I know this is somewhat off topic for a college message board but there seem to be people with lots of knowledge about various things who post here and I’m hoping someone has some experience with this.
My daughter is a freshman in college, she’s always suffered from anxiety and depression and had a really difficult first semester being away from home, missing her friends, hard time finding her tribe, etc. etc. She sees a therapist regularly and they suggested she see a psychiatrist over break to talk about medication. She started on 10mg of prozac for 2 weeks then 20mg for 6 weeks then a week ago went up to 30mg. She’s been tired and had headaches at first but was starting to feel that the medicine was doing something. She was texting me constantly last semester miserable and that has subsided. She seems to be getting into the swing of things at school. She’s happy she started the medication.
All sounds good except she called me Wednesday to say that her lips are moving involuntarily. She sent me some videos and it’s frightening. I read there is something called Tardive Dyskinesia - basically involuntary movements brought on by SSRIs and anti psychotics. It sounds like it’s not uncommon and it can be permanent. She called the doctor and he lowered her dose back to 20mg but in the meantime I am both upset and very frightened. She has neurological issues already so this just makes me more concerned that she could be more prone to this.
Anyone have this issue or a kid that had this issue? How long does it take for a medication decrease to kick in? I’m not sure if it’s the build up of what she’s been taking or the increase in dose. It breaks my heart because I feel like she is finally finding relief. I know these medications come with a risk but there is no way you can be “happy” if you can’t control your facial movements. I now question if she should be on this at all. I know you can’t go off cold turkey so I’m not sure there is anything more she can do at this point until she steps down the dose.
If anyone has any advice or info to share I would really appreciate it.
A friend of mine’s son had this; his entire body had involuntary jerking and spasming after an increase in prozac. The prozac was tapered back and the jerking resolved. He was on Prozac for about a year or so; he no longer takes it.
It is my understanding (I am not a medic) that the dosage can be tapered back and reduced, not halted, fairly quickly if she has not been on it too long i.e. days rather than weeks or months. I could be wrong. I hope that your D recovers quickly
H has this. He had multiple cardiac arrests this summer, and was placed on Prozac before leaving the hospital. Ever since coming home, he has very violent, stiff, jerking movements of his arms and legs during sleep. They don’t usually wake him up, but it’s extremely disruptive to my sleep and I always worry it’s another attack.
We have mentioned it to the cardiologist and other doctors. They brushed it off, and blamed it on the arrests and disruption to other body systems. None of them want to deal with Prozac. Anger management and anxiety are not good for cardiac patients, and it seems like they should pay more heed.
Sorry I have no specific advice. Prozac does help keep him calmer and less volatile, so at this point, he’s living with the side effects. I do wonder if previous neurological issues contribute. I hadn’t considered that. Good luck to you D.
Doesn’t sound like tardive dyskinesia (which can be debilitating) but one of the very unpleasant but “10 percent of patient population” gets it side effects. I would not suspect that it is permanent.
Prozac has a pretty long half life so it could take up to two weeks for improvement from the decreased dosage.
There are other meds she could try if this one doesn’t work out for her.
@sryrstress — Not to alarm you but Prozac can have some serious cardiac effects which I would definitely worry about in someone as compromised as your husband. Especially after a heart attack.
You know him best. Make it very clear how concerning this is to you.
Unfortunately the range of drugs is so broad that even the best of docs have trouble keeping up so sometimes it lands on you. But don’t let them brush you off. There are other alternatives to Prozac.
@sryrstress —The involuntary muscle jerking is a side effect of Prozac and may be helped by lowering dosage (although not sure it’s a good idea to start with).
Perhaps taper her off Prozac , which came out @ 1976, and replace with a newer version of a SSRI or SNRI. I doubt it is TD. I do wonder about why the mad chose this particular medication.
Thank you all so much for responding. They chose Prozac for her because of her age (i think the choice was between prozac and zoloft and prozac is good for anxiety) and also because my husband is on it and has a good response. They said there was a genetic component to how people react. Thanks for the info on the long half life, I will try not to panic yet. It’s been super scary because she’s far from home and I know she’s crushed that she just started to feel so much better about things and was starting to feel good and settled about college and now this. It’s not a small twitch or tremor it’s very noticeable and she’s not able to sleep which isn’t helping!
Appreciate all the support. This community is awesome.
Prozac is a drug that can be stopped at once. There is no need to taper, according to my doctor.
I tried Prozac during a stressful period. As my dose was increased I developed a form of lockjaw.
The pain in my jaw was excruciating. Since I clench at night it was difficult to figure out. Neither my
Doc H nor my Doc had ever seen this but it is on the list of side effects. It resolved within a few days after I stopped taking it (upon my doc’s direction). I believe that my research was the reason it did
get figured out…
There are many other medications for your D to try. She needs to insist on a new medication.
I will keep her in my thoughts.
@oregon101 —. Prozac may or may not need tapering dependent on the dose and how long it’s been used.
In emergency situations tapering will not be done.
@romanigypsyeyes Prozac is probably considered one of the top first-choice antidepressants. It’s old but it’s cheap.
@Dancer41 Almost five percent of the white population is very deficient in producing the CYP2D6 enzyme, which is necessary to metabolize virtually all SSRIs, of which Prozac is one. The percentage is slightly higher for Southern Europeans and much higher for those with Arab blood.
Does your daughter process codeine? By process, I mean is it effective at all in treating a cough or can she not even feel it. Poor metabolizers can’t convert codeine to morphine because they lack the enzyme. Second, has your daughter ever taken dextromethorphan, that’s the DM in many cold remedies. If so, did she complain that it made her feel bad? Most people feel a very slight eurphoria after taking dextromethorphan, but poor metabolizers hate it.
I strongly suggest you have your daughter quit taking the medicine and go to a clinic as soon as possible. Serotonin syndrome can be deadly.
I’m posting a link for an article I bookmarked a few years ago when my daughter was on her own medication odyssey. Just because Prozac is old does not mean it is a poor choice. In fact, it’s the safety record and efficacy of Prozac that make it a popular first choice. Newer antidepressants do not need to be more effective than existing ones to gain approval, they only need to show benefit over placebo. Due to patent expirations the pharma companies must constantly churn out new formulations, even if they are inferior to existing off-patent medications. The article explains how pharmaceutical companies hide their negative results by only publishing results of clinical trials that show benefit. The two antidepressants that had mostly positive results in clinical trials were Prozac and Effexor. https://www.nejm.org/doi/full/10.1056/NEJMsa065779
In my opinion doctors tend to increase dosages before allowing enough time for a new medication to have an effect. They are also slow to decrease a dosage to find the lowest effective dose. This may be driven by a desire to do “something” for a suffering patient, but in the long run many people end up with side effects that cause them to discontinue treatment.
Hopefully your daughter will be able to do well on a lower dose of Prozac. You didn’t mention a therapist, but antidepressants tend to be more effective in conjunction with regular therapist visits.
Also - suggest she eats lots and lots of yogurt with live bacteria, probiotic drinks, regular walks outside, good veggies, etc. The whole “brain - gut” connection is becoming more understood, and there is research that shows that folks have improved mood if they eat yogurt daily. (I know, I know… it sounds nutty, and much of the mass market research is oversimplified - but it does look that there are some real findings here.)
This sounds like an “extrapyramidal symptom”. I personally would stop taking a drug with this side effect immediately. Prozac has a long half-life, so it will take a couple of weeks to wash out. I would then try a different SSRI/SNRI altogether.
Zoloft caused me to have not a care in the world - (missed deadlines, stopped following up on issues, didn’t care about being on time)
Prozac made me have violent outbursts and I was on the lowest dose. Verify with a doctor (or two) about quitting cold turkey or slowly weaning.
Paxil seemed to work best. When I no longer needed the drugs, I was very careful to wean myself off.
I learned later in life that I am slower (intermediate) to metabolize the Cytochrome P450 CYP2D6 and CYP2C19 drugs so that may explain my reactions. You may find it interesting to research. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4512908/
EVD, wow. such interesting information.
I have not taken a cold remedy is 40 years as they made me feel terrible.
I have to beg in situations such as an ER or surgery that I am given low doses of nearly
everything as I react to strongly. The only thing that this is not true for is Versed used for a colonoscopy.
I need a lot and I feel fabulous after. I do not know why that one drug impacts me differently.
Not to high jack this thread…
Any news from your D?, Dancer41???
@oregon101 Thanks for asking. Doctor took her off the prozac. He was hoping the lower dose would help but after a few days the movements haven’t stopped so he had her stop taking it. He thinks that maybe she is more sensitive to the side effects becasue of her pre-existing neurological issues. I’m hoping the movements stop soon then we will determine next steps. She goes to school out of state so the doctor from home that started her on the medicine over break can’t start her on something new - we are trying to move up the appt she has at school. Thanks to all of you for helping me with advice and support. I really appreciate it.
@Dancer41, just wanted to say that my heart goes out to you with your daughter OOS and the worry. My daughter had a dyskinetic reaction to an anti-nausea medication once and it was so frightening.
Your daughter had probably just gotten used to the Prozac and to the point where started to help . Please let us know when the lip movements stop, and I hope your daughter has support around her to get through this time until the right medication is found so that she can feel better! Might she need you to go down there or is she weathering all this ok?
. Please let us know when the lip movements stop, and I hope your daughter has support around her to get through this time until the right medication is found so that she can feel better! Might she need you to go down there or is she weathering all this ok?