[27F] Experiencing outbreak anxiety despite SSRI use

Patient Description

A 27-year-old female reports experiencing outbreak anxiety over the past two days, despite being on a daily SSRI regimen (Prozac). The anxiety episodes began recently and are primarily triggered by feelings of being unwanted or not fitting in within her friendships. She describes feeling on edge but denies any physical symptoms such as palpitations or sweating, and reports no changes in sleep patterns or concentration difficulties. The patient does not consume alcohol or use recreational drugs. Her medical history includes a diagnosis of panic disorder, and she has no known allergies.

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Arora's Assessment

What might be happening

Based on the information you've provided, it seems like you are experiencing increased anxiety despite being on Prozac, which is a type of SSRI (Selective Serotonin Reuptake Inhibitor) commonly used to treat anxiety and panic disorders. Here are some possibilities:

  • Adjustment Period: If you recently started or changed your dosage of Prozac, it might take some time for your body to adjust. It's common for SSRIs to take several weeks to reach their full effect.
  • Situational Stress: Stressful situations, such as feeling unwanted in friendships, can trigger anxiety episodes even when you're on medication. This is a normal response to challenging social dynamics.
  • Medication Efficacy: Sometimes, a particular medication may not be as effective for everyone, or the dosage might need adjustment. It's important to discuss this with your healthcare provider.

What you can do

  1. Consult Your Doctor: It's important to talk to your healthcare provider about your recent increase in anxiety. They can assess whether your medication needs adjustment or if additional therapies might be beneficial.

  2. Practice Relaxation Techniques: Techniques such as deep breathing, meditation, or yoga can help manage anxiety symptoms. These can be particularly helpful in stressful situations.

  3. Stay Connected: Reach out to friends or family members who make you feel supported and valued. Sometimes, talking about your feelings can help alleviate anxiety.

  4. Use MDandMe: Consider using the MDandMe app to journal your symptoms and track your progress. This can provide valuable insights and help you share detailed information with your healthcare provider.

What you should look out for

  • Worsening Symptoms: If your anxiety becomes more severe or starts to interfere significantly with your daily life, it's important to seek help promptly.
  • New Symptoms: Be aware of any new symptoms, such as changes in mood, sleep disturbances, or physical symptoms like palpitations, and report these to your doctor.
  • Emergency Situations: If you ever feel overwhelmed or have thoughts of self-harm, seek immediate help from a healthcare professional or contact emergency services.

Remember, while I can provide information and suggestions, it's crucial to work with your healthcare provider to find the best approach for managing your anxiety.

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1 mo ago


People Also Ask


Can SSRIs like Prozac stop working over time?

While SSRIs like Prozac are generally effective, some people may experience a decrease in efficacy over time. This can be due to various factors, including changes in stress levels or the body's adaptation to the medication. It's important to discuss any concerns with your healthcare provider.


What are some common triggers for anxiety despite being on medication?

Common triggers for anxiety, even when on medication, can include stressful life events, relationship issues, work-related stress, or significant changes in routine. It's important to identify and address these triggers with the help of a healthcare professional.


How long does it typically take for SSRIs to show their full effect?

SSRIs typically take about 4 to 6 weeks to reach their full effect, although some people may start to feel better sooner. It's important to continue taking the medication as prescribed and to communicate with your doctor about any concerns.


What should I do if I feel my medication isn't working as well as before?

If you feel your medication isn't working as well as before, it's important to consult your healthcare provider. They may consider adjusting the dosage, switching medications, or adding other forms of therapy to help manage your symptoms more effectively.


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