I have started Fluoxetine for severe anxiety and OCD

Thanks for your reply Deeb how did you come to know 40mgs was the right dose for you? I've heard higher doses are best for OCD so im just curious.. did you taper up to 20mg then 30mg then had satisfactory results with 40mg?

Hi

Really I would like to go up to a higher dose of fluoxetine but my doc says they only prescribe upto 40mg . I assume its better for ocd than depression at the higher doses. They increased me direct from 20mg to 40mg. I expected equal or worse side effects as I experience first starting fluox, but instead had nothing that noticeable, just a little extra anxiety for short period. Possibly a bit snappy and sleepy but I am not 100% it was anything to do with meds. I think I am naturally snappy!!

If my mood suddenly dips further down I might ask for stronger dose in citalopram perhaps. I have family members on this and it has no adverse effect on them. I increased dose to 40mg when I was about 6 or 7weeks in.

Try to read mind org or nhs website. This will show you treatments for oCD etc so you can make informed choices before you go to gp appointments. I panic a lot if I feel rushed into making snap decisions but the websites give me enough info to ponder way Before I have to or feel more involved with my treatment.

If it will upset u to have reduced libido let your doc know before you increase on any antidepr so they can pick which is least likely to have that effect or can have the dose tweaked in small increments.

Hi Mitch i can totally relate. I haven't even been able to work or see friends for the past 2 months. I've had terrible anxiety since October last year but it's been in overdrive for the past 2 months, I wish i didn't let it get this out of control before trying to sort medication, but you know what's best for you. You could be like me and buy a pill cutter and start with a quarter of a pill and gradually go up from there. I really think that's the best way to do it for severely anxious people like us. Also just remembering that things might be slightly worse for a few weeks but to stick it out for at least 4 weeks before deciding to quit or change meds. You have to make that commitment i think. Unless of course the side effects are really really bad.

As an update, i ended up going back down to 5mg for 2 days because i felt horrid on the 8th morning. Tomorrow i'm going to start 7.5mg and i'll probably do that for a week and then try 10mg again. I'm feeling stable again.

I'm so sorry to hear that! Hang on, you got this! Are you still on 7.5mg?

Thanks Yup im still on 7.5mg and have been for 6 days. Will start again on 10mg soon. I'm feeling better since that last post thankfully.. its hard when you already feel crap so you take meds and get even crapper for a couple of weeks but im determined to get past the side effects. It sounds like its a lot smoother sailing after weeks 2-3 and im just entering my 3rd week now.

So glad to hear that! Keep going!!!!

Keep the updates coming!!! I'm really glad to hear about your progress. It also give sme some hope because I really really want to avoid meds even though I know I need them desperately

Hey! Sorry i was going to reply to your last message and completely forgot.

Time for an update. Today marks 5 weeks! Although im still only on 10mg i feel definite improvement. The past week has even been an improvement on last week. Mornings are the hardest time of day for me and afternoons and evenings are good. Mornings have improved heaps though. Usually i would be bed bound spiraling into horrible anxiety but this past week I've been out of bed every morning feeling a lot better. I still have bad anxiety in the mornings but its much more manageable. My derealization and foggyness has been slightly better too.

Next Wednesday i will start on 15mg and alternate 15mg and 10mg for a week and then bump it up to 15mg every day for a few weeks im sort of dreading the dose increase after ive only begun to feel improvement these past 2 weeks. I hope all the side effects don't come back.

Thanks for checkin in Mitch! How are you going??

So I guess people really are right when they say to stick it out, eh? I'm so glad that you're progressing. By the sounds of it, I think this increase will only help you get to where you want to be Mornings are ALWAYS the worst. I definitely know how you feel. You think you will surely die or that the anxiety will never end, but like you mentioned, it gets better throughout the day. My biggest fear is getting high heart rate from the meds, do you get that?

My anxiety had been improving steadily, but progress is still not where I want it to be. I'm preparing myself mentally to try out medication because my anxiety is affecting my life is so many ways. I went from fully fuctioning--student, working, pretty independent person--to needing to be with someone all the time. I can't be alone, AT ALL. My boyfriend is with me pretty much at all times, except for when he works (3 days a week), but he'll be getting a full time job soon so I need to start coping in a better way. It's been a year of this so I guess the only option for me now is medication. Thank you for asking

I totally understand what you're going through i've been there many times. I hate losing my independance. I haven't been out of the house by myself in like 6 months. I think you should definitely try a med! The first 2-3 weeks are tough but then it gets easier. It might be good to start before your boyfriend starts a full time job, that way he can be there to support you through the early weeks. I'd recommend starting at a really low dose too, and possible asking your doctor for some valium or something to get you through. I didn't notice an increased heart rate because of the meds. I have a prety fast heart rate to begin with. I notice it beating faster during panic attacks (i had a few in the beginning of taking the med) but other than that, not really.

Today marks 6 weeks! Aaaand i'm still on 10mg, lol. I started getting mild muscle jerks and spasms exactly 1 week ago that i assume is a side effect of the prozac, so i'm hesitant to up the dose at the moment. If they settle down in this coming week then i will go up to 15mg.

I'm continuing to see improvement! I woke up 99% anxiety free yesterday morning, which is HUGE for me because i have literally woken up incredibly anxious every morning for the past year. This med is definitely working for me, even at 10mg. I still am not 100% at all.. my mood is low at times and I still have OCD and i'm still not ready to go out by myself or go to work, but i think i'll get there, hopefully once I start 20mg.

Hi Aquin! I've just found your post and your experience seems similar to mine. I have always had anxiety but never enough to interrupt my life. However I came off birth control and it made my anxiety crazy and I developed OCD thoughts and some depression it's been hell. I'm really sensitive to medication. I've finally decided to start fluoxetine and it's been a big decision, I'm only starting on 4mg. I've been taking for four days and already feeling headachy and exhausted. Your post is giving me hope to keep going! What kind of side effects did you have at the start?

Hi Pipk!

I had those exact symptoms in the first week. Headaches and fatigue on and off. I felt a bit spacey too. It's so nice to meet people who are going through something similar! Weeks 2 and 3 were the hardest for me.. sorry to say it but my anxiety and OCD became a little worse. I know how hard it is but its soooo worth it to push through. You should message me anytime if you want to chat to someone who understands. I'm so glad i pushed through because i am seeing definite improvement. Yesterday was my best day yet! I still have the ocd thoughts but they aren't bothering me anywhere near as much and my anxiety is a ton better too!

Thank you! It defiently helps to talk to someone who knows what it's like. It's hard knowing you have to be almost worse before you get better. I've noticed my OCD thoughts spiking a bit, have had a headache the whole four days and feel so exhausted today. The first night I woke up feeling panicky but I haven't had that yet. It's so hard to want to stick with it when you know it's going to be hell for a while. I'm glad you are feeling much better X does your head feel more normal now? Like not spaced out? I'm hoping 10mg will be good for me and I won't need to go up X I'm only on 4mg right now. Did you find it hard to increase to 10 from 5? Thanks so much xx

Yup i totally understand being scared for things to get worse. I was at the point before meds where i didn't think things could even get worse. Thats what pushed me to keep at it. I had a breakdown a few months ago and i was getting worse, it was unliveable. I knew i had no choice but to give this med a go because i couldn't go on the way i was.

I am feeling heaps less spaced out. My derealization was so bad i was constantly panicking. All i had to do was think about a panic attack and i would have one. My anxiety has been a lot more controlled these past 2 weeks. Ive been in situations that definitely would have brought on panic attacks previously and i handled them so much better.

I went to 7.5mg for a week before going up to 10mg. I think it helped

It's almost like my anxiety is trying to freak me out and make my thoughts even scarier just because I'm taking the medication. I have always been anxious about taking medication and it's been a big fear so I think my OCD and anxiety are playing on this. I'm doing okay. That's awesome you are feeling a bit better, are you still feeling that way? I'm only on 4mg for another week then will go up to 5 then 7-8 then 10 x doing it really slow as I'm very sensitive. Hopefully I won't have the full on side effects every time I go up. Are you going to stay on 10mg for a while? It's so nice having someone to talk to that knows what it's like xx

Mine did the same! My thoughts got ridiculous and even though I knew they were ridiculous i still had crippling anxiety from them. It was a really hard time but im so glad i pushed through. Im still having stupid thoughts but i barely get the intense anxiety associated with them now but they still bother me. I have a bit more to go before I get to a good place but i am a lot better than i was. I couldn't even leave the house until a couple if weeks ago (i only left the hoise for doctors appoinments for 2 months) and now im seeing friends in low key situations and went to a couple of cafes etc. Definite progress and i haven't used any xanax in a few weeks even when i leave the house! I think im going to start 15mg next Monday depending on how this week goes with my muscle twitching/spasms.

Yeah, I'm also having worries like what if medication will never help me etc. not nice! That's great they got better! Did you take quite a lot of Xanax In the first weeks? I've got some anti anxiety tablet but I haven't been taking it. Don't want to feel more drugged. Glad you are doing much better!!

In typical anxiety/OCD form, i was terrified to take xanax because of its addictive qualities and also because i didn't want to feel more drugged. I was prescribed the lowest dose possible and i split the pill in half so i would have half at a time. It definitely helped but i had an irrational fear of becoming addicted to this miniscule amount i was taking every 2-3 days, lol.. even though I've taken more xanax in the past with no problems whatsoever. Maybe you could test taking some and hr or so before bed time so that if you don't like the effect you can just sleep through it?

Yes I've also had those same worries and concerns! Even though deep down I guess it's not likely etc. i might give a quarter a try and see how I go. It would be good to have it in really anxious times. I have harm OCD and my thoughts are a lot based around myself, so am having a lot of those at the moment. Didn't feel quite at spaced out today. Hopefully that's a good sign and will be able to increase my dose soon! Did you keep working etc while going through all of this?

Hello! Gosh i can totally relate. I experience harm ocd too.. i had a few really terrible days where i couldn't be left by myself i was that scared. It was the worst mine relates to myself and my family. It's horrible. I have other themes too.. my mind has been all over the place with obsessions since August.

I actually had sort of a nervous breakdown in mid July and i haven't been able to work since then.. but im starting back at the end of this month. Are you working?

It's horrible isn't it. I'm getting a lot more burning anxiety in my chest since I started the tablets. Hope this goes! I took an anti anxiety last night. It helped a bit. Wish I could fast forward time!! Did you ever have times at the start where you freaked out and thought I not want to take this anymore!? Did you have regular contact with a doctor? Xx I'm just working part time at the moment. I might take a few weeks off though!

Absolutely, at times I felt like I was poisoning myself with this med. Weeks 2 & 3 were the hardest for me. The only thing that kept me going was the knowledge that there was no way i could go on like i was before meds either. That and i did toooons of research online and was reassured that it was normal to be feeling this way. There's a really good fluoxetine timetable that someone created. I'll find it for you and copy and paste it here.

I've only seen my doctor once since starting. I feel comfortable going at it by myself because i don't feel like she would be able to offer much help/support for some reason. I have support from my family though which helps so much. Do you have much support? Im honestly feeling so much better. I went out for a few hrs yesterday afternoon and saw a friend. It was really nice and my anxiety was super manageable. I hope this helps you xxx ?

Here's the timetable. I copied the whole post:

A timetable for recovery on Fluoxetine / prozac.

I thought it would be useful to provide a typical timetable for the journey to recovery. I have been on fluox for over 8 weeks and have read many, many posts of people's experiences here. Though everybody is different, it seems there is a common path for those where this medication has been successful. Many people seem to give up too soon, or change their dosage too soon because this is a very, very slow acting drug. My hope is, this will help those who are questioning their recovery by giving hope that, with time, this is a magnificent med when it does work.

First, the disclaimer: I am not a doctor nor am I capable of giving medical advice to any one specific person. This is merely a summary of the experiences I have read about. Further, there are many exceptions to this typical experience. Many claim success the first week while many others find that prozac just is not the right medication for them.

Further, this experience is typical for the person who has taken fluox in the past. For some reason, first time users seem to get much faster results and usually less side effects.

Also, this is a typical timetable for those who do not change their dosage. Changes in dosage seem to lengthen the time for recovery, almost like starting over.

So, in short, here is what I have read to be typical:

Week 1: This week can go either way. Some find almost immediate improvement while other see the side effects (see weeks 2-3) after the first day.

Weeks 2,3: These are almost always the most difficult. Anxiety and depression can get worse than before the medication. Side effects kick in, these can include sleeplessness, nightmares, diarrhea, nausea, hot flashes, excessive sweating (especially at night), dry mouth, muscle twitches, overall muscle weakness and pain, zero appetite, and very negative mental outlook. My advice is, take these one day at a time and try not to get discouraged, not every day will be bad and better times are ahead!

Weeks 4,5: Some improvement. The side effects lessen to some point, and there are moments when you start to feel normal. Typically evenings are the best and mornings the worst. Many start playing around with dosage at this point because they are told that the Prozac should be working, my advice: hold the course!

Weeks 6,7: More improvement. Maybe 50% to 70% better than before starting. There are often blips where you feel just terrible for a few days, but not usually over a week. Some side effects lessen, but also you may get new side effects. Hang in there, you are getting ready to turn a corner!

Weeks 8-10: Even more improvement. There still are blips, but they are less severe and shorter, maybe 1-2 days. Not normal yet, but getting better day by day. The side effects are usually 75% or so gone. Light at the end of the tunnel!

Weeks 10-12: Maybe this is wishful thinking for me (I'm not here yet), but this is where most see the best results. Some quotes from this time period: "best in months", "Amazing", "Feel good", "brilliant". Again, this is for the people for whom the prozac did work, not everyone, and for those who stuck to their original dosage. For some, this happens at 7 weeks, for some, 3-4 months. But, from what I have read, 10-12 weeks is the payoff time.

I hope this helps, please let me know if it does! Others, please feel free to offer differences, or additions to this summery. The purpose is to give those struggling an idea of what to expect. I feel for everyone struggling through this terrible disease, it's truly awful, but you will get through it! There are many great posters here willing to help with questions and are very supporting. I am grateful to them all!

Yes that's how I feel like I'm actually poisoning myself. I'm wondering if I'm experiencing heart burn but identifying it as burning anxiety, as at times I don't feel anxious but have burning in my chest. Yes I have my lovely partner who is very supportive and also I'm in contact with my Psychaitrist who I'll talk to maybe once a week. So nice to talk to someone who knows! So cool you are feeling heaps better! Maybe 10mg will suit you okay? Thank you for the timetable thats really helpful. I wonder if it will make my side effects longer because I'm going up so slowly in dose! Hope not! .. xx

Ive wondered the same thing about tapering on slowly and prolonged side effects. Thats partly why I've been hesitant to increase my dosage - because im finally feeling a bit more stable, i don't want to go back to crap. My doctor and (and psychiatrist i saw once) think i will need at least 20mg. Im in Australia and 10mg isnt even available here. The lowest available tablet is 20mg so ive been having to cut it in half. I'll be able to let you know how i go once i increase. Im thinking of starting 12.5mg on monday and seeing how that goes. My mood is still pretty low.. I've only seen improvement with my anxiety mostly so i really want to get to an even better place mentally. I'm hoping that because my body is already used to the medication that if i go up slowly the side effects will be minimal.

Im so glad to hear you have solid support. You can totally get through this! Just remember there's no way you would ever act on the thoughts. They bring you anxiety because they scare you and are far from who you are as a person. I know it's hard. The self harm ocd actually scared me the most because i also deal with pretty bad depression at times too so my mind just goes around in circles and I end up feeling even more depressed because i know i don't ever want to hurt myself but the thoughts/images won't go away. But they are SO much better now, I've been able to brush off the thoughts much easier.

Thank you so much for getting back to me! I'm in New Zealand 😬. My Psychaitrist said that once I get to 10mg we will stay there for a while and see how I go.. I'm on a dissolvable tablet that I make up 4mgs, I was going to go on the liquid but couldn't get it anywhere.. she said this should be the worst time for the side effects And they shouldn't get worse when upping dose, not sure if I believe her.

Cool let me know how you go with the increase, it will be interesting and I really hope will be okay. Xx

The harm OCD about myself is very scary, I know how you feel. I think it's harder to believe you would never do those things to yourself, even though deep down you know you don't want too. But when you are having OCD about others I find it easier to know I would never do that.. and when you are having low mood because of the OCD makes it even harder to know the meaning of the thoughts or if that is your true intention. Xo

You're so welcome. I'm so happy i can offer encouragement to you about this med. Something that i had no idea i would be able to do just a few weeks ago.. there is so much hope for you! Just have to get past the first couple of crappy weeks.

Yup i think itsca good idea to stick on 10mg for a while. Ive been on 10mg for 4.5 weeks now. I used to get anxiety from the med within the first hour of taking it and that isn't happening anymore so i think its definitely settled into my system. I thought you might be from this area of the world because we seem to post at similar times we have the dissolvable tablets here too!

I totally agree with what you said about harm OCD. I definitely find it easier to know i wouldn't act on my thoughts about others (but the thoughts are still terrifying). OCD sucks! We will get better though. It won't be a lifelong illness for us. ?

Did you notice much of a change when you went to 7.5 from 5? X hopefully il go to 6 next week maybe. Yes I thought we must be in a similar time zone!! It's good having someone who can reply, thank you it's helping so much 💗. I've been getting quite bad anxiety yesterday and today. Worse then when I started eek. But will keep going.

Yeah OCD is hell. Did it just start for you last year when you got sick? Mine started after coming off birth control it was horrendous..many other ladies have had the same happen!! So scary!! How's your day going today?

Thanks for posting this gives me a fresh outlook from this point on sonce I'm going on to wk 3 of meds.