# Do I need Fluoxetine?



## Emelcee (Feb 24, 2011)

Hi Guys I was just wondering if I could have your opinion, as my GP was not a great help... nor was my psych.

I went to my doctor complaining that I am feeling demotivated and tired, thinking perhaps I have a deficiency of some kind. He prescribed me Fluoxetine and said "Take this medication." He didn't tell me it was an anti-depressant (lucky I'm not an idiot) and I asked what the side effects were, or if he had some kind of fact sheet & he fumbled around in a blatantly empty draw and says "Oh, no I don't have one sorry."
I said to my psychologist that I'm not really keen on drugs, as I did not understand them fully.

I struggle to get out of bed in the morning but when I'm up and dressed I am fine for the rest of the day. It's my days off that I struggle. I don't have much of a social life because of my SA, so I will literally laze around all day. It's now 11am and my tummy has been growling for hours and I don't even have the motivation to make breakfast.

I don't get "sad", as I did when I was a teenager. My moods are quite balanced it's just this lethargy bothering me. Will Fluoxetine help this?

I know exercise and healthy eating makes me feel a bit better but I am really struggling at the moment.


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## Arisa1536 (Dec 8, 2009)

Yeah fluoxetine is what all doctors tend to give to people first off because its a relatively safe SSRI, it used to be paxil but the side effects and withdrawal symptoms are too severe, however fluoxetine does not do a hell of a lot for people with severe depression and anxiety, it was meant to help my anxiety, SA and eating disorder, it made me depressed, over weight and giggly. That was an adverse effect its highly uncommon you will experience it, most people find they lose weight or maintain weight, feel lighter and generally have less anxiety but for SA i think Paxil is better, however its not fun getting used to or coming off of, with fluoxetine i experienced no withdrawals and i was on 3 pills a day for three months

try it and see how u feel after three weeks, and i do not think your withdrawals will be bad at all, they are one of the safest to take but SSRI's are seen as a wonder drug by doctors and psychiatrists now days so be careful u do not say you feel better if u really dont because there are way more effective antidepressants out there


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## Emelcee (Feb 24, 2011)

The psych's pop quizzes say my depression is just above moderate. I'm just really hesitant to start them, I've been carrying the pills around in my handbag for two months.

I'm reading all these posts about people on a cocktail of medication, jesus. I don't want to be dependant on medication but I am getting kinda desperate at the moment.


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## Arisa1536 (Dec 8, 2009)

Its not really an issue at that this stage of getting dependent, i think your mental health should be your main priority and antidepressants, while not easy to withdraw from (well some of them) they are not addictive. If you started taking hypnotic sedatives and benzodiazepines then the risk of dependancy is extremely high but to be honest i do not really care all that much. I used to worry when i was a teenager about pills and being labelled ad "Addict" but i realize its my health and my mental state thats at stake here so if i need a pill or two to cope then i will take a pill or two to cope and fluoxetine wont make you dependent, i withdrew from them cold turkey and i was on them for three months. 

If your depression is moderate and causing you more grief than anxiety or SA then i do not think SSRI's are personally the way to go. I do not think they work well enough for depression as other older style Antidepressants but these fluoxetine would be one of the safest to try out and see rather than going on something that may be really good but could have adverse effects and be hard to come off of. 

IF fluoxetine does not work, you can come off them easily and taper if you want as well and implement a new antidepressant, i would say EFEXOR but the withdrawals are horrendous and if they do nothing for u, its a lot of pain and worry for something that does not work so yeah right now stick with the fluoxetine and hopefully you will feel better


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## broflovski (Feb 1, 2011)

Seems that you need something more directly dopaminergic for motivation and noradrenergic for energy as a day starter. Wellbutrin maybe... but among SSRIs fluoxetine (5HT2c antagonist) seems to be the best for your state.


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## sarafinanickelbocker (May 16, 2010)

Fluoxitine was diagnosed to me for anxiety, which it did absolutely nothing for. However, I was depressed and I think it helped a bit when given the chance. The feeling I got from it was slightly dazed...not alot you function as normal, but I was sleepy and I could tell I was not as alert as normal. It also helped with startle response. I do think it helps for depression. I don't think it does a thing for anxiety. However, I think drugs like this work differently for each person. You need to see how it works for you.


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## Implicate (Feb 1, 2011)

You need new doctors, you know, real ones, that understand what and why they prescribe you something. Make an appointment some place else, and get a second opinion. I'd personally suggest doing some research before calling anyone. Make a list of how you are feeling and have it prepared for the day you meet your new doctor.

Many doctors default to Prozac because it is much more well tolerated than many other medications, so I am not saying yours in particular is bad, but if you leave the office and still are not sure he has not done his job.


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## Emelcee (Feb 24, 2011)

Implicate said:


> You need new doctors, you know, real ones, that understand what and why they prescribe you something. Make an appointment some place else, and get a second opinion. I'd personally suggest doing some research before calling anyone. Make a list of how you are feeling and have it prepared for the day you meet your new doctor.
> 
> Many doctors default to Prozac because it is much more well tolerated than many other medications, so I am not saying yours in particular is bad, but if you leave the office and still are not sure he has not done his job.


I made a list of how I was feeling before seeing the first doctor, so I didn't go in there like a babbling idiot & waste his time. I felt as though he didn't care, and just treated me straight out of a textbook. "Here's some pills" and then started ranting about how drinking is bad for my body. No sh*t doc.

I agree, maybe a second opinion is the way to go before starting fluoxetine. I might also go to a female doctor this time, she may be more sensitive to my individual sitatuation.


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## wxolue (Nov 26, 2008)

The way my doc put it, choosing an ssri is more or less a roll of the dice as to how a person responds to it. My doctor started with celexa since it has some of the fewest side effects. It had no effect, so he moved me onto prozac (Fluoxetine). It worked well the first two days, but its kind of died out now.


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## Emelcee (Feb 24, 2011)

Two days? I thought it can take up to 6 weeks before you can even feel any difference.


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## Emelcee (Feb 24, 2011)

Right now I am using alcohol a lot to manage my lack of motivation. Surely an SSRI is far less invasive than alcohol, right?
I really am ridiculously hesitant about this lol. Somebody tell me if I am being stupid.


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## wxolue (Nov 26, 2008)

Trust me, I was just as hesitant. I waited 2 years, blindly and stubbornly thinking I could handle my anxiety without it. I was hesitant, but I came around to the idea after I realized how many people are on antidepressants for different things. It's really not that uncommon. I guess its helped that I've been literally side effect free, but I would recommend you try them.

As far as working for the first two days, I think it was just a reaction to first going onto it. I wish it would have lasted, but I'll wait another 3 weeks until it is "supposed" to kick in before I call it officially dead.


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## Arisa1536 (Dec 8, 2009)

See a new doctor, mention that SSRI medication is not working for you
All you can do is ask about wellbutrin and more effective antidepressants

just because doctors act like SSRI's are the only medication available, they are NOT
SSRI's work for many people, but they also do nothing for LOTS of people too, people like me who have tried celexa, fluoxetine and aropax, and i was on each of them for a significant period of time. 

Even EFEXOR will be better as it works on another receptor, not just serotonin because there is more to depression and anxiety than serotonin levels


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## wxolue (Nov 26, 2008)

I've only really been on one. Haven't been on prozac for long enough to tell if it's for me or not. I'll probably try at least 3 ssris before i conclude they're not for me. I do want to try welbutrin though, although depression isn't usually a problem for me.


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## Emelcee (Feb 24, 2011)

Mm. All very interesting. My thoughts are that my depression/lack of motivation is caused by a lack of solid friendships/relationships. SA is really what's holding me back and quite a few people have said that Fluoxetine has actually increased anxiety. I'm not sure it's the best option for me.


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## broflovski (Feb 1, 2011)

Arisa1536 said:


> Even EFEXOR will be better as it works on another receptor, not just serotonin because there is more to depression and anxiety than serotonin levels


Fluoxetine increases noradrenaline (and dopamine) levels as well, via 5TH2c antagonism, while Effexor does not significantly inhibit noradrenaline reuptake in doses less than 200-225 mg. Dopaminergic action is unlikely under 375 mg. So in theory its superiority over fluoxetine is disputable. And Effexor is much more expensive.


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## broflovski (Feb 1, 2011)

wxolue said:


> My doctor started with celexa since it has some of the fewest side effects. It had no effect, so he moved me onto prozac (Fluoxetine). It worked well the first two days, but its kind of died out now.


I had the following sequence of effects: initial hypomania (I thought it started working from the very first 10mg!), then depression struck back for 1-2 days, and at last the pure therapeutic effect kicked in on the 2nd week. I used yohimbine to hasten/strengthen the action.


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## Emelcee (Feb 24, 2011)

broflovski said:


> Fluoxetine increases noradrenaline (and dopamine) levels as well, via 5TH2c antagonism, while Effexor does not significantly inhibit noradrenaline reuptake in doses less than 200-225 mg. Dopaminergic action is unlikely under 375 mg. So in theory it's superiority over fluoxetine is disputable. And Effexor is much more expensive.


You're more intelligent than my GP, that's worrying haha. 
What does increasing noradrenaline and dopamine levels actually do to you? (excuse my naivety)


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## broflovski (Feb 1, 2011)

Emelcee said:


> You're more intelligent than my GP, that's worrying haha.
> What does increasing noradrenaline and dopamine levels actually do to you? (excuse my naivety)


Going to Australia to start practice, haha. 
1) I suggested above that dopamine and noradrenaline may be the key of your problem. Prefrontal dopamine = intellectual and overall activity and motivation, mesolimbic dopamine = pleasure and reward. Noradrenaline determines the alertness and energy. Both are primary affected by amphetamine-like drugs, so you may figure out what is dopaminergic/noradrenergic action in its extreme. 
2) SSRI in this case is not a first choice option, because you're not classically depressed, so dopaminergic/noradrenergic wellbutrin may work better - it is not antidepressant in the same sense as SSRI. 
3) Considering SRI, fluoxetine and Effexor are the best options, but I see no superiority of Effexor (and it's more expensive). For both them, dopaminergic/noradrenergic action is secondary. 
For me dopaminergic action of fluoxetine was noticable at the early beginning, before its consistent serotoninergic effect adjusted. I was mildly stimulated and motivated, there was a definite mood-lift. After the main serotoninergic effect kicked in, the overall state became more mellow.


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## wxolue (Nov 26, 2008)

I've never really been depressed, but responded really well to what i guess would be the initial dopamageric effects of prozac. Would this confirm my belief that I would likely respond well to wellbutrin for my anxiety?


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## broflovski (Feb 1, 2011)

wxolue said:


> I've never really been depressed, but responded really well to what i guess would be the initial dopamageric effects of prozac. Would this confirm my belief that I would likely respond well to wellbutrin for my anxiety?


Not sure... Your case is much different from that of Emelcee. Dopaminergic/noradrenergic effect of, to say, wellbutrin, is needed to counteract demotivation etc. Wellbutrin as I know is not very efficient as dopaminergic, more noradrenergic. In case of anxiety without much depression wellbutrin and other noradrenergic compounds tend to be anxiogenic if taken alone. In prozac it is masked by its primary action, but wellbutrin...


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## wxolue (Nov 26, 2008)

Thats what i keep hearing, but for some reason i get the feeling that motivation would really help my anxiety. Also, my brother responded to it when he took it for aspergers. Quite different from SA, but is there any evidence that response to antidepressants runs in families?


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## Emelcee (Feb 24, 2011)

I don't like the idea that my doctor says "Try this" and then come back and see me. He didn't ask any in-depth questions in the slightest. If doctors spent an extra 5 minutes and could get an accurate diagnosis and prescribe the right thing the first time, wouldn't that be more beneficial?

I feel strange going to the doctor saying what meds I think would work best for me. I think a second opinion is the go before starting fluoxetine.


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