Prozac Side Effects--Normally Occur on Day One?

I called the doctor about this already and she said go ahead and stop taking the medication just to be careful, and get in touch with my PCP on Monday. But meantime, I’m just wondering some things.

Yesterday at 3PM I took my first dose of Prozac (or any SSRI or any kind of depression medication at all) ever. Felt fine all day. Around 2AM I woke up with stomach cramps. Went to the bathroom, and returned to bed feeling dizzy. In bed, I was restless and unable to sleep–very unusual for me, especially at that hour–and got up to go hang out downstairs since I couldn’t sleep anyway.

Still dizzy, and feeling oddly heavy, I got to the top of the stairs, realized stairs were a dangerous proposition, and sat down. Began feeling the familiar feel of being about to pass out, so laid on my back. Passed out.

Wife heard me making noises, came to check. She reports (I do not remember this) that I woke up, stood up, reported I needed to go to the bathroom, and stumbled that way down the hallway. At this point I crashed to the floor, unconscious, falling onto an object that left several scratches on my chest–which are still there this morning.

After several seconds, I came to–this I remember–and did not understand how I had gotten to the point in the hallway where I was. (As far as I knew, the last place I’d been had been at the top of the stairs.)

Is this in any way a reaction to Prozac that could be reasonably expected to possibly occur, just one day in to the medication regimen??

Or was this just some wild coincidence?

I’ve never taken Prozac, but I once had a terrifyingly bad reaction to an antibiotic and this occurred within a few hours of taking the first pill. So it seems plausible to me that if you were going to react badly to Prozac this could happen within about 12 hours, although again I don’t have any personal experience with Prozac and I’m not a medical professional.

Well, I’ll talk to the doc about it ASAP.

I just found out that before I got out of bed the first time, my wife was already aware something was up because, she says, I was doing this really loud deep breathing and moaning thing that I personally have no recollection of. She also says I said at the time that my heart was racing.

So yeah, maybe I’m not a good candidate for Prozac. Sucks–it’s only $4 a month! Hopefully other options won’t be too expensive.

I’ve been on and off various SSRIs over my life, and in my experience there are usually some side effects when starting them. Yours seem more extreme than any I’ve had, but in my experience, and based on things I’ve read, the side effects often go away in a few weeks. Your doctor will be able to give you more information, and whether it’s worth continuing with them depends on why you’re taking them, whether you have the time and ability to spend a few weeks adjusting, and what other options there are.

Yes, side effects are most common right when starting, and tend to get better over time. Side effects after having been on it for a while are uncommon–except is so called “poop out” or tachyphylaxis–something I’m currently dealing with.

It does sound somewhat like serotonin syndrome. Did you start on a high dose? You might be fine with a lower dose - your doctor should know. (I don’t know your age, but dosage recommendations are typically reduced in the case of the elderly - if that applies to you, what would be a normal dose for a younger person could be a too high starting dose for you.)

(I had a very mild reaction once when my doctor upped my dose one time too many. What I mainly remember is that it felt really weird. I too had balance problems, IIRC. I was fine when I went back to the previous dosage, though.) Hopefully you can work out a suitable dose/medication!

Weird! I actually have the lowest dose – 20mg – yet what’s described at that wikipedia page sounds like exactly it!

My wife said my hands were tremoring. I was having bowel issues the whole time (hence the bathroom talk mentioned in the OP). I was sweaty and felt cold–which may have been hyperthermia, though I didn’t get an actual temperature readout.

Interesting. I’ll make sure to mention such things to the doctor. Thanks for pointing this out.

So yeah, this was pretty much it.

WebMD’s write-up on Seratonin Syndrome.

Geez, so does this mean SSRI’s are pretty much a no-go for me?

I have been getting a lot of encouragement from friends with depression who have sought treatment. This is going to be very disappointing to all concerned.

Well anyway, the doctor will have things to say. Other kinds of treatment exist.

Serotonin syndrome with only an SSRI is quite rare. And what you describe also fits the side effects of SSRIs and having a panic attack due to them.

Serotonin syndrome tends to cause a fever. Did you have one?

It kinda sucks that you were unable to go to the doctor when it was happening, so they could tell the difference.

I just hate the idea of you missing out if it wasn’t serotonin syndrome.

Like I said above–I felt very cold and was sweaty, so though I didn’t get a temperature readout at the time it seems very possible I was feverish.

But yeah, I am keeping my mind open to what the doctor will say – the panic attack due to side effects has been suggested elsewhere. The thing about that is, I didn’t feel panicked (I’m one of those people who becomes calm and analytical during emergency situations) but maybe you can have a panic attack without being consciously aware of internal feelings of panic? I wouldn’t be surprised if that’s possible, human bodies are weird.

If a racing heart was a side effect, that could be one of the few things I can imagine inducing some kind of panic attack in me–I really, really, really hate to think about or be made aware of blood flow inside my body. Just this quirk about me. It has in fact caused me to pass out in the past, and though I don’t remember being conscious of blood flow during this episode, my wife reports that during the blacked-out portion of the episode I did mention I could feel my heart racing. This was after the first time I passed out though.

ETA: My reaction to thinking about my own blood flow is severe enough that I feel a little faint right now just typing about how I hate to think about it!

Yeah, the actual passing out is the most worrying part. Even if it wasn’t serotonin syndrome, it might be enough to say you should stay away from at least Prozac.

The side effects are usually different on different SSRIs, though. So maybe they’ll think it’s okay to try another one. I personally hated Prozac, myself.

I just had a conversation with my psychiatrist about this when I bumped up both my Zoloft and trazodone prescriptions. Serotonin syndrome is usually a medical emergency and doesn’t resolve on its own. You have to take overdose-levels of SSRIs or combine more than one such drug at high doses to develop it.

I’m guessing you either had a bad side-effect reaction to it (not the same as serotonin syndrome) or a panic attack. Keep us updated!

Frylock, 20 mg is not the lowest dose. I think I was started on 5 mg.

Yes, it’s absolutely possible to have a panic attack without feeling panicked. There would usually be some strong, negative emotion, but not necessarily one recognisable as fear. Basically, a panic attack is when the unconscious fight-or-flight reflex is triggered without (obvious) cause, which can result in a wide range of physical and emotional responses.

They’re not particularly uncommon, especially when taking SSRIs, or for that matter having a condition for which one would take them, and they are often manageable. Your doctor should be able to help.

Welp, fwiw I finally was able to talk to the actual doctor who I’m actually working with, and I described the incident, and the first thing he said was “That sounds like serotonin toxicity.” I didn’t ask him how unusual this would be. The plan is to talk about alternatives when I meet see him next.

I actually asked him if I could go ahead and try again, just to see if it was some coincidence or something that that stuff happened to occur the night after my first dose, told him I felt okay about trying it out since it was a relatively brief episode and this time if I started to feel it coming on I’d know what to expect so would be safer. But he was having none of that.

Oh well.

fwiw, I had to try several SSRIs before I found one that worked properly for me. I still get occasional dizziness from mine, even though I’ve taken it for 4 years now. Not everybody is a candidate for SSRI drugs, and you may not be. But there are other means of addressing the issues you have with medication of a different type. Perhaps your doctor will suggest something else to try.

Update for anyone interested:

Doctor thinks (and I agree) it was a kind of panic reaction based on anxiousness (which I may not be internally aware of as anxiousness but which manifests as thinking a lot about possible things that may go wrong) and exacerbated by a strong vasovagal reflex.

Nevertheless, he recommended changing to low dose Zoloft. He was explicit that the main reason was to help me stay not-nervous about it. Even if I know the reaction was “psychosomatic” at least by changing meds I won’t worry as much that I’ll have another psychosomatic reaction!

Have been taking low-dose Zoloft now for a week. Everything seems okay. I know improvements shouldn’t show up by this point on average (esp. with this low dose) but I swear on my life I’m less edgy around the kids and I am doing WAY less compulsive stress eating. Like, I know what hungry feels like now. And I stop when I’ve had enough. If this is placebo, GIVE ME MORE PLACEBO.

(Zoloft is said to induce weight gain actually, so we’ll see how that goes…)

Also, doctor and therapist think my problem is more anxiety disorder than depression, though both are indicated. Somehow I never really realized anxiety disorder was a thing for me but really, it fits.

What happened to sounds like what happened to a friend of mine when she mixed Prozac, which she had been on for over a year with no problems, with an OTC cough medicine containing dextromethrophan. Do you take any cold medicine or allergy medicine, or did you take a cold pill to help you sleep?

Restlessness from tricyclics and Wellburtin is well known, but I suppose Prozac could do it too. Then if you took a cold pill to help you sleep, that could have caused everything else.

Not your fault if no one warned you not to do it.

Sorry to do a little diary-ing here but I mean, this is just really amazing to me. The effects so far are quiet, subtle, yet in their implications, really dramatic.

Food. I don’t want to eat everything anymore. Not that I feel sick or something–just that constant urge to eat whatever food I see, it’s just not there anymore. I don’t know if this is placebo or what and I don’t see this listed on any list of effects of zoloft (in fact weight gain is the usual side effect it seems) but this is the simple fact. I drove in a car today with half a pizza sitting in the passenger seat. It’s hard to explain if you don’t have the problem I’ve had with food but it is simply mind-blowing that the pizza survived the drive. And it wasn’t even a close call. It simply wasn’t tempting. Sure I knew I’d enjoy the taste if I ate it, but I also knew I was too full to eat anything. It would hurt if I finished the thing off.

You don’t understand. “I won’t eat that because I feel full” is not something that I ever think, ever. Instead, at best I’ve only ever been able to think “I really shouldn’t eat that because I’m full but oh god nom nom nom.”

I was just like, “eh, that’ll be nice to eat tomorrow.”

And I passed by a Jack in the Box which, on this evening on the way home each week, I usually grab a burger. And fries. from, hungry or not, already ate dinner or not. I know this sounds so weird to many people but it was like a compulsion–one I enjoyed a great deal, though I knew it had no good effects on my body or my budget.

Yet tonight–not. even. tempted. a little bit. It was so incredibly unreal.

I haven’t yelled at my kids even one time this week. I’m sorry to say this is also a wonderful sign. My kids and I are close but I have been far too on edge with them for many months now at least. That has stopped. Cold turkey, almost from day one.

Brain fog. I didn’t even know I had what a lot of sufferers call “brain fog.” I thought I was just, like, groggy. No–that’s gone! There’s a clarity to things that is just----different.

Sleepiness. I’m not drowsy all day. I’m not even sure I ever was actually “drowsy” now–I just wanted to disengage I think. I’m not sure, it’s hard to explain. But this thing happened yesterday. I have a habit, when I’m feeling like I don’t want to get my shit together at some point during the day, of just closing my eyes. Eventually this leads to sleep many times, but the main thing is I’m just closing my eyes, just kind of ceasing activity for a while. Not so much forced by tiredness to fall asleep, but rather, letting tiredness take over so I don’t have to do anything else.

Yesterday I was feeling a bit like that. I closed my eyes, as is my habit. And not a voice, but anyway my thought, came through very clearly, clearly enough it’s best I just put it into words: “What are you doing? There’s a world out there, open your eyes and let it in.”

Guys, this is not me. I mean it’s me, of course, but it’s not what I’ve ever been like.

Holy moly.

This’ll sound funny but I’ve graduated from just ceasing all useful activity when I’m tired of having my shit together, to procrastinating by doing something useful when I’m tired of having my shit together! :smiley: Like, instead of sitting there reading the internet all day, I’ll go organize my pantry. I mean don’t get me wrong I’m no workhorse, doubt that I’ll ever be. But there’s just a little more energy and drive happening than I’m used to. I’ve been able to do things before, I’m not comatose, but it feels much less like forcing myself to do something than I’ve been used to for a long time.

Anyway, just registering how surprised I am by all this. It’s not like I have a hugely different internal feeling, it’s rather that the world around me seems a little different, in a way that lets me engage in fewer self-destructive behaviors. And I know the world seeming different is almost certainly an effect of whatever this zoloft is doing to my brain. So I’m pretty happy about this.

Man alive. I wish I’d done this long ago.

I hope it’s not temporary.

That’s all great news! Just regarding the temporariness issue, hopefully it won’t be at all, but it’s possible that some of it will be. BUT, if that does happen, and things do start to slip back, read your post again to remind you what’s possible, and what you can be.

It may be that the medication alone will be enough for you, or it may be that it will take work to maintain this state - but either way it’s possible, and what I really want to say is that, if things do slip back at all, don’t think that everything has failed, and that there’s no hope of getting back to where you were. There is!