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Dr. Andrew Rynne

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Diagnosed with major depression. On prozac. Why do I feel good with 5mg and worse with 10mg?

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Dr. Jonas Sundarakumar

Psychiatrist

Practicing since :2003

Answered : 2190 Questions

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Posted on Fri, 4 Jan 2013 in Mental Health
Question: Hi,I was diagnosed with PTSD/Major depression a year ago .i moved out of my house 15 months ago because i was suicidial and my parents were being emotionally abusive.When i moved out of my house my moods improved and i didn't feel depressed or suicidal anymore. Then all of a sudden, about a month ago my feelings came back.My pscyhiatrist started me on 5 milligrams of Prozac daily a couple of weeks ago to combat my depression and suicidal thoughts.I took it for a week and felt great,then he upped my dose to 10 milligrams.As soon as i started taking the 10 milligrams, I started to feel depressed,weepy, down and suicidial again. What's worse is my roommate believes that i may have been suicidal a year ago but now she thinks i'm saying i'm suicidal just because i want the attention.I would never do that. She says i'm sending her mixed signals because on the one hand i feel suicidal, but on the other hand i'm excited about an internship program i'm applying for next month.She wants to know how can i feel suicidal at one time but be excited about the future at the same time?She's also said that she's borderline not trusting me and that really hurt my feelings because she's become like my second mom.I XXXXXXX with my pschyiatrist monday and she's going to go with me because she wants to discuss "inpatient treatment" with him.I bumped myself back down to 5 milligrams today and I feel fine. What do i do?how do i make sense of all this?Is it normal to feel fine on a lower dose of prozac then be bumped up to a higher dose and start feeling depressed and suicidal agian?is there really that much of a difference between 5mgs and 10mgs? I don't want to lose my roommate's trust because she's the one person in this world i respect and look up to so to lose her trust would be devastating to me.And i certainly don't want to go to an "inpatient" program in a pschy ward because i feel like that would destroy all my chances of getting into the internship in the future
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Answered by Dr. Jonas Sundarakumar 1 hour later
Hello and welcome to Healthcare Magic. Thanks for your query.

I'm sorry to hear that you've been going through a difficult time lately. I can understand that it is indeed difficult to deal with your depression, suicidal ideas and your PTSD.

Prozac (Fluoxetine) is an SSRI antidepressant commonly used in the treatment of depression. Now, there could be a reason why you had felt worse with 10 mg, when you had actually felt good with 5 mg. SSRI antidepressants including Prozac have a side effect of paradoxically increasing anxiety or inner restlessness in the initial few days of starting treatment. So, it is possible that these side effects were not prominent with a lower dose, but became more obvious with an increase in dose. Neverthless, if you are comfortable and doing well with 5 mg of Prozac, then you can continue the same dose.

It is also not abnormal for a person to feel a little excited or experience temporary emotions of happiness even when they are in a depressive phase and feeling suicidal. So, it does not mean that you are pretending or trying to seek attention. You could try explaining this in a gentle way to your room mate, so that she is able to understand what you arevgoing through. I understand that since you have already been through a lot of emotional trauma and have been in an abusive relationship with your parents, you may be very worried or fearful or losing trustworthy relationship in your friend. Don't worry, I'm sure that she will be able to understand you and continue to support you.

Regarding the possibility of an in-patient programme, this decision will be tkaken only in consultation with you and your dear ones. So, you can feel free to discuss this in detail with your psychiatrist, and express your concerns and choice in this matter.

So, don't get too worried and distressed; I'm sure that with continued treatment and therapy, you will be able to overcome your problems soon.

Wish you all the best.

Regards,
Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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