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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Leonardo on October 6, 2000, at 6:46:18
Hi everyone, this is my first post to this board, though I looked in occasionally earlier this year.
I used to take part in asdm, but it seems to have gone completely to pot now, so I have given up. I have been on ADs for about 18 months, following a traumatic bereavement and a long history of stress and low level depression.
Right now I am looking to change my current med combo of reboxetine plus Paxil. It works fairly well, most of the time, but I still have problems with sexual dysfunction, lethargy, lack of concentration, foggy thinking, fatigue, over eating, over sleeping, especially since the arrival of Autumn (I have seasonal affective disorder as well as regular depression...).
I have previously tried mirtazapine (Remeron), alone and in combinations with the other two. A complete disaster! Terrible sedation, weight gain, and no relief from depression, in fact I became more depressed than ever before after 3 months on Remeron.
Looking for ideas now. I'm thinking of augmenting the Paxil/reboxetine with Wellbutrin, perhaps completely replacing the reboxetine if it works well. Also thinking about replacing Paxil with a different SSRI, or adding Deprenyl to the current combo. And of course there's Effexor... I haven't tried tricyclics yet....
Any suggestions/ideas/comments? I am in the UK, but will probably use US drug names as everyone else here seems to!
Leonardo
Posted by Tori on October 6, 2000, at 12:55:29
In reply to Hi from the UK! Changing from Paxil/reboxetine to?, posted by Leonardo on October 6, 2000, at 6:46:18
Hi Leonardo,
Please accept my sympathies on your loss; going through the death of a loved-one is traumatic at the very least (I lost my mom from pancreatic cancer three years ago on Nov 25; she was only 40 and was given out of the blue 6 months to live). I guess I have PTSD as I recently read the description of it and it was bang-on (recurrent nightmares, loss of family, loss of seeing life in the future as anything positive because of the experience.... the list goes on).
For myself I have tried every single SSRI/other combination other than the tricyclics; the bipolar part of my illness started when my mom became ill. I finally had to get off the wellbutrin/celexa combination (no sex drive) as it stopped working and started Parnate two weeks ago and have noticed remarkable improvement; it is supposed to work very well long-term in atypical depression (excessive sleep, overeating, lethargy, etc.). I'm not a doctor and I'm just writing this from personal experience.
Wellbutrin they say has no sexual dysfunction side-effects but it happened to me, as well as every single other med out there. Wellbutrin didn't give me the 'energy boost' but others have reported it to be very beneficial.
Make sure when you go off the Paxil you taper off of it SLOWLY as the withdrawal is horrible, as well as what I went through with Celexa and wellbutrin (I dropped celexa 40 mg cold-turkey as I really wanted to get on the Parnate ASAP; dropped 300 mg wellbutrin within a week, withdrawal was hell for three weeks and similar to what I experienced with Paxil, as well as 80 pounds of weight gain when I was on that med, weight that has yet to come off no matter how hard I try...).
I hope this rambling helps .. just off the top of my head.. Best of luck to you.
:-) Tori
Posted by Leonardo on October 9, 2000, at 4:42:25
In reply to Re: Hi from the UK! Changing from Paxil/reboxetine » Leonardo, posted by Tori on October 6, 2000, at 12:55:29
Hi Tori
My sympathies to you too for the loss of your mother. I think when a loved one dies so suddenly and unexpectedly it is much harder to cope with. My father killed himself out of the blue (he was 68), but his age didn't help much. I sometimes think I have PTSD rather than just depression, but I don't really get the flashbacks to the event that are supposed to be a key part of it.
Did they recommend any particular drug approach for PTSD, or did they treat it just like depression?
Sorry to hear you're having difficulty with finding the right meds. In the UK the doctors are reluctant to keep changing, or to prescribe combinations, so it is a very slow business, I've only tried 3 in 18 months.
The wellbutrin I've had to buy privately online, as its not approved in the UK, except as Zyban, the quit smoking aid!
I've had 3 days trying Wellbutrin + Paxil now, good news is that for me it seems to be improving the sexual problems, but at the moment it is making me feel woozy and tired, which is what I really don't want.
I don't know anything about Parnate I'm afraid, its an MAOI isn't it? DO you have to do diet restrictions? Elizabeth Shapere who used to post on here and posts on ASDM has a lot of expereinece with this I think.
Best wishes
Leonardo
Posted by Tori on October 9, 2000, at 13:41:10
In reply to Re: Hi from the UK! Changing to Wellbutrin » Tori, posted by Leonardo on October 9, 2000, at 4:42:25
> Did they recommend any particular drug approach for PTSD, or did they treat it just like depression?
No, I just know I have that from doing research. I'm talking to my shrink about it now, finally.
> Sorry to hear you're having difficulty with finding the right meds. In the UK the doctors are reluctant to keep changing, or to prescribe combinations, so it is a very slow business, I've only tried 3 in 18 months.The key is to be your own advocate, that's what I've learned. If the dr does not agree, go to a different doctor. A lot of GP's know nothing about mental illnesses and they only prescribe the meds that the drug distributors have come by and given free samples of (perfect example ... first visit to my GP and he has an Effexor note pad -- guess what he prescribed me?).
> The wellbutrin I've had to buy privately online, as its not approved in the UK, except as Zyban, the quit smoking aid!
I think I have over 100 pills of wellbutrin that I don't use anymore. 100 and 150 mg. I *may* need them again. Also have tons of prozac, some luvox, serzone.... celexa....
> I've had 3 days trying Wellbutrin + Paxil now, good news is that for me it seems to be improving the sexual problems, but at the moment it is making me feel woozy and tired, which is what I really don't want.
You may want to take the WB in the a.m. (i.e. two hours before you get up) to give you a jump start if it has the stimulating effect. Paxil, I dunno .. I hated that stuff.
> I don't know anything about Parnate I'm afraid, its an MAOI isn't it? DO you have to do diet restrictions? Elizabeth Shapere who used to post on here and posts on ASDM has a lot of expereinece with this I think.
Well I've been on it for over two weeks and I feel great; hopefully it'll work in the long-term. I haven't had problems with the dietary restrictins, only thing that pisses me off is I can't have sushi anymore (soy sauce/avocados, I eat tons of it).
> Best wishes
> LeonardoYou, too. :-) Tori
Posted by Leonardo on October 10, 2000, at 6:48:41
In reply to Re: Hi from the UK! Changing to Wellbutrin » Leonardo, posted by Tori on October 9, 2000, at 13:41:10
Hi Tori
I had some success with the 'be your own advocate' approach, in a go it alone sort of way! When my Pdoc wouldn't let me come off Remeron (which was very sedating for me) I came off it anyway and tried my own combo of Paxil + Reboxetine which I suspected would work, and it did. After I had done it, my Pdoc said, 'OK then, if it works'.
Now I am discharged from the Pdoc and just see my GP, she advised me not to take Zyban.... but I am doing anyway.
I am now taking 150mg wellbutrin SR (Zyban) as soon as I get up in the morning. I find it only moderately stimulating, and the effect wears off by about lunchtime. I have been taking reboxetine for 9 months which is also a stimulant, so I guess I need lot of stimulating).
My doc or Pdoc never got around to discussing MAOIs or tricyclics, so there is a lot I could try yet, if I can get them prescribed. This wellbutrin experiment will take a month or two I guess. I may up the dose to 300mg if I can lose the wooziness side effect..
Leonardo
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