What could cause sleeplessness, tiredness, nausea, cough, excessive mucus and vomiting while on Prozac?

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Posted on Wed, 20 Nov 2019 in Mental Health
Question: My husband XXXXXXX is 49 years old. He is 5 ft 10 and he weighs 250. He has the full body large muscle structure that you would not believe he weighed what he does. He has lifted weights for years and is very active. He has attended cross fit classes 3 to 5 times a week all winter, which are around an hour and a half sessions. XXXXXXX eats very well, eating the best brands of bison and hamburger, eggs, many veggies, salads, almond milk and works hard to consume the best foods available. He does consume sweet food but not a huge amount. XXXXXXX is a general contractor and normally is very concrete and to the point. He normally has had a fast temper and rarely would allow him self to relax. He always has had work projects to do after work and on weekends. His only real extra enjoyment has been hunting, hiking and riding his pedal bike. He pedals ten plus miles at a time and (has many times gone for 30 or more miles in high heat). Until this winter, I have not seen XXXXXXX be sick. Yes he has had colds, but never thrown up not one time, nor had anything wrong with him. We have been together for over 23 years and what I am describing is very different. For the whole time I have known him he has struggled with sleep problems, which was thought to be sleep paralysis, but there was nothing that was done about it. 15 years ago he did try trazadone for sleep but he did not like to wake up feeling like he did with it and quit. This winter he became very depressed and went to the doctor which is amazing because he does not do doctors. Normally he does not take medications or have medical problems. He began taking the generic Prozac 20 mg several months ago, the doctor built him up to 60mg and mentally this has been great for his mood and our 15 yo and I have very much enjoyed being with him and engaging in away that we never could.Then 4 months ago XXXXXXX began to get sick; he threw up and stayed home from work. Previously if he took a sick day it was to work on a side job. So he got better and worse several times. Then he began having problems with his breathing, getting swollen tonsils and was not well. The PCP did not think it was an issue. XXXXXXX felt that his sleeping was worse and they added 50 mg of trazadone. This time the medication did not affect him like it had before and he left it. Although he did go to sleep better he did not feel like he had rested still. He had a sleep study done with normal readings.George’s older brother told him he started to take testosterone and was sleeping better. XXXXXXX had it tested and he was a low normal. He then started taking it two weeks ago. XXXXXXX is resting and not feeling tired for the first time since I have met him. Normally XXXXXXX could put his head back on the truck seat and be asleep before a minute and was tired all the time. Now he can not take naps when he lays back and he does not feel tired, which he loves XXXXXXX does not feel sick, but he has things happening and he wonders if it is a reaction to Prozac, as he has read the side affects. He has to Clear his throat several times an hour, he Feels like his saliva / mucous does not go down his throat when he swallows, he has strange pains in his neck that are occurring randomly without swallowing. They are dull and are there and then gone. He reports that it Feels like his bronchial tubes are swollen, like when you have a chest cold, but he does not have a cold. He coughs all through the night and he does not suffer from a cold. He feels like his breath is restricted and he can not take a deep breath. He reports that he has a queasy stomach a lot for no reason. His pcp does not think he has anything big happening, but XXXXXXX is very concerned about it. After many times we did get a referral to an ENT specialist, but this is not until XXXXXXX XXXXXXX wonders if he should just stop medications to see if things get better . George’s parents both have had many forms of cancer. His father had throat and voicebox cancer and he had to have an operation. His father’s voice was never the same. George’s voice is different but this may be from excess mucous and saliva in his mouth and throat. XXXXXXX has a history of smoking for twenty years two packs a day. He quit a few years back. He does not drink or do drugs of any kind. He continues to be active even with his ongoing symptoms.

doctor
Answered by Dr. Alexander H. Sheppe 24 minutes later
Brief Answer:
Consultation

Detailed Answer:

Hello,

You ask above if these symptoms are due to Prozac. I do not think this is likely. In my experience, Prozac does NOT cause symptoms like this.

In this scenario, I would explore medical causes, or consider the possibility that anxiety is making these somatic symptoms worse.

Please let me know if I can assist you further.

Dr. Sheppe


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Alexander H. Sheppe 57 minutes later
Does it matter if it is the generic prozac.
I understand you do not believe that this medication can have symptoms like this. However, when looking up this medication on many medical websites that state many similar symptoms, such as the hard time swallowing, pains in the throat, hoarseness and respiratory symptoms over and over. How can we know if it is the medication, besides stopping it all together? I realize there is only a small population that list these symptoms, but couldn't he be part of this population that have symptoms? XXXXXXX has always believed this medication made him tired more than normal.

Are there other antidepressants that do not have these symptoms, that he could switch right over to without having to wean off and building back up? I know that you do not prescribe medications, but the pcp will work with us if we need to change him.

What is your clinical opinion?
doctor
Answered by Dr. Alexander H. Sheppe 4 hours later
Brief Answer:
Followup

Detailed Answer:

Hi,

In my ten years as a psychiatrist I have never seen Prozac cause the symptoms you list. If you read the package insert for Tylenol, you will see several rare symptoms such as liver failure, but that does not mean that it is likely. I would not recommend changing this medication as I do not believe it is causing these symptoms.

Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Sheppe
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Alexander H. Sheppe 35 hours later
Thank you, could your continue with us for a bit longer?

My husband would like to know if this could be a bronchial issue? I know you do not handle this, but you have the medical background.

He continues to have his cough at random times and at night some, has a minor sore throat, slight hoarseness and the restricted air flow and he feels like it is when he has a cold in his bronchial tubes and they are irritated and restricted. If this was the bronchial issue, would this just require some sort of antibiotic to clear it up. He has had the symptoms for 8 weeks. It is not constant and not a cold.


So in your professional opinion, you do not believe that this could be caused by taking his generic prozac? He did begin this medication in November, but went up from 20 to, 40 to 60 mg. He was always convinced this medication made him more tired. Have you seen this make people tired and it not get better after months of treatment?

Being tired has been a life long problem. Not only because he was active, but because he would fall instantly asleep and wake up 15 minutes later and be up and down all night. So when he thought this really made this worse it was difficult to keep him on this medication.However, he was not feeling the additional head and throat symptoms until 8 weeks ago. He does not seem like he has a cold, as it all is so random.

He is doing a Testosterone pump two pumps daily. He finally does not feel tired, which is the only real problem he has struggled with his whole life. He tested his testosterone and it was a low normal, but this pump has made a huge difference. Would testosterone make any male 50 yo sleep and feel better or is this truly helping because he was a low normal and needed this? This in addition to the prozac has made a new man with a better outlook on life. The same person who can still get upset, just not hold the upset for days and weeks. Now he is rested and able to joke and relax which he could not do in 20 plus years.

1. If this was a bronchial issue would this just require some sort of antibiotic to clear it up. He has had the symptoms for 8 weeks?

2. If it is this physical issue, wont a Ear Nose and Throat doc be able to identify what is going on? His specialist ENT apt is in two months.

3. Do you think when a parent has had cancer in the throat and voice box leading to surgery, this relates to the child? Some things are genetic and others have no bearing on a current situation.

4. In your professional opinion, you stated you do not believe that this could be caused by taking his generic prozac, but have you seen this with Trazadone or the combination?

5. Is there a possible connection to taking testosterone or is there a huge concern that he is taking this as a 50 year old?

Thank you for your time!
doctor
Answered by Dr. Alexander H. Sheppe 9 hours later
Brief Answer:
Follow up

Detailed Answer:

Hi,

1. This is outside my area of expertise. I would consult with a primary care doctor for a physical exam to determine the cause, and then to decide on appropriate treatment.

2. Yes

3. There are some genetic underpinnings of cancer, but we aren't able to specify with certainty at this time.

4. No

5. As long as an endocrinologist is prescribing testosterone for a documented low-normal deficiency, this is acceptable.

Please remember to rate and close this answer thread when you are finished and satisfied.

Hope I have answered your question.

Regards
Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2242 Questions

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