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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 59. This is the beginning of the thread.
Posted by conundrum on December 20, 2009, at 11:48:10
For a period of 6 years after stopping prozac I have suffered from anhedonia(the world seems to lack color), low motivation, poor concentration and memory, sexual dysfunction, and low energy. Has anyone ever found anything to reverse this?
Bupropion and Methylphenidate didn't do anything and SSRIs exacerbate the problem. Could an SNRI help. Has anyone on this board ever sucessfully cured themselves from the seemingly permanent post SSRI side effects?
Posted by conundrum on December 20, 2009, at 11:50:09
In reply to Is there hope for Post SSRI side effects?, posted by conundrum on December 20, 2009, at 11:48:10
I would also like to add that I had none of these symptoms before taking prozac. Before taking prozac I suffered from anxiety, mainly worries about the future and sadness. Feelings of not caring if I was alive or not. I don't have any of these feelings now and just want to feel alive again, including being able to feel anxiety and sadness.
Posted by Phillipa on December 20, 2009, at 12:49:22
In reply to Re: Is there hope for Post SSRI side effects?, posted by conundrum on December 20, 2009, at 11:50:09
You know I think you are the first that has posted of this and I thought it was me. I find the same myself? Same symptoms pre SSRI"s and now dead. What is it? Phillipa
Posted by SLS on December 20, 2009, at 12:59:35
In reply to Is there hope for Post SSRI side effects?, posted by conundrum on December 20, 2009, at 11:48:10
How long were you on Prozac for?
- Scott
Posted by conundrum on December 20, 2009, at 13:20:47
In reply to Re: Is there hope for Post SSRI side effects? » conundrum, posted by SLS on December 20, 2009, at 12:59:35
4.5 years. From age 16 to 20. 20 mgs
Posted by conundrum on December 20, 2009, at 13:23:49
In reply to Re: Is there hope for Post SSRI side effects? » conundrum, posted by Phillipa on December 20, 2009, at 12:49:22
Well see I know longer have those symptoms of anxiety and sadness, just anhedonia, feeling blah about everything, not giving a @#$% about things, and poor concentration/memory.
Is this what you are saying as well or are you saying you now have the original symptoms as well as post-SSRI symptoms?
Posted by SLS on December 20, 2009, at 13:57:25
In reply to Is there hope for Post SSRI side effects?, posted by conundrum on December 20, 2009, at 11:48:10
> For a period of 6 years after stopping prozac I have suffered from anhedonia(the world seems to lack color), low motivation, poor concentration and memory, sexual dysfunction, and low energy. Has anyone ever found anything to reverse this?
>
> Bupropion and Methylphenidate didn't do anything and SSRIs exacerbate the problem. Could an SNRI help. Has anyone on this board ever sucessfully cured themselves from the seemingly permanent post SSRI side effects?You could try a tricyclic or a MAOI. I would probably opt for nortriptyline first followed by the addition of Parnate (this is the preferred order). I am biased towards these drugs, so take my suggestions with a grain of salt. If you decide to go for an SNRI, don't forget that you can add Remeron as an adjunct.
- Scott
Posted by conundrum on December 20, 2009, at 17:05:18
In reply to Re: Is there hope for Post SSRI side effects?, posted by SLS on December 20, 2009, at 13:57:25
I was interested in Remeron but my pdoc needs more on my background and what not i've only seen him 3 times and he doesn't think I have a major depressive disorder.
What exactly did you notice from nortriptyline? What did you feel when you added Parnate?
Did you ever experience palpitations from noradrenergic drugs?
Posted by Phillipa on December 20, 2009, at 18:48:18
In reply to Re: Is there hope for Post SSRI side effects? » Phillipa, posted by conundrum on December 20, 2009, at 13:23:49
First it was high anxiety and fear. Now feel more dead? Phillipa
Posted by bleauberry on December 20, 2009, at 21:01:46
In reply to Is there hope for Post SSRI side effects?, posted by conundrum on December 20, 2009, at 11:48:10
This phenomenon has been experienced by perhaps half a dozen people or more at this board over the last 6 months. We've kind of given it the name post-ssri syndrome. It can happen with all the ssris, not just prozac.
I think somehow over longterm the heavy serotonin manipulation causes adaptive changes on the other neurotransmitter systems and genes.
The best things I have found all include a fairly strong focus on norepinephrine, but with a little bit of serotonin too. Those include:
1. Nortriptyline+Zoloft (very low dose zoloft, such as 6mg or 12.5mg).
2. Milnacipran (Savella) low dose (12.5 bid or 25mg bid).
3. Parnate any dose from 5mg to 80mg.Wellbutrin or Remeron? No, forget it. For an ex longtime ssri user these will work lousy or worse.
Mileage varies of course.
Posted by mtdewcmu on December 20, 2009, at 21:29:08
In reply to Is there hope for Post SSRI side effects?, posted by conundrum on December 20, 2009, at 11:48:10
I don't know if it was caused by the Prozac or not, but those are all symptoms of depression. So I would imagine that you should approach treating it exactly as you would treat depression.
Posted by conundrum on December 20, 2009, at 21:29:59
In reply to Re: Is there hope for Post SSRI side effects?, posted by bleauberry on December 20, 2009, at 21:01:46
Thats interesting because I thought remeron would work since it antagonizes various serotonin receptors.
Unfortunately I'll probably have to try what my pdoc wants me to try first, since I am the patient and he is the doctor, nevermind that its my body. This likely means an SNRI after my trip back from Europe.
Its weird, cuz I figured wellbutrin would give me an idea of what NRI would feel like but it seems to have its own feel not similar to other norepinephrine drugs.
I just hope to regain the color in my life. I used to be a musician and was studying music in college. Since stopping prozac I've switched majors and music just sounds like notes to me with no feeling. Christmas doesn't even feel like christmas, it feels no different to me than being at the beach this past summer except colder.
Well thanks for the support guys.
Posted by conundrum on December 20, 2009, at 21:32:17
In reply to Re: Is there hope for Post SSRI side effects? » conundrum, posted by Phillipa on December 20, 2009, at 18:48:18
Exactly. :/ Wish I had never taken them...
Posted by Newquestions on December 21, 2009, at 11:34:24
In reply to Re: Is there hope for Post SSRI side effects? » Phillipa, posted by conundrum on December 20, 2009, at 21:32:17
Go to paxilprogress.org/general discussion and read the posts there. There is a lot of good advice for people who have "pooped out" on SSRI's and are in protracted withdrawal.
If you really are in "poop out," or what benzo people call "tolerance withdrawal", then your serotonin receptors have adapted to the drug and other drugs that affect sertonin won't help and might make you worse. I think the cycle goes like this:
1. Long term use of SSRI
2. Brain adapts to drug and increased serotonin
3. SSRI stops working and may make you worse
4. Patient must stop SSRI
5. Patient experiences protracted withdrawal syndrome, including head pressures, cognitive problems, memory loss, fatigue and adedonia.If you are in this cycle, adding drugs will only cause more damage. You have to go off the drugs and stay off of them! TCAs, MAOIs, other SSRIs, SSNRIs will not help. Some people report that fish oil and magnesium can help but don't take any drugs that affect serotonin or other neurotransmitters. Your body has to heal!
Posted by conundrum on December 21, 2009, at 17:24:35
In reply to Re: Is there hope for Post SSRI side effects?, posted by Newquestions on December 21, 2009, at 11:34:24
Tried staying off and taking fish oil and magnesium for years. I used to be a member on a list like that. Didn't help much.
Posted by bleauberry on December 21, 2009, at 17:48:25
In reply to Re: Is there hope for Post SSRI side effects? » bleauberry, posted by conundrum on December 20, 2009, at 21:29:59
> Thats interesting because I thought remeron would work since it antagonizes various serotonin receptors.
Well, you could be right. I have the same scenario as you. Remeron actually did feel immediately helpful right away, set aside the intense sedation. But within a few days it was dreadfully obvious I was crashing bad on it.
>
> Unfortunately I'll probably have to try what my pdoc wants me to try first, since I am the patient and he is the doctor, nevermind that its my body. This likely means an SNRI after my trip back from Europe.You said it right, except you interpretted it backwards. That is, the patient is the boss, the doctor is not. Who is paying who anyway? YOU are the paying customer. HE is providing a service that YOU are paying for. HE works for YOU, you don't work for him. The customer is always the boss. Just because it happens to be mental health instead of cars or retail doesn't change anything. You are in charge. He is there to help you figure things out, make suggestions, and monitor your progress on joint team decisions that you both make together.
>
> Its weird, cuz I figured wellbutrin would give me an idea of what NRI would feel like but it seems to have its own feel not similar to other norepinephrine drugs.Wellbutrin really isn't much of an NRI. Very weak. Its mechanisms, as stated in all the literature and labels, is unknown. I have my own hunch it is more involved in the nicotinic and nitric oxide pathways than anything else. What we do know is that its NRI action is rather weak.
>
> I just hope to regain the color in my life. I used to be a musician and was studying music in college. Since stopping prozac I've switched majors and music just sounds like notes to me with no feeling. Christmas doesn't even feel like christmas, it feels no different to me than being at the beach this past summer except colder.
>
> Well thanks for the support guys.Yeah I hear ya. Color in life. How nice. I'm trying to think what it was in the last few years that allowed me to experience that color again. Let me see. They are not your ususal suspects.
Savella tiny doses.
DMSA (a mercury/lead chelation drug)...felt absolute remission while on it.
Ddoxycyline+tiny dose Hydrocortisone combination (antibiotic and supporting weak adrenals). What beautiful color.It just goes to show you, our symptoms can and do have causes that are not touched by psychiatric drugs, but are impacted positively by other drugs acting upon illnesses, diseases, or conditions we weren't aware we had.
Posted by mtdewcmu on December 21, 2009, at 18:39:22
In reply to Re: Is there hope for Post SSRI side effects? » bleauberry, posted by conundrum on December 20, 2009, at 21:29:59
> Thats interesting because I thought remeron would work since it antagonizes various serotonin receptors.
>
> Unfortunately I'll probably have to try what my pdoc wants me to try first, since I am the patient and he is the doctor, nevermind that its my body. This likely means an SNRI after my trip back from Europe.
>
> Its weird, cuz I figured wellbutrin would give me an idea of what NRI would feel like but it seems to have its own feel not similar to other norepinephrine drugs.
>To me, Wellbutrin feels like a very mild amphetamine. Not too surprising, since structurally, it is derived from amphetamine.
> I just hope to regain the color in my life. I used to be a musician and was studying music in college. Since stopping prozac I've switched majors and music just sounds like notes to me with no feeling. Christmas doesn't even feel like christmas, it feels no different to me than being at the beach this past summer except colder.
>
> Well thanks for the support guys.I wonder what tianeptine would do to you guys if your serotonin receptors have supposedly been damaged by taking SSRIs.
Posted by conundrum on December 21, 2009, at 21:12:56
In reply to Re: Is there hope for Post SSRI side effects?, posted by bleauberry on December 21, 2009, at 17:48:25
Just curious what country do u live in? Savella was just approved by the FDA in the US this past January, never really heard much about it, except that its an NSRI as opposed to an SNRI. Are you still taking it and does it help?
I guess chelation doesn't last forever so you are no longer taking that drug.
Also I was seeing a naturopathic doctor for while but stopped, maybe I should have kept seeing him. A lot of the nutritional stuff he told me to take like Omega 3s, zinc, Phosphatidyl serine, didn't do anything. He did a blood cortisol test which isn't very accurate and was I was at the low end of the normal range. I don't think I have low cortisol or adrenal dysfunction as I am borderline high blood pressure. It would be nice if something like that worked.
Posted by conundrum on December 21, 2009, at 21:14:46
In reply to Re: Is there hope for Post SSRI side effects?, posted by mtdewcmu on December 21, 2009, at 18:39:22
I think I could order it from overseas here in the US. I wonder if it would be the real deal or some scam since its not FDA regulated.
Posted by Bob on December 21, 2009, at 21:29:45
In reply to Re: Is there hope for Post SSRI side effects?, posted by SLS on December 20, 2009, at 13:57:25
> > For a period of 6 years after stopping prozac I have suffered from anhedonia(the world seems to lack color), low motivation, poor concentration and memory, sexual dysfunction, and low energy. Has anyone ever found anything to reverse this?
> >
> > Bupropion and Methylphenidate didn't do anything and SSRIs exacerbate the problem. Could an SNRI help. Has anyone on this board ever sucessfully cured themselves from the seemingly permanent post SSRI side effects?
>
> You could try a tricyclic or a MAOI. I would probably opt for nortriptyline first followed by the addition of Parnate (this is the preferred order). I am biased towards these drugs, so take my suggestions with a grain of salt. If you decide to go for an SNRI, don't forget that you can add Remeron as an adjunct.
>
>
> - Scott
>
Scott,I thought you had given up on Parnate. Aren't you switching to Effexor?
Bob
Posted by SLS on December 21, 2009, at 22:31:08
In reply to Re: Is there hope for Post SSRI side effects? » SLS, posted by Bob on December 21, 2009, at 21:29:45
> > You could try a tricyclic or a MAOI. I would probably opt for nortriptyline first followed by the addition of Parnate (this is the preferred order). I am biased towards these drugs, so take my suggestions with a grain of salt. If you decide to go for an SNRI, don't forget that you can add Remeron as an adjunct.
> I thought you had given up on Parnate. Aren't you switching to Effexor?
Yup.
I favor Parnate and nortriptyline for several reasons. The only extended remission (6 months) that I experienced was when I was on a combination of Parnate and desipramine. Unfortunately, this treatment no longer works.
- Scott
Posted by morganator on December 21, 2009, at 22:55:33
In reply to Re: Is there hope for Post SSRI side effects?, posted by bleauberry on December 20, 2009, at 21:01:46
>his phenomenon has been experienced by perhaps half a dozen people or more at this board over the last 6 months. We've kind of given it the name post-ssri syndrome. It can happen with all the ssris, not just prozac.
>I think somehow over longterm the heavy serotonin manipulation causes adaptive changes on the other neurotransmitter systems and genes
So I guess you don't think this is as likely to happen with medications like Nortriptyline?
Posted by conundrum on December 22, 2009, at 7:10:01
In reply to Re: Is there hope for Post SSRI side effects?, posted by morganator on December 21, 2009, at 22:55:33
For me prozac only "pooped out" after I stopped taking. When I find something that makes me feel normal again, I'll never stop taking it.
Posted by conundrum on December 22, 2009, at 9:14:35
In reply to Re: Is there hope for Post SSRI side effects?, posted by bleauberry on December 21, 2009, at 17:48:25
You said:
"You said it right, except you interpretted it backwards. That is, the patient is the boss, the doctor is not. Who is paying who anyway? YOU are the paying customer. HE is providing a service that YOU are paying for. HE works for YOU, you don't work for him. The customer is always the boss. Just because it happens to be mental health instead of cars or retail doesn't change anything. You are in charge. He is there to help you figure things out, make suggestions, and monitor your progress on joint team decisions that you both make together."Unfortunately mtdewcmu(mountain dew?) is correct in that most of my symptoms sound like depression, so it only makes sense from the doctors prospective to try some of the standard first line treatments. I've already failed two SSRIs recently and bupropion, but never tried an SNRI. Luckily my doc doesn't see the point in trying to drugs that are very similar. For instance if someone fails Zoloft he won't try prozac he'll move to an SNRI, and if that doesn't work add bupropion or ritalin(a drug that also failed).
But he does seem old school like he is the boss. When I started talking about receptor antagonists and things like that he told me I have OCD. I know I don't have OCD and no one around me believed that he said that. It was almost like saying, "stay out of my way."
Posted by SLS on December 22, 2009, at 9:35:37
In reply to Re: Is there hope for Post SSRI side effects?, posted by conundrum on December 22, 2009, at 9:14:35
> But he does seem old school like he is the boss. When I started talking about receptor antagonists and things like that he told me I have OCD.
When someone says something like that to me, I often respond that I am extraordinarily focused on attaining a successful treatment of my illness. This is something that my doctors have not yet been able to do. Once that is achieved, I will no longer have the need to educate myself further regarding the phenomenology of the illness.
- Scott
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