Upped dose has sent me into a dark place

Treatment and medication
1

After severe panic attacks started one night I went to the doctors and was put on Prozac 20mg. The panic got worse, as well as severe crippling depression and anxiety with at first suicidal thoughts. I ended up in the emergency room 3 days in where they gave me Xanax to get over the initial hump. The first 2 weeks were complete hell but, thought I was going crazy, suicidal, intrusive thoughts and so on. In the next few weeks my mood improved drastically, and by the end of week 4 I was on top of the world, feeling completely normal and better than I had in years. 

Over the next two weeks however, my condition slowly deteriorated, not to where I was the first two weeks of meds, but pretty bad. I went to the psychiatrist and he said that some people have a huge response to Prozac at first and then it wears off slowly. So 6 weeks in, he upped the dose to 40mg and the next couple days were okay, not the best but not the worst. Felt kinda numb sometimes and kinda depressed others. Now, at day 16 of the increased dose the past three days have been horrible. Borderline suicidal, intrusive thoughts, panic, and very depressed, with fast mood swings. I have questions:

1. Could this be from the increase in dose? Would it make sense that the side effects would be delayed 2 weeks after a dose increase? 

2. I have been sick with a fever the past few days, could that have something to do with my unstable mood and deterioration? 

I’m so sad because I did so so good for a few weeks and it’s just been downhill.

2

The effects do not wear off.  The slump you experienced after feeling on top of the world is completely normal and how the meds work.  Throughout recovery on these meds there will be many peaks and troughs (blips) and your mood will be up and down.  The downs do not mean the meds have worn off (it doesn't) but that it is settling in your body and the good feelings will come back.  Doctors never seem to understand this.

Increasing meds will not bring about a quick recovery - nothing will do that.  Each increase will cause more side effects which in turn will need to settle down too.  It doesn't matter what dose you're on you will not escape those 'peaks & troughs' and will have to pass through each one.

The original dose of 20mg might be suitable for you but you won't know this until you've been on that one dose for a good 3 months or so.  It can take as long as 9 months to recover, sometimes quicker, sometimes even longer.  The type of meds do not give you a quick recovery like other meds maybe would, but they help you recover over time.

Many people get confused by this up & down phase and think they're ill again.  They're not.  Its just a phase in the meds.

K x

3

Hi been there I've been on prozac since Xmas 4weeks on 60mg awfull side effects but now getting better days stick with it I know it works every increase will take a good few weeks I do a lot of mindfullness on YouTube really helps good luck