Are My Meds Working?

[Mrs. King]

This sounds ridiculous, but I do not know. I was put on Prozac (20mg daily) to help with depression after splitting up with my husband. Some days, I feel like the Bees Knees, and what a big loss he had when I chucked him. Other days, and there are many of these (especially during my college breaks, when I am at home with the kids) I just sit and cry because our relationship died. Yet I don't want him back.

My sister and sister in law both say that Prozac is meant to be short term. Six months, your serotonin levels are back to normal, you come off the Prozac. Any weepiness/ emotional flaws after that time, and these are down to my 'true' personality, they said. Not depression. Their doctors told them this. I am mighty troubled that I am going to be the world's biggest emotional rollercoaster for the rest of my life, if Prozac has had its optimum effect on me. (By the way, have been on 20mg daily for about 10 months now). Does anyone know if this is an accurate description of how Prozac works, please?

 

[Mrs. King]

This sounds ridiculous, but I do not know. I was put on Prozac (20mg daily) to help with depression after splitting up with my husband. Some days, I feel like the Bees Knees, and what a big loss he had when I chucked him. Other days, and there are many of these (especially during my college breaks, when I am at home with the kids) I just sit and cry because our relationship died. Yet I don't want him back.

My sister and sister in law both say that Prozac is meant to be short term. Six months, your serotonin levels are back to normal, you come off the Prozac. Any weepiness/ emotional flaws after that time, and these are down to my 'true' personality, they said. Not depression. Their doctors told them this. I am mighty troubled that I am going to be the world's biggest emotional rollercoaster for the rest of my life, if Prozac has had its optimum effect on me. (By the way, have been on 20mg daily for about 10 months now). Does anyone know if this is an accurate description of how Prozac works, please?

 

[Retired]

Mrs King,

Treating depression, especially following a traumatic event in one's life, often goes through cycles of good days and bad days.

You've stated your only concern is that sometimes you will feel in good spirits while on other days you feel you fall back into the depression.

It seems these cycles are a expected part of the therapy which can last for more than the ten months you are being treated.

Are you seeing your treating physician for regular visits for support and a review since the last visit?

The use of Selective Seretonin Uptake Inhibitors (SSRI's) can last months and years until a maintenance dose is achieved.

A subject worthy of discussion is whether your physician of pharmacist has discussed the potential for drug interactions with fluoxetine (Prozac).

Let us know what if anything was explained to you about what other medications , prescribed or over the counter, might affect the effectiveness of Prozac.

Let us know any other prescribed medications you take as well as any other over the counter meds such as ant-acids, cold and cough medications, oral contraceptives etc.

There could be other underlying factors contributing to the swings you experience.

Looking forward to hearing from you.

 

[Retired]

Mrs King,

Treating depression, especially following a traumatic event in one's life, often goes through cycles of good days and bad days.

You've stated your only concern is that sometimes you will feel in good spirits while on other days you feel you fall back into the depression.

It seems these cycles are a expected part of the therapy which can last for more than the ten months you are being treated.

Are you seeing your treating physician for regular visits for support and a review since the last visit?

The use of Selective Seretonin Uptake Inhibitors (SSRI's) can last months and years until a maintenance dose is achieved.

A subject worthy of discussion is whether your physician of pharmacist has discussed the potential for drug interactions with fluoxetine (Prozac).

Let us know what if anything was explained to you about what other medications , prescribed or over the counter, might affect the effectiveness of Prozac.

Let us know any other prescribed medications you take as well as any other over the counter meds such as ant-acids, cold and cough medications, oral contraceptives etc.

There could be other underlying factors contributing to the swings you experience.

Looking forward to hearing from you.

 

[David Baxter PhD]

My sister and sister in law both say that Prozac is meant to be short term. Six months, your serotonin levels are back to normal, you come off the Prozac. Any weepiness/ emotional flaws after that time, and these are down to my 'true' personality, they said. Not depression. Their doctors told them this.

No. None of that is true.

First, medications like Prozac are not intended to stop you from feeling anything - that would not be helpful at all in the long run - you are grieving the loss of a dream if not the relationship as well as struggling with coming to terms with abuse and trauma.

Second, once you are in a major depression and start to take an SSRI like Prozac, you may start to feel a better in 6 months but at that point only half the job is done - you still need to rebuild resilience, both psychologically and in terms of neurochemistry. This typically takes at least a year, sometimes more. Discontinuing the medication at 6 months leaves you vulnerable to relapse. If you can remain on the medication for one and a half to two years, your risk of relapse (suffering another major depression in the future) is significantly reduced.

 

[David Baxter PhD]

My sister and sister in law both say that Prozac is meant to be short term. Six months, your serotonin levels are back to normal, you come off the Prozac. Any weepiness/ emotional flaws after that time, and these are down to my 'true' personality, they said. Not depression. Their doctors told them this.

No. None of that is true.

First, medications like Prozac are not intended to stop you from feeling anything - that would not be helpful at all in the long run - you are grieving the loss of a dream if not the relationship as well as struggling with coming to terms with abuse and trauma.

Second, once you are in a major depression and start to take an SSRI like Prozac, you may start to feel a better in 6 months but at that point only half the job is done - you still need to rebuild resilience, both psychologically and in terms of neurochemistry. This typically takes at least a year, sometimes more. Discontinuing the medication at 6 months leaves you vulnerable to relapse. If you can remain on the medication for one and a half to two years, your risk of relapse (suffering another major depression in the future) is significantly reduced.

 

[Mrs. King]

Thank you both, so much, for replying. I don't take any other medicines, except paracetamol for headaches. I did try 40mg fluoxetine daily for two weeks, but I was still weepy, and very tired, so I cut back to 20mg a day, again. I am not sure exactly what Prozac is meant to do, apart from help the brain to optimize use of poor serotonin levels (I read some of the posts ) So I am not sure what results to expect, except I was hoping to avoid all suffering. Lol. Just joking.
I have been able to process my thoughts quite well, I think, with my counsellor. I believe you are right, David, that the death of the dream probably causes me more pain than the loss of the person. Trouble is, he wasn't always horrible, so I keep thinking maybe it's all my fault. Maybe I simply misunderstood him. That's when I take the nosedive, and the crying begins. Actually, my husband once mugged somebody, so he is capable of real anti-social and selfish behaviour. But he hid it under such a charming exterior that my memory sometimes only remembers the nice guy; then I think I've really lost something worth having and I cry. Is this a normal reaction, do you think? I have found some really uplifting moments in the posts here, and I know that I could never take him back. Nor do I like him. I know that forwards is the only way for me now. So why can't I go?

 

[Mrs. King]

Thank you both, so much, for replying. I don't take any other medicines, except paracetamol for headaches. I did try 40mg fluoxetine daily for two weeks, but I was still weepy, and very tired, so I cut back to 20mg a day, again. I am not sure exactly what Prozac is meant to do, apart from help the brain to optimize use of poor serotonin levels (I read some of the posts ) So I am not sure what results to expect, except I was hoping to avoid all suffering. Lol. Just joking.
I have been able to process my thoughts quite well, I think, with my counsellor. I believe you are right, David, that the death of the dream probably causes me more pain than the loss of the person. Trouble is, he wasn't always horrible, so I keep thinking maybe it's all my fault. Maybe I simply misunderstood him. That's when I take the nosedive, and the crying begins. Actually, my husband once mugged somebody, so he is capable of real anti-social and selfish behaviour. But he hid it under such a charming exterior that my memory sometimes only remembers the nice guy; then I think I've really lost something worth having and I cry. Is this a normal reaction, do you think? I have found some really uplifting moments in the posts here, and I know that I could never take him back. Nor do I like him. I know that forwards is the only way for me now. So why can't I go?

 

[David Baxter PhD]

It is quite normal, actually. The problem with abusive individuals is that they are capable of being charming when they choose to be. In addition, they are very good at (and can be quite convincing superficially at) blaming other people for whatever they do wrong -- that's part of what causes you to question yourself now... "was he right?"... the answer is "not a chance" but it's understandable that you will ask the question.

 

[David Baxter PhD]

It is quite normal, actually. The problem with abusive individuals is that they are capable of being charming when they choose to be. In addition, they are very good at (and can be quite convincing superficially at) blaming other people for whatever they do wrong -- that's part of what causes you to question yourself now... "was he right?"... the answer is "not a chance" but it's understandable that you will ask the question.

 

[Mrs. King]

This site gives me a lot of support in my thinking, and I am grateful for that. Thank you )

Here is a question: my friend read that Prozac sometimes does not work on individuals who are low on folic acid. Has anybody heard this, and would a vitamin supplement help me, do you think?

 

[Mrs. King]

This site gives me a lot of support in my thinking, and I am grateful for that. Thank you )

Here is a question: my friend read that Prozac sometimes does not work on individuals who are low on folic acid. Has anybody heard this, and would a vitamin supplement help me, do you think?

 

[David Baxter PhD]

No, I haven't heard that, Mrs. King. In fact, I don;t know of any connection between folic acid and depression or anxiety, although I'm not a nutritionist and that doesn't mean that no such link exists.

What I would suggest that if you are low in folic acid, B12, iron, or other essential nutrients, you should talk to your doctor about this and ask for advice on (1) the reasons for the deficiency, and (2) the best way to remedy the deficiency. There are broad differences in the quality and type of vitamins and mineral supplements and you can waste a lot of money taking supplements that only increase levels of those nutrients in the water supply.

 

[David Baxter PhD]

No, I haven't heard that, Mrs. King. In fact, I don;t know of any connection between folic acid and depression or anxiety, although I'm not a nutritionist and that doesn't mean that no such link exists.

What I would suggest that if you are low in folic acid, B12, iron, or other essential nutrients, you should talk to your doctor about this and ask for advice on (1) the reasons for the deficiency, and (2) the best way to remedy the deficiency. There are broad differences in the quality and type of vitamins and mineral supplements and you can waste a lot of money taking supplements that only increase levels of those nutrients in the water supply.

 

[ThatLady]

Most people don't really eat correctly, so taking a multivitamin supplement daily is never a bad idea. However, supplementing individual vitamins/minerals without first obtaining medical advice isn't really something one would want to do, for any number of reasons.

If you're not currently taking a multivitamin, doing so would probably be just fine. )

 

[ThatLady]

Most people don't really eat correctly, so taking a multivitamin supplement daily is never a bad idea. However, supplementing individual vitamins/minerals without first obtaining medical advice isn't really something one would want to do, for any number of reasons.

If you're not currently taking a multivitamin, doing so would probably be just fine. )

 

[Mrs. King]

Thank you both )

 

[Mrs. King]

Thank you both )

 

[Daniel E.]

my friend read that Prozac sometimes does not work on individuals who are low on folic acid.

There is some indication that having enough folic acid (folate) may be helpful for some people with depression:

CONCLUSION: Low serum folate levels were found to place patients with remitted MDD [major depressive disorder] at risk for depressive relapse...

Serum folate, vitamin B12, and homocysteine in major depressive disorder, Part 2 (2004)

On the basis of current data, we suggest that oral doses of both folic acid (800 microg daily) and vitamin B12 (1 mg daily) should be tried to improve treatment outcome in depression.

Treatment of depression: time to consider folic acid and vitamin B12. (2005)

However, most depressed people have a normal level of folic acid, and I am sure that I wouldn't feel any better if I had a higher level of it. Also, the correlation is not amazingly strong since most people with low folic acid levels don't have depression.

 

[Daniel E.]

my friend read that Prozac sometimes does not work on individuals who are low on folic acid.

There is some indication that having enough folic acid (folate) may be helpful for some people with depression:

CONCLUSION: Low serum folate levels were found to place patients with remitted MDD [major depressive disorder] at risk for depressive relapse...

Serum folate, vitamin B12, and homocysteine in major depressive disorder, Part 2 (2004)

On the basis of current data, we suggest that oral doses of both folic acid (800 microg daily) and vitamin B12 (1 mg daily) should be tried to improve treatment outcome in depression.

Treatment of depression: time to consider folic acid and vitamin B12. (2005)

However, most depressed people have a normal level of folic acid, and I am sure that I wouldn't feel any better if I had a higher level of it. Also, the correlation is not amazingly strong since most people with low folic acid levels don't have depression.