Category: 20mg

Three weeks with half dose of Fluoxetine

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It’s March 2022. I have timed it right: start reducing Fluoxetine in spring, and give it up completely by summer. It is a process that takes as long as it takes, I think it’s quite personal. I started taking one 20mg pill every other day, and see how it feels. Once I feel I am in charge, I reduce to 1 pill every three days.

While my psychiatrist told me I could do this whole process in 3 weeks, my psychologist warned me that I must take my time. The body has been used to receiving a chemical for the last 2 years, and it’s accustomed to whatever Fluoxetine does (it inhibits the presynaptic reuptake of the neurotransmitter serotonin…there you go). Not that I understand completely what it does, but it works by inhibiting something on the serotonin level. In normal cases, I am the one inhibiting this action, but for the last 2 years I have been helped by something external.

Hence, I need to start doing that action again by myself, serotonin and all. But I won’t rush my brain to produce serotonin, while my brain has been told to ease that action for 2 years. I am taking it off little by little.

So: how am I doing?

I am doing fine, working on my psychological well being by seeing my doctor every three weeks (or more often if I need to), and three weeks have gone by where I have done one day with 20mg, one day without. The first week I got spooked, cause about 3 nights after the new dosage, I had a crying crisis, and I felt really bad, thinking that I’ll never get out of this. Then I realised that I was close to my menstrual cycle, where I am moody and sad by default (thank you, hormones!) and got relieved. Also, I think that maybe my system started feeling the lack of the medicament, and had a first reaction, just like it happened when I first started taking Fluoxetine (I felt like shit, worse than with my own depression, for about 2 weeks, before the medicine seeped in).

Yesterday I started with phase two: Since beginning of the week I had one Fluoxetine only. I am doing 1 day on, 2 days off. I just started, so I can’t tell how I feel yet. Yesterday (two days in a row without) I felt good. Today (with Fluoxetine) I feel good.

The surroundings and the actions I take to feel good are super important. I am not waiting around monitoring my moods without Fluoxetine. I am doing an hour of sport every day (gym and swim), I am doing physio to heal my knee (ski accident, season is over), I keep working (despite frustrations at work), I keep following the flight course, I keep making one podcast interview per week, I make efforts in going out with people and feeling less lonely in the Swiss environment. All this helps, not only it helps, it makes the difference. Distributing my eggs in different baskets is key: if one basket is not going well, I have another 4 or 5 that my mind can bring its attention to.

My main focus is not to fall into the self pity trap. While there are tons of things I could be unsatisfied about, there are as many things that make me happy, little things and bigger things. I am learning to give more weight to the little achievements. I tend to disregard them as a given, while the non achievements take a much larger space than they should. Lots to work on, but this year the biggest achievement of al will be getting rid of Fluoxetine. One milligram at a time.

15 feb 2022: first day off meds

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Since last year I have been preparing for this day: getting off Fluoxetine. I spoke about it with my psychologist, and on 15 Feb with my psychiatrist, ’cause it’s her who needs to give the go ahead. And so she did. She asked me (to confirm) if I was feeling good, strong and self confident. I sort of am, I have had stronger times last year, when work was going well and I wasn’t doubting my skills. Today I feel good, not “happy” but good enough to give it a go. And I have a concrete reason to do this right now: I want to succeed at my flight school. They won’t let me fly if I am on antidepressants (makes sense). This means that I won’t be able to pass the medical test until months after I quit. The psy said that I will be able to pass the medical exam by July, by then there’s nothing more in my system and I will be stable in my moods. I will do that.

How does it work? I take one tablet every other day on week 1; then one every 3 days on week 2, and by week 3 I stop. Yesterday I didn’t take it. Today I did. Tomorrow I won’t. Spirits are quite high (despite the shitty weather). I am working it out: as soon as some negative thoughts come in (which they do constantly) I acknowledge them but let them go, just like meditation. However, I haven’t been able to sustain meditation sessions over the years, I just find it too numbing in a way, I prefer to have my eyes open and deal with my reality with all my senses. Kudos for those who can meditate, I envy them.

I am definitely scared about letting go of Fluoxetine, no doubt about that; however, I have never gained any benefit from being scared or worried, it just makes things more difficult. So, how about I put aside fear and worry, and let things evolve?

Stay the course, stay the course. Your objective is: by 2024 get Swiss nationality, live in a new home, be a pilot, stay off meds, and keep working at the same company. It’s a big objective for the next 24 months, but feasible, and it gives me reason to be here in Switzerland, and justify the hard times when I say “what the hell am I doing here”.

I am going to better weigh the significance of positive events in my life. Instead of undermining them and taking them for granted, I will pause, observe them and rejoice for every single positive drop in the ocean. It will counterbalance the negative drops that my brain so easily fuels into my body.

Also, 20mg of psychotropes a day, how much can it really be impacting on my whole body? Last night I had dinner with a friend who is taking much more than that. And after 3 years he is still stuck with them, his psychiatrist doesn’t want him to get off meds. Mine does. So that’s in itself a victory. I am ready to let go. My body is. 20mg: goodbye. I will replace it with another 20mg of self induced good mood. Like in the good old days.

Wish me luck!

Side Effects of Fluoxetine (Prozac)

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If I dig into my older diary pages, I will find my notes about side effects. I will check later. I thought this morning I would check again on the Internet, because I have two clear changes that I feel to attribute to taking Fluoxetine. I am sort of doing a self diagnosis, based on the fact that I have taken two long repetitions of Fluoxetin, and I notice the same pattern. Nothing major, but to be monitored.

The first time I took Fluoxetin was December 2019 until June 2020, the second time was December 2020 until now (April 2021). in 2019 I starting reducing from June to September, taking 10mg instead of 20mg, then I stopped in September and October, but by November I was feeling depressed again, and I started again December until now. I still take the same dosage, 20mg. In both cases I had no Fluoxetin in the gloomier months of the year for me: October-December, and I had to wait until end of Jan in order to start feeling better. I confirm that it takes 4 to 6 weeks for Fluoxetin (Prozac) to kick in. So, in both cases, I have the same pattern developing: 1. once my mood stabilises and I feel happier, I start dreaming very vividly; 2. I become more cocky, blunt, sometime verbally aggressive in my reactions. As if the social mask that inhibits our very being from expressing itself was taken off.

These are not amongst the common side effects of Fluoxetine. If I look at the NHS in the UK, the side effects that happen in more than 1 in 100 people are:

  • nausea, headaches, being unable to sleep, diarrhoea, feeling tired or weak.

    • I am far from that, I actually sleep like a baby. And I have these vivid dreams, they feel so real that I wake un in the morning remembering them as they really happened. Last night I dreamt something that has been recurring to me: I was missing the plane, and I felt this anxiety and breathlessness because I was stressed, I had to take that plane, and nobody around (my family) was helping me getting there in time. My father, who usually likes to get to airports 2 hours in advance, was telling me to not go until an hour from the flight time, but this was not going to help, as we were on the other side of London (why London I dont know…). I had this dreams in different sauces several times. It is not a happy dream, but it is not a depressive one either. It kind of gives me adrenaline.

    The other thing is feeling cocky. The only common point I can interpret from the NHS list of serious side effects (happens less than 1 in 100 people) is this

    1. headaches, trouble focusing, memory problems, not thinking clearly, weakness, seizures, or losing your balance – these can be signs of low sodium levels

    2. thoughts about harming yourself or ending your life

    3. fits, feelings of euphoria, excessive enthusiasm or excitement, or a feeling of restlessness that means you can’t sit or stand still

    4. vomiting blood or dark vomit, coughing up blood, blood in your pee, black or red poo – these can be signs of bleeding from the gut

    5. bleeding from the gums or bruises that appear without a reason or that get bigger

    NHS article on Fluoxetine

    I feel number 3 is close to what I feel. During the day, when working or doing my own personal projects, I feel I am regaining confidence, and strength, and I tend to cast away everything that threatens that confidence. I don’t feel inhibitors in telling people what I think, and I feel good in what I am doing. Work is going better, I started (yes, finally!) my podcast, it feels good.

    But I need to be careful not to exaggerate. I live in Switzerland, not in Italy, and the direct way of confronting people is not appreciated. I even thought of telling my CEO that he was wrong in doing what he did to one of my clients. But he is the boss, I have no right to tell him what I think, right? And he is not the kind of person who will easily accept a critic. So I need to be careful to not ruin my own happiness by saying too outloud, or being too enthusiastic (euphoric sometimes yes).

    All in all, I am doing well, I feel that the medicine is helping me. Unlike I read in another article, I don’t think it is like a placebo. But I need to prepare my own internal medicine, my own mental weapons to fight depression if it comes back after I am out of Fluoxetine. When will I stop Fluoxetine? I don’t know yet. I am scared of the gloomy depressive winter. I will check with my Congolese psychiatrist.

    The North Wind

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    A month and a half ago I halved the intake of Fluoxetin, otherwise known as Prozac. From 20mg to 10mg every morning. So far so good. A couple of changes occurred, but I cannot tell if its psychological suggestion or chemical adjustment in my body. I want to understand this better, and discern between self induced effects, placebo effects and real medical effects. No matter what happens in my body, I am still happy and satisfied about what I am doing. Work is going well, very well indeed, I have closed a major deal for the company, and in a new field, aviation, which I like much more than automotive. I am very proud of how I handled this deal and the negotiations since January. It all went pretty smoothly and quickly. 6 months of talks for a very good outcome. I gave myself a good pack on my back. And so did my CEO and the whole company. We popped two bottles of good champagne at work, and F. made a speech announcing I had made the biggest deal in the company’s history. What a good satisfaction. And if I think that only 7 months ago I wanted to quit.

    One thing I am learning about this anti-depression process: to cultivate patience, and to fight my perfectionism. More things I am learning, which I will write as I go.

    Patience is a big deal for me. And acceptance of a certain routine. I realised that over the last 14 of my relationship with W., and even before, basically since I left Italy to go and live in Germany in 1998, I have not been in one place or one job for more than 2-3 years. Events in life, jobs made redundant, W. entering my life (he is still the love of my life, although we are no longer together), new passions being born, the quest for film making, the eagerness of seeing the world, the choice we had to change our lives when we saw fit and how we pleased, made me wonder around the globe, traveling across oceans to beautiful places, living in the turquoise beaches of the Caribbean, moving to South Africa to pursue a film career, going to Canada to work at the Olympics, going back to Italy for a short while (3 years) setting up a company I didnt want to create, getting angry at life in Rome, leaving again, etc etc. I realised I have not been in one place for more than 2-3 years in the last 20 years. Whereas my childhood and my youth have been very regular, filled with routine. And my youth was very happy. I realise now that Alain de Botton is right when he says that in love we seek to reproduce the familiarity of what we are used to in our childhood. I recommend one of his speeches at Zeitgeist. Where I am getting at is that, also in life, not only in love, we seek balance based on what is familiar to us since the beginning. Now, I still need to understand why I was so attracted to a life without rules, and I still am, but why this has over 20 years damaged my self esteem, my happiness, and my relationship to the greatest man for me. Everytime I didn’t like what I was doing, I (I should say, we) would pack up and leave. I am like Juliette Binoche in Chocolat: I leave from village to village at the blow of the north wind.

    Once I returned to Switzerland, helas without W., it was 20 years after I left my home in Rome, the home of routine, familiar habits, and the love of my family. I wondered in this world for 20 years, 14 of which with the love of my life, and now that I am back in CH, my life has been shaken from the core. I had to stop, in a very harsh and hard way, and depression has been the climax of this journey. There’s more to say, but I need to get up and go to my next meeting. Life is full of surprises, definitely worth living every bit of it, even the suffering parts. I am growing through this process. I am learning to be patient. I will find my answer, but not yet today.

    Control your emotions

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    I have not written in over 15 days. I have been thinking a lot about the diary, and I made notes in my calendar of what I was going to write next. Work has been overwhelming, as we started going out again, visit customers, and going abroad. But despite the more hectic schedule, I have managed to always meditate in the morning. I do it as I wake up. Mornings are when I have most thoughts coming through my head, and I process what happened the day (or days) before and I do my list for the day. This list promptly shows itself while I am breathing through my mantra, and I try to not put attention to this list, but rather to let go my thoughts, as meditation teaches. Not easy, Especially these days, when I find myself being very excited about work – amazing if you think that in December I was ready to quit.

    I am presently charged with positive emotions, sometime I am so excited and happy that I want to burst. If I think back only 6 months ago, my emotions were loaded with negative guns, firing up through my stomach, head brain and Agata brain suffering (see Agata here). Negative then, positive now; I’d rather burst of joy than of sadness, that is 100% sure. But I think of ways to protect myself from falling down into the abyss of depression, and for this reason I want to control my emotions, even when they are extra positive. Meditation helps me in the morning. And breathing consciously during the day.

    I often think of my boss these days, He is a charismatic, young and ambitious man who has managed to create a great innovative company from scratch over a decade ago. I am working more and more on international projects and often happens that I sit with him, and the creative juices start pouring from both our heads. He is very inspiting and smart, and I feel excited and stimulated by his intelligence, and feel that we are on the same wavelength. This shoots in my vains the equivalent of 20mg of Fluoxetin per day, making my day and week better. I feel the seratonin going crazily well, and I want this to never end. But, I have to be very careful, to not make a yoyo out of this. Too happy today, too sad tomorrow. No way. Plus I need to remember that I have halved the dose of Fluoxetin, it’s been almost a month now, and so far so damn good. I don’t want to mess up my good work. That is why I want to control my positive emotions, so that I know how to control my negative ones one day. It is super important.

    By reducing the level of excitement for things happening today, such as a good deal made with a client, a beautiful sunny day out with my family, a hike in the mountains etc, I know that I will preserve my newly found self, and will be ready for the gloomier days in life. Cause those are part of our life, it’s not always happy moment, it’s difficult ones, and the only difference it makes in me is how I deal with them. Half full or half empty glass. I choose the full.