Posted by Peter on September 30, 2003, at 6:10:39
In reply to Re: switching between SSRIs, posted by Jasmine Neroli on September 29, 2003, at 23:07:53
> Hey Peter: Howz it going? Hope the Lexapro is beginning to help you now.
> Just wanted to tell you a theory of mine re SSRI's. You may recall that I was on Celexa for 8 months, felt better, went off it. Bad mistake, after 2 weeks started to suffer greatly. Re-started again a month later.
> Well, with the original Celexa treatment, my symptoms responded within 3 weeks. However, when I took it the second time, it was about 5-6weeks before I felt ANY improvement, and 8 weeks until I felt myself again! My theory is that, after an initial exposure to SSRI's, subsequent treatments take longer to work. I have no idea WHY (scientifically speaking) this might be the case. Just from personal experience and reading others' similar stories.
> You might be experiencing this effect too.
> The patience required by mental health sufferers is immense! Keep at it - there has to be a combo for you out there somewhere!
> Jas
>>Hey Jasmine!
How are you? Haven't seen you posting in a while. How's the klonopin treating you? Did you try provigil? How's work at the school?
Thanks for your info about it taking longer for subsequent SSRI treatment to kick in. That's definitely been the case with lex for me. But what I don't understand is that I've been on all the other SSRI's multiple times, and I never ran across the issue of their not kicking in for over 4 weeks. Within the past year alone, I took zoloft for months followed by prozac for months, and the prozac didn't have a more-than-usual lag time to start working. And usually the combination of adderall + an SSRI proved to work pretty well with me - the SSRI 'smoothed over' any mood choppiness created by the adderall, while the adderall lowered such SSRI SE's as apathy, lethargy, and heightened impulsiveness due to dopamine down-regulation. But this time, with the lex +adderall, everything is so wierd; the synergy between the 2 seems to be working to my detriment, not my benefit. Each adderall dose gives me a slight lift in mood, sociability, focus, energy, but is much more short-lived than when I took adderall alone or with other SSRI's; within 1-2 hours after each dose, I become EXTREMELY socially-withdrawn, avoidant, and depressed. There are also bizarre physical symptoms involved that seem to stem from this adderall/lexapro synergy: for instance, I get FREEZING cold regardless of the weather, like the cold is inside my bones. I could wear 3-4 layers of clothes and still feel frigid. This effect tends to increase throughout the day, maybe an attestment to the phenomenon being brought on by the synergy of the lex+adderall, since I take adderall thru the day (3 doses) and I suppose it thus builds up in my system, and I get colder and colder. At night, however, when most of the immediate adderall effects have worn off, I get a wind of energy and restlesness, sometimes to the point of it being uncomfortable. So in a way it seems like the adderall, during the day, is curbing my impulses TOO much, and maybe 'covering up' the possible energizing, mood-improving effects of the lex. Maybe it's because of the adderall that it seems like the lex ain't doin' crap. So, I've been tapering the adderall by 5mg every 4th day, and I'll see how that affects me. What I don't understand is that I have symptoms that I can't attribute to the adderall; for instance, I have a heck of a hard time waking up in the morning and usually feel hungover and sick BEFORE I take any meds (including adderall). So maybe that's proof of the lex not really working, because, in the past, one of the first therapeutic effects of SSRI's for me is that they improved my wake/sleep architecture and helped me wake up earlier and with more energy and better mood. Not so with the lex; and this fact is independent from the adderall, since this occurs before I begin taking my daily adderall. Also, in terms of the klonopin: remember my pdoc had me go up to 3.75mg when he was on vacation in August? Welll, since then, I've gradually gone down to 3.5, 3.25, 3, and the last taper was to 2.5mg (pdoc told me to do it, as the daytime klonopin could also be interfering with energizing effects of the adderall). So now I take 2.5mg total klonopin (only .5mg during the day divided into 2 doses). But I wonder if the klonopin tapering could be contributing to my feeling lousy, although none of the symptoms really involve any rebound anxiety, and my pdoc said that I won't have any withdrawal from the klonopin decreases. Another thinng that might be making it hard to gage whether the lex is working at all (this is day 25) is that I've been so used to my patterns of isolation that I haven't ventured out to any social thing or played any gigs in months; it's been really hard to get out of my isolation rut, especially because of the mood lability and bizarre physical symptoms I've been experiencing, and I thus haven't been in a context from which I could gage whether my social anxiety/anticipatory anxiety has improved at all. It's a real catch-22. Sorry, I'm blabbering away again. Thanks again for your post, it's good to see you here again! Keep in touch!
Peter
poster:Peter
thread:263877
URL: http://www.dr-bob.org/babble/20030928/msgs/264403.html