Prozac Users - Need Support

[Erin_ann]

Hi all,
So I was on Effexor for a few years and recently weaned off of it (a slow taper over several months), but the withdrawal was so bad for me that my pdoc put me on 10mg of Prozac.  After a week she determined it wasn't the withdrawal anymore and that I was just depressed - she increased my dose to 20mg.

I have now been on the Prozac for three weeks and I still feel pretty bad.  I have nausea and dry heaving in the morning, VERY high anxiety in the morning (different from how I felt before meds), and a general feeling of being unwell.  I feel very "blah" and like I don't have a personality anymore.  I realize that Prozac takes 4-6 weeks to fully take effect.  I'm trying to push through, I just hate how I feel.

If you've been through this and have any advice or support I would greatly appreciate it!

[Erin_ann]

I have an appointment with a new psychiatrist in about a week.  We had a phone consult and she sounds so much better than the woman I'm seeing now.  She's taking a much more in-depth approach, which makes me feel so much better.

Here's the thing - I'm scared to death to go back on Effexor.  I'm almost 30 days off of it and I don't want to start over on the withdrawal.  I did a slow taper and I still felt horrible withdrawals.  I can't go through those beginning stages of that again.

But I do appreciate your thoughts and support.

[Paxiled]

What you're probably experiencing is called protracted withdrawal.  Your psychiatrist is having a typical psychiatrist reaction, which is to ignore common sense which would tell anyone that when you have a problem you never had before and the only new thing is you stopped taking a medication, you're brain is probably having a hard time adapting back to working naturally.  This is a common reaction to taking antidepressants for a long period of time, as you did.  So your psychiatrist is dissembling and claiming you have suddenly, for no reason, developed a new illness when what you're suffering is a protracted withdrawal.  Look on the internet for the term PAWS, or Protracted Withdrawal Syndrome, print out what you find, and present it to your psychiatrist.  Here are your choices:  sometimes, people have success switching you over to Prozac and then weaning you off Prozac, because it's thought to be easier to stop taking Prozac than shorter half-life antidepressants.  But this assumes you will properly metabolize Prozac and that it will work for you, which isn't guaranteed.  Also Effexor isn't in the same class of medication as Prozac, and even if it were, no two drugs work the same -- they target different receptors and have different effects.  It is well known that Paxil and Effexor are the most difficult to stop taking.  What I would personally do, because I didn't do this when a psychiatrist tried the same garbled thinking with me when this happened to me on Paxil, is go back on the Effexor at the last dose at which you felt fine and taper off even more slowly.  Like Effexor, Prozac is a stimulating antidepressant, and side effects come before effects, and I hope this will work for you but I'm in the camp that says quit a drug successfully before trying another.  That way you know which are withdrawal effects and which are the side effects of a new drug.  Again, some people do believe in using Prozac at the end of a difficult taper, but usually that's when you're stopping another ssri, and Effexor is an snri.  It is a theory, but not one I think makes sense but that doesn't settle the issue just because I might believe that.  What you shouldn't do is let a psychiatrist that isn't using her common sense determine for you what you think about it -- you need to do your own homework and make your decisions in concert with your psychiatrist and if you don't like what you hear, find a different one.  Good luck.