clear before starting). I had horrible night terrors and woke up in full flight or fight mode - plus my partner was at work. I was about half an hour from checking myself in to the ER (because the panic attack just wouldn't stop!!) I was up from about 12:30am to 4:00am paper bad breathing, drinking tea and doing meditations trying to get back to sleep.

So far the main side effects I have experienced are mild nausea and some bad headaches. I seem to wake up with a headache every day, only one has been horribly debilitating. And I'm not sure if this is TMI, but either my old AD was making me very constipated, or Prozac is also having a bowel moving effect.

Anxiety levels have been about the same as usual - I'm on 5mg Valium a day for the changeover (more if required), but I haven't experienced full blown panic since I started, which is a big deal because I was terrified of the anticipatory backlash of last week's mega-attack. I was worried that another one whilst transitioning would just make me lose all faith in the drug from the start!

I do feel a little flat and two dimensional. I will be upping my dose to 40mg in a couple of days and see how I go with that.

[soManyProblems]

Withdrawal from any monoamine-boosting antidepressant can be bad, that includes serotonin-boosting drugs like Lexapro and norepinephrine-boosting drugs like Edronax (reboxetine, which laurandisorder was taking previously). The worst offenders, in terms of withdrawal, are drugs like Paxil (paroxetine) and Effexor (venlafaxine) which boost both, although in both cases the serotonin boost is stronger and takes place at a lower dose than the norepinephrine boost.

I have gone through Paxil withdrawal several times, I can perhaps relate to the agony and anguish you felt coming off of Edronax. That's over now, and Prozac has *much* milder withdrawal.

Nausea and diarrhea are both very common serotonin-induced side effects, and thus they are common side effects from Prozac. The good news is that you gain tolerance to the side effects in a few days or weeks. After a few days or weeks, you should also start feeling the real benefits. SSRIs usually take 1 or 2 weeks at full dose to deliver full benefits, and sometimes it takes as long as 8 weeks (especially in OCD).

Edronax (reboxetine) should not cause constipation, but Prozac definitely causes diarrhea for many people. Headache is a slightly less common side effect of Prozac, but still rather common. Prozac can also be used to treat headaches.

I am cross tapering onto Lexapro currently, and it gives me a headache every day. Hopefully it will subside once my dose is stable and I gain tolerance.

Good luck!

[laurandisorder]

Just a brief update.

I have been on Prozac for about three weeks now and upped to 40mg after the first week.

I am feeling a lot better. My moods are more level and I haven't had any suicidal ideation since I weaned off the Edronax.

Side effects have waned on the most part. I'm still going to the toilet a LOT more than my usual 1-2 times a week, but I don't mind that. I haven't experienced any nausea, but I do get some cramping (toilet issues related!!). Still getting headaches. They usually wane by afternoon on the most part, but I had a cracker today and had to take the day off work and school.

I am concerned about weight gain. I feel like I'm really gaining weight and I'm too scared to weigh myself because I have a loooooong history of eating disorders and generally don't weigh myself at all because it leads to bad repercussions. It's also the onset of winter here in Aus, so I think that is making me hungrier. When I started on the Edronax, I lost a bunch of weight and was really happy with my size/shape. I was really hoping for the nausea side effect (shallow, I know!)

The most interesting thing is my resting pulse. On Edronax, my resting pulse was around 110-120 BPM. I'm now between 60-70 BPM - my tachycardia, which I assumed was related to poor eating in my past - was caused by the medication! I think my circulation has improved too. I have warm hands for the first time in a decade. At this time of year, my hands are usually freezing and covered in chilblains.

Have had 2-3 moments in the last few weeks where I have had to take an extra Valium due to anxiety building up to panic attack. That's pretty good for me

[Anne1221]

Try to focus on how good you're feeling now. Maybe later, you can talk to your doctor about a lesser dose, if you experience bad side effects. Work with him to get just the right amount. I was on 40 mg of Prozac for a while, then later he cut it back to 20 mg.
when I was better.