Hi. I have been on an SSRI for about 3-4 years now. Initially Citalopram, increasing to 40mg. About 6 months ago I talked to my GP to look at either changing or reducing. I can't remember fully why, but it was essentially because I had been on it for so long. The GP at the time suggested swopping to Fluoxetine 40mg, even though I was tolerating the citalopram well and it did even out my PMS for a lot of the time. I found the side effects on Fluoxetine too intrusive: drowsy, tired, too vivid dreams, difficulty dealing with complex information at work. Anyway, I reduced to 20mg about 2-3 months ago and have been experiencing a resurgence of PMS symptoms. I have looked at a lot of stuff on here and have now joined NAPS. I've seen my GP today, and have self-referred to a community gynae: I'm unsure about the gynae appt as he is not on NAPS recommended list... My GP has suggested that I titrate my Fluoxetine dose back up to 30mg by taking an extra 10mg at night, keeping with the 20mg in the morning. She thinks that this may offset the side effects but still build up the drug to a therapeutic level.
Has anyone else tried this: splitting the dose?
I have also bought some Agnus Castus 20mg but haven't started taking it yet, thinking that I should perhaps play with the SSRI first. I haven't gone down the hormone route yet. Thanks for any help offered.

Hi Milliemoogle,

I can't offer any advice on splitting the Fluox, but I think for your community Gynae appointment its worth thinking about beforehand, is the depression present all the time, or is it most severe when your pmsing - i expect they will try to fathom whether you have very severe pms or depression with pms. Also watch out for them saying the best course is for you to go onto birth control - it does work for some, but for me certainly it threw me into a terrible pms time as I am intolerant to progesterone. If you have any questions once you get back from your appointment do come back and ask.

Much luck.

Hello,

Thank you for your advice. I feel quite nervous about my gynae appt on friday: as if I'm making a fuss over nothing.

That's actually really normal - I think its because for most of the month we pms sufferers do feel ok, or least know we can handle things and then PMS hits and it feels like the earth is ending. For years, I would only come on this forum at the end of the month when I was desperate and for the rest of the month I wouldn't use it because i had no symptoms.

Lots of luck, and try not to downplay how you are feeling, the appointment was made for a reason!