What does prozac feel like when it starts working?

Antidepressants won’t cure your depression, but they can help you manage its symptoms. Still, finding the right medication can take some trial and error. Not all medications work for all people.

It’s important to know the signs that a medication you’re taking may not be right for you.

You feel better right away: It might sound strange, but this could be a sign your medication isn’t working the way it should. Feeling like you’re instantly better may be a placebo effect — you think it’s helping. Real help won’t happen that fast. It takes weeks for your medicine to start working.

No relief after 12 weeks: While you won’t notice changes from these medications overnight, you should start to feel some difference in 4 to 6 weeks, with the best results sometimes coming in 8 to 12 weeks. If you don’t feel better by 3 months or your symptoms get worse, let your doctor know.

Big mood swings: Any serious changes in your emotions, positive or negative, can be a sign that you need to change your medication.

Your depression gets worse: This can happen, especially if you’re taking other medications as well. Some can cause your antidepressants to act differently, and that can make your symptoms worse. Make sure your doctor knows about all medications you are taking.

The side effects are too much for you: As with any medication, antidepressants can come with side effects. The most common ones are nausea and diarrhea. They usually get better in a week or so.

(Picture: Ella Byworth for Metro.co.uk)

But the decrease is welcome. It’s a fairly massive difference from having at least one panic attack a week, nearly always without an obvious trigger.

I haven’t been obsessively checking things. I’m able to stop checking after the second time, instead of the seventh.

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Like I said, I don’t feel like an entirely different, always happy, anxiety-free person.

But I feel lighter, a little happier, and more able to be myself.

My sense of humour hasn’t disappeared. Instead, it feels easier to make jokes. I feel more confident now I’m not as weighed down my depression telling me that what I’m about to say isn’t funny or isn’t worth mentioning.

I’m still creative, and I feel like I have the energy to come up with more ideas. I’m less worried about making an idiot of myself or getting fired, so I feel freer to try out-there things and make suggestions. Which is great.

(Picture: Ella Byworth for Metro.co.uk)

I don’t feel numb. I can still feel things. I’m still myself, but without a thick fog hanging over everything and holding me back.

I’m not entirely sure how much of these changes are down to meds, and how much is down to finally opening up about my mental illness.

But honestly, I’m not that bothered. If taking medication plays a part in feeling like a slightly happier, better version of myself, I’m not going to stop taking fluoxetine – as long as there aren’t any longterm side effects with taking it.

And two months in, I’m only experiencing one irritating side symptom: feeling incredibly awake during the week, then falling immediately asleep for hours on end whenever I sit down anywhere comfy during the weekend.

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I’m crossing my fingers and hoping that this is another side effect that’ll disappear once the meds settle in or I actually sort out my sleeping routine. I need a proper bedtime.

But if it continues, I’ll have to have a serious think about whether one very annoying side effect is life-ruining enough to give up antidepressants.

At the moment, I don’t think it is.

(Picture: Ella Byworth for Metro.co.uk)

I know that for a lot of people, medication isn’t the answer. I’m still on the waiting list for therapy, and I don’t like the fact that I’ve been taking meds for two months without any non-pill treatment to go alongside them.

Antidepressants are not a quick fix. They don’t magically transform you into an entirely happy, emotionally stable being.

But for some people, they’re life-saving. And for me, they level me out and up my mood just enough that I’m able to get on with things. That might sound small, but it’s a huge deal to me.

Pills aren’t everything, they’re not a quick fix, but they can help. And those are the stories we should be sharing – not just the scary ‘my friend’s mum took antidepressants and they completely messed her up’ ones or the ‘antidepressants are just part of a massive conspiracy to keep you complacent’ ones.

I don’t want to say that everyone should take meds, or suggest that antidepressants are a replacement for therapy (I still believe that they need to work side-by-side).

But I want to break down the fear around antidepressants. I want anyone who’s struggling to know that medication can help. Slowly and in small ways, but still, they help. And that’s nothing to be ashamed of.

For more information, advice and support about mental health, you can call Mind’s confidential Infoline, available on 0300 123 3393 (lines open 9am – 6pm, Monday – Friday).

MORE: How to talk to your GP about your mental health

MORE: How I’m using self-care while I’m on a massive waiting list for therapy

MORE: What it’s like to start taking anti-depressants

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Fluoxetine, Oral Capsule

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

Dosage for bulimia nervosa

Generic: Fluoxetine

  • Form: oral capsule
  • Strengths: 10 mg, 20 mg, 40 mg
  • Form: oral delayed-release capsule
  • Strength: 90 mg

Brand: Prozac

  • Form: oral capsule
  • Strengths: 10 mg, 20 mg, 40 mg

Brand: Prozac Weekly

  • Form: oral delayed-release capsule
  • Strength: 90 mg

Adult dosage (ages 18 to 64 years)

Typical dosage: 60 mg per day taken in the morning.

Child dosage (ages 0 to 17 years)

This drug hasn’t been studied in children for this condition. It shouldn’t be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

Seniors may have a higher risk of side effects from this drug. Because of this risk, your doctor may lower your dosage or reduce how often you take the drug.

Dosage for major depressive disorder

Generic: Fluoxetine

  • Form: oral capsule
  • Strengths: 10 mg, 20 mg, 40 mg
  • Form: oral delayed-release capsule
  • Strength: 90 mg

Brand: Prozac

    Form: oral capsule

  • Strengths: 10 mg, 20 mg, 40 mg

Brand: Prozac Weekly

  • Form: oral delayed-release capsule
  • Strength: 90 mg

Adult dosage (ages 18 to 64 years)

  • Typical dosage: 20–80 mg per day.
  • Maximum dosage: 80 mg per day.
  • Initial dosage: 20 mg per day taken in the morning.
  • Alternative dosage: You may be a candidate for taking this drug once per week. In this case, your doctor will stop your daily dose of the immediate-release capsules and switch you over to the delayed-release capsules. You’ll take 90 mg once per week. You’ll start taking it seven days after your last daily dose of fluoxetine.

Child dosage (ages 8 to 17 years)

  • Typical dosage: 10–20 mg per day.
  • Initial dosage: After your child takes 10 mg per day for one week, your doctor may increase their dosage to 20 mg per day.

Child dosage (ages 0–7 years)

This drug hasn’t been studied in children for this condition. It shouldn’t be used in children younger than 8 years.

Senior dosage (ages 65 years and older)

Seniors may have a higher risk of side effects from this drug. Because of this risk, your doctor may lower your dose or reduce how often you take the drug.

Dosage for obsessive-compulsive disorder

Generic: Fluoxetine

  • Form: oral capsule
  • Strengths: 10 mg, 20 mg, 40 mg
  • Form: oral delayed-release capsule
  • Strength: 90 mg

Brand: Prozac

  • Form: oral capsule
  • Strengths: 10 mg, 20 mg, 40 mg

Brand: Prozac Weekly

  • Form: oral delayed-release capsule
  • Strength: 90 mg

Adult dosage (ages 18 to 64 years)

  • Typical dosage: 20–80 mg per day.
  • Maximum dosage: 80 mg per day.
  • Initial dosage: 20 mg per day taken in the morning.
  • Alternative dosage: You may be a candidate for taking this drug once per week. In this case, your doctor will stop your daily dose of the immediate-release capsules and switch you over to the delayed-release capsules. You’ll take 90 mg once per week. You’ll start taking it seven days after your last daily dose of fluoxetine.

Child dosage (ages 13 to 17 years and higher weight adolescents)

  • Typical dosage: 20–60 mg per day.
  • Initial dosage: 10 mg per day. After two weeks, your doctor will likely increase your child’s dosage to 20 mg per day.

Child dosage (ages 7 to 12 and lower weight adolescents)

  • Typical dosage: 20–30 mg per day.
  • Initial dosage: 10 mg per day.

Child dosage (ages 0 to 6 years)

This drug hasn’t been studied in children for this condition. It shouldn’t be used in children younger than 7 years.

Senior dosage (ages 65 years and older)

Seniors may have a higher risk of side effects from this drug. Because of this risk, your doctor may lower your dosage or reduce how often you take the drug.

Dosage for panic disorder

Generic: Fluoxetine

  • Form: oral capsule
  • Strengths: 10 mg, 20 mg, 40 mg
  • Form: oral delayed-release capsule
  • Strength: 90 mg

Brand: Prozac

  • Form: oral capsule
  • Strengths: 10 mg, 20 mg, 40 mg

Brand: Prozac Weekly

  • Form: oral delayed-release capsule
  • Strength: 90 mg

Adult dosage (ages 18 to 64 years)

  • Typical dosage: 20 mg per day.
  • Initial dosage: 10 mg per day. After one week, your doctor will likely increase your dosage to 20 mg per day.
  • Alternative dosage: You may be a candidate for taking this drug once per week. In this case, your doctor will stop your daily dose of the immediate-release capsules and switch you to the delayed-release capsules. You’ll take 90 mg once per week. You’ll start taking it seven days after your last daily dose of fluoxetine. Talk to your doctor about whether this option could be right for you.

Child dosage (ages 0 to 17 years)

This drug hasn’t been studied in children for this condition. It shouldn’t be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

Seniors may have a higher risk of side effects from this drug. Because of this risk, your doctor may lower your dosage or reduce how often you take the drug.

Dosage for depressive episodes associated with bipolar I disorder

Generic: Fluoxetine

  • Form: oral capsule
  • Strengths: 10 mg, 20 mg, 40 mg

Brand: Prozac

  • Form: oral capsule
  • Strengths: 10 mg, 20 mg, 40 mg

Adult dosage (ages 18 to 64 years)

Fluoxetine must be taken in combination with the drug olanzapine.

  • Initial dosage: 20 mg of fluoxetine with 5 mg of olanzapine taken once per day in the evening.
  • When changing your dosage: Your doctor may increase your dosage of fluoxetine up to 50 mg per day. They may increase your dosage of olanzapine up to 12.5 mg per day.

Child dosage (ages 10 to 17 years)

Fluoxetine must be taken in combination with the drug olanzapine.

  • Initial dosage: 20 mg of fluoxetine with 2.5 mg of olanzapine taken once per day in the evening.

Child dosage (ages 0 to 9 years)

This drug hasn’t been studied in children for this condition. It shouldn’t be used in children younger than 10 years.

Senior dosage (ages 65 years and older)

Seniors may have a higher risk of side effects from this drug. Because of this risk, your doctor may lower your dosage or reduce how often you take the drug.

Dosage for treatment-resistant depression

Generic: Fluoxetine

  • Form: oral capsule
  • Strengths: 10 mg, 20 mg, 40 mg

Brand: Prozac

  • Form: oral capsule
  • Strengths: 10 mg, 20 mg, 40 mg

Adult dosage (ages 18 to 64 years)

Fluoxetine must be taken in combination with the drug olanzapine.

  • Initial dosage: 20 mg of fluoxetine with 5 mg of olanzapine taken once per day in the evening.
  • When changing your dosage: Your doctor may increase your dosage of fluoxetine up to 50 mg per day. They may increase your dosage of olanzapine up to 20 mg per day.

Child dosage (ages 0 to 17 years)

This drug hasn’t been studied in children for this condition. It shouldn’t be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

Seniors may have a higher risk of side effects from this drug. Because of this risk, your doctor may lower your dosage or reduce how often you take the drug.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.

How do antidepressants trigger fear and anxiety?

“The hope is that we’ll be able to identify a drug that inhibits this circuit and that people could take for just the first few weeks of SSRI use to get over that hump,” said senior investigator Thomas L. Kash, PhD, the John Andrews Distinguished Professor of Alcohol Studies in the UNC School of Medicine’s department of pharmacology. “More generally, this finding gives us a deeper understanding of the brain networks that drive anxiety and fear behavior in mammals.”

The new study, published in Nature, counters the popular view of serotonin as a neurotransmitter that promotes only good feelings. SSRIs, which are taken by about one in 10 people in the United States and about one in four women in their 40s and 50s, are thought to improve mood by boosting serotonin activity in the brain. There are brain circuits through which serotonin does seem to improve mood, and some studies have linked depression to abnormally low levels of serotonin. But the short-lived promotion of anxiety in many patients on SSRIs — even suicidal thinking, particularly in younger people — has long hinted that serotonin can have negative effects on mood, depending on the precise brain circuit where it acts.

In the Nature study, for which co-authors were UNC postdoctoral researcher Catherine A. Marcinkiewcz, PhD, and UNC graduate student Christopher M. Mazzone, the researchers used an array of sophisticated methods, including advanced optogenetic and chemogenetic tools, to trace a serotonin-activated pathway in the brains of mice, a pathway that drives anxious behavior.

The team first demonstrated that a mild shock to the paws of mice — a standard method for evoking fear and anxiety behaviors — activates serotonin-producing neurons in the dorsal raphe nucleus (DRN), a brainstem region known to be involved in mood and depression. These DRN serotonin neurons project to a brain region that is called the bed nucleus of the stria terminalis (BNST) and has been shown in previous studies to have a role in serotonin’s negative mood effects in rodents. Artificially increasing the activity of the DRN-to-BNST neurons enhanced anxiety-like behaviors in the mice.

UNC scientists found that the serotonin output from the DRN neurons activates their target neurons in the BNST through a specific subset of serotonin receptors, known as 2C receptors. These serotonin-activated BNST neurons then tamp down the activity of another family of BNST neurons, which, in turn, project to the ventral tegmental area (VTA) and lateral hypothalamus (LH) — key nodes in the brain’s reward, motivation and alertness networks.

The pathways from BNST to VTA and LH have been reported in previous studies to improve mood and relieve anxiety. Researchers confirmed that artificially driving the activity of these pathways has the effect of reducing foot-shock-induced fear and anxiety behaviors in the mice. By contrast, the silencing of these pathways by serotonin-activated BNST neurons effectively allows the anxiety level to rise.

Examining the impact of SSRIs, the scientists exposed 2C-receptor BNST neurons to fluoxetine (Prozac), which like other SSRIs gives a boost to serotonin levels wherever the neurotransmitter is at work. This turned out to increase the 2C-receptor neurons’ inhibitory effect on the neighboring VTA- and LH-projecting neurons, worsening fear and anxiety behavior in mice.

How can this effect be blocked? Kash and his team observed that the anxiety-mediating BNST neurons expressed the stress-signaling molecule corticotropin releasing factor (CRF). When they added a compound to block CRF activity, they witnessed that fearful behaviors — which had been triggered by fluoxetine — were greatly reduced.

One of the next steps is to confirm that this serotonin-sensitive DRN-to-BNST anxiety circuit exists in humans as well. “It’s logical that it would,” Kash said, “since we know SSRIs can induce anxiety in people, and the pathways in these brain regions tend to be very similar in mice and humans.”

Another next step will be to test drugs — ideally FDA-approved for various conditions — for their ability to alter this anxiety circuit and thereby block SSRIs’ anxiety-inducing effect. In principle, a CRF-blocker might work. For years, pharmaceutical companies have been trying to develop CRF blockers to treat depression, anxiety and addiction. In practice, Kash said, CRF blockers haven’t yet had success in clinical trials, so an FDA-approved one is probably still years away at least.

“Other researchers are working to develop better CRF-inhibiting compounds, so that’s one potential direction to take, but there are others,” Kash said. “We’re now looking at the various proteins expressed by these BNST neurons, and we’re hoping to identify a receptor that is already targeted by established drugs. One of them might be useful for people as they start taking SSRIs.”

Interactions Between Prozac and Alcohol

Some adults like to have a drink for a special occasion. Others might drink more often to alleviate stress. Regardless of why or how much you drink, alcohol has the same basic effects on your body. It’s a depressant that impacts your brain function. Drinking slows down and even blocks messages within your brain. It can cause the following problems:

  • trouble thinking and impaired judgment
  • fatigue
  • anxiety
  • depression
  • trouble hearing and seeing
  • decreased motor skills

Interactions

The ingredients in Prozac are designed to help calm your mood. One of the side effects of the drug is tiredness. Prozac can interfere with coordinated movement and alertness, like alcohol does. Combining Prozac with alcohol can quickly lead to increased sedation. Having even one drink while you take Prozac can cause extreme drowsiness. This effect can lead to potentially dangerous situations. These include poor decision-making, impaired driving, and an increased risk of falls and injuries.

Mixing alcohol and Prozac can also lead to other side effects. These can include:

  • dizziness
  • sudden fatigue and weakness
  • feelings of hopelessness
  • suicidal thoughts

Mixing Prozac and alcohol may cause fatigue and weakness, which may interfere with your ability to finish simple tasks. You may find yourself needing to take a break to rest.

Alcohol can also keep Prozac from working as well as it should. Taking antidepressants like Prozac doesn’t mean you’re immune to the depressive effects of alcohol. Instead, alcohol may actually keep your medication from working to its full effect. This means you won’t get the full benefits of Prozac. This can make the symptoms of your condition even worse.

What to do

If you take Prozac, do not drink alcohol. Mixing the two can put your health at risk. If you have strong urges to drink, talk about these feelings with your doctor.

If you’re trying to control your drinking, there’s some good news. According to a review in American Family Physician, there’s a small amount of evidence that suggests that fluoxetine, the generic name of Prozac, may help alcohol-dependent people abstain from drinking alcohol. This doesn’t mean that Prozac should be used to treat alcoholism. But it does suggest that the drug may reduce your desire to drink.

It’s important to note that the effects of combining alcohol with Prozac can happen even if you don’t drink at the same exact time you take the drug. Prozac is a long-term medication, so it stays in your body for a long time after you take it. Waiting a few hours after you take the drug to drink won’t reduce your chance of negative effects. If your doctor stops your treatment with Prozac, ask them how long you should wait before drinking any alcohol. How long the drug stays in your system depends on your dosage and how long you’ve been taking the medication. Some forms of the drug can affect your body for more than two weeks after you take your last dose.

Read more: The dangers of abruptly stopping antidepressants “

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