Knowledge of depression?

[mizfiesta]

I have suffered bouts of moderate depression and have been taking 20mg of Prozac daily for around ten years. A couple of months ago, due to an ongoing period of stress, I got really depressed while still taking my 20mg Prozac. I was too ill to cope with work so I have been off sick since the start of September. The doctor advised me to start taking a double dose of Prozac, so I started taking two 20mg tablets a day. 8 weeks and one failed attempt to go back to work - they had made no marked difference. Maybe my mood stabilised very slightly but my sleep became more difficult and I felt more 'jittery'. I went back to my doctor around two weeks ago and explained I still didn't feel well and certainly not well enough to return to work.The doctor suggested we try another medication and gave me a prescription for Mirtazapine. Firstly though I was to reduce my Procaz intake. For the first week I was to cut down my Prozac from 40mg to 20mg daily. Then the second week I was to take a 20mg Prozac pill every SECOND day. I am due to start the Mirtazapine on 23rd November.This is where my dillema begins! The past few days, for no apparent reason I have started to feel a bit better! And I'm only taking 20mg of Prozac every second day! I was expecting my mood to plummet while I reduced my Prozac to start Mirtazapine and was a bit scared - but the opposite is true! I'm sleeping a bit better and feel quite good and my mood is the best it's been in weeks. I now don't know whether to start the Mirtazapine or not?! Should I just continue with the 20mg of Prozac every other day till I figure this out? I don't want to get lulled into a false sense of security. Maybe my dark cloud is waiting round the corner. I need to get back to work before I lose my job so should I just start the 15mg Mirtazapine daily to enable me to do that? I know it will certainly help me sleep. Would it be crazy for me to try and go drug free and risk crashing at the first sign of stress at work for example?

[boxtops]

I sympathise with you - and yes, the short answer is yes, you would be crazy to come off altogether and try to manage without. You sound like you are heading in the right direction - but I know from personal experience that to go cold turkey is a mistake. Weaning yourself off by slowly reducing the dose under medical supervision is by far the best way. Good luck with it - let us know how you get on!

[trt]

I agree with boxtops, wean yourself off by slowly reducing the dose under medical supervision.

Good luck.

[NOX]

Well, I'm going to disagree with the other posters I'm afraid, having also suffered from depression. In some people Prozac exaccerbates the situation and actually makes you feel worse. The best way I ever found of managing my depression was soley lifestyle and attitude based, drugs really did not help (I tried plenty both legal and illegal) and it wasn't until I actually lived to the mantra of 'Happiness is not a destinaiton happiness is a way of travelling' that I got any better at all. The other thing is it's really quite personally empowering to be drug free, you feel more alert, more alive and for sure that also means that stress can hit you harder, but stress is a normal state of being in many situations and usually , not always but usually, we can work through those phases if our mental attitude is right. It took me a long time until someone showed me this, but I have been drug free since I met my ex partner and although I do have some very dark phases I surf them and know they won't last forever and I can manage.

[crisgal]

poor you, mizfiesta - you've really have been having a bad time of it haven't you?

I too have been on medication for about 15 years and can understand how you are feeling.
i am on mirtazipine and have been for about 3 years now.
it's a difficult one really, I feel so well that sometimes I forget to take my tablets! But then, sure as eggs is eggs, I will suffer days or even a week or two later.
I think the medication has a long lasting efect and it may not be that you are feeling better because of you reducing the pills, but through taking more before that. Do you know what I mean?
For myself, I believe, if the drugs work - take 'em!
Why not continue with the program suggested by your gp, (they are the experts after all!)and give it say, 4 months and then see how you feel.

Whilst I appreciate that some people are able to manage their depression through positivity and lifestyle, I can only say that we are all different and I battled for years before starting on meds - there is absolutely NO way that I could have managed without them. Nox, i think you are one of the lucky ones.

I hope you continue to feel well, miz, whatever you decide to do. x ♥ x

[NOX]

My point was though chrisgal that whilst I totally respect anyone's decision to continue taking anti depressants, I found actually that once I was off them and understood fully other coping mechanisms I think they had been making me worse- it's fairly well documented that many anti depressants actually do have an adverse affect on many people who take them- and it seems that mizfiesta is now feeling better since she's taking fewer- which may or may not be because she's not taking them. I was not in any way trying to take the moral highground on now being free of them, quite the reverse but I really don't consider myself ' lucky', depression is a terrible thing and you can't judge anyone else's- I don't know if yours is worse than mine or mine is worse than yours- I just know that I had been treated for years by 'experts' and that once I stopped doing what those experts assured me would help me I felt a whole lot better because I was actually dealing with the problem myself and not relying on chemical fix- it's just a different point of view but there's nothing very 'lucky' about it.

[craft1948]

There's nothing worse than the jitters.......I've been on Mirtazapine for a few years now, I was originally on 30mg a day, and I'm now down to 15mg but I'm given extra tablets in case I still have an attack of the jitters. My medication is up for review next May and I think I will still need it. Do take the Mirtazapine as prescribed, I've felt better and ditched it, and ended up worse than ever. I'm not even bothered if I'm on it permanently as it does what it's meant to do.

[boxtops]

NOX, I hear where you are coming from. Once you can get the thing by the horns and take control then YES, you can do it yourself, but I was a long long time getting to that stage, and as crisgal says, everyone is different. I never had Prozac but plenty of other meds for far too long a period of dependence, and I know how hard they were to get off, even though I knew I wanted to, you can't just stop or you go right back down again. The positive attitude I was able to find helped me to hang on by my fingertips during those days of recovery - which is why I recommend the slow process as having 100% success - for me. It might not work for everyone, it's impossible to offer blanket advice for this sort of situation - but you are right, knowing when you are at the right place to take control of your own destiny is an empowering point. I well remember that point, and it sounds very much to me as if miz is getting there - and more power to her elbow. We'll be here for you, miz - we've been somewhere very similar, and it does get better, and life is out here waiting for you!

[beso]

All drugs have side effects and we all have variations in brain chemistry. Read up on as much as you can about the Mirtazapine before you decide take that path. Make sure you are completely aware of what to look out for and remember there is no guarantee that is is going to suit you.

Results are what counts in any antidepressant medication. If the reduced Prozac dose is heading you in the right direction then stay with that while you prepare an ongoing strategy. Maybe continue to very slowly reduce the dose and monitor your mood.

However I think going cold turkey while you try to get back to work could be courting disaster.

Another great idea is to slowly replace Prozac with natures own antidepressants. Endorphins. Vigourous exercise get them flowing and is very good for sleep. Also yoga and meditation which has a calming influence on the brain.

Do something you enjoy with other people. I highly recommend making music with a group of people. Taking up singing has been the most positive treatment I have ever found.

[crisgal]

i haven't been on here all week, how are you feeling mizfiesta?

[mizfiesta]

Thank goodness I checked back on here this evening as I hadn't been informed I had any replies by email alert! I was soo heartened to read all your replies - thanks so much :) I'll give you an update on how things are for me just now. Well, ten days ago I said my mood had lifted somewhat, but unfortunately it didn't last long. Around three or four days after that my mood deepened and I became very irritable, bad tempered and depressed. I subsequently started the 15mg of Mirtazapine on the 23rd of Nov as instructed by my G.P. One week on and I can honestly say that from night one I have never slept as well for years. I have read since that Prozac interferes with the sleep cycle. No wonder I always felt tired! Since yesterday I feel my mood has been a bit lighter. It's not nearly as difficult getting up in the morning and facing a new day I'm glad to say. I visited my G.P today as arranged, and we both agreed that 'so far, so good'. She has now instructed me to take two 15mg tablets of Mirtazapine from NEXT Tuesday, 7th November, so I will be on 30mg daily. I was hoping to stay on the 15mg dose as I'm not too keen (is anyone?) on relying on drugs, but she assured me that 30mg was the 'therapeutic dose'. I want to get better so shall plough ahead. I just want to feel better. It's early days but I'll keep my fingers crossed that I'm on the road to recovery. I'll update this thread again. Once again you are all champions for taking the time to submit your thoughts and experiences x

[boxtops]

Well done mizfiesta, it's good to know that things are looking promising for you. Keep us informed!