Category: fluoxetin

1 day on, 2 days off Fluoxetine – first week

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I did about one week of major reduction of Fluoxetine intake: 1 day on, 2 days off. Today I felt a bit down. I don’t want to be paranoiac, but it’s a fact: every time I feel down now I relate it to the fluoxetine, or lack thereof.

Like my best friend rightfully reminded me the other day, I need to remember that everyone gets moments up and down. I can feel less motivated because of the circumstances.

Good news: my mood hasn’t worsened during the day. I feel ok tonight. I did the evening flight course, went to the gym after work, kept myself busy. The lesson was interesting. Tonight I sense that I could go another full day without fluoxetine… but I will stick to the rule. For now it is 1 day on and 2 days off. once I feel stable and confident, I will start 1 day on and 3 days off. Right now I am happy if my moods stay stable after 2 days without medicine. It’s a real success. I don’t underestimate it. The body is getting used to receiving less chemicals. It will take the time that it will take. I don’t want to rush this mega step.

Step by step.

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!

Time to cut off Fluoxetine

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One of the three objectives of my next two years is getting a private pilot license. The other two are: becoming a Swiss citizen and moving to the new house. But I forgot one major, major one: getting off Fluoxetine and stay away from medicaments for ever. This is a big deal, because I tried once before, and I slipped into another phase of depression. So I had to go back to my meds. It’s been over 2 years with Fluoxetine (the equivalent of Prozac) and this year, in spring, I want to do it again and this time, I want to succeed.

Last week I learnt that I need to pass a medical test to be allowed to fly for my pilot license exams. I told the doctor at the aviation club that I am taking antidepressants, and he said that this is a no-go by default. I need to be off medicaments for a number of months, and a follow up from my psychiatrist must ensue, before I can have the ok to fly. That has created a negative effect on me, as I almost found a good reason not to do the license. But then I thought that this can go to my advantage: I will eliminate Fluoxetine on 1st March and if all goes well I will be able to get the green light to fly by fall. This is my thinking.

It is easier for me to see the half glass empty, but I am working to see it half full. This is what my psychoanalyst is saying: train yourself to turn the negative thoughts to positive. Make a conscious effort, now that you are still using the medicine and feel strong, to actively turn the sad or negative into happy and positive. It’s all in the mind, and the mind can overtake decisions if we give it too much room to act. The other mind, the positive one, must take counteraction, and fight for the good of my whole being.

I would lie if I said that I am fine giving up Fluoxetine. I do know the good it did to me, and I am quite terrified to abandon this comfortable crutch. But man, it’s time to continue life, and to get back to normal; I want to rely on my own strength, my own self confidence.

What if I start feeling depressed again?

Well, what if I won’t?

Booklet from my health insurance

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Today in the mail I received a booklet from my health insurance entitled “Guide – Depression”. I didn’t have to do much research to figure out that Switzerland has the world’s second highest count of suicides – great! Before us is a country that lives 6 months in darkness. Wow, that must be soooo hard! Tough people, the Nordics. Those who don’t commit suicide I bet they live forever.

Enough with suicide, which is not the topic of this diary. One thing I know for sure is that, despite the lowest, saddest moments I have had in my life, I could never take my life, cause life is too beautiful, and kind of the one precious thing we have. Depression, I admit, makes you think about death a lot, often as sort of a liberation from the unbearable sadness that devastates our souls while depressed. But we know what life is, we don’t know what death is. As my grandma used to say “chi lascia la strada vecchia per la nuova, sa quello che lascia ma non sa quello che trova” (the one who leaves the old road for the new one, he knows what he leaves, but ignores what he is going toward). I don’t know, I just find that this planet is so amazing, and there’s so much to see, so many people to meet, whereas eternity is what, eternal? That sounds boring to me already. So, I tell myself “get your sh*t together and enjoy this world”.

My insurance must know that I am not the only one who tends to be depressed in winter. They must have printed thousands of those booklets. Thousands of potential depressive? In 2020, more than 265 million people were depressed around the world. Proportionally, the African countries are the most affected. I would have not guessed that. I always think of the Africans as of someone dancing, happy, like this guy Mufasa!

It seems that depression is a disease because something changes in our brain, specifically in the way the neurons transfer information. Hence it become a disease. I always considered depression as something we could and should solve with our own efforts, not with medicine. That was true until 2019, when I could no longer get out of bed. Terrible feeling, I don’t wish it to anybody. It’s worse than pain I think, because you are completely unable to control your mind, although you ARE your mind. Don’t get me wrong, I don’t like pain, on the contrary, there is some excruciating pain that I don’t even want to imagine. The best is to have no pain and no depression, all right!

Jim Carrey, John Lennon, F. Scott Fitzgerald, Robin Williams, Ernest Hemingway, Van Gogh and many other artists were suffering from depression. Incredible that art and depression can go so hand in hand. The good news is: they were not alone in their struggle.

Anyway, all that to say: I found that the health insurance did a good thing by publishing this booklet. It helps take off the stigma from depression. I was in denial for many years. I still wish that I didn’t have to take medicaments, but I tell myself that I’d rather have a fine, serene winter with the help of Fluoxetin than feeling helpless and unmotivated without it. God bless medicaments. I am working on getting mind-stronger with the help of Dr. G, my psychologist. That is actually the biggest weapon to gain strength and avoid relapse once healed.

My biggest fear, after 2 years of medical treatment, is what will happen once I walk on my own again, without the Fluoxetin crutches. Dr. G. says I am doing well, and I am practising with positive thoughts, exercises and putting my eggs in different baskets. It is a daily work, and winter makes it harder, but I am doing well, and today was sunny and I felt especially well. I worked, swam and recorded a podcast episode.

Stay the Course. It will pay off. One day.

Latent Depression?

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Strange. Yesterday I wrote a page of this diary saying how much I had enjoyed the different sense of time in Oman, where everything flows so slowly compared to Europe; and I mentioned that I took the afternoon off, snoozing on the couch, doing nothing but watching TV and some favorite movies. I did that twice actually, on Saturday and Sunday. Today is Monday, back to working mode. The morning went well, that’s when I am most active. But: right after lunch, here comes the same lack of drive as yesterday. I lied down on the living room parquet to catch the shy heat of the winter sun, and have laid there for almost an hour. I am feeling, although not as severely, the same lack of drive as I had last year when I was depressed. And yet I am taking Fluoxetine, 20mg per day every single morning. Why do I feel like this then?

I am worried because I know that sense of helplessness, which comes from inside, a plug that is pulled out of my body and mind. I didn’t like feeling it today, while I was sunbathing to catch some vitamin D on the floor. I recognise this feeling, and I don’t like it one bit. It scares me. And I know that when I think of W., the love of my life whom I left 5 years ago, it means that I feel vulnerable and I wish he were there. Today I thought of him a lot.

Back to work now, but first I am going to write these words here, to make a point. A point of warning: I must be vigilant, depression isn’t over, sometimes I wonder if it will ever be. Are there people out there who were depressed, went on Fluoxetine, and got out of it? Doctors say that this molecule is not addictive (unlike Xanax), but is it really? Or are they just saying, so that we don’t worry?

Today for the first time in ages I felt the need to pull the plug, the inside black hole coming to surface again. I know it’s winter, November is the month I most hate, days are short, it’s cold and dark, it’s depressing by definition, but I am doing better than last year, and I am taking antidepressants, so where is the problem? It’s been two years now since I started taking this medicine. My intention is to reduce to 10mg in spring 2022, and stop early summer. See how it goes. Last year I stopped in September, just at the beginning of autumn. Not a clever decision. this year I am smarter. Come on L., get it together. You can do this.

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.

    Anger again

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    Yes, anger again, same as last year. A cycle is kind of repeating: in the winter I am depressed and start taking fluoxetin; the medicine slowly but regularly starts having effect and equalises my moods, making me happier and stronger every day. It takes about 2-3 months to get stable. I am miserable in October-November-December, then from January things start getting better. Then around early spring (about now) I start becoming cocky, and angry at things and events; it is as if I was gaining too much confidence, and I can face any event or situation; I need to be careful, because at work I risk to respond abruptly to people (and to the Management) and I know I will regret if I do. So I tell myself “stay humble, don’t explode”. So I do. I try my best. So far I succeed, but sometimes I am really eager to give the proper feedback to people. I play it in my head over and over, as to rehearse the perfect speech.

    I remember last year I was angry against W., my ex (the love of my life), for not fighting for our relationship, for letting me go like that; the anger was good to not think of him too much, self defense I reckon. As I already wrote in another page, I’d rather be angry than depressed. And I remember that last year, around late spring, I decided together with my psychiatrist, to start diminishing the dose of antidepressant. Because I was feeling strong, and because I knew I could manage reducing the pills. This year I feel I am doing well again, I feel I could let go of Fluoxetin, but I want to be more careful, and not rush things. I don’t want to end up later this year with a winter coming and depression galloping again in my brain.

    Man, it’s so challenging to find a balance. I said from the beginning that I will win this fight, and I will. It feels though like a lifelong battle, that this will be my fight until the end of my days. I must never let my guard down, I must remember that there is always a risk of falling into depression. Like asthma. You have it and then it stays with you; you can calm it down, thame it, but never lower your guard, never underestimate the enemy.

    Step by step

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    For someone who wants everything and now, thinking in steps, small drops, little daily progress is a huge endeavor. It’s almost paradoxical: for me small steps take a huge effort! And yet it’s true: I realise it now, after losing the big love, after returning to a country where it’s difficult to make friends, and with a job that gives me lots of frustration, I would rather leave, and get the immediate gratification of moving away from here, rather than working drop after drop every day, in the hope that it will bring joy in the future.

    Tomorrow is March 2021: 5 years since I moved back to Switzerland. Very hard times, let me tell you, and it ain’t over yet. But: I am learning to be patience, to not drop everything at the first (or second or third) difficulty; I have been wanting to quit my job since October 2020 (and in 2019 too), and have been telling myself to resist; this time you resist, damn it! It hasn’t worked out in the past, running away I mean, so why should it now? Resist! Embrace!

    My psychologist, whom I meet every 2-3 weeks, tells me that I have this pattern: when I feel blocked I want to leave. Mmmhh. yeah! I feel so constrained that it feels unbearable. Leaving is finding new horizons, changing landscape, moving household. Change is good for me, I seek movement, change, speed. But he says that this is not good for me, it’s a wish for escape, but problems will not disappear, they will tag along. He may be right; I don’t like him particularly, but I keep seeing him, for one reason: I have been wrong before, he may be right. He got this typical Swiss attitude, the rational one, you know? Rational, pragmatic, boring. Add Switzerland and Covid, and you’ll get boring all right! But then I must say that Switzerland during Covid is quite extraordinary: I am able to ski, paddle board on the lake, walk around without a mask. It’s a little paradise.

    So, long story short: I have to be patient, I have to go through my obstacles and blockages, the only way around it is through it. It’s so damn hard, but it is feasible. The medicine I am taking is helping me feel ok, even good again. Starting my new hobby is helping me tremendously (podcasting), and gives me inspiration that counterbalances the frustrations at work. Through some expat whatsapp groups I am meeting new, refreshing people, and that’s good. Step by step, drop after drop, I am going through this hard, dark winter: Fluoxetin has kicked in, some problems at work are being tackled, my podcast is finally up and running, skiing with new friends on weekends is fun, and the days are getting lighter, sunnier and warmer. Spring is around the corner.

    Happiness is an atttitude: I can be happy if I so choose.

    Step by step.

    Back to drugs

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    Third day of Fluoxetin, 10mg. Dr N. said ok. I am surprised he gave me the answer via phone, through his assistant. Usually he requests an appointment (300 chf please).

    I decided not to be stubborn this time, and to take the medicine immediately, as I am starting feeling that depressive emotion again. I am familiar with the symptoms: when I start thinking of going away from Switzerland, when I want to go to Canada and find W. and when I want to change job, that’s the alarm bell for me. Last year this time I was in a terrible mood, this winter I want to be better, be good, be great. Despite the fall, despite the challenges at work, despite not having W. in my life.

    I feel disappointed that I am back to square one, but I have decided not to feel sorry or ashamed for taking Fluoxetin again. Like my friend says: “be happy that you have found something that works for you”; she is right; this medicament is helping me, and I will take it. Possibly for a short while, during winter maybe, until the sun shines again and Corona ends.

    After 4.5 years I am still thinking about W.. Will it ever end? I tell myself that I will forget him when I find a new love. Good luck here in Switzerland, where it’s so hard to make friends, let alone find love. I don’t go out enough (and now with covid even less), I should get into more social circles. I need to find a way to meet people from the IMD, or similar international schools; people who come here to do masters degrees, people my age, that come from all over the world, one I can fall in love with.

    But W. is my special love, the one with the big L, the one I would like to grow old with… well if he ever decides to speak to me again. For now I have no chance. I emailed him.. nothing; I sent him a message on FB, he blocked me; I reached out on LinkedIn, he makes himself invisible to me; I even delivered a letter to him via an acquaintance of mine who so kindly went to Banff to give it to him in person, and he received it, saying he was going to read it. But I never heard from him. This was last year. Now what should I do? I tried forgetting him and get over him. it’s been almost 5 years. No chance. He was my steady star, we completed each other, now I feel empty.

    But: when I was with him I had already signs of depressions. I was crying a lot, I was dissatisfied about my own professional battles, things were hard also when he was around, loving me and caring about me. So I wonder: even if I saw him tomorrow, would his love make me happy? Would I make him happy? Or do I still need to search inside me a while longer to find happiness? That’s what I am thinking right now. I need to get back to my feet for good, before I can find someone (or him) again. I can’t rely on someone else to be happy.

    If I were with someone, I would feel less lonely.