Switching from Fluoxetine to Sertraline, bad trip

[Danielsiam]

Hello, I was under Fluoxetine, for 2 weeks, ( but I was started from Sertraline in my country, and I was out of medication in Thaland, and finally I was so silly I change to Prozac (Fluoxetine), I bought it without prescription at some pharmacy near Nana in Bangkok.

Well, I took Prozac for 2 weeks, but feeling not much better, then the next day I stop Fluoxetine, I take back Sertraline, I buy it again at the pharmacy in Nana !!

and it happened, a very bad trip.. feel big dizzy, tachychardia, my eyes being dark ( iris small ), got a fever.. ( I went to hospital, psychiatrist .. cost me around 5000 baht !!! )

I said about my story, he just told me to stop medication & use Valium (Diazepam) and see the doctor again..

So after 17 days ( I try to get a half of Sertraline... so 25 mg ) and I was feel bad again at night time but during day I was feel at the good mood..

I don't understand, I buy a Sertraline from Thai brand GPO.. not a copy..

Did the fluoxetine can stay so long time & it's the cause ?

it never happened any side effect before with the sertraline but why now..

I try read that the Prozac also giving a Norfluoxetine ( and his half life it's 16 days )!!!

I hope it's the reason..

I don't know what to do..

and Thai psychiatrist cost so expensive.. and seems they don't know too.. they told me to take the Sertraline ( after 4 days ) ..;

Don't know what to do..

I sleep so bad, feel very bad mood, if I drink a beer, I will feel so so so bad..

I hope I am not crazy.. it's just a depressed..

[TerryLH]

"...if I drink a beer, I will feel so so so bad..."

[oncearugge]

Messing with powerful medication is always a bad idea.

Self prescribing is also a bad idea.

Sadly some people will never learn but are surprised when it all goes wrong.

A consultation with a Thai medical specialist costs no more than 1-3000 baht even at the most expensive of private hospitals.

Are you planning to return home soon or will you be seeking on going medical care in Thailand ?

Do you need advice about where to seek medical assistance?

Edited September 20, 2015 by oncearugge

[Sheryl]

It is called Seratonin Syndrome, and a good example of why you should not self-prescribe these things.

Fluoxetine has a very, very long half life. It is slow to take effect and then quite slow to clear the system. Whereas sertraline has a much shorter one, takes effect more quickly (about weeks versus a month or more for Fluoxetine).

When you switched from comparatievly short-acting Sertraline to Fluoxetine, it was initially as if you abruptly went off SSRIs altogether and your serotionin levels plummeted. Then you did not give the fluoxetine enough time to kick in before switching to sertraline but as some of it was still in your system, what would have been a usual dose of sertraline for you was too much.

You have been putting your brain chemistry through a real roller coaster with all this and it will likely take a while to settle down (and won't settle down at all if you keep on with this sort of switching between drugs of very different pharmakinetics).

There are some very competent psychiatrsts in Thailand, though as with all doctors there are also some mediocre and even quite poor ones, and one has to put some effort into selecting the right doctor. Where in Thailand do you live?

[gamini]

Some of the best psychiatrists I have seen in Thailand i.e. government hospitals and charge a maximum of 300 bt. So I suggest you go to your nearest government hospital

[DogNo1]

Well, I can verify that a psychiatrist at Bumrungrad charged me more than 5,000 a visit for consultations about sleeping medication. She was pleasant but swithched me through several medications before arriving at a combination of Ambien and Ativan. With the proper dosage, I feel alert when I wake up.

[Sheryl]

Well, I can verify that a psychiatrist at Bumrungrad charged me more than 5,000 a visit for consultations about sleeping medication. She was pleasant but swithched me through several medications before arriving at a combination of Ambien and Ativan. With the proper dosage, I feel alert when I wake up.

More than 5,000 baht this is either a total for more than one consultation or it also includes medication costs.

Fee for a single specialist consultation even at Bumrungrad will usually be around 1,500 plus the hospital add-on. Possible that some are as much as 2,000 but no one there is 5,000 for a single consult.

In OP's case the meds involved are OTC so he need not buy them at the hospital pharmacy which will save quite a bit. In your case no choice as they are controlled drugs.

I trust she warned you that ativan is physically addictive and not recommended for long term regular use. Short-term use OK, or intermittent use long term, but not daily long term use.

[chubby]

so, you want to know what?

what drug you should now take, based on your symptoms?

i'm not sure that either of these drugs has the high efficacy despite their wide use. are you saying you'd been on sertaline for a long time? how long ?

my understanding is these drugs can take a month before one notices slight improvements, so if your expecting them to pep you up, then starting and stopping them, someone may have misinformed you, these are not blood pressure pills.

if you've got clinical depression, see if you can find cognitive behavioural therapist in Thailand. don't jump to medications, of course, you don't say anything about your age and history .............

Edited September 24, 2015 by chubby