Posted by Elizabeth on July 11, 2001, at 1:56:53
In reply to is everything a sign of underlying dep???!!! , posted by delna on July 10, 2001, at 11:28:25
> I mean I used to have severe depression, sleep all day(20hrs at least), never leave the house and had no future plans and was perpetually suicidal. had no job, life, friends for years and no desire to even get a life.
This sounds somewhat typical of severe, early-onset depression.
> SSRIs didn’t help much- I felt less anxious and self destructive but I had no enthusiasm- so I continued the same lifestyle.
Same problem here with MAOIs (SSRIs didn't do anything that I noticed).
> With effexor I love doing stuff eg working making friends and am full of life and plans. I am enthusiastica
Great! What dose?
> Overall the drug has changed my life- I feel normal.
That's a panacea for anyone who's been in your position.
> But so sleepy. But I don’t sleep excessively like when I was depressed. I still jump up to go to work in the morning. I just feel sleepy at work and not 100% alert.
Would you describe this as "brain fog?"
> My psych insists that the sleepiness indicates that the depression (atypical) is still there and wants to switch me to parnate.
I don't know if that's such a good idea -- you're doing so well on Effexor otherwise, it seems like a bad plan to tinker with it. Also, Parnate isn't always as stimulating as its reputation would lead you to believe. (I would expect the Parnate to help with your depression, but it just might not be worth it.)
I'm also not sure I agree with your pdoc about the fatigue being related to the depression. Drowsiness can be a side effect of Effexor, although activation is more common.
> I know I don’t have narcolepsy as the symptoms don’t quite match but I feel that if the low mood, apathy, depressive symptoms have gone and I am happy and raring to go, how can he say that the sleepiness is a sign of unresolved depression??
Maybe, but it can just as easily be a med side effect. Only you can tell for sure (consider the quality of the sleepiness compared to fatigue in depression, relation to dose timing, etc.). Narcolepsy is more than just daytime sleepiness (it involves daytime attacks of REM sleep -- often provoked by emotions -- with cataplexy, not constant daytime sleepiness.)
> Shouldn’t he just add stimulants to effexor to control the sleepiness?
I think that seems like a reasonable idea. Provigil seems like a good bet since it has helped you in the past. Mirapex (a dopaminergic antiparkinsonian drug) may also be helpful for you. If those fail, there are always the standard psychomotor stimulants (Ritalin, amphetamine, Cylert). This seems much more reasonable than expecting you to go through the washout period to try a MAOI which may or may not solve the daytime fatigue problem.
-elizabeth
poster:Elizabeth
thread:69599
URL: http://www.dr-bob.org/babble/20010708/msgs/69691.html