Patient's Query
Hello doctor,
I have been on Fluvoxamine 100 mg CR for the last two months for health anxiety issues. Thoughts are controlled and sleep is fine. The mood is generally fine. But feeling very tired and lethargic a lot. Want to know if this is the effect of Fluvoxamine and if the change of SSRI will help to restore energy.
Hello,
Welcome to icliniq.com.
Yes, you are right, Fluvoxamine has a side effect of increased sedation. Because of sedation person feels lethargy. You can do this thing that if Fluvoxamine is causing sedation, you can shift the medicine to night time, just before sleeping. This would sort out your problem. If this does not sort out your problem, you can have a trail of another SSRI Sertraline which is a safer option in the heart disease patients as you already tried Escitalopram and Paroxetine.
Patient's Query
Thank you doctor,
I have been taking Fluvoxamine 100 at night and the tiredness has persisted. Is Sertraline a safer alternative for long-term use? Do I directly stop the Fluvoxamine 100 and switch to Sertraline? What should the starting dose be?
Hi,
Welcome back to icliniq.com.
No, you cannot stop Fluvoxamine directly. It should be tapered off and then stop over 6 to 8 days. Sertraline can be gradually introduced.
Patient's Query
Hi doctor,
Thank you very much for the support. My age is 48 years. It would be grateful if you could please modify the prescription. Can I safely expect that Sertraline will not also cause tiredness and lethargy like Fluvoxamine- especially since you have prescribed it to be taken in the morning? Also, may I assume that long-term use of Daxid is safe and will not have any major adverse impact on my cardiac condition (one stent for a 95 % block in LAD- done eight months back). Or cause major adverse interactions with my other medicines- which are Ecosprin 75 mg, Atorva 10 mg, Cilacar T, Brilinta and Prolomet 25 mg after the stenting. Pan 40 mg, digestive enzymes, and probiotics for GERD and allied digestive issues. Also have chronic sinus issues also for which I take Acetylcysteine,Desloratidine,andAudiovit (for ear issues- tinnitus).
Hi,
Welcome back to icliniq.com.
Yes, Sertraline will not cause tiredness and lethargy. Sertraline is safe in cardiac issues even on a long-term basis. On the other Fluvoxamine do have some anticholinergic side effects, which are not desirable for heart problems.
Patient's Query
Thank you doctor,
Are there any other major issues I need to expect when I switch from Fluvox to Sertraline? I had been switched from Escitalopram (first 10 mg, then 20 mg) to Paroxetine, as the doctor felt it was not helping my health anxiety enough. But was switched out of Paxidep 25 mg to Fluvox because it caused nearly 5 kg weight gain over a few months.
Hello,
Welcome back to icliniq.com.
Yes, I know at times it is hard to find the accurate drug but let us hope this time it should work. With Sertraline, there may be a side effect of increased restlessness for 2 to 3 days but then it will settle. Let me know if it does not. Also, let me know if you have any other side effect. There is no do not on long-term use of Sertraline.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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