I am often asked whether I believe antidepressants can be of any help to a floxed person. Keeping in mind that I am not a doctor, I answer that I believe that SSRI’s can be beneficial to ‘some’ after floxing, but like many medications, they can be a double edged sword, helping some and hindering others.  I have had contact with floxed folks who are adamantly against antidepressanttheir use and for good reason, and I have heard from others who have told me they could not have survived without them.  Having said that, my intent is not to convince you to take or not take any medication. My intent is that whatever your choice, it is important for you to be informed and very cautious.  To help achieve this, the best thing I can do is supply information on antidepressants that other floxed folks have shared with me and toss in a little of my own experience.  Again, this information is not intended as medical advice just shared information. Please read my disclaimer and consult your physician for any medical advice or care.

First, it has clearly been documented that FQ’s have the ability to alter brain chemistry (1) (2). It appears they do so by a variety of factors that include damaging or interrupting certain receptors or setting the stage for imbalances of neurotransmitters. It would appear that the GABA receptors and the acetylcholine receptors have had the most involvement followed by serotonin and adenosine (3).  Either way, it appears that many floxed folks become very  sensitive to changes in brain chemistry post floxing .

It certainly appears that when many floxies try these drugs (SSRI’s, SNRI’s and any other drug that alters brain chemicals) they need to start in at lower doses than the ‘average’ person.  This can be hard to get across to some doctors because they want to start at, and/or build up to, normal therapeutic doses relatively quickly.  For example a non-floxed person may tolerate 30mg’s of Lexapro very well and yet a floxed person will get very ill from side effects at that level and should only be taking 5mg to 10mg.  Many floxed folks have shared with me that they got full benefits from a lower dose than a non-floxed person received at recommended therapeutic doses.

Second, I believe the FQ’s impact the metabolic pathways in the liver of some floxies and these same pathways are also responsible for processing many other drugs.  So, many drugs that use the same pathways as the FQs did for clearance can, after floxing, have problems with drug serum levels (usually building too high).  A lot of the antidepressants use the same enzymatic pathways, again another reason why dosages should be given in smaller amounts under the watchful eye of a physician.  This doesn’t include those who have genetic predispositions for clearance issues.  Liver pathways are highly polymorphic, which means that even without throwing the FQ’s in the mix, drug clearance varies greatly from person to person. So just because you have a normal liver function tests does not mean that you will not have issues clearing or metabolizing a drug from the body.

I have compiled through my own experience and the information from others the following information on antidepressants:

Please note that ALL antidepressants below can have insomnia as a side effect, especially while adjusting, so if you are prone to insomnia, they can aggravate your existing insomnia for short time.  For most, the side effect of insomnia wears off but for some it can be too aggravating to continue.


  • citalopram (Celexa): Some floxies I have talked to found this one helpful. It was reported as lightly sedating, will control anxiety and night time restlessness.  Effective against depression.  Possibly can help with some nerve pain. Withdrawal can be moderately unpleasant. (5mg to 10mg doses)
  • escitalopram (Lexapro): Some floxies I have talked to found this one helpful. It was reported as lightly sedating, will control anxiety and nighttime restlessness.  Effective against depression.  Withdrawal can be  moderately unpleasant. (5mg to 10mg doses)
  • fluoxetine (Prozac):  Not recommended by the floxies I have talked to because it is too excitatory in nature and can severely aggravate insomnia and anxiety. Withdrawal is easy.
  • fluvoxamine (Luvox):  No information from floxies.
  • paroxetine (Paxil): Some floxies have had limited success with Paxil reporting it as generally sedating, and will control anxiety and night time restlessness.  Effective against depression.  Withdrawal can be very  unpleasant. (5mg to 10mg doses)
  • sertraline (Zoloft): Info from floxies report Zoloft as too aggravating to insomnia and nerve pain in floxies.Withdrawal can be moderately unpleasant.
  • zimelidine (Zelmid, Normud): No information from  floxies.


  • venlafaxine (Effexor) –  No positive reports from floxies on this antidepressant. Most floxies report it as having the most severe withdrawals, also known as discontinuation syndrome, plus a litany of side effects while taking the medication. Some withdrawals have taken six months or longer.
  • vesvenlafaxine (Pristiq)[2] – Same reports as Effexor.
  • duloxetine (Cymbalta)-  Some floxies have reported limited success with Cymbalta saying it can help with nerve pain, and anxiety control. Conversely  some report it has caused come joint pain and some withdrawals issues. Can be hard on liver so use should be closely monitored. Withdrawal can severe for some.


  • mirtazapine (Remeron): Some floxies have report  that this was very good against their depression.  Some help with anxiety in some patients, while others reported an increase in anxiety.  They used smaller doses 7.5 mg to 15mg. Withdrawal fairly easy.

Atypical antidepressants:

  • bupropion (Wellbutrin): Floxies have reported this as too aggravating to insomnia.  I have no reports on anyone who successfully continued with this medication for a long time.

Low and Slow

‘Low and Slow’, is a motto I live by since being floxed. If you are concerned, tell you doctor that you believe (or if you know for sure) that you are a poor metabolizer of drugs.  Most physicians will allow you to start slowly with a smaller amount so that you can monitor yourself for any troublesome side effects, should they occur.

This information is obviously my own opinion and is based on data that I have compiled by after talking to those damaged by flouroquinolones and have tried antidepressants for help.  Obviously everyone’s physiology is different and drugs affect each person differently, so these choices may or may not apply to you. Please talk to your doctor about medication choices.



David was damaged by fluoroquinolones in 2007 at age 46. Prior to, a healthy law enforcement official. Now an amateur FQ researcher, author, and commentator contributing to case studies and published papers on the FQ’s in the BMJ, European Journal of Medicine, The Journal of Community and Supportive Oncology, Oxford Academic Clinical infectious Diseases, and contributed data to many more.

11 Responses

  1. Compras says:

    I am unquestionably bookmarking this web site and sharing it with my friends. You will be getting plenty of visitors to your web site from me!

  2. Floxedspouse says:

    Hi David — great site. I am in a process of developing one myself for my husband who was floxed slightly under 1 year ago after contracting cellulitis on a vacation we were taking exactly one year ago… anyway, regarding some anti-depressants: another reason to be careful: fluoridated drugs. Specifically fluoxetine (Prozac) is a fluoridated drug JUST like our favorite antibiotic class we love to hate. Floxies should be careful about ALL fluoride intake but especially in another daily dosed drug.

  3. Bruce says:

    Thank you for this information. Any information that we can share with one another to help us make decisions is worth while.

  4. Omar says:

    Asperger’s syndrome is also linked to weakened GABA function and increased gut sensitivity. I was also on Levaquin when my symptoms worsened.

    I’m thinking that Levaquin may not have an effect on people with healthy guts, but those of us who were already sensitive were given a whammy.

  5. Justin says:

    I personally would strongly recommend against antidepressants: like FQs, they can cause severe and in fact permanent side-effects. In fact, the manufacturers of celexa are not only aware that their drug can cause permanent side-effects, they proudly market this fact in their literature (of course they are talking about a “beneficial” side-effect but this shows they are aware that permanent changes to the brain are happening). Up to 70% of patients on antideprssants experience some form of sexual dysfunction and an unlucky few will, like us FQ victims, develop *SEVERE* sexual dysfunction which doesn’t go away after you stop taking the drug.

  6. Candie says:

    Here is an Index of Fluorinated Pharmaceuticals (including anti-depressants and anti-anxiety drugs). This may be helpful in making a choice.

  7. Teresa says:

    I am so thankful I found this site and everybody that is trying to get rid of the killer drug levaquin. My father was walking with the assistance of a walker at this time last year he was going outside and had just bought himself a brand new car, he could take a shower on his own , dress himself , feed himself however we both watched in horror as he turned from the strong , prideful , independent , honorable self respecting man he once was into A completely bedridden , diaper wearing crying mess who could not even get a cup of coffee on a table sitting next to him thanks to the adverse effects of levaquin he lost all of his motor skills he suffered a cruel slow death on June 15th 2015. It is my own opinion but this to me should be a criminal offense with the intent to harm and anybody who is involved in the distribution of this killer drug should be charged with aiding and abetting . The FDA should be proud

  8. Katie says:

    Such informative stuff. I recently started Zoloft – not great results!, got toxic fast by mixing with necessary cold n allergy med, now must wean off and try one for floxies. Yeah there is such a thing as serotonin syndrome, it’s much like being floxxed, be very careful.
    Pills are like Russian roulette to me and I was floxxed in 09.

  9. Martha says:

    I was flexed by levaquin in the fall of 2015. I did recover in six months but I am sensitive to medications. However I have dealt with depression anxiety and insomnia ever since I was floxed. I have found mirtazapine to be a good ad for me at 22.5 mg. I sleep fairly well, don’t feel drugged in the morning like some who take this especially at lower doses. The depression and anxiety symptoms are less or I would say smoothed, I combine this with acupuncture. It seems to help. I have had no adverse reactions. I did try cymbalta first and it brought back nerve pain so stopped and this resolved quickly. Each of us is different and it takes help from a doctor who is willing to work with this even with limited knowledge. I have shared this site with two doctors who found it helpful actually. They better understand my fears and work with me.

Leave a Reply

Your email address will not be published. Required fields are marked *

WordPress Anti Spam by WP-SpamShield