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Dr. Bob is Robert Hsiung, MD,
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Posted by ayrity on October 17, 2002, at 21:10:58
In reply to Re: orgasms... Huh?????, posted by Phil on October 17, 2002, at 17:50:18
Absolutely, Phil:
Please be careful about such advice you receive here or elsewhere.I was born with an endocrine disorder and need to take Testosterone because I essentially produce none on my own. The dosage I take is 200 mg twice a month by injection. So the dose that Pharmrep recommended is a *full replacement* dose and likely way too high for someone without T deficiency.
Furthermore, testosterone injections can definitely cause mood swings and depression (just as lack of T can as well). Not to mention the risk of numerous other problems, large and small, from acne to liver failure (rare).
However, that being said, careful exploration of hormonal augmentation *in collaboration with an experienced doctor* (I can't stress that enough) might be a useful addition to standard AD treatment.
> I don't think it's real smart to get on testosterone injections without your doc doing a blood workup and seeing what your level is.
> If you have a normal level of testosterone and want injections, you may be making a mistake. Talk to your doctor.
Posted by Seamus2 on October 17, 2002, at 21:32:52
In reply to Careful with that T, was Re: orgasms..., posted by ayrity on October 17, 2002, at 21:10:58
Ayrity, why aren't you using a transdermal gel instead of the shots? It evens out the fluctuations in T levels and if you get it compounded it's not that expensive. (Androgel, OTOH, is).
What do you do about testicular atrophy?
Once I got on the T, I haven't had a need for anti-depressants at all. Wish I'd had my levels tested 20 years ago...
Posted by pharmrep on October 17, 2002, at 21:40:57
In reply to Re: orgasms, posted by pharmrep on October 17, 2002, at 12:12:46
*** I am not recommending this...I merely asked what everyone thought about it. (and if you read closely...I am referring to males only..for those who think girls with mustaches will appear)
> > *** anyone heard of this one? I asked this one DR what hid did for people having difficulty w/ orgasms...and he told me that for guys, he would give an injection once a month of testosterone (250-500mg)...he said that after that his male pts didnt have ejac. probs anymore.
>
Posted by SLS on October 17, 2002, at 23:31:08
In reply to Re: Careful with that T, was Re: orgasms... » ayrity, posted by Seamus2 on October 17, 2002, at 21:32:52
Hi Seamus.
> Once I got on the T, I haven't had a need for anti-depressants at all. Wish I'd had my levels tested 20 years ago...
Gosh. I can hardly believe it.How would you describe your depression and how it affected you? What drugs have you tried in the past?
I have been thinking about testosterone on-and-off over this past year. I'd like to see if there are any similarities between your experiences and mine.
Thanks in advance.
- Scott
Posted by Phil on October 18, 2002, at 6:46:24
In reply to Re: orgasms/testosterone, posted by pharmrep on October 17, 2002, at 21:40:57
pharmrep, I haven't been using you as a punching bag. If you go back over the last four years, I've talked about Pharm Companies and just about everything else you can think of. What I've said about Lexapro would have been said whether you were here or not. Generally, I direct my statements at the industry shortcomings but I know some of this comes across like the whole thing is your fault. I apologize for that.
That being said, Lexapro overall is the best AD I've been on. I'm hoping the sex SE will lessen but if it doesn't, I've learned to be creative.
If I had two wishes for pharm companies, one would be for them to realize how high the numbers of people having sexual difficulties really are instead of publishing studies that deny it. Denial won't solve the problem. If I was Soloman, I'd put up 25 mil for anyone in the company that could unlock that lock. You guys have to know that if Lexapro Plus was marketed w/ no sex SE, 25 mil would be a miniscule investment.
Secondly, why do pharm c's charge the US one price and many other countries pay another?Peace,
Phil
Posted by mills on October 18, 2002, at 9:09:53
In reply to Re: orgasms... Huh?????, posted by mills on October 17, 2002, at 15:30:24
Yo, Phil, we're talking about injections only; I didn't mention anything about a patch, and my post said I was going to my doctor, so advice on that one not needed. Thanks bro.
> What the...?
>
> > If your girlfriends voice drops or she develops more facial hair, that will get interesting.
> > The dose pharmrep recommends may be small, I don't know, but guys taking testosterone therapy have often seen their g.f. or spouse change a little.
> > Double check with your doc and don't take "some docs" advice.
> >
> > my 2 bits
>
>
Posted by Seamus2 on October 18, 2002, at 10:28:13
In reply to Re: Careful with that T, was Re: orgasms... » Seamus2, posted by SLS on October 17, 2002, at 23:31:08
see
http://www.dr-bob.org/babble/20020617/msgs/110611.htmland
Posted by jrbecker on October 18, 2002, at 11:41:47
In reply to Re: Careful with that T, was Re: orgasms... » Seamus2, posted by SLS on October 17, 2002, at 23:31:08
I was able to get an edocrinologist to prescribe me Androgel last year since I had a low-moderate T level. It ended up having a fairly good effect on my mood, completely vanquishing all of my atypical symptoms, and making me more focused and calm. And talk about getting in shape, it starts to change your physique almost immediately and really motivates you. You feel more full of energy, more confident. Yes, it really was that effective (and no, this is not an infomercial). As for T as a depression treatment, I have to say that it was mild to moderately effective, so I think that it makes a great candidate as an augmentation therapy for anyone with a lot of fatigue probs or high stress problems (T helps attenuate cortisol levels).
T gets a bad rap. In fairly low dosages it can be a great treatment, especially for depressed men. T abuse on the other hand (or taking T when you already have high endogenous levels) will also give you a depressed mood and a lot of agression to boot.
Personally, the reason I stopped taking it was because I feel like I'm fairly motivated without it these days and my psychopharmacological treatment is going fairly well by itself.
Doctors are loosening up these days about prescribing it. It used to be only for geriatric men, but many endos (not all) are now prescribing it to the larger population. It definitely wouldn't hurt to get checked out. Be honest in the consulation. Tell the doc you suffer from depression, anxiety, fatigue probs, etc, and ask him/her if you can get a blood test to see if your T count is somewhat low and if this might be a viable therapy option. Read the book the "Testosterone Syndrome" by Eugene Shipman to delve into the subject more.
Bottom line is that it's not a cure-all (as a lot of the hype out there will tell you), but it can be quite effective.
PS - T treatment can induce mania, so for you BPs out there, be cautious.
Posted by Phil on October 18, 2002, at 12:09:38
In reply to Re: orgasms... Huh?????, posted by mills on October 18, 2002, at 9:09:53
Sorry about that.
Posted by cody on October 18, 2002, at 12:43:43
In reply to lexapro and alcohol, posted by discoduck on October 15, 2002, at 15:14:28
I've been on Lexapro about 2 1/2 weeks now. Started at 5mg for 10 days, then 7.5 for 10 days. I haven't gotten any relief from my anxiety yet. In fact, it seems to make me more anxious and I think I'm starting to get depressed over it. I'm thinking about going back to Remeron, although I don't like the s/e, it at least seems to help more with the anxiety. Any thoughts on this would be helpful.
Posted by Alan on October 18, 2002, at 13:39:53
In reply to Is Lexapro helping anyone with anxiety, posted by cody on October 18, 2002, at 12:43:43
Hi,
What is your primary dx? Is it an anxiety disorder and what type?
Alan
Posted by SLS on October 18, 2002, at 14:31:54
In reply to Re: Careful with that T, was Re: orgasms... » SLS, posted by Seamus2 on October 18, 2002, at 10:28:13
Posted by SLS on October 18, 2002, at 14:52:30
In reply to Is Lexapro helping anyone with anxiety, posted by cody on October 18, 2002, at 12:43:43
> I've been on Lexapro about 2 1/2 weeks now. Started at 5mg for 10 days, then 7.5 for 10 days. I haven't gotten any relief from my anxiety yet. In fact, it seems to make me more anxious and I think I'm starting to get depressed over it. I'm thinking about going back to Remeron, although I don't like the s/e, it at least seems to help more with the anxiety. Any thoughts on this would be helpful.
Hi Cody.Anxiety is very often a start-up side effect of SSRI antidepressants. I have seen people complain about every one of them. Fortunately, this side effects seems to go away for most people, although I can't say what the average length of time is. Certainly, don't get depressed about things so soon. If things go well, perhaps the anxiety will begin to disappear after another week, and you will begin to see some positive improvements within another month. Perhaps your doctor can make you more comfortable in the meantime using a mild anxiolytic. Try to stick it out for at least another week with the anxiety.
Best wishes.
- Scott
Posted by cody on October 18, 2002, at 15:24:30
In reply to Re: Is Lexapro helping anyone with anxiety » cody, posted by Alan on October 18, 2002, at 13:39:53
Not really sure what my dx is. It started 3 years ago, after what was to me a taumatic experience. My symptoms began with nausea, dizziness and progressed into a constant state of extreme anxiety. I thought and still think that I was on the verge of a breakdown. I can't concentrate, very anxious and my heart pounds 24/7. Was put on Remeron and ativan and have been on them ever since. It has allowed me to function but I don't think I have felt any kind of happiness in 3 years, which is why I think my doc wanted me to try Lexapro. Right now I feel worse than before and I don't think I can take it much longer. I have a husband and 4 young children and I'm barely managing to cope. I was hoping that the Lex would be my answer, to make me feel "normal" and "happy" again. I'm starting to think that's never going to be possible. I'm sorry to ramble and give you my life history, but I don't know what to do right now. This board has been a big help, and I appreciate all of your advice.
Thanks,
Posted by Alan on October 18, 2002, at 16:02:55
In reply to Re: Is Lexapro helping anyone with anxiety, posted by cody on October 18, 2002, at 15:24:30
> Not really sure what my dx is. It started 3 years ago, after what was to me a taumatic experience. My symptoms began with nausea, dizziness and progressed into a constant state of extreme anxiety. I thought and still think that I was on the verge of a breakdown. I can't concentrate, very anxious and my heart pounds 24/7. Was put on Remeron and ativan and have been on them ever since. It has allowed me to function but I don't think I have felt any kind of happiness in 3 years, which is why I think my doc wanted me to try Lexapro. Right now I feel worse than before and I don't think I can take it much longer. I have a husband and 4 young children and I'm barely managing to cope. I was hoping that the Lex would be my answer, to make me feel "normal" and "happy" again. I'm starting to think that's never going to be possible. I'm sorry to ramble and give you my life history, but I don't know what to do right now. This board has been a big help, and I appreciate all of your advice.
>
> Thanks,
============================================
A form of Post Trumatic Stess has been known to bring to the surface an underlying, prexisting type of anxiety...not that you necessarily have PTSD.Is there a reason that your doctor hasn't offered you the option of a benzodiazapine like ativan or klonopin taken in single form (monotherapy)? The same way they have offered an AD (Leaxapro) as monotherapy? Or have they offered bzds in monotherapy at all?
The best anxiolytic or anti-anxiety medications for the general population has been bzds for the last 40+ years. There are trade off's for both types of drugs but if you have overriding anxiety, seems that you might want to bring this up with your doctor.
I tried all of the AD's and in combo with bzd's and finally found that the bzd klonopin + ativan PRN was by far the most effective.
The success treating anxiety disorders with bzds and even MAOI's are in the 78 - 80% range while the AD's are in the drug co's own stats merely 30 - 50% effective - hardly above pacebo rates.
Of course statistics don't necessarily apply to individual cases but I bring this up because what you are doing now seems not in need of modification, but a rethinking of how to go about treating your symptoms effectively. Especially one with your responsibilities...
Best,
Alan
Posted by sweets on October 18, 2002, at 16:06:56
In reply to Re: Is Lexapro helping anyone with anxiety, posted by cody on October 18, 2002, at 15:24:30
I have just been prescribed with lexapro. Although I have only been on it for 2 days, I feel a lot better than I have in the past year. After having a "break down" my doctor prescribed it. I am in a better mood and don't feel so anxious or depressed. I have noticed that for about 2 hours after I take it, i feel a little bit buzzed. Other than that, I think, so far, it is really helping. Hope this helps!
Posted by Alan on October 18, 2002, at 16:10:07
In reply to Re: Is Lexapro helping anyone with anxiety, posted by cody on October 18, 2002, at 15:24:30
If your doc is one that is not listening to you when you tell them that your symptoms are not treated fully - and they want to try one commercially driven AD after another because they bring up the "A" word (addictive)in regards to bzds alike ativan or klonopin, you may want to print this article out and show it to them. Perhaps you may need a second opinion if they dismiss it. It is common knowledge and accepted treatment amongst those doctors that specialise in the treatment of anxiety disorders and who know these medicines:
http://panicdisorder.about.com/library/weekly/aa031997.htm
Best,
Alan
Posted by Grace on October 18, 2002, at 16:33:01
In reply to Re: Benzodiazapines vs. AD's for anxiety disorder » cody, posted by Alan on October 18, 2002, at 16:10:07
I am diagnosed with panic/anxiety disorder and mild
depression (mostly because of the effect the panic/
anxiety has had on my life).I have tried MANY different meds and am currently taking:
30 mg celexa (at night)
.5 mg 2x day klonopin
10 mg claritin (for sexual side effects)my doctor recently added the claritin to my meds
because of the sexual side effect problem, which
nothing else fixed (buspar, ginko, wellbutrin, etc.).
She had a study that another doctor had done with his
own practice of 9 patients on SSRI's and sexual side
effects. Of those 9, 7 reported their sexual s/e went
away with the claritin and 2 had some improvement.
I figured it was worth a try and amazingly it has
had some effect.I now have some desire for sex (which was non-existent before)
and am able to orgasm without it taking 2 hours and more work
than it was worth. I figure I'm a tough case, so maybe you
can bring this up with your docs.Also, I've just been switched today to Lexapro because of
being very sleepy for the whole time I've been on Celexa.
I'm starting out with 10mg (anytime) and moving up to
15....we'll see.
Posted by maririp on October 18, 2002, at 16:38:28
In reply to Re: Is Lexapro helping anyone with anxiety, posted by cody on October 18, 2002, at 15:24:30
> Not really sure what my dx is. It started 3 years ago, after what was to me a taumatic experience. My symptoms began with nausea, dizziness and progressed into a constant state of extreme anxiety. I thought and still think that I was on the verge of a breakdown. I can't concentrate, very anxious and my heart pounds 24/7. Was put on Remeron and ativan and have been on them ever since. It has allowed me to function but I don't think I have felt any kind of happiness in 3 years, which is why I think my doc wanted me to try Lexapro. Right now I feel worse than before and I don't think I can take it much longer. I have a husband and 4 young children and I'm barely managing to cope. I was hoping that the Lex would be my answer, to make me feel "normal" and "happy" again. I'm starting to think that's never going to be possible. I'm sorry to ramble and give you my life history, but I don't know what to do right now. This board has been a big help, and I appreciate all of your advice.
>
> Thanks,
I went through the same thing in 1986..why not just try lexapro and xanax? I have tried them all and lexapro has been the best for me. I have been on it just one month and it has worked wonderfully, I use xanax but rarely now. Once you find the right medications that work together you should start to feel like yourself again. Its a long road but getting the right combination of meds is the key.
Posted by maririp on October 18, 2002, at 17:19:19
In reply to Re: Benzodiazapines vs. AD's for anxiety disorder, posted by Grace on October 18, 2002, at 16:33:01
> I am diagnosed with panic/anxiety disorder and mild
> depression (mostly because of the effect the panic/
> anxiety has had on my life).
>
> I have tried MANY different meds and am currently taking:
> 30 mg celexa (at night)
> .5 mg 2x day klonopin
> 10 mg claritin (for sexual side effects)
>
> my doctor recently added the claritin to my meds
> because of the sexual side effect problem, which
> nothing else fixed (buspar, ginko, wellbutrin, etc.).
> She had a study that another doctor had done with his
> own practice of 9 patients on SSRI's and sexual side
> effects. Of those 9, 7 reported their sexual s/e went
> away with the claritin and 2 had some improvement.
> I figured it was worth a try and amazingly it has
> had some effect.
>
> I now have some desire for sex (which was non-existent before)
> and am able to orgasm without it taking 2 hours and more work
> than it was worth. I figure I'm a tough case, so maybe you
> can bring this up with your docs.
>
> Also, I've just been switched today to Lexapro because of
> being very sleepy for the whole time I've been on Celexa.
> I'm starting out with 10mg (anytime) and moving up to
> 15....we'll see.Isnt claritin a sinus medication? how does that help sexual side effects of antidepressants?
Posted by cody on October 18, 2002, at 18:23:44
In reply to Re: Is Lexapro helping anyone with anxiety » cody, posted by Alan on October 18, 2002, at 16:02:55
Alan,
Thank you for the helpful information. No, I have not been offered bzd as monotherapy. In addition to the Remeron, I have also been asked to try Paxil and Celexa, but was unable to tolerate either. My doctor has always seemed willing to prescibe the ativan and has told me to increase the dosage while adjusting to the Lexapro. As hard as I try, I just don't seem to be able to tolerate any AD except Remeron. I don't know why, but I have always tried to avoid taking any bzd. After reading the info on the subject, I now have a better understanding of my illness and ways to treat it. Thank you so much for your help.
Posted by pharmrep on October 18, 2002, at 18:24:51
In reply to Re: Benzodiazapines vs. AD's for anxiety disorder, posted by Grace on October 18, 2002, at 16:33:01
> I am diagnosed with panic/anxiety disorder and mild
> depression (mostly because of the effect the panic/
> anxiety has had on my life).
>
> I have tried MANY different meds and am currently taking:
> 30 mg celexa (at night)
> .5 mg 2x day klonopin
> 10 mg claritin (for sexual side effects)
>
> my doctor recently added the claritin to my meds
> because of the sexual side effect problem, which
> nothing else fixed (buspar, ginko, wellbutrin, etc.).
> She had a study that another doctor had done with his
> own practice of 9 patients on SSRI's and sexual side
> effects. Of those 9, 7 reported their sexual s/e went
> away with the claritin and 2 had some improvement.
> I figured it was worth a try and amazingly it has
> had some effect.
>
> I now have some desire for sex (which was non-existent before)
> and am able to orgasm without it taking 2 hours and more work
> than it was worth. I figure I'm a tough case, so maybe you
> can bring this up with your docs.
>
> Also, I've just been switched today to Lexapro because of
> being very sleepy for the whole time I've been on Celexa.
> I'm starting out with 10mg (anytime) and moving up to
> 15....we'll see.*** why go to 15mg? 10mg of lexapro is very potent and demonstrating efficacy compared to 40mg of celexa...dont titrate just to "see" (ps...try taking lex in morning...since you probably wont have that tired feeling you got from celexa...i hear mornings work better for most)
Posted by pharmrep on October 18, 2002, at 18:27:27
In reply to Is Lexapro helping anyone with anxiety, posted by cody on October 18, 2002, at 12:43:43
> I've been on Lexapro about 2 1/2 weeks now. Started at 5mg for 10 days, then 7.5 for 10 days. I haven't gotten any relief from my anxiety yet. In fact, it seems to make me more anxious and I think I'm starting to get depressed over it. I'm thinking about going back to Remeron, although I don't like the s/e, it at least seems to help more with the anxiety. Any thoughts on this would be helpful.
*** 10mg is the starting dose...can you try it?
Posted by cody on October 18, 2002, at 18:46:17
In reply to Re: why only 5, then 7.5mg? » cody, posted by pharmrep on October 18, 2002, at 18:27:27
> > I've been on Lexapro about 2 1/2 weeks now. Started at 5mg for 10 days, then 7.5 for 10 days. I haven't gotten any relief from my anxiety yet. In fact, it seems to make me more anxious and I think I'm starting to get depressed over it. I'm thinking about going back to Remeron, although I don't like the s/e, it at least seems to help more with the anxiety. Any thoughts on this would be helpful.
>
> *** 10mg is the starting dose...can you try it?>>>I seem to be very chemical sensitive. It's not only the physical s/e that bother me. I feel like I'm in a fog, can't think straight, have a harder time just functioning. Also, the Lexapro seems to make me nervous on top of the anxiety.
Posted by pharmrep on October 18, 2002, at 19:17:51
In reply to Re: why only 5, then 7.5mg?, posted by cody on October 18, 2002, at 18:46:17
> > > I've been on Lexapro about 2 1/2 weeks now. Started at 5mg for 10 days, then 7.5 for 10 days. I haven't gotten any relief from my anxiety yet. In fact, it seems to make me more anxious and I think I'm starting to get depressed over it. I'm thinking about going back to Remeron, although I don't like the s/e, it at least seems to help more with the anxiety. Any thoughts on this would be helpful.
> >
> > *** 10mg is the starting dose...can you try it?
>
> >>>I seem to be very chemical sensitive. It's not only the physical s/e that bother me. I feel like I'm in a fog, can't think straight, have a harder time just functioning. Also, the Lexapro seems to make me nervous on top of the anxiety.*** for most people...1-2 wks is all they need...and for others 4-6...why, i dont know, everyone responds differently...perhaps it might take a little longer for you but lexapro does help with anxiety too...hang in there and keep us posted
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