Depressed partner has been on fluoxetine for 4 weeks. His negative side effects are unbearable...

Treatment and medication
1

My spouse finally sought help for his depression and anxiety.

Was initially prescribed buspirone for anxiety by GP, then fluoxetine by psychiatrist. A week in he had some type of psychosis (hallucinations, disordered thinking that was either due to meds or alcohol or combination of both) He reported it to therapist who didn’t seem concerned and told him to continue with meds and avoid liquor because of his tendency to overdo it with liquor but that beer should be ok because he has better control. (ASIDE: Therapist also told him he doesn’t abuse alcohol even though he binge drinks every time he drinks –hes a big guy but can drink about 9 drinks on his drinking days Fridays/Saturdays sometimes Sundays + dad was an alcoholic) Anyway, It has been taking meds for about a month and now he is suffering from anhedonia. He is having some kind of identity crisis and claims he doesn’t feel anything, not for me, not our son, not even for life itself. He says he is fighting this and knows that deep down he cares but at the same time he doesn’t. He also feels like he needs to escape and go somewhere. He also shared some sucicial thoughts such as him fantasizing about crashing the car, walking into the desert, etc. This is really frightening to me because this is VERY uncharacteristic of him.

We’ve talked and he stopped taking the meds yesterday and due to the long half-life, I don’t know how long it will take for the effect to completely wear off, but he is very lethargic, he is barely eating and is very nauseated (dry heaves throughout the day – some smells trigger it too).

My questions are: Have any of you experienced anything like this? Are the effects permanent? How long did it take after discontinuation of anti-depressants to feel “normal” again? What is your experience with failed anti-depressants and what ended up working for you? Any general advice would be helpful. I’m heartbroken that I can’t help him and that I won’t be getting him back… How do I help???

2

Has he been properly diagnosed? Could it be more than depression not just side effects my husband had similar problems and was diagnosed with bipolar he had hallucinations, spent money did and say things that he normally wouldn't do

If you're unsure about this it wouldn't hurt to get a second opinion

Also if he went off his meds he should consult his doctor first

These pills take time to adjust to

3

I am on this medication and feel exactly the same I think it is normal and nice to hear that some own feels the same. Today has been a bad day for me not want anyone just myself and can't be bothered with my own partner feel I don't love him and want to be alone but half of that is because he doesn't want to drag you down with him! Just try and reassure him if he wants love love him if he asks to be alone just let him be alone! He's not meaning to be distant it's just side effects of the medication always here but don't feel alone xx

4

Best person to advice you so so well xx

5

Fluoxetine and similar SSRI meds can be tough to take for some people, and the symptoms described can be typical side effects.  Hallucinations should be reported to his medic team though.  These meds can make you feel depersonalised, numb, can make your thoughts a bit erratic, tiredness, nausea, heightened anxiety ... but these usually wear off after some weeks.  Some people do get suicidal thoughts initially too - but again it's usually the side effects of the meds and it does wear off.  He should however report is to his medical team too.

These meds can take months before the patient feels any benefit, but they are good, and many people recover on them.

He shouldn't just stop taking the meds as they need to be weaned off slowly, or he'll start feeling ill.

Also drinking alcohol should be avoided at the start, especially heavy drinking.  Alcohol is a depressant, and it affects the brain too.  These meds also cross the blood brain barrier and shouldn't be mixed.  Trying to treat depression with one thing and counteracting it with another ...... ?

No the effects aren't permanent - staying on the meds these side effects wear off, and being off the meds they will eventually disappear, though of course some people feel like this when depressed.

K x

6

Hello, 

Thank you for your response. I feel really alone and trying to help my partner. I am afraid he will do something to himself while I am at work. From my own readings I gather that fluoxetine is either a medication that doesnt work for him or that he needs to continue through this horrible phase where accustoms to his brain chemical changes before it can get better.... however, I think that the suicidal thoughts are very frightening for the both of us. I think thats why he isn't complying with treatment.  

I agree with the alcohol consumption, but I can't control him... His "therapist" didn't help by saying that his drinking habits are fine... (I will bring this up to psychiatrist) 

I have made him an appointment with psychiatrist for tomorrow so we will see what he thinks. This is scary and I'm telling myself it will get better and my partner will be ok soon. 

7

Thank you for your perspective. He is pushing me away, but I won't abandon him. I am trying to give him his space too, though. He stopped taking fluoxetine yesterday and I made him appt with psychiatrist for tomorrow so we will see what he says. It seems my partner can't handle the "adjustment phase"...

8

Thank you for your advice. I made him an appointment with his psychiatrist and we will discuss his hallucinations (was a one time thing but still). I have family members who are bipolar and he isn't spending money but he sometimes has manic speech and thoughts (based on his description of his erratic thinking) Hope to find out what the next step is tomorrow...

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Yeah my husband didn't know what he was saying he would hallucinate and the things he would see would be distorted or would see things that didn't exist

Couple of times he was confused as to where he was

He had manic speech was verbally abusive and would ruin many friendships as a result

It took a long time to find a medication that worked he's on lamotragine and has been doing great on it his doctor wanted to add another pill to it called abilify

I have noticed a huge difference in his whole demeanour

And he can control his emotions more and we rarely fight any more

Mind you I'm on fluoxetine for my issue I have a mood disorder around my cycle ..if you can keep a log of his symptoms that will help when talking to the doctor it's also helpful to be present with the psychiatrist visit as you see more than your husband it will also help with helping figure out what medication would be best for his problem

10

I was also afraid to leave him at home as he was severely suicidal

To the point that he took himself to the hospital but only to be turned away

Which I was appalled by...the hospital won't take a person serious if they're not injured on the outside even though he had thoughts of suicide and reached out for help

I'm relieved he didn't pursue anything but could have and I would have held the hospital responsible for his death!

It helped to stay in communication with him throughout the day sent texts here and there

Have to go to work will comment again in a bit

11

I nursed my son through treatment on these meds when he had an anxiety and depressive episode.  It was tough, so know how you feel.  My son had suicidal tendencies at the time which scared us all, and he did suffer badly initially when on these meds.  Over much time though, and through family help and regular doctor visits, he finally started to recover and has now been back to his normal happy self for nearly a year now.

Ive also gone through the same many, many years ago and took similar meds, so know how scary this is for the sufferer too.

No you can't control his alcohol consumption, but only remind him on the pitfalls.  If he wants to give himself the best treatment to help with the depressive illness, then alcohol is a no no.  I wouldn't want to ever revisit  my depressive years - I'd rather lose a limb than have to go down that road again.  Could he come on this website too?  It can help him - though of course you're doing a grand job by trying to find help here too xx

My son had a terrible time on these meds, but the side effects do wear off.  The meds can take a long long time to start working, but you have to give your body a helping hand by eating well, early nights, exercise, no alcohol, talking, socialising if possible, keeping busy (even though the body is often unwilling) and reading about the illness really helps to understand what's happening and takes some of the mystery from it.

Yes it's often trial and error finding the right medication, and he won't know until he's been on these meds for quite a while - I'd say a good 3-4 months to start with anyway.  Some people feel the benefits earlier, and some longer.  The wait is worth it though, and they do work for a lot of people.

Suicidal tendencies aren't the 'real' him.  It's part of the illness, and the meds can exaggerate this too to start with.  It does get better - really.  My son was in a very dark, scary place for a while and he thought he'd never get over it - he did - and many other people do too.

Seeing the psychiatrist tomorrow is good.  Maybe he could take a smaller dose to start with to ease onto the meds?  But if he really wants to help himself and stop the depression, tell him the alcohol really, really doesn't help.

Good luck tomorrow.  Let us know how it goes.

It does get better - really xx

12

In case any of you find my update helpful or are curious as to what the doctor said:

I explained everything to the doctor and he believes my partner has bipolar depressive disorder that was unmasked by fluoxetine and made his depression worse (apparently is common for this type of bipolar disorder) and will be prescribing Latuda.

Now of course my partner is hesitant to take something because his experience with Fluoxetine was traumatic. Doctor said I shouldnt have waited to update him, so i think its always important to not assume that the side effects (suicidal thoughts/anhedonia) are supposed to be there as they can be a warning sign that the medication may not be for you. The therapist was not helpful in identifying that (grrr) 

Anyway, I am encouraging my partner to at least try the Latuda for two weeks to see if it helps. 

The psychiatrist also recommended he refrain from alcohol. Partner is not happy about that and is pretty defensive about accusations that his drinking is not normal. (Drinks every weekend or every other weekend but typically has 6-10 drinks on a drinking day) Doctor recommends AA or an outpatient program, but for now it doesnt seem to be something he is open to. I am patient and hopeful that he will come around. I just dont want alcohol to be a priority during his weekends. I'm also afraid that he will be an alcoholic like his dad (his bro recently got a DUI) so I don't think my fears are ridiculous. 

I will update with any developments in case this is helpful for anyone. 

Thank you all for your support and advice!!! It meant (means) so very much to me and I can't accurately convey how grateful I am to this forum discussion! xxxx

13

That's so good they pinpoint his problem!

Just the things you described reminded me of what I went through with mine

It's a rough road to recovery and you will both have to be patient with one another

The first step is for him to admit he has a problem and to work through it and get on the right medication

It will be the hardest thing to go through just be there for him

it helped me to put my feelings on the back burner and realized it's not him saying and doing hurtful things but his illness

I'm here if you need to talk as I've been through this for many years

Hang in there!