possible adrenal crisis?

[Molly555]

2 nights ago I had severe pain both sides low mid abdomen, it reminded me of ovary pain years ago but was higher. It was so very bad I was hesitating to phone 999, but took paracetamol and 3 mg prednisolone, I felt like fainting so lay down and must have fainted / slept as woke up later and pain had gone. This has scared me greatly.

The situation is I came off antidepressants 6 months ago, and 2 weeks ago had a severe sudden breakdown, I contacted my gp and was just texted an appt with a mental health coach in a weeks time. So in desperation I began taking fluoxetine (Prozac)again . This has made me very anxious and sick. I’m now wondering if the 2 interact or my breakdown is affecting the steroids needed? I’m at my brothers but have to go home tomorrow, I am on my own and have no local support , the village ‘friends’ don’t want to know , can’t help? I fell very isolated as despite asking for help there seems none available. Should I up steroids? ( ps no polymyalgia symptoms at present)

[DorsetLady PMRGCAuk volunteer]

hi,

Sorry to hear this, must have been very frightening.

See you are at 4mg…so if you took extra 3mg… what daily dose are you on now? 7mg or have you gone back to 4mg?

If 7mg maybe stay there for a week…if not then maybe go to up to there and let things settle. If you feel okay after that, step down to 5mg - and stay there at least a month .

Your adrenals probably need a bit more time to catch up… and one very sensible Rheumy does leave his patients at that dose for some time to allow that to happen.

But do make sure all this doesn’t cause a flare of your PMR -,hopefully it won’t and the extra Pred should keep it at bay.

See how things go, and there is always someone here to listen. 🌸

[PMRpro Ambassador]

The fluoxetine will take time to work - you know that I assume? I think you probably need an emergency appointment to speak to the GP immediately to discuss it. But upping your pred to 5 or 6mg wouldn't hurt for a week - you don't need to taper slowly after that time.

I can't find any suggestion of interactions between corticosteroids and fluoxetine.

Is there no local mental health crisis line you could call? Or are you too rural?

[random901]

Hi Molly555. Going back on fluoxetine can make things worse for a couple of weeks before they kick in, in my experience. I do hope you have some supportive friends and neighbours when you get back home. Thinking of you 💐

[Pixix]

have you checked the side effects of fluoxetine? I was put on it for muscle cramps, but it gave me bad stomach pain, followed by nausea. The sickness became so bad I couldn’t continue to take it. I know you took it before, but if you break & then go back on, it takes a while for the body to get used to it again. I guess you could get different side effects the next time, too, maybe? Just a thought…