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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Shirley on November 12, 1998, at 20:48:28
I've had some success with Effexor XR, and recently increased the dose to 225mg in order to try (in vain?) to feel more like a regular person. I have read a lot of the literature out there on depression and psychomeds, and I'm disappointed that I have not yet experienced the NEW, IMPROVED version of myself. I haven't any idea where Peter Kramer gets the idea that his clients are being miraculously cured of all that ails them-and more-all without overwhelming side effects. This is not what I have experienced with either Zoloft, Buspar, Trazodone, or even the Effexor (although it has at least had some positive effect).
What is really unnerving to me are my mood swings. One day I'm "up"--and applying for a new job within the University that I work at, and then by that night I'm wishing I would please just die in my sleep. I go back in forth, and when I feel relatively fine, I always wonder what the fuss was all about. Then I feel like hell again. If buspar was supposed to help the anxiety, it's not. I think I've been taking it for maybe 5 weeks, so I may just give up on it.
I'm wishing this would stop. I'm afraid I'll have some kind of anxiety attack during the job interview, and then I won't even have the job I hold now.
Anybody else have this experience with depression &/or meds?
Thanks--Shirley
Posted by Annie on November 13, 1998, at 16:29:05
In reply to Mood Swings, posted by Shirley on November 12, 1998, at 20:48:28
Shirley,
I understand the frustration you're feeling. All the commercials say how "treatable" depression is and that within a few weeks, you'll be back to normal. LOL. It does happen that way sometimes, but, sometimes it takes months and even years to find the right medication. I hope you have shared your description of being extremely "up" and then "down" in the same day with your doctor, because it sounds more like rapid cycling bi-polar depression than uni-polar. I am not a doctor, it just sounds like someone I know. Regarding whether to stop a med, all the new research is suggesting that the duration of an adequate trial of a med should be much longer than originally thought. Hang in there.
Posted by anon on November 16, 1998, at 11:37:39
In reply to Re: Mood Swings, posted by Annie on November 13, 1998, at 16:29:05
could someone give more info re rapid cycling bipolar?
either from a personal perspective or more
from a doc's perspective.
Posted by jessie on February 28, 2001, at 11:45:29
In reply to Re: rapid cycling, posted by anon on November 16, 1998, at 11:37:39
> could someone give more info re rapid cycling bipolar?
> either from a personal perspective or more
> from a doc's perspective.
i am suffering rapid cycling, getting worse over the past 4 or 5 months. and by rapid i mean violent swings within hours.
i have been hospitalized twice for MDD recurrent severe, and am diagnosed Dysthymic, not Bipolar. my psychiatrist suspects that the load of antidepressants prescribed at the last hospital (is spent 2 months at Sheppard Pratt) is aggravating the situation. i take 600 gabapentin qid, 300 wellbutrin, 225 effexor, and ativan .5 bid. He wants to try tegretol and decrease the antidepressants. right now i am taking clonopin to alleviate the symptoms (which are intolerable) And i will see him tomorrow to reassess meds and have my psychotherapy (which i do with my psychiatrist)i am interested in some of the newer mood stabilizers (topomax and lamictal)
i am so disappointed that the neurontin did not help, and that all that time in hospital has apparently left me in a worse state than i was in before.
i have searched a bit on the internet, not much help, especially since i have never been diagnosed bipolar, per se. the mood swings go from scattered agitation with some productivity, to extreme frustration then down into soul crushing depression, and all that can be within 6 hours.
the clonopin is giving me a lot of relief but i know it is temporary.
anyway, more to say on the topic, if you'd care to contact me, you may.jessie
Posted by judy1 on February 28, 2001, at 21:06:49
In reply to Re: rapid cycling, posted by jessie on February 28, 2001, at 11:45:29
Hi Jesse,
It sounds as if your pdoc suspects bipolar since he is decreasing your AD's (which often aggravate dysphoric manic symptoms- sounds like your agitation with productivity). I have been rapid cycling for over 3 years- euphoric hypomanic or manic episodes crashing into depressions. If klonopin is helpful now, there is no reason to believe it will not be helpful for years (I've taken 6mg/day for 3 years). It is often used as a secondary mood stabilizer, especially in agitative states. Neurontin did nothing for me either, tegretol made me vomit- have you tried depakote yet? Lamictal was great in depression- pushed me into a manic episode. I am not 'allowed' to take AD's. I bet once the AD's are out of your system and you find an effective mood stabilizer, you'll feel a lot better. In the meantime, raise the klonopin? Take care, Judy
Posted by Cece on February 28, 2001, at 22:29:17
In reply to Re: rapid cycling, posted by jessie on February 28, 2001, at 11:45:29
Hi Jessie-
I really feel for you- what you are experiencing sounds terrible.
I haven't experienced such rapid cycling, I'm bipolar II (I guess! seems like diagnostic categories aren't always especially precise). But I'll share my experience with mood stabilizers, and also mention my neice's, who is Bipolar I, with chronic low grade depression. I hope you don't mind reading a long post.
I've taken clonazaepam for a long time (8 years), in a very small daily dose. It is an anti-anxiety agent, but also a mood stabilizer. Unlike some other people who have posted, I haven't experienced it pooping out. Unless I take only a tiny dose, I get very groggy/sloggy. I have just now started to try reducing the dose to go off it, to see if I'm okay without it as I suspect it may be contributing to an ongoing problem with feeling mentally fogged even at a very small dose. And I'm taking other mood stabilizers now, so may not need it any more. BUT, I've read of other people's very good experiences with it at higher doses over long periods of time. (There is a lot of discussion of it on the Panic Disorders Bulletin Board).Over these 8 years, I have tried MANY meds, in different doses and combos. I now take a pretty substantial mix, several in small doses.
I tried Depakote very early and immediately felt a weight (like an electric charge on my skin) lifted off. I took a "regular dose" of 1000mg/day for several months, got some anti-depressant effects as well, but felt I was getting too much sedation. But if I stopped entirely (gradually going down), I got quite agitated again. Now I take 250mg/day which seems a good dose for me.
When I started Neurontin, I felt a new experience of well-being- amazingly so for awhile, then less but still significantly- I take 1200mg/day. It seems that for people who it helps, it works well as an adjunct to other meds, rather than a stand-alone.
Topomax did not work for me as a mood stabilizer, and did give me some trouble with word-finding. However, on the 10 months I was on it, I lost quite a bit of weight (caused by the Depakote, and also by Nortiptyline). If it weren't for the cognitive problems, I would have stayed on it for the weight loss!
The Nortrityline has help my sleep and depression significantly. Since it caused weight gain and I got horrible dry mouth, I went down to the lowest dose that held off bad depression and reduced those side effects- 40mg/day- and have stayed at that dose for several years.
I also was on zoloft for about 2 years- 25mg/day, and it did have some good AD effects- but it was unclear whether it might be causing me agitation, and I was sexually disabled. I have been completely off it for 1.5 years, and don't miss it at all.
Last year I started Lamictal, since low energy and low grade depression continued as a problem and it is a more activating mood stabilizer. I have found that it has improved my mood overall. I take 125mg/day, a relatively small dose. I did a very gradual increase schedule to get on it- my pdoc is cautious, having seen some bad reactions in patients, and I seem to be quite sensitive to meds in general. It has seemed to help me with weight loss also (contrary to other people's experiences), but not as dramatically as the Topomax.
I also take xanax, not a lot- total of 1.25mg/day, with extra PRN if I have a period of heightened anxiety. It works on anxiety and also has some anti-depressant effects. I find it to be a very helpful med.
My neice, who has had 2 manic episodes that required hospitalization, has very comfortably settled into Topomax as her only med, having been on many others (mood stabilizers and AD's) over several years. She had sedation/cognitive problems with most of the other mood stabilizers- (Tegretol, Depakote, and Neurontin).
Just to fill in, I also take cytomel (for several years, as an AD adjunct), and just recently started Adderall (10mg/day total), and Levotroid (50mcg/day). Each of these were added to help continuing brain fog/low energy/focussing problems, and each has helped significantly- although if I go over these low doses I get agitation.I am still struggling with some background, chronic "demon"- trying hard to describe well what it is. It's some kind of lack of well being, physical tension, suseceptibility to stress, agitation, low motivation- I've described it sometimes as chronic grief. I've asked my pdoc about Xyprexa (based on what I've read on other people's postings here) and he thinks that it is worth trying- but we're going to wait for the new version, ziprasidone to come out in March to avoid the weight gain side effects. If it works, I might be able to drop something else out.
If anyone reads this who recognizes my "demon" and has any feedback, I'd appreciate hearing it.I get very tired of dealing with all these meds and running my own home pharmacy. But each one has helped in its own particular way, so I try and accept it. I spend an evening every 3-4 weeks and pack up my meds into little ziploc bags so that I don't have to deal with all those bottles all the time.
By the way, both my neice and I take daily Flax Seed Oil- I think that the dose I take is 10grams/day (2 tablespoons of the oil- my neice uses the capsules). She is positive that it has helped her to feel better overall- I'm less certain, but since it is good for health in general, I continue.
So everyone's experience is a bit different, with some common overlaps- but there is sure no one answer. Hopefully your new doc will work out the right combo for you before too long. All I can say is hang in there, be as honest and articulate as you can with your doc, and have faith that other people have gone through these awful experiences and gotten better. It is great that you are able to work with the same person for psychopharmacology and therapy.
Best wishes,
Cece
Posted by Chris A. on March 1, 2001, at 1:00:17
In reply to Re: rapid cycling » jessie, posted by Cece on February 28, 2001, at 22:29:17
Dear Cece, Jessie and anyone else who struggles with cycling,
Your mention of the chronic ongoing "demon" hit home with me. I can identify. The constant struggle is exhausting. My therapist recently asked me to write out the ways in which I have accepted and dealt with my illness. Even though I've faithfully taken my meds and worked hard to find the best solutions, my angry response suprised me. I am tired of trying keep this "demon" under control and being a failure at it. Lately I've been a bit desperate. Fron experience, I know going to the hospital isn't going to fix "it." All the wellness plans and mood stabilizers in the world don't always kick in when needed. The desperation will go away when I'm fortunate enough to be in a hypomanic or euthymic state. I can't tell the difference between them in myself. The desperation always returns with a vengence, as now. It makes one feel totally shut off from others. I can't connect and feel very much alone. Is ziprasidone going to be the "miracle" drug? I'm not overly optimistic at this point. One can only hope. Perhaps hope is the answer to that demon. When I'm without it there is no end to the doward spiral.
I wish you all hope and peace and succes in running your own "home pharmacies"
Chris A.
> I am still struggling with some background, chronic "demon"- trying hard to describe well what it is. It's some kind of lack of well being, physical tension, suseceptibility to stress, agitation, low motivation- I've described it sometimes as chronic grief. I've asked my pdoc about Xyprexa (based on what I've read on other people's postings here) and he thinks that it is worth trying- but we're going to wait for the new version, ziprasidone to come out in March to avoid the weight gain side effects. If it works, I might be able to drop something else out.
> If anyone reads this who recognizes my "demon" and has any feedback, I'd appreciate hearing it.
>
> I get very tired of dealing with all these meds and running my own home pharmacy. But each one has helped in its own particular way, so I try and accept it.
Posted by judy1 on March 1, 2001, at 12:01:10
In reply to Re: rapid cycling, posted by Chris A. on March 1, 2001, at 1:00:17
Ah Chris,
I am so sorry to read that you are exactly where I am. It is so exhausting, isn't it? I'm starting with this STEP-BD program next Wednesday. I keep thinking that there is some hidden drug out there, kind of like your 'miracle' drug. I know you have a family like me, and I guess that's what keeps us going- at least until the next hypo or manic episode. Praying for your recovery too- judy
Posted by strong-in-new-york on March 9, 2001, at 16:39:35
In reply to Re: rapid cycling, posted by jessie on February 28, 2001, at 11:45:29
rapid cycling is the pits, no question.
in my early 20s, i took tegretol for about
four years, since lithium just had no effect
at all, at any dose.taking that drug was just absolutely horrible.
i had to take it twice a day, and whenever it
kicked in, it made me so sleepy i could barely
walk straight--that's not to mention the way it
made my speech all slurry. and it killed off my
production of both red and white blood cells, down
to leukemic levels.on the plus side, it did slow my cycling down
enough that i was able to go several years with
no meds. i still don't know whether it was worth
it.now i take remeron, which buffers me from
depression. because i take it at night and it
makes me quite drowsy, it helps me sleep through
the night, and keeps me from getting high.
This is the end of the thread.
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