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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Cindylou on March 18, 2001, at 19:29:18
I just discovered this site last night, and it has been SO affirming to know that it's not just me who has a hard time tolerating the different antidepressants out there. I have had chronic depression since I was 13 (I believe it is very much connected to my HORMONES since it gets progressively worse as the month goes on, to the point where I can't stand living that last week.)
I didn't receive treatment until 12 years later (I medicated myself with alcohol and relationships during those years -- really healthy stuff.) And now, for the past 11 years I have been on and off several medications.
I have tried most of the SSRIs (Prozac, Paxil, Zoloft, and Effexor) They all make me extremely fatigued and "drugged out" -- with severe "brain grog" as someone mentioned in this site. (A great description!) My doctor acts as if I'm making up the fatigue because she said she's never known anyone to get tired on Prozac or Zoloft. I was on ZOloft + Wellbutrin for a couple of years -- the Wellbutrin helped with the fatigue a bit, but I still wasn't fully "awake."
I got off the Zolfot+Wellbutrin a couple of years ago in order to get pregnant. During my pregnancy, I did pretty well off the meds (probably because I was no longer ovulating!) but the minute my baby was born I was hit with severe postpartum depression and anxiety. I was SO SENSITIVE to meds that even 5 mg of Prozac knocked me out. I had to use a dropper and work up to 5 mg, which helped for a couple of months, but then backfired (this happened to me once before on Prozac.) I finally ended up on Effoxor + Wellbutrin, but the Wellbutrin didn't do enough to get rid of the exhaustion caused by the Effexor, so I am now weaning myself off the Effexor (I'm down to 50 mg and already feel more alert -- people have even commented on the difference).
HOWEVER, now that I can actually feel things, I am experiencing anxiety. I tried Buspar for a few days, but it "drugged me out" just like the SSRIs. I am now trying Klonapin, which doesn't seem to do much, and does make me sleepy (not as bad as the others though.) I am leary about the risks involved with it as well, so I don't think I'll continue it.
So that's where I'm at. My questions for anyone out there are ...
- can you think of any antidepressant that won't make me so fatigued??
- Has anyone tried Desipramine? I was on that in the very beginning and it seemed to help with minimal side effects, but I was told later that I wasn't taking a therapeutic dose. I was only taking 40 mg. I think. What is a normal dose for Desipramine? And does it have many side effects?
- I have heard a lot of meds mentioned that I wasn't aware of, like Celexa, Neurontin, Luvox ... do any of these sound like they could help me considering my extreme sensivity to SSRIs?
Any advice, thoughts, opinions are greatly appreciated!!
Sorry for the rambling message -- didn't know how to put my complicated history into too small of a nutshell. I hope someone made it through to the end.
- cindylou
Posted by SalArmy4me on March 18, 2001, at 19:40:02
In reply to have i tried everything??, posted by Cindylou on March 18, 2001, at 19:29:18
Here's some stuff to try:
Nefazodone - great for sleep; no sexual dysfunction; no anticholinergics side-effects.
Lamotrigine - good side-effect profile; most antidepressant properties
Carbamazepine - less side effects than Lithium or divalproex sodium
Topiramate - the newest mood-stabilizer; it promotes weight loss
Desipramine - the least side-effects of all the Tricyclics; one of the SNRIs
High-dose Venlafaxine - at higher doses Venlafaxine affects more chemicals than SSRIs.
Buspirone - an effective antidepressant and anxiolytic at high doses.
Dopamine Agonists - Pramipexole has two studies on it (I take it).
"Power Combinations" - Remeron+Effexor; Wellbutrin+Remeron, RemeronProzac
Augmentation of anything you have tried before with Lithium, Pindolol, or Buspar (i took pindolol
Foreign medications to the US: the RIMA Moclobemide; Reboxetine; Amisulpride, etc
Atypical Neuroleptics/Antipsychotics with antidepressant properties: Risperidone, Olanzapine, Seroquel
Provigil - a stimulant that is possibly effective
Irreversable MAOIs - Phenelzine, Tranylcypromine. Extremely Effective.
MAOI-B - Selegiline, an antidepressant almost comparable to Phenelzine.
I hope that gives you hope!
> I just discovered this site last night, and it has been SO affirming to know that it's not just me who has a hard time tolerating the different antidepressants out there. I have had chronic depression since I was 13 (I believe it is very much connected to my HORMONES since it gets progressively worse as the month goes on, to the point where I can't stand living that last week.)
>
> I didn't receive treatment until 12 years later (I medicated myself with alcohol and relationships during those years -- really healthy stuff.) And now, for the past 11 years I have been on and off several medications.
>
> I have tried most of the SSRIs (Prozac, Paxil, Zoloft, and Effexor) They all make me extremely fatigued and "drugged out" -- with severe "brain grog" as someone mentioned in this site. (A great description!) My doctor acts as if I'm making up the fatigue because she said she's never known anyone to get tired on Prozac or Zoloft. I was on ZOloft + Wellbutrin for a couple of years -- the Wellbutrin helped with the fatigue a bit, but I still wasn't fully "awake."
>
> I got off the Zolfot+Wellbutrin a couple of years ago in order to get pregnant. During my pregnancy, I did pretty well off the meds (probably because I was no longer ovulating!) but the minute my baby was born I was hit with severe postpartum depression and anxiety. I was SO SENSITIVE to meds that even 5 mg of Prozac knocked me out. I had to use a dropper and work up to 5 mg, which helped for a couple of months, but then backfired (this happened to me once before on Prozac.) I finally ended up on Effoxor + Wellbutrin, but the Wellbutrin didn't do enough to get rid of the exhaustion caused by the Effexor, so I am now weaning myself off the Effexor (I'm down to 50 mg and already feel more alert -- people have even commented on the difference).
>
> HOWEVER, now that I can actually feel things, I am experiencing anxiety. I tried Buspar for a few days, but it "drugged me out" just like the SSRIs. I am now trying Klonapin, which doesn't seem to do much, and does make me sleepy (not as bad as the others though.) I am leary about the risks involved with it as well, so I don't think I'll continue it.
>
> So that's where I'm at. My questions for anyone out there are ...
>
> - can you think of any antidepressant that won't make me so fatigued??
>
> - Has anyone tried Desipramine? I was on that in the very beginning and it seemed to help with minimal side effects, but I was told later that I wasn't taking a therapeutic dose. I was only taking 40 mg. I think. What is a normal dose for Desipramine? And does it have many side effects?
>
> - I have heard a lot of meds mentioned that I wasn't aware of, like Celexa, Neurontin, Luvox ... do any of these sound like they could help me considering my extreme sensivity to SSRIs?
>
> Any advice, thoughts, opinions are greatly appreciated!!
>
> Sorry for the rambling message -- didn't know how to put my complicated history into too small of a nutshell. I hope someone made it through to the end.
>
> - cindylou
Posted by noa on March 18, 2001, at 21:23:28
In reply to Re: have i tried everything?? » Cindylou, posted by SalArmy4me on March 18, 2001, at 19:40:02
Cindy, I recommend you take a look at several books: Elizabeth Vliet, MD, Screaming to Be Heard and Women's Moods by Deborah Sichel, MD.
Both talk about the hormone connection. You sense it's there and my hunch is you are probably right.
You may still need ADs, but might respond a whole lot better if any hormone problems are addressed.
Posted by aDaMs on March 18, 2001, at 21:57:12
In reply to have i tried everything??, posted by Cindylou on March 18, 2001, at 19:29:18
DHEA??
My mother was taking it, she was going crazy because of her hormones, the DHEA worked good. I dont know anything about DHEA other than that, so it might be the wrong medicine for you, but just thought I would mention it, its available at nutritions stores like GNC.
Posted by Cindylou on March 18, 2001, at 22:07:58
In reply to Re: have i tried everything?? » Cindylou, posted by SalArmy4me on March 18, 2001, at 19:40:02
WOW! Thank you so much ... I haven't heard of most of those, although I did try Provigil once, and it made me feel dizzy and nauseous, like I had the flu or a bad hangover. I will definitely talk to my doc about your list.
> Here's some stuff to try:
>
> Nefazodone - great for sleep; no sexual dysfunction; no anticholinergics side-effects.
>
> Lamotrigine - good side-effect profile; most antidepressant properties
>
> Carbamazepine - less side effects than Lithium or divalproex sodium
>
> Topiramate - the newest mood-stabilizer; it promotes weight loss
>
> Desipramine - the least side-effects of all the Tricyclics; one of the SNRIs
>
> High-dose Venlafaxine - at higher doses Venlafaxine affects more chemicals than SSRIs.
>
> Buspirone - an effective antidepressant and anxiolytic at high doses.
>
> Dopamine Agonists - Pramipexole has two studies on it (I take it).
>
> "Power Combinations" - Remeron+Effexor; Wellbutrin+Remeron, RemeronProzac
>
> Augmentation of anything you have tried before with Lithium, Pindolol, or Buspar (i took pindolol
>
> Foreign medications to the US: the RIMA Moclobemide; Reboxetine; Amisulpride, etc
>
> Atypical Neuroleptics/Antipsychotics with antidepressant properties: Risperidone, Olanzapine, Seroquel
>
> Provigil - a stimulant that is possibly effective
>
> Irreversable MAOIs - Phenelzine, Tranylcypromine. Extremely Effective.
>
> MAOI-B - Selegiline, an antidepressant almost comparable to Phenelzine.
>
> I hope that gives you hope!
>
> > I just discovered this site last night, and it has been SO affirming to know that it's not just me who has a hard time tolerating the different antidepressants out there. I have had chronic depression since I was 13 (I believe it is very much connected to my HORMONES since it gets progressively worse as the month goes on, to the point where I can't stand living that last week.)
> >
> > I didn't receive treatment until 12 years later (I medicated myself with alcohol and relationships during those years -- really healthy stuff.) And now, for the past 11 years I have been on and off several medications.
> >
> > I have tried most of the SSRIs (Prozac, Paxil, Zoloft, and Effexor) They all make me extremely fatigued and "drugged out" -- with severe "brain grog" as someone mentioned in this site. (A great description!) My doctor acts as if I'm making up the fatigue because she said she's never known anyone to get tired on Prozac or Zoloft. I was on ZOloft + Wellbutrin for a couple of years -- the Wellbutrin helped with the fatigue a bit, but I still wasn't fully "awake."
> >
> > I got off the Zolfot+Wellbutrin a couple of years ago in order to get pregnant. During my pregnancy, I did pretty well off the meds (probably because I was no longer ovulating!) but the minute my baby was born I was hit with severe postpartum depression and anxiety. I was SO SENSITIVE to meds that even 5 mg of Prozac knocked me out. I had to use a dropper and work up to 5 mg, which helped for a couple of months, but then backfired (this happened to me once before on Prozac.) I finally ended up on Effoxor + Wellbutrin, but the Wellbutrin didn't do enough to get rid of the exhaustion caused by the Effexor, so I am now weaning myself off the Effexor (I'm down to 50 mg and already feel more alert -- people have even commented on the difference).
> >
> > HOWEVER, now that I can actually feel things, I am experiencing anxiety. I tried Buspar for a few days, but it "drugged me out" just like the SSRIs. I am now trying Klonapin, which doesn't seem to do much, and does make me sleepy (not as bad as the others though.) I am leary about the risks involved with it as well, so I don't think I'll continue it.
> >
> > So that's where I'm at. My questions for anyone out there are ...
> >
> > - can you think of any antidepressant that won't make me so fatigued??
> >
> > - Has anyone tried Desipramine? I was on that in the very beginning and it seemed to help with minimal side effects, but I was told later that I wasn't taking a therapeutic dose. I was only taking 40 mg. I think. What is a normal dose for Desipramine? And does it have many side effects?
> >
> > - I have heard a lot of meds mentioned that I wasn't aware of, like Celexa, Neurontin, Luvox ... do any of these sound like they could help me considering my extreme sensivity to SSRIs?
> >
> > Any advice, thoughts, opinions are greatly appreciated!!
> >
> > Sorry for the rambling message -- didn't know how to put my complicated history into too small of a nutshell. I hope someone made it through to the end.
> >
> > - cindylou
Posted by KarenB on March 20, 2001, at 12:23:29
In reply to Re: have i tried everything??, posted by Cindylou on March 18, 2001, at 22:07:58
Dear Cindylou,
I have had the same response to every SSRI - EXTREME fatigue and sleepiness. I have tried six. Turns out, I was misdiagnosed for years with depression, when it was actually Bipolar Disorder that was causing my depression and alternating energy/irritability/agitation.
I finally spent the big bucks and saw one of the best mood disorder specialists in the country here in Denver. He said I am most assuredly Bipolar and suggested some beginning routes of therapy - which are working better than anything ever has. It was money well spent. I wish I would have done it years ago (I just turned 40).
I still struggle with fatigue (and PMDD) but it is getting substantially better as my doc and I adjust the dosages. Most importantly, I now have HOPE of getting to some semblance of "well," soon.
My med combo is: Trileptal (mood stabilizer)600mg am & pm, Geodon (anti psychotic - helps with ruminating thoughts and breakthrough mania) 40mg am & pm, Xanax .5mg (anti anxiety) as needed, although I have found after adding the Geodon just recently that I rarely need the Xanax.
You didn't say, Cindylou, if you had an actual psychiatrist. Sounds like it may be your family doc guessing and throwing the SSRI's at you. Please...do yourself a favor and find a really good psych doc - preferably a woman, especially with your hormonal issues (they LISTEN). I am very happy with mine of the past few months but I did get a real bonehead on my first attempt. Don't give up if that happens to you. A teaching hospital or a university school of medicine is a good source for referrals. And don't forget to tell your new doctor EVERYTHING about the meds you have tried and their effects. It helps to write it out for them.
Take your health into your own hands and find the very best help available. You go, girl.
KarenB
Posted by Cindylou on March 20, 2001, at 19:29:03
In reply to Re: have i tried everything?? » Cindylou, posted by KarenB on March 20, 2001, at 12:23:29
Dear Karen,
THANK YOU SO MUCH!!!! Your message was extremely affirming after three different doctors have told me that Prozac and Zoloft WILL NOT cause fatigue (E.g. it's all in my head.)I do have a psychiatrist, but she's not the greatest -- I think she's pretty new to the field. She's nice, but it seems that I'm always suggesting things to her instead of the other way around.
I used to have a wonderful pdoc -- her sessions were 30 minutes, instead of the standard 5-10 minute sessions. She truly cared about her clients (even hugged us as we left!) Sadly, she retired a few years ago.
Things have become most difficult for me in the past 15 months since I had my baby. Now is when I need an excellent pdoc, but I haven't had much luck in locating one. I will definitely try your advice and call a university hospital (we have an excellent one in the area.)
I am so happy that you have found the help you need -- Now you can live your next 40 years with peace and comfort.
Thank you again for your message and your encouragement!!
- cindy
> Dear Cindylou,
>
> I have had the same response to every SSRI - EXTREME fatigue and sleepiness. I have tried six. Turns out, I was misdiagnosed for years with depression, when it was actually Bipolar Disorder that was causing my depression and alternating energy/irritability/agitation.
>
> I finally spent the big bucks and saw one of the best mood disorder specialists in the country here in Denver. He said I am most assuredly Bipolar and suggested some beginning routes of therapy - which are working better than anything ever has. It was money well spent. I wish I would have done it years ago (I just turned 40).
>
> I still struggle with fatigue (and PMDD) but it is getting substantially better as my doc and I adjust the dosages. Most importantly, I now have HOPE of getting to some semblance of "well," soon.
>
> My med combo is: Trileptal (mood stabilizer)600mg am & pm, Geodon (anti psychotic - helps with ruminating thoughts and breakthrough mania) 40mg am & pm, Xanax .5mg (anti anxiety) as needed, although I have found after adding the Geodon just recently that I rarely need the Xanax.
>
> You didn't say, Cindylou, if you had an actual psychiatrist. Sounds like it may be your family doc guessing and throwing the SSRI's at you. Please...do yourself a favor and find a really good psych doc - preferably a woman, especially with your hormonal issues (they LISTEN). I am very happy with mine of the past few months but I did get a real bonehead on my first attempt. Don't give up if that happens to you. A teaching hospital or a university school of medicine is a good source for referrals. And don't forget to tell your new doctor EVERYTHING about the meds you have tried and their effects. It helps to write it out for them.
>
> Take your health into your own hands and find the very best help available. You go, girl.
>
> KarenB
Posted by MA on March 21, 2001, at 22:20:39
In reply to have i tried everything??, posted by Cindylou on March 18, 2001, at 19:29:18
Hi Cindy,
I have had many different reactions to the various AD's. I took Prozac at night since it made me sleepy. For most people, Prozac tends to be more energizing than sedating. But there are always exceptions (me and it sounds like you)
I'm on Celexa now with pretty good results. I had some trouble with nausea in the beginning so I split the dose taking half in the AM (started with 10 mg) and half at night, getting up to a total of 40 mg. It took a few weeks. I also take Wellbutrin 150 mg in the AM and Adderal 10 mg in the AM to combat the fatigue and loss of energy that I get with SSRI's.
My doctor and I have figured out that I need to be on an SSRI type of med but also need the stimulating effects of Wellbutrin and Adderal (Used to treat ADD, like ritalin).
I have never taken Serzone or Luvox so i can't recommend those.
Your doctor need to refer you to a colleague if she can't find another combination that gives you some relief. I got to the point with my doctor where I asked him to refer me since I was not getting any better. This can happen esp. if you doc is inexperienced, but you shouldn't have to suffer for it.
GOOD LUCK!
This is the end of the thread.
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