Please help me with the pills

[LapisLazuli]

Hello. I have a big problem. My Dr is currently making me take pills, that make me feel extremely bad. They have worsened my depression, and left me unable to even get out of bed. I want to go back to fluoxetine (efectin) which made me feel extremely good and full of energy. The thing is that my next visit to the Dr is going to be in over a month, and I dont think I will be able to last that long, while feeling so terrible. Thats why I want to change the pills on my own.
I`ve already slowly stopped taking the current pills (duloxetine) and I have lots of the fluoxetine pills to make my dosages, but here is the problem. The pills should be taken like this :
75 mg for the first week, then 150 mg for another week, then 150 +75, and then 150 + 150 mg for the final week. The problem for me, is that I don`t have enough 75 mg pills. I have only 5 of those, and 4 of them are 5 years out of expiration date. Is it safe to take them ? The way I see it I have 3 options

a) I can take 75 mg per 5 days including the ones after expiration date, and then stay at the 150 dosage.

b) I can open the 150 mg pills and pour out the dust inside them, and try to separate the portion in to half, and take the half of it, and this way I could go up to full dosage.

c) I can take 5 x 75 mg per 5 days, and then already start taking 150 mg and after a week, I could make it to 2 x 150 mg.

Or I can just try to wait for the Dr visit, but there is no assurance that he will agree to change back the pills to fluoxetine, and I am almost sure that he will want to increase the dosage of duloxetine which would only make me feel worse.
What should I do now ? Can you help me ? I want to feel better already, but Im really scared of any of the 3 methods above. Is it possible that any kind of organ damage, or brain damage could occur from any of those methods ? Please help me and advice me, because Im really hopeless right now

 

[TheMetalhead]

First of all, how long have you been taking your current pills? Most stuff usually starts by worsening the depression and gradually with time it helps.
You shouldn't change ur dosage unless your doctor allowed you to mix with it.
When I was taking pills, my doctor would ask me which medication felt better etc.
Given you are able to, you should contact your doctor via whatsapp or whatever you guys agreed on and ask him. That's what I have been doing whenever I was in your place.
You shouldn't be given a higher dosage if it makes you feel worse, a doctor should either change the medication completely or give you an alternative.
I changed my meds like 5 times in a span of a few months plus what was given to me in psych ward after a CTB attempt.

 

[LapisLazuli]

First of all, how long have you been taking your current pills? Most stuff usually starts by worsening the depression and gradually with time it helps.
You shouldn't change ur dosage unless your doctor allowed you to mix with it.
When I was taking pills, my doctor would ask me which medication felt better etc.
Given you are able to, you should contact your doctor via whatsapp or whatever you guys agreed on and ask him. That's what I have been doing whenever I was in your place.
You shouldn't be given a higher dosage if it makes you feel worse, a doctor should either change the medication completely or give you an alternative.
I changed my meds like 5 times in a span of a few months plus what was given to me in psych ward after a CTB attempt.

Im taking duloxetine for about a month.

 

[NumbItAll]

I'm a little confused but I can at least answer one part of the question which is that I don't think you have to worry about taking expired pills since they are not liquid. With a few exceptions, expired medicine is generally safe, but it might have just lost a little bit of potency. It looks like Efectin is actually venlaxafine, not fluoxetine? But either way, if you have extended release capsules it's probably best not to split them since you might get all the medication at once. I'm not sure what the best schedule would be, especially while simultaneously coming off of a different drug. Definitely best to communicate all of that with the doctor and be sure to advocate for yourself and not get pushed into taking something that is hurting you. Good luck though, I hope things will get better for you.

 

[Blue LIPS]

Yikes, Duloxetine made my hair fall out as well as what you described. I trust my doctor personally but I am also brutally honest and tell her like it is and so far she has helped me out alot on how I feel. I say confide in your doctor more and just tell them how it makes you feel and you don't want to continue the medication but that a previous medication gave you a lot better results on how you feel overall.

 

[LapisLazuli]

I'm a little confused but I can at least answer one part of the question which is that I don't think you have to worry about taking expired pills since they are not liquid. With a few exceptions, expired medicine is generally safe, but it might have just lost a little bit of potency. It looks like Efectin is actually venlaxafine, not fluoxetine? But either way, if you have extended release capsules it's probably best not to split them since you might get all the medication at once. I'm not sure what the best schedule would be, especially while simultaneously coming off of a different drug. Definitely best to communicate all of that with the doctor and be sure to advocate for yourself and not get pushed into taking something that is hurting you. Good luck though, I hope things will get better for you.

Thank you for your reply and help. And yes I might have mistook the chemical name of the pills.

 

[LapisLazuli]

I'm a little confused but I can at least answer one part of the question which is that I don't think you have to worry about taking expired pills since they are not liquid. With a few exceptions, expired medicine is generally safe, but it might have just lost a little bit of potency. It looks like Efectin is actually venlaxafine, not fluoxetine? But either way, if you have extended release capsules it's probably best not to split them since you might get all the medication at once. I'm not sure what the best schedule would be, especially while simultaneously coming off of a different drug. Definitely best to communicate all of that with the doctor and be sure to advocate for yourself and not get pushed into taking something that is hurting you. Good luck though, I hope things will get better for you.

Would you mind if I asked one more thing ? Do you think it would be okay if I took 75 mg venlaxafine for 5 days, and then increased to 150 mg ? Im a little worried because my Dr told me to increase the dosage after a week of taking 75 mg, but I dont have such option because of only having 5 pills. Do you think that any damage to the brain or organs could occur from such increase in dosage ? I remember that when I was in psychiatric hospital, then I had dosages increased or decreased in matter of days not weeks, but Im not 100 % sure, because my memory is very foggy. Im sorry if Im asking for too much of you, but Im in a really hopeless situation, and I currently have no option to contact my Dr.

 

[NumbItAll]

Would you mind if I asked one more thing ? Do you think it would be okay if I took 75 mg venlaxafine for 5 days, and then increased to 150 mg ? Im a little worried because my Dr told me to increase the dosage after a week of taking 75 mg, but I dont have such option because of only having 5 pills. Do you think that any damage to the brain or organs could occur from such increase in dosage ? I remember that when I was in psychiatric hospital, then I had dosages increased or decreased in matter of days not weeks, but Im not 100 % sure, because my memory is very foggy. Im sorry if Im asking for too much of you, but Im in a really hopeless situation, and I currently have no option to contact my Dr.

I would not be worried about brain/organ damage from that. The reason for a gradual increase in dosage is to give your brain and body some time to adjust to the medication, but it's not really an exact science. I doubt that the difference between 5 or 7 days would really matter that much since it takes weeks to fully adapt anyway. I would be more concerned about taking it while you are still taking duloxetine because of potential interactions (serotonin syndrome). Since they are both SNRIs you may be able to get away with just stopping one and starting the other (direct switch). Not necessarily recommending anything, but it is one option if you are convinced about switching over quickly.