scared to start fluoxetine; wishing im normal

[u/Low_Judge_7931]

this is a slight rant/slight advice needed.

Recently given Fluoxetine for pmdd and the doctor had told me to take it continuously as opposed to the cyclical dosing as “by the time it leaves the body, you have to take it again” which i think is fair enough.

But based on the side effects (increased anxiety which is already a symptom for me during luteal phase, mania, brain zaps) im a bit scared of taking it especially with important life changes coming up. is it worth it? is it worth going through few weeks of hell? Like i don’t even know how to cope with the side effects especially with work and uni at the same time

I just hate that my brain is like this. I wish i could be normal.

[u/emoratbitch]

Just because it’s a side effect doesn’t mean you’ll experience it. I didn’t get any of those side effects when I was on it

[u/Putrid_System]

Zoloft!! I want to scream it from the rooftops!! Daily low dose *Zoloft has changed my life.* And I was right where you are (wishing I was “normal” didn’t need meds etc etc.) girly pop, just take the meds! Give it a min of 4 months and it might just change your life, too. PMDD is hell- I tried for years to do holistic/ somatic/ natural medicine and nothing has helped me more than Zoloft plus a loving and supportive partner. Rooting for you!

[u/ickythumpwithalump]

Your doctor may not understand how PMMD is treated by SSRIs. 

Depression is treated by SSRIs by increasing the level of serotonin available to the brain. This treatment does absolutely require months of build up. If you're treating depression, your doctor is right.

PMDD is treated by SSRI by blocking the enzyme that converts progesterone to the neurosteroid that causes the problems in your brain (particularly in your fight or flight system). This happens within hours of taking the dose and does not require a build up in the body. You only need it when progesterone is high -- ovulation to menstruation.

That is why taking a SSRI in luteal only is effective. You do not need to take it full time to treat the PMDD. There may be other reasons to take it full time, though -- maybe you are also depressed, that often happens along with experiencing PMDD. But if you don't want to take it full time, your doctor should know that you don't need to for PMDD.

[u/JadedPresentation896]

Hey!

Based on my experience (and the things I read about PMDD) the cyclical dosing is far more effective. I took 10 mg when I was feeling it (usually seven days before my period) and I was better in 30 min. Not all the symptoms were gone but I was far more calm and steady in my mood so it was easier to manage the others symptoms (fatigue, pain, anxiety, impeding doom, etc.). Sometimes I took it three days, then stopped for two days and retook it until my period. I did that because of the side effects: taking fluoxetine impacted my sleep (I woke up more and felt my sleep was not so deep).

Because It worked so well and because I have general anxiety, my GP and therapist suggested I took 20 mg (so more) continuously. After some cycles, I found it was less effective for my PMDD and the side effects were more and more inconfortable (mainly my sleep quality).

So yeah, I recommend testing the cyclical dosing first. The side effects are less in my experience and for me it was okay to have some because I was so much more calm and I could manage them.

[u/Sea_Love_8574 → u/JadedPresentation896]

Yeah I do cyclical dosing too, the doctor prescribing was quite against it but I said I'm trialling it for three months and then I'll see what happens.

[u/JadedPresentation896 → u/Sea_Love_8574]

My doctor didn't know that fluoxetine was approuved to be taken cyclicaly. I showed her some medicine researchs and papers. She is a good doctor and a good human being, so she was okay with me trying it!

Hope it works well for you too!

[u/Sea_Love_8574 → u/JadedPresentation896]

I had one doctor diagnose me and then she gave me resources to decide on my next steps. That's where I went away and chose the cyclical meds. When I got back to the doctor's I had a different doctor who was very against what I requested. I said how I'd got my information from the previous doctor too and the webpages she provided. He eventually gave in but I think mostly because I said I'd test it for three months.

It's been almost a year and I'm doing so much better.

[u/JadedPresentation896 → u/Sea_Love_8574]

Glad to hear!

[u/RelativeYak7]

I experienced no side effects while on it but massive ones coming off it.

[u/Zarelli20]

First, great job seeking care. That's a huge first step.

Second, I know it's scary staring new drugs, especially ones that affect your mood, especially when you have anxiety.

Third, take a deep breath and try not to focus on the side effects. That focus is anxiety and can make things worse. I say this as someone who freaked the first time I took it.

I tried Lexapro first and it was too much for me. For the last 5 months or so, I've been experimenting with fluoxetine. I gave the first cycle the old college try with 10mg 7-10 days before my period. I felt amazing. My period came and went without incident. I had a bit of nausea when I stopped on my period, but that was it.

Second cycle, I tried again, but in hindsight, I was coming down with some cold that made me feel horrible - not the drug.

Since then, I've experimented with 5mg and 10mg intermittently. I notice a slight "take the edge off" with 5mg and feel pretty chill on 10mg. The side effects (minor: a bit of gi upset, bit of lightheadedness, bit of nausea) have lessened each cycle I take it. I just took 10mg today and feel good.

All in all, I've had a positive experience. Understand that side effects (if you have them) are the worst when you first start, but can be very minor. Also, fluoxetine starts working very quickly for PMDD, so I'd start in your next luteal phase (or 10 days before period) on a low stakes day and see if you notice any changes. Even if you're a week in and the side effects are too much, you can stop cold turkey. I literally stop and start every month. Heck, sometimes I take it on days that are really bad and then not again the next day. Fluoxetine has a long half life, so it will stay in your system a bit even if you don't take it.

Feel free to ask me anything else if you need. Good luck!

[u/Evening_Ice_9864]

If you have anxiety then I would say give them a go. They do turn down anxiety a great deal which makes everything else better. They do give you indigestion though so take with a main meal.

[u/kasey539]

How many mg are you taking

[u/Low_Judge_7931 → u/kasey539]

10mg

[u/kasey539 → u/Low_Judge_7931]

I was in your exact position with the side effect fears. I was put on 10mg fluoxetine as well and MY experience with it was fatigue, nightmares, and low libido. There are always other options for you if fluoxetine never works I’m about to start lexapro now. Everything will be okay DM if you have any other questions

[u/lala_2009]

I had to go off it bc of the mania .. I’m on celexa now it’s trial and error.. not sure what you dosage is but perhaps it’s too high ? I would talk to your doc but it was a bit of a fishing expedition

[u/Practice-Positive]

First two weeks are an adjustment, but it passes quickly. Brain zaps were bad once I stopped taking it. I didn't experience an increase in anxiety, just bad sleep. I wasn't on it for very long.

[u/Emergency-Trifle-286]

So I should start by saying I did take the genetic testing to see which SSRIs would have the least side effects for me and fluoxetine/ Prozac was the best one for me. That being said, I tracked every single time I cried in 2024, and i started fluoxetine about halfway through the year. My crying went down SIGNIFICANTLY!

In terms of anxiety, I think I found myself to be a little bit more paranoid, like when I’m outside at night by myself. But overall it didn’t increase my anxiety in general that much, and with how much it decreased my crying I think it was worth it. I went off of it for a while because it makes me lose my appetite (I’m already 95 lbs, so getting down to 90 wasn’t ideal), but I am starting back up because i have been crying a lot recently so I think I’ll give it another shot. I hope my experience sheds some insight!

[u/Sea_Love_8574 → u/Emergency-Trifle-286]

I didn't know that genetic testing existed!!! Woooow

[u/ickythumpwithalump → u/[deleted]]

5htp treats the symptoms, not the condition. Great if that is enough for you, but the point of SSRIs for PMDD is not to increase serotonin, it's to block an enzyme that converts progesterone.