Opinions - How to know when to start on Prozac (fluoxetine)?

[delphinen]

SWIM wants to try an antidepressant. No more opiates or psychedelics, only maybe some benzos to avoid serotonin syndrome at first (he's a Tramadol abuser).

SWIM is not visiting a Doc because they dont give him the stuff, he has been to three psychologists (you cant go to a psychiatrist directly here) and they will NOT prescribe you anything.

SWIM is lucky that he can get Fluoxetine cheap on his own. 20mg.
So, whats to expect and what should he do? start on 20mg per day or more? or less? what other meds should he avoid?

Thanks in advance.

Reputation Comments on this post:

Self-incrimination from a one year old member

[Compost Mentis]

Look out for persistent flu symptoms muscle aches and extreme tiredness - ended up having full blood tests which found nothing.

In my case I had no problems for 12 years.

I found it useful - helped extract me from a very deep hole.

As to interactions I hardly drink and never smoke tobacco and don't drink coffee. It may have potentiated the ganja I was indulging in heavily at the start... but I was spending a lot of time in raves at the time too. (no pills)

I especially liked the way it suppressed my libido - very convenient when you live alone.

Reputation Comments on this post:

sound advice

[Intoxicating Dreams]

Swiy really should see an MD before starting. Not sure about how it is where swiy lives, but here psychologists can NOT prescribe any drugs. Here, a family doctor, a doctor in a free clinic or any doc who has an MD can prescribe antidepressants and after s/he evaluates a person, they are handed out rather freely. Unless a person is under 18. There has been a concern of increase in suicide attempts with patients underage. Swim is not sure which ones, but some antidepressants are deemed better than others for this group of people. Please, at least google prozac before taking what might or might not be prozac.
That said, swim has had good experiences with prozac. If swiy is going to do this without an MD swiy might start with 20 mgs a day for a week and a half. Then evaluate. If swiy has any intense weird feelings (hyperactive, can't sleep, overly sleepy) if very intense do not continue after the first dose. If swiy doesn't feel anything keep doing what swiy is doing. Swiy probably already knows that antidepressants can take up to 2 weeks to kick in. Swim noticed her depression starting to lift after the 3rd day.
Sometimes, Mental Health Services can evaluate people, moniter them and even help people get their medication for little or no charge.
Best wishes,BE CAREFUL, and let Swims know how swiy is. If swiy wants to s/he can feel free to pm swim.

[Compost Mentis]

Originally Posted by Intoxicating Dreams

Swim noticed her depression starting to lift after the 3rd day..

Glad it's not just me. Time and time again that happened - though the doc always said .."of course you won't notice anything for at least two weeks" ....

With the last course I took after a particularly grim Xmas period I "came up" in 3 days - felt like I imagine ecstasy should be like (only took it once, found it very disappointing) ...
Worryingly it was this course of 20mg per day that eventually saw me falling asleep mid-afternoon by late in the year. Having eliminated various other symptoms and ailments I suffered that year, I was left with the belief it was the Prozac wot done it - after 12 years of benefits.

As to the medical profession .... they clearly can't have personal experience of all the drugs they prescribe, but given their professional career success, they know least of all about depression.

[sarbanes]

Prozac/Suboxone is really another great way to quit tramadol (other than taper). If you want to go cold turkey, it can be a great way, and almost 100% erases WD symptoms. The buph takes care of the typical opioid WD, and the fluoxetine (with its long half life) takes care of the shooting electrical shocks (tramadol's acute, SNRI effects). You could even possibly conbine with an anticonvulsant mood stabiliser/anti craving, in small amounts (like phenytoin). That way you won't be tempted to start the tramadol again (out of sheer desire) when your only partially withdrawn. Really (for me), you need to completely be withdrawn before you start again. You really ned to give your body (and especially brain), lots of vacation/rest. But withdrawal needen't be very painful at all. Especially with the Fluoxetine/buprenorphine/phenytoin combo, you won't even notice it, if at all, and I'm talking cold turkey, NO EXAGERATIONS. For me, withdrawal is absolutely a necessary process, intended to freshen up the body and brain in preperation for using again. If you constantly use, you begin to basically rot out your brain and not enjoy the drug, and that is a hell as bad (or worse) than WD even is. Does what I'm saying make any sense?

[delphinen]

Originally Posted by sarbanes

Prozac/Suboxone is really another great way to quit tramadol (other than taper). If you want to go cold turkey, it can be a great way, and almost 100% erases WD symptoms. The buph takes care of the typical opioid WD, and the fluoxetine (with its long half life) takes care of the shooting electrical shocks (tramadol's acute, SNRI effects). You could even possibly conbine with an anticonvulsant mood stabiliser/anti craving, in small amounts (like phenytoin). That way you won't be tempted to start the tramadol again (out of sheer desire) when your only partially withdrawn. Really (for me), you need to completely be withdrawn before you start again. You really ned to give your body (and especially brain), lots of vacation/rest. But withdrawal needen't be very painful at all. Especially with the Fluoxetine/buprenorphine/phenytoin combo, you won't even notice it, if at all, and I'm talking cold turkey, NO EXAGERATIONS. For me, withdrawal is absolutely a necessary process, intended to freshen up the body and brain in preperation for using again. If you constantly use, you begin to basically rot out your brain and not enjoy the drug, and that is a hell as bad (or worse) than WD even is. Does what I'm saying make any sense?

Thank you a lot for the info. Say SWIM has does 500mg Tramadol one more time, when SWIM should start taking the Prozac? SWIM has Lorazepam and Diazepam to avoid seizures, and Melatonin and Carisoprodol for sleep.

[sarbanes]

Since I'm not a doctor, I can not legally advise you, and caution you to seek professional assistance before embarking on this. I can, however, share with you my experience, and I was able to take the fluoxetine (Prozac) easily within 24 hours of my last tramadol dose, and sometimes even less (remember, dose is a factor as well). Certainly, do not take them together, and especially in any real quantity (I think I have taken like 20mg fluoxetine and 25 mg tramadol without incident), but its foolish and not necessary. What I did, is substituted the Suboxone (for tramadol), and when I started to get the dreaded zaps (about 36 hours later), I took one 50 mg Prozac (fluoxetine), and that was all it took until 3-4 days later, when I had milder zaps, and just took another one. That was it. Like I said, one way I always failed was with the cravings, and both Dilantin (phenytoin, diphenhydantoin), and Trileptal (oxcarbamazepine) helped me not to crave the tramadol, and complete my WD rather painlessly. The anticonvulsants can be had online, and sent to the US without incident usually.

Remember, the SNRI effects of tramadol are some of the shortest of all. Those of Prozac (fluoxetine) some of the longest (up to 1 week half life). The long half-life makes fluoxetine the choice of physicians' when patients are withdrawling off other anti-depressants with a shorter half life.

Reputation Comments on this post:

self incrimination

[delphinen]

Well SWIM just started it. Took a 2mg Lorazepam, a 10mg Diazepam (in order to avoid seizures because of the Tramadol) and his first 20mg Fluoxetin.. He should take another pill tomorrow it says

[jonnyblades]

i would recommend seroxat/paxilthese have bad press reports, people commiting suicide on them etc. the thing is these r as addictive as prozac....once youre on them to get of them causes bad withdrawl....hense some people commiting suicide.seroxat works for me. u get a great nights sleep too.

[Intoxicating Dreams]

Important! Do not use melitonan with antidepressant! Bad and dangerous
Careful!
Easy Easy!

[Jatelka]

Self-medicating with SSRI's?

Come on people. While the flamingo accepts that these drugs help (and suit) some people, there is a big enough body of evidence that they can be problematic.

A withdrawal syndrome all of their own, dozens of interactions and the aforementioned increase in suicidal thoughts, not to mention the psychotic reactions.

Unless your marmoset has been formally diagnosed as having depression, and prescribed these drugs by a physician then they really shouldn't be messed around with.

ENOUGH!