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Re: Depressing diagnosis

Posted by Sean on April 21, 1999, at 18:24:15

In reply to Depressing diagnosis, posted by Sarah on April 20, 1999, at 22:37:53

> I started taking Prozac with great results five years ago for long-term, chronic depression, but had to quit after a year due to a change in health coverage circumstances. When I started taking it again, it didn't seem to work, so my doctor prescribed Paxil. I took that for about a year and a half and suddenly fell victim to the most hideous ulcerations in my mouth. No-it isn't herpes. It's apthous ulcers, commonly known as canker sores, serious enough to have eroded the sides of my tongue and the insides of my cheeks. I'd like to know for starters if anyone, anyone at all, has experienced this side effect with Paxil or Zoloft, which I switched to briefly. It would make me feel less ridiculous trying to convince a new psychiatrist that what the PDR says about this potential, if uncommon, unpleasantness might actually be true.
> The same psychiatrist put me on Wellbutrin three weeks ago when I expressed concern over the aforementioned ulcers, though the reason I think he was moved to do so is that I was also utterly exhausted, affective, and sleeping 12-16 hours a day on Paxil and then on Zoloft. When I started having nasty waves of dizziness, he attributed them to withdrawal from the Zoloft and prescribed my old friend Prozac. It seems to have done the trick for the dizziness, but I'm edgy, itchy, tense, insomniac, and, well, depressed. I know it will probably take a couple/few more weeks for the Wellbutrin to have any measurable effect, so I wasn't too concerned. Until I saw the psychiatrist this evening and he prescribed YET ANOTHER DRUG--depakote.
> I found this disturbing given the short time I've been on Wellbutrin, and more so because I see that depakote is used primarily to treat bipolar disorder and I've never had any sort of manic episode that I can remember, and the psych. himself characterized my state as I described it as "always low, maybe occasionally OK". Am I overreacting or is it a little soon for him to be drawing his conclusions? Thanks for any feedback.

Wow Sarah, seems like you've been through alot...

It is hard to say what your p-doc is thinking, but
I have heard of Tegretol being used as an anit-dep
in non-BP people. On the other hand, I've read alot
about a possible link between the underlying
physiology of atypical depression and BP disorder.
It may be the case that you will get a good
response out of Depakote, or even Lithium.

In Europe, Lithium and other BP meds are used
more commonly in people who are not bipolar in
the classic sense. The view there (are getting
more so here) is that the chronic, or episodic
forms of depression (without mania) are perhaps
best managed by mood stabilizers. There is some
evidence that antidepressants can actually make
things worse and phase-shift such people into
earlier relapses than if they were not given an
antidepressant to begin with! That is kind of
depressing in itself...

I'm not a doc, and I don't know your situation,
but you do seem to have atypical symptoms (lots
of sleeping for one). You also report insomnia
on Prozac (which also get on SSRI's) and that to
me suggests a bit of an "overshoot" as they call

After my experiences with SSRI's, I compared my
response with some friends and realized that I
was in fact having a very different reaction. To
me, this was a solid piece of information about
what might be physically going on in my wonderful
but moody brain.

So you might want to keep an open mind to what
your doc is doing. I found that when I really
looked at my mood swings, the overspending, the
questionable "life
decisions", and the depressions that followed, I
landed somewhere in the bipolar camp. But it took
years and years and years to figure this out.

Anyway, hope this helps and good luck.





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