Always tired on Prozac even after sleep, Need some Help

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I wonder if someone could give some insight. So far no doctor has been able to give me an answer their either saying it's not the medicine or they don't know whats causing the issue.

I suffer and OCD and generalized anixety. It took over a year to finally bring it to controllable levels. Now new issues have popped up.

- I been on SSRI medication since November 2014. Almost ever SSRI that's out their I have been on.

- I was put on Prozac in August of 2015, it was slowly increased to 80mg. Which it remains their today. I take it ever morning.

- The big problem now is my OCD and anxiety is basically under control minus a few things here and their. Every single day when I wake up I feel like I haven't slept in days. Even though I'm getting more then 8 hours of sleep a day. I do wake up twice during the night but usually fall right back to sleep.

- My guess I'm not entering REM sleep at all or very brielfy.

- I was put on Provigil temporarily to keep awake during the day. The first week on provigil was amazing. I was awake. As time went on it became less effective, It only helps part of the time now. They currently have me on 200mg a day. Not sure If I'm allowed to go any higher. I have to ask next time I'm at the doctors office.

- Usually I can only stay awake around 8 hours. Even 6 hours is a struggle for me.

- I was put on Cpap machine, it didn't do anything for me. They took it away and having me use a mouth piece instead.

I was wonder if anyone has any kind of idea whats going on with my sleep. Or suggest something that would help me stay awake during the day? Any type of medicine help me enter REM Sleep or removing something help more? I'm just clueless whats going on.

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  • Posted

    Hi Revean, 

    How long have you been at 80 mg?  Did the tiredness correlate with going up to 80 mg?  That is a tremendously high dose of Prozac.  I am thining it is a side effect of this high dose.

    You said that you have tried many ADs, and I am assuming none of them worked. You might want to look into having the genetic testing done for cytocrhome p450, which determines how you metabolize these drugs.  I am willing to bet you are a fast metabolizer, which means your liver enzymes clear the drugs too fast, before they hae a chance to do their thing.  That would explain why so many didn't work for you, and why you require such a high dose of Prozac, which is one of the longer half-life ADs.  Ask your doctor about having that test done.

    I'm assuming that the dose was increased because you were reaching tolerance and it wasn't working as well - anxiety and depression showing up again?  This is a sign that your system is getting sensitized to the drug, and may be part of why you are having the exhaustion.

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    • Posted

      With OCD you have to be on the maxed dose possible. It's hard to say since I was switching from one SSRI to another. I was already tired.

      I had to stop a two due to the side effects it was having on me. The other wasn't doing anything.

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    • Posted

      My one doctor says it's not the medicine, However another one says it is. It's hard to know which one is right. I keep getting the same answer. Yes, I had therapy for OCD (exposure Therapy) Since normal talking therapy does nothing for me.

      I just want to feel rested for once, This feels like a form of torture.

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    • Posted

      I hear ya!  I have a friend trying to come off mirtazapine and he is having extreme fatigue which is causing him depression.  It's a tough bind because going off faster may unsettle his system more, but updosing a little bit didn't work.  There's so much subjectivity and bias in medicine!  I swear, no two p-docs will agree on the same diagnosis!  And once we have a label, we go helpless and think of ourselves as defective.  Don't!

      Do you mind my asking what the object of the desensitization was?  Having studied psychology and learning theory, I don't think exposure will work unless you go for true flooding, which means keeping you in the midst of the stimulus for as long as it takes for you to desensitize to it, and that could be a very long time!  Not practical, really!

      Talk to the one that agrees that it might be the med and see about down-dosing just a little bit.  It may be possible for you to get a liquid version that can be dosed with a syringe.  You could do a 10% cut per month and see if it shifts anything. 

      It would be interesting to see if you could titrate down to a point where maybe the exhaustion is alleviated while the OCD is still controlled.

      Go to OCD-UK and check out their website.  It may be that you just didn't have the right type.  There's lots of CBT self-help online, so why not take the bull by the horns and tackle this thing?  Meditation and mindfulness as well as Grounding therapy can be very helpful, too; free versions of all of this online.  Also, Emotional Freedom Techniques.

      Good luck!

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