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Prozac & Side effects
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Prozac & Side effects

Hi, I was on Prozac 20 years ago for a period of a year for post-natal anxiety disorder....it worked well for me then.
I am now 45 years old & on blood pressure meds...I've had a very traumatic few years which resulted in post traumatic stress, panic attacks & claustraphobia. I bacame obsessed that this stress would all make my bp go up again.
My doc prescribed xanax to take if & when I need, altho I only take if absolutely neccessary and has then prescribed Prozac for me as I was on it before with no bad side effects...HOWEVER this time it's giving me prickling skin which is very uncomfortable, nightmares, sweating, shaking, very dry mouth & bad tummy upset. I've tried to persevere like she recommended but the side effects aren't lifting....I'm worried that the anxiety of the side affects is actually going to make me worse & not better! I'm also worried that this added anxiety won't help my bp....however I do feel I really need a med that stays in my system long term rather than just a quick fix calmer which is also addictive....any advice would be welcome especially from anyone that may have had similar probs.
Thanks!
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480448_tn?1403547723
Hello and welcome!

What you describe is a pretty common phenomenon.  A medication that you were on previously and tolerated well is much rougher the second time around.  This happened to me as well, with Lexapro and Zoloft.  There is a theory that our brains have a sort of "memory" when it comes to the meds, and the reintroduction of the drug into our systems causes a faster than normal increase in the serotonin, which leads to more severe side effects.  Some people had no side effects initially, and the second time around, have every one in the book.  That was me, pretty much.

The bad news is, it will probably be much more difficult for you to adjust to the Prozac this time around, you may have to endure more side effects that are bothersome. The GOOD news is, the side effects still should subside in about 2 weeks (maybe a little less). The Xanax will definitely help with the side effects as well.  You may want to speak with your doctor and see if he would be okay with you taking a slightly higher dose of the Xanax while you adjust to the Prozac...just a few weeks.

You already know that these meds take time to work, so patience is a must.  You may require a higher dose than what you were started at, so keep in mind that this may be a few month process of adjusting.  Even after a dosage increase, you have to give the med several weeks to start doing its thing.  So many people sadly throw the towel in too soon, never really being able to assess the effectiveness of the medication for themselves.  

Also, dosage wise, you will probably end up requiring close to your ending dose for a similar therapeutic effect.  For example, my first go-round with Zoloft, I started out at 50 mg, and after several years, ended up at 200 mg per day.  The second time I took it, I started at 25 mg (due to the increase in side effects) and gradually tapered up to an ending dose of 150 mg, which had me feeling very good.  I didn't need quite as high a dose as I ended up with initially, but the lower doses definitely didn't make much of a difference.  Of course everyone is different, you may find a lower dose will be effective for you.

My recommendation, based on my OWN experiences would be to TRY to tough it out and give the Prozac another chance.  My opinion with meds is that a person should exhaust ALL possibilities with ONE med (including dosage increases) before switching to a new one.  Obviously, it's hard with the side effects..I've been there as well and know how hard it can be.  I took PRN Ativan during the adjustment periods and it helped a lot.  That's why I recommended asking your doc if it's ok to bump up your Xanax for short while, while you wait for the side effects to start subsiding.

Keep the lines of communication open with your doctor, let him know how you're feeling.  If the side effects just become TOO much, talk to your doc about it.  You always have the option of trying another kind of antidepressant.  

This is a perfect example of why I always tell people to think LONG and HARD about coming off a med that has helped them...a med that they have taken for a decent period of time, because pretty frequently, it IS much harder during the subsequent regimens.  That's not in any way a dig at you stopping the med, I totally understand, a lot of people try to give it a go without the meds as they would prefer not to have to take something long term, plus yours was more situational due to the anxiety presenting after you had a baby.

I wish you the very best of luck, I hope you start feeling better soon.  Please update us when you can, I'd like to see how you're doing.  You're among friends here who know what you're going through.  You're definitely not alone.
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Avatar_m_tn
Hi there. I have been on antidepressants for over 27 years and have been on just about everything. In the end it was Paxil that helped me. I have spent many hours taking to "shrinks" and doing research on the many meds they give. One of the biggest mistakes made is putting someone on and antidepressant AND a tranqilizer, like Xanax. Antidepressants are to bring you up when you are depressed or feeling down. Tranquilizers are to bring you down when you are having anxiety symptoms. Many MD`s don`t seem to "get it". When you are taking an upper AND a downer, it puts you on a rollercoaster type effect. If it were me, I would talk again with your doctor and try to decide on one or the other because if you are depressed you should not be on a drug like Xanax. And if it is depression, and even anxiety at times, Prozac "should" be all you need. Sometime doctors are too willing to just keep writting you scripts without even taking other factors into account, like how you are getting sick now. This is just my opinion from 27 years of experiance dealing with depression,anxiety, and PTSD.  
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2193833_tn?1339414902
Thanks so much for the replies guys. I've decided to hang in there with the Prozac for now....the xanax I haven't really needed as much lately, so hoping the Prozac will be enough....
I am at the hospital on 26th June for appointment at lupus clinic. I am going to say it to the doc I see there as they specialise in that area also....

Once again thanks so much....I can just about put up with the side affects but my biggest worry was that the Prozac would raise my bp and I'm trying to keep that level...however I've been told that Prozac is not one of the usual SSRI's that raise bp......see a classic sign that I need to take them is actually the fact that I'm worrying about practically everything! and analyzing so much!
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480448_tn?1403547723
I respectfully disagree with you.  When an anxiolytic, like Xanax, or Ativan is used as a rescue med ("as needed') with an SSRI, it can be extremely helpful.  Especially when a person is trying to adjust to the meds and may be having some side effects.  When I started on Zoloft a long time ago, I was still having several massive panic attacks daily.  I needed something to help me get through that.  As the Zoloft started working, I needed the Ativan less and less, until I didn't need it at all anymore.  

Also, it is not entirely true that benzodiazepines are "downers", in the same way that alcohol would be.  They work to reduce anxiety, not your mood.  Sure, some people have noticed a blunting of their mood with benzos, but that's more common with long term benzo therapy.  When used properly, for short term intervals, benzos are great medications!  The medications actually work nicely together, not against one another.
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2193833_tn?1339414902
Yes my doc did say that Xanax can help while waiting on Prozac to take affect, if needed....I found as the days went on I needed less Xanax...I certainly never feel down on Xanax, they just take the edge off the panic to the adequate level for me....I've only ever taken 0.25mg in a dose but sometimes would only need half that.....
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2193833_tn?1339414902
Hi, I meant to ask you this question earlier but forgot....as a nurse have you ever come accross other people on bp meds AND Prozac, and is the combination usually ok? I know there's no listed contra-indications that I can find...I'm on Coversyl arginine (perindopril)10mg and Istin (Amlodipine) for bp.....have heard that Prozac can raise bp but on the other hand can lower it a lot too and I don't want it to drop too low as realise this can be just as dangerous!
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480448_tn?1403547723
No, there is no contraindication with SSRIs and BP or BP meds.  I have never come accross any patient with hypertension that were not allowed to take them.  If your doctor is concerned, he will probably just want to monitor it a bit more often.  However, I agree with what you said that if anything, reducing your anxiety with the Prozac will reduce your overall pressure.  Nothing to worry about with your BP hon!
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2193833_tn?1339414902
Hi  thanks for your reply......... I'm going to mention to my doc about the possibility of trying another anti-depressant.....she was keen to keep me to Prozac as I had it 20 years ago for post natal anxiety type depression, and it worked well for me then....however I'm sure body chemistry must change over time, and also I wasn't on the bp tabs then...so I dunno maybe all that is relative. All I know is I've given the Prozac a fair go & really don't feel they are agreeing with me this time round.....I can put up with the prickly skin altho bothersome, and even the nausea/stomach cramps but the tummy probs are getting worse & as for the nightmares!! They're horrific! I'm waking up soaked to the skin & also getting sweats during the day but different to the kind I would get sometimes from anxiety.....Also I'm getting restless legs now and I remember that as a side affect when I was on then years go....it's a shame really.......
I have systemic lupus and am back at the hospital in 2 weeks for my appointment with consultant. I will mention all this at the clinic as they also specialise in treatment for anxiety/depression related to lupus.

Thanks for your help hun :-)
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2193833_tn?1339414902
My doc has now suggested Zoloft....I'm happy to try this....only on reading through the user information leaflet (I know...I should have left it alone)...is says it can cause high blood pressure...albeit in the uncommon side affect section. The last thing I want is that! Any feedback appreciated...thanks
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480448_tn?1403547723
Zoloft is the most commonly prescribed SSRI for the treatment of anxiety disorders and panic disorders, because it is generally well tolerated by most, and very effective.

You shouldn't have any significant worries with your BP.  People with hypertension take Zoloft concurrently all of the time.  Try not to worry about it too much.

Just like the Prozac, this med requires up to 4-6 weeks for it to really start working.  If you have any side effects (which you may not), they will be similar to those of Prozac, an increase in anxiety (feeling "jittery"), sleep disturbances, GI upset, headache.  The sude effects will start subsiding after a week or two.  I took Zoloft with very few problems, and it worked wonderfully for me.  Keep taking the Xanax when you feel you need it.

Let us know how it's going!
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2193833_tn?1339414902
Aw thanks hun, really appreciate that. I SO need to get by blood pressure phobia under control....can't even have a bp monitor near me now or as soon as the cuff goes on I get a massive panic attack...just bang, no warning! It's awful....it's affecting all aspects of my life.....ever since I was caught on a bad flight in January....it all started with that but I can't handle feeling trapped in any way now & my CBT therapist reckons this is what's going on re; the bp.....

Will let you know how the Zoloft go
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Avatar_f_tn
Hello Nursegirl
I am also starting again on Prozac(fluoxetine) for the second time.  I am 48 years old and started with 10mg for 3 weeks, Dr. upped the dosage to 20mg for the next 4 weeks and now 30mgs for the last almost 2 weeks.  I have still had anxiety this whole time as well as sleep issues.  Got over the stomach upset and now have an appetite again.  Is it normal for the side effects to last so long after each new dosage increase?  I have some good days here and there but it is an up and down road.  Is this normal?
Thanks,
Willowwisp
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Avatar_f_tn
hello,
Your comment is the first and only that I have searched and found to be similar to what I am experiencing.  I have been on 10mg of Fluoxetine for about 4 years.  Last winter I cut down to 5 mg and late October I cut to 2.5 and then I started to have a lot of weird things happening, dizziness, anxiety, etc.   Two weeks later I started back on 5mg so I never truly stopped the medicine.  My doctor thinks I was experiencing withdrawels symptoms.  Since then I have not felt right and can't understand why it is like I am starting all over again.  A month later I still don't feel right and still have anxiety.  My counselor said it is possible that your body could be sensitive to adjustments and takes awhile.  I have some good days, but am nervous that I am still not quite right.  Have you been told that this is normal for it to take so long?  This is my first ever post !
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Avatar_f_tn
Hello,
Yesterday I posted my first ever posting.  I responded to willowwisp and then realized that perhaps I should have sent it to you.  I am not sure if you saw my post so I will recap..fluoxetine 10 mg for about 4 years last winter tapered to 5mg no issue, this october cut back to 2.5 and two weeks later weird things started to happen, neurological, etc.  dizziness, anxiety, naseua(sp) agitation weird head feelings, and so on.  Went to doctor felt I was experiencing withdrawal and went back up to 5mg.  Month later still not feeling normal 100%  Have my moments when I feel partially better and then have bad ones as well.  My therapist states could be body is sensitive to adjustment and be patient.  I am overly concerned that something is medically wrong. Bloodwork all normal one month ago.  Is this within the realm of normal and possible and debating on whether to go back up to 10 and whether this will make symptoms worse and a a result cause yet more anxiety.  I am 43 work full time with two children and lately feel taht is all I can do and not much beyond my responsibilities.  I have never done this before (posted) so really am hoping I can get some help!  Thank you
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Avatar_f_tn
My first post at well!!  I get different opinions.  It just seems that the second time around on Prozac has been rougher.  I am into 2 1/2 weeks of the last dosage increase and still have the restlessness, the need to keep moving to burn off the jitters!  I wake up about 3:30am and am awake.  I still get 5 hours of sleep but never had all this the first time on Prozac.  I was just starting to get a little relief from the side effects on 20mg when I was upped to 30mg.  I wonder if my body just needs time to adjust for awhile and stick with a dose for at least 6 weeks.  Total time on all three dosages has been 9 weeks.
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Avatar_f_tn
I have been searching for answers on this as well!  I hate that we are going thru all this but it is nice to have someone to share with.  I work for a dentist and manage thru the day at work but have to take some Xanax to keep the nervousness under control. ( Take probably 1/2 of a .25 in am, and afternoon.  Mornings seem to be the worst!  Please feel free to contact me!
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Avatar_f_tn
hello,
Thank you so much for responding!  I am only on 5 and never stopped entirely jusy lowered the dose.  My problem is I am extremely concerned that there is something medically wrong with me and unfortunately I know that no one can really give a clear cut answer when it comes to these meds.  When you first started did you have side effects for awhile?  I just don't like these neurological weird feelings...this constant state of wooziness and just not feeling "normal"...Are you experiencing that as well?  I find it so mentally draining to get through the work day (I teach) and have a script for xanax but have never taken it and am nervous about doing so.  Im sorry to hear you cant sleep that just makes things worse.  It was great to see you respond and I must admit it felt comforting knowing that I was able to connect with someone who could understand.  Perhaps we can get through this together!.  I am contemplating increasing to 10 but am concerned about making these symptoms even worse...
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Avatar_f_tn
Hello again!  Yes, getting thru this together would be such a blessing!  I don't remember having side effects the first time I started it, but it was awhile ago.  I went off of it about a year or so ago.  I started it again due to the fact I was getting very irritable with my family, starting to cry once in while as we had several family issues going on, so I figured , no big deal, just start the Prozac again.  About 5 days after starting on 10mg I started to feel some anxiety instead of the anger.  It seemed to escalate (feeling weird, yes! and very unsure of myself) and the anxiety with it.  I went to   my medical doctor and he decided that I wasn't at a high enough dose as I was on 20mg before. So, I upped to 20mg.  Just when I was starting to see a little progress, same as before, 5-6 days after starting the 20mg, more anxiety.  Also have had "weak, shaky feelings" my legs especially and mostly in the mornings when I get up.  I did not want to take the xanax  but it has helped.  I take probably a half of a .25 in the morning and again in the afternoon to keep me from getting too anxious. I know this is temporary until this nervousness goes away.  I believe it is due to the medicine.  That is why I was intrigued by what nursegirl said about "second time around" on anti depressants.  Well, started to see a little improvement after 4 weeks on the 20mg,checked back in with my doctor, and he said I should up to 40mg since the holidays and all were coming.  I did not want to double my dose due to the side effects I was having.  We both agreed to 30mg.   Well, sure enough, after about 5 days on 30mg...same thing.  I have heard that it is only a couple of weeks for side effects to diminsh but for some reason they start later and last longer with me.   How long have you had side effects on the 5mg dose?  I went to a counselor and she said, "Well, you have been on Prozac for almost 9 weeks now.  It should be doing something."  I believe that it is and will even more if I ever get to stick at one dose for more than 4 weeks.  She wants me to consider changing my med but I would rather waituntil my seritonin has a chance to level for awhile as it seems to take me longer getting rid of side effects.  You could possible have more side effects upping to 10mg.  That's what your xanax is for.  We are the type of people that are not addictive personalities.  We don't want to be on it any longer than we have to, I know I don't.  I also take a tiny bit of Ambien to get to sleep at night.  (1/3 of a 5mg tablet)  Didn't want to take that either but it turned out fine and my mom and some really good Christian friends keep letting me know that this is a temporary medication along with the xanax just to get me through until my Prozac and the good Lord get it taken care of.  I worry about all the diffferent feelings I get.  Probably way too much.  My husband just tells me not to think about it...gee, like I want to???  Easier said than done.  Look forward to hearing from you soon!!  Maybe we could exchange cell numbers or something, coach each other along and pray for each other as well!  If that is ok with you.  





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Avatar_f_tn
...and I also want to say thank you for responding to me as well!  It is reassuring to have someone going thru what I am yet I don't wish it on anyone!  Thanks again and take care!
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Avatar_f_tn
This feed has been great for me and very reassuring.  
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