![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 16 to 40 of 52. Go back in thread:
Posted by Elizabeth on June 8, 2001, at 16:24:15
In reply to Re: Xanax use, posted by gilbert on June 8, 2001, at 12:27:19
> I find that I feel way more stoned on an ssri or like I am on speed on Wellbutrin than being on xanax.
I sympathise. I feel much more like myself on opioids than I do on typical ADs. Definitely not "stoned."
> The huge push for ssris for anxiety disorders did coincide with patents on benzos running out and new expensive drugs being pushed for panic that benzos were treating with a fair amount of success.
Antidepressants also tend to have more side effects, especially for people with panic disorder, than benzos do.
> All of the truly serious anxiety websites recommend benzo use and show it's efficacy superior to ssri treatment. I.E. Tapir, anxities.com, Dr Shipko and the Panic institute. The studies showing ssri efficacy on panic if you dig deep enough are usually sponsored by drug companies or paid for by drug companies with an interest in ssris.
I think this is plausible, but could you point me to some research showing benzos to be superior? They definitely work faster and without the initial period of increased anxiety; I'm thinking more of the long term (after the AD has had a chance to work). I have panic disorder and my experience has been that ADs work fine; when I was on them (I'm in the process of a switch right now) I never needed to resort to using my "emergency Xanax" for panic.
> The ssri school of thought that benzos are addictive and your brain will shrink and memory will go is scare tactics to sell more ssris.
I agree, although it is true that chronic benzo use (not necessarily abuse) causes long-lasting brain changes. It's *not* known whether these changes constitute "brain damage" or have any bad effects, though.
> I am not foolish enough to think that their are not those out there who abuse benzos...there are. There are people out ther abusing turpentine, there are people out there abusing ssris too.
Those are almost silly examples. But for kicks, try searching Medline for tranylcypromine and (abuse or addiction or dependence). Tranylcypromine *would* be a controlled substance under the Analogues Act if it hadn't already been in use when the Act was passed.
> But study after study proves otherwise it is a very small minority.
Yes. And furthermore, the very small minority consists almost exclusively of people who are abusing other drugs also.
Cam makes a good point that if you get into trouble with benzos, the doctor who prescribed them can get into trouble too. But you're right, doctors are overly benzophobic as a result.
> In my experience over the past 2 years of trying everthing and I mean everything the ssris have been the least cleanest drugs to get away from. The rebound depression and jones for some extra seratonin reminds me of my cocaine withdrawal and my jonesing days off the powder.
MAOI withdrawal is worse, but AD withdrawal is not generally associated with cravings. It's a pharmacological abstinence syndrome, not an addiction.
> I have detoxed off of vodka....cocaine....and other various substances and beilive me when I say this that coming off of antidepressants has mimicked those awful detox sysmtoms closer than any benzo withdrawal.
You're in the minority there, although this might have been because doctors didn't recognise AD withdrawal phenomena until relatively recently (so they just had their patients stop the SSRIs cold turkey). People who have experience with both often say that benzo withdrawal is worse than heroin withdrawal.
In most cases, there are ways to make drug discontinuation relatively painless. You can switch to a milder and longer acting drug (e.g., buprenorphine to get off of heroin, or Klonopin or Tranxene to get off of Xanax), for example. You can also try to treat the withdrawal symptoms with drugs like anticonvulsants (for benzos), or clonidine, propranolol, etc. (for opioids). This can work with AD withdrawal syndromes as well: switching from Effexor or Paxil to Prozac; using benzos, Benadryl or hydroxyzine, etc. to alleviate the withdrawal symptoms.
> I just think that the stigma surrounding benzo use actually forced me to try drugs that made my condtion worse.
That has happened to a lot of people: you're definitely not alone.
> I did not have the self esteem or fortitude to stand up for myself.
It's *hard* to stand up to doctors, AA members, friends, relatives, etc. when they're all pushing you to do something that you don't feel is right for you. Don't get down on yourself over it. There was a time when I was younger and feeling *very* demoralised I had a tough time standing up to doctors and psychologists, and it ended up making things worse for me too.
> My peers in AA and friends would say Gil get off xanax and try an antidepressant before the xanax leads you back to drinking.....what a joke.
What a joke indeed! Alcohol is a lame and toxic substitute for benzos -- if you have adequate doses of benzos, you don't *need* to drink. The idea that a history of alcoholism is cause to avoid benzos is just wrong -- morally as well as factually.
> Your body will tell you when it is right.
Amen.
> The doc said let's stick with what works stay on the xanax leave the rest alone see ya in 3 months so that is where I am today....
Stick with what works. Nice. I'm glad you've got a doc who understands that.
Oh yeah also that vet study on klonopin and impotence I went back and looked 46 % of the klonopin users experienced impotence but the dose was like enough to knock out an elephant. I think it was from 3 to 5 grams per day.
***GRAMS***????
I think this is the abstract of the study you mean:
Anxiety 1994-95;1(5):233-6
Clonazepam-related sexual dysfunction in male veterans with PTSD.
Fossey MD, Hamner MB.
Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC 29401, USA.Medication-induced sexual dysfunction can significantly interfere with patients' quality of life and lead to poor compliance. This retrospective study examined the records of 100 male veterans with post-traumatic stress disorder (PTSD) selected in alphabetical order from an active treatment file of 230 patients. Forty-two patients had received clonazepam (mean maximum dose: 3.4 +/- 1.6 mg/day) at some point during their treatment. Of these, 18 (42.9%) complained of significant sexual dysfunction (primarily erectile dysfunction). Eighty-four patients received diazepam (mean maximum dose: 52.1 +/- 29.7 mg/day), nine received alprazolam (mean maximum dose: 5.2 +/- 2.8 mg/day) and eight received lorazepam (mean maximum dose: 3.8 +/- 2.4 mg/day). None of these patients complained of sexual dysfunction during treatment with these three other benzodiazepines. Our findings suggest that benzodiazepines, particularly clonazepam in the current study, can be a cause of sexual dysfunction in many male patients. Prospective studies comparing the overall clinical utility of various benzodiazepines are indicated in this and other clinic populations.
Some of those doses are high-end, but not outrageous. Klonopin 1.8-5.0 mg/day isn't at all unreasonable. 50 mg of Valium and 5 mg of Xanax are a bit high, but not too bad. Like I said (different post, same thread), the dose range of Xanax for depression is around 8-12 mg/day.
-elizabeth
Posted by gilbert on June 8, 2001, at 16:36:25
In reply to Re: Xanax use » gilbert, posted by Elizabeth on June 8, 2001, at 16:24:15
Thanks Elizabeth it is the study I read and I keep screwing up that grams thing on my post and scaring the hell out of people. Have you ever read any of the interviews of Stuart Shipko....or gone to his website. He has quoted some long term studies there. I will find the other web site studies and give it to you but I know Dr Shipko has some of that data. I have searched extensively on this topic to try and rid myself of the guilt of benzo use and I have not marked down all of the reasearch URL's But I will track a couple for you and get them to you.
Thanks,
Gil
Posted by lisa99 on June 8, 2001, at 21:24:22
In reply to You knew I had to jump in here, Gil , posted by grapebubblegum on June 7, 2001, at 11:57:19
feel fine except dammit if those brain-eyeball-freezes aren't dogging me. I mean, I'm almost afraid to look right or left because ot triggers "electric head," which happens without any apparent triggers anyway. I still don't know what it is except the explanation of a short-circuited beginning of a seizure sounds plausible but is not exactly comforting. > > > > > >
I've seen a zillion different names for the kind of funky symptoms all the various meds posted on this site produce, and brain eyeball freeze and electric head are pretty on target. Is there any research that puts these phenomena which we all seem to be suffering into "scientific" terminology which everyone understands and knows what is really going on?????
Posted by gilbert on June 8, 2001, at 22:19:32
In reply to Re: You knew I had to jump in here, Gil » grapebubblegum, posted by lisa99 on June 8, 2001, at 21:24:22
Elizabeth,
You said you were in the middle of a med switch if I am not prying too much what and why. I would love to have had a ssri work for me much more socially acceptable...almost hip to be on prozac now. People just love too know your balancing out your chemical problems. I just can't seem to get a dose that doesn't kill my sex life. My latest trial was 5 mg per day and still anorgasmia......did you also have to dose way down on an ssri. The only thing I didn't try was like 2.5 per day or 5 mg every other day and would ya think these doses would even be effective at blocking panic.....that's if they still didn't take away my sex life. My wife and I are very much in love she is 41 and hitting her prime...we enjoy each other very much I just am not willing to handicap or diminish those wonderfull moments of intimacy. Please don't any body follow up with how great it is just to cuddle and smile on the ssri while sex takes a back seat I have had ample time to cuddle whilst on my ssri's and while augmenting them with the so called cures..
Gil
Gil
Posted by Elizabeth on June 8, 2001, at 23:29:44
In reply to Re: Xanax Rollercoaster effect, posted by gilbert on June 8, 2001, at 16:22:59
> It is so weird I can take xanax once a day and not have rebound maybe I am a slow metabolizer.
Maybe. Its metabolism is mediated primarily by the cytochrome enzyme p450 3a6. How much do you take? I know some people who take the full daily dose in the AM and don't have need for more.
> The worst sensation I have ever even gotten from forgetting to take the xanax is a kind of low blood sugar feeling but nothing that makes me run for a needle and a spoon like you read about.
< giggle > Not with Xanax! (Some people really get fixated on the ritual of shooting up, to the point where if they don't have anything, injecting *water*
> I also think Elizabeth makes some very valid points. I have stayed on the same maintenace dose of xanax for the last year it still gives me the panic coverage I need. I have friends and family mebers on effective doses for over 10 years.
This is typical. Some people do develop tolerance, but that is rare.
> The chances someone could get that long and stable of a result from the same ssri without increasing the dose or augmenting with a second drug or poop out is slim.
Now, that, I don't know about. It seems to me that SSRIs do poop out, but it's not clear how frequent that is. Also, if there is a tolerance phenomenon, it is much slower than benzo tolerance can be for those who do develop tolerance to benzos.
> The talk about how ssri's get to the root of panic disorder while benzos only medicate the symptoms is hogwash.
Yeah. People try to make the same claim about opioids and depression. There's no evidence to support it.
> Any drug I have taken with seratonin effects screws me up worse than prior to meds.
Now, that may be an immediate effect related to the panic disorder. Study after study has shown serotonin sensitivity in people with PD. The chronic use of SSRIs decreases this sensitivity, I would bet.
> Any drug with noraephrinine effects gives me tachycardia....
How bad? (Like, how many beats/minute?) I regret giving up on desipramine because of this relatively minor and treatable side effect.
> Take a short term ssri and see what kind of roller coaster ride you get. I was on paxil and luvox talk about up and down.
Short-acting, you mean? I never took Luvox, but I got agitated/hypomanic on Paxil.
> The benzos have been around along time. The studies on abuse even show people with panic and anxiety even ex addicts like myself don't abuse the meds.
Yeah. The information hasn't had a chance to trickle down to the average community pdoc yet, though.
> The abuse that comes from ER rooms and walk in clinics is different in that patients melt down the pills and shoot them either with heroin or cocaine.
Yes: it's the people who are abusing other drugs who look for benzos in order to abuse them. Heroin addicts seem to have a general preference for sedative-anxiolytic drugs; cocaine users sometimes like the combination (like a milder speedball?).
> Very few street addicts would be happy with the results they get from swallowing the pills.
Here's something that gets me: making benzos, opiates, stimulants etc. hard to get by prescription doesn't affect junkies a bit because the black market is completely unregulated. It just makes life harder for people with pain or anxiety or ADD or depression.
> They have to be torched and mainlined to get that instantaneous blast most addicts look for.
That's true. I don't think most people realise that. I sometimes hear that someone gets a fantastic high from oral opiates; I never fail to be surprised. They're nice, no question, but it's not a rush. I don't even have a basis for comparison, but I don't get high from oral drugs -- nothing that I'd identify as a high, and nothing that anyone observing me would identify as a high, either.
> Doctors and emergency room workers who have benzo beggars show up should look first for needle marks or crack smokers they ain't there just for the pills.....sometimes they will use the pills to get them from one fix to the next but it sure ain't for anxiety disorder.
Hmm. Arguably, addiction often arises as a result of self-medication of anxiety or mood disorders.
> I have been around and worked with addicts for the better part of 20 years and no one I know was holding up a pharmacy for xanax or klonopin......
Holding up pharmacies. Jeez. Ever see _Drugstore Cowboy_? (Note that Bobby throws away a bottle of 10 mg Valiums; when you have a bottle of something ending in "-morphone" in your hand, Valium doesn't seem like much!)
> It was not their drug of choice for abuse...it wasn't even in the top 10.....now demerol or morphine that's a different story.
Morphine has poor bioavailability when taken orally. And Demerol is just weird, although I gather that IV Demerol is an experience like no other.
> I thank God my pdoc allows me the opppportunity for a normal life with the use of xanax.
And I'm glad for you. A normal life is what we all strive for.
-elizabeth
Posted by Elizabeth on June 8, 2001, at 23:36:59
In reply to Re: Question for Elizabeth, posted by gilbert on June 8, 2001, at 22:19:32
> You said you were in the middle of a med switch if I am not prying too much what and why.
I stopped taking Parnate because I didn't think it was doing me much good. I'm doing an experiment with Ultram at the moment, but otherwise I'm just taking buprenorphine and occasional benzos.
> I would love to have had a ssri work for me much more socially acceptable...almost hip to be on prozac now.
Forget socially acceptable; it's just *easier*. Prozac (up to 60 mg) and Zoloft (up to 200) were totally free of any side effects for me. Unfortunately they were also free of any other effects as well.
The only thing I didn't try was like 2.5 per day or 5 mg every other day and would ya think these doses would even be effective at blocking panic.....that's if they still didn't take away my sex life.
They might be effective. The way to treat PD with ADs is to start at a low dose -- like 10 mg of imipramine, 5 or even 2.5 of Prozac, 25 of Zoloft, 37.5 of Effexor, etc. -- and increase it very slowly. And hope you have Xanax handy while you're waiting.
Sexual dysfunction is a side effect that many pdocs don't take seriously enough (weight gain is another). The problem, I think, is that they can't put themselves in our place. Like, how would they feel if they put on 50 lbs, or couldn't have an orgasm anymore?
-elizabeth
Posted by gilbert on June 8, 2001, at 23:57:14
In reply to Re: Xanax » gilbert, posted by Elizabeth on June 8, 2001, at 23:29:44
Elizabeth,
What works for you. It seems we have similar paths like Grapebubblegum too. Here is my list of tried and failed meds...buspar, serzone, remeron, prozac, celexa, paxil, luvox, deseryl, pamelor, zoloft, elavil, klonopin,......and I know I am forgetting a couple. Now over the past 2 years I have given most ot these the good ole college try. Are you saying that if staying on ssri's long enough the side effects become less. My experience is otherwise. I was on only 5 mg prozac per day each time I tried it which was 3 times. The sexual side effects got worse and worse. I was on serzone and remeron not only did I get anorgasmia on both but I felt like a total zombie worse after each dose. Do you have any insight you could share with me. The xanax works best but it is not without it's drawbacks as well.......apathy etc....What's a neurotic middle aged male to do.....LOL
Gil
Posted by SalArmy4me on June 9, 2001, at 2:00:41
In reply to Re: Elizabeth what works for you, posted by gilbert on June 8, 2001, at 23:57:14
I was thinking of desipramine or an MAOI/RIMA for you. MAOI's are some of the most effective and potent antidepressants still on the market.
> Elizabeth,
>
> What works for you. It seems we have similar paths like Grapebubblegum too. Here is my list of tried and failed meds...buspar, serzone, remeron, prozac, celexa, paxil, luvox, deseryl, pamelor, zoloft, elavil, klonopin,......and I know I am forgetting a couple. Now over the past 2 years I have given most ot these the good ole college try. Are you saying that if staying on ssri's long enough the side effects become less. My experience is otherwise. I was on only 5 mg prozac per day each time I tried it which was 3 times. The sexual side effects got worse and worse. I was on serzone and remeron not only did I get anorgasmia on both but I felt like a total zombie worse after each dose. Do you have any insight you could share with me. The xanax works best but it is not without it's drawbacks as well.......apathy etc....What's a neurotic middle aged male to do.....LOL
>
> Gil
Posted by gheld on June 9, 2001, at 9:39:26
In reply to Re: Happen to be lurking around, Cam? » grapebubblegum, posted by Cam W. on June 8, 2001, at 9:22:03
> This is probably one reason why SSRIs are preferred over benzos. Also, SSRIs are safer in overdose, especially in polydrug overdoses; I believe SSRIs attack the " biochemical cause" of the anxiety more directly; and SSRI prescriptions are not monitored as closely as benzo prescriptions.You must mean that SSRI's are preferred by physicians who don't or won't spend the time necessary to accurately diagnose their patients as having anxiety or panic and not depression. Considering the side effect profiles I'd think a benzo would be preferable to an SSRI every time if it would work. I have never heard of a person dying or suffering any irreversible damage from an OD of benzo's. Have you?
Gordon
Posted by Cam W. on June 9, 2001, at 10:33:50
In reply to Re: Happen to be lurking around, Cam?, posted by gheld on June 9, 2001, at 9:39:26
Gordon - Yes, I have heard of several suicide deaths from from overdoses of benzodiazepines mixed with alcohol, resulting in respiratory depression. Also, more people have died from taking taking overdoses of benzodiazepines alone (granted, it is rare), while people who have taken massive overdoses of SSRIs alone have recovered without any problems. There have only been a few deaths reported in which someone has died from ingesting overdoses of SSRIs alone, but less than 10 worldwide (I believe).
As to considering the side effects profiles, the top ten side effects listed for any SSRI usually describe the start of side effets of these drugs, and disappear within 2 weeks in a vast majority of people.
The body has adjusted to a lack of serotonin by altering the mix of the other neurotransmitters. With an increase in serotonin, as a result of taking an SSRI, one must expect that the body would have to readjust the mix of other neurotransmitters, hence, the start up side effects.
If the depression/anxiety did not result in a decrease of serotonin and you add an SSRI, then, yeas, you are going to get side effects associated with excess serotonin. These side effects are similar to the start-up side effects and really, the only way to tell the difference is (sometimes) the intensity of the side effect and if the side effect does wane over 2 to 3 weeks.
Let's compare side effets profiles (in no particular order):
Rivotril™ (clonazepam - Klonopin™ -U.S.)
Most Common - CNS depression in approx, 50% of people, respiratory depression, aggressiveness, argumentative behavior, hyperactivity, agitation, depression, euphoria, irritability, forgetfulness, confusion, nystagmus, unsteady gait, slurred speech, dysarthria, vertigo, palpitations, gynecomastia, hallucinations, muscle weakness, low back pain, increased appetite, nocturia, hypersecretion in upper respiratory tract, urinary retention, enuresis....Prozac™ (fluoxetine)
Start-up side effects - headache, nervousness insomnia, anxiety, emotional lability, nausea, tremor, dizziness, diarrhea/constipation, myalgia, flu-like sympoms, anorexia.....Long-term side effects - decreased libido, anorgasmia, increased appetite, excessive sweating, fatigue, twitching, change in accomodation, acne, back pain, joint pain, dry skin, urinary tract infection, painful menstruation....
Choose your poison. (ref. Compendium of Pharmaceuticals and Specialties, 2000).
BTW - If your doc does not spend time with you, find one that does; one that you can trust and trusts you. My pdoc and I work closely together to monitor my progress. He is only a phone call away, day or night.
- Cam
Posted by Greg on June 9, 2001, at 10:38:49
In reply to Re: Xanax vs. Klonopin, posted by Elizabeth on June 8, 2001, at 15:47:38
Thanks everyone for the feedback on this. I knew I'd get a lot of varied responses and that really is what I'm looking for. I think I'll ask my psych to try me on the Klonopin, I can always go back to the Xanax if I need to. I have an extremely addictive personality and have some concerns about withdrawals effects I'll have coming off the Xanax. Hopefully this will be a better solution in the long run.
I really appreciate ya'll taking the time to respond to this.
Peace,
Greg
Posted by gilbert on June 9, 2001, at 14:35:10
In reply to Re: Happen to be lurking around, Cam? » gheld, posted by Cam W. on June 9, 2001, at 10:33:50
- Yes, I have heard of several suicide deaths from from overdoses of benzodiazepines mixed with alcohol, resulting in respiratory depression. Also, more people have died from taking taking overdoses of benzodiazepines alone (granted, it is rare), while people who have taken massive overdoses of SSRIs alone have recovered without any problems. There have only been a few deaths reported in which someone has died from ingesting overdoses of SSRIs alone, but less than 10 worldwide (I believe).
I can overdose on most of my blood pressure meds and certainly taking a bottle of beta blockers won't keep you breathing too long but no stigma with those. Also very very hard to predict how many suicides take place because of use of either of the above mentioned drugs. I think spontaneous suicidal ideation is a listed side effect on most ssris. Now a toxic dose of the drug did not kill them but what about the drugs effect on their decision to take their own life. This will not show up in a toxicology report but we all know the web is full of this data....some of which are not Christian Scientists sponsored web sites.....LOL
> As to considering the side effects profiles, the top ten side effects listed for any SSRI usually describe the start of side effets of these drugs, and disappear within 2 weeks in a vast majority of people.If that were true this board would be non existent. Look at these posts week after week month after month almost all are side effect related most of which are long time users of ssris
> The body has adjusted to a lack of serotonin by altering the mix of the other neurotransmitters. With an increase in serotonin, as a result of taking an SSRI, one must expect that the body would have to readjust the mix of other neurotransmitters, hence, the start up side effects.Are you sure this is what happens. The med research I have read isn't even really defining how other neurotransmitters are effected. They don't even know why wellbutrin works. If the predictable of brain chemistry were so certain we could just dose by body weight and everyone would have the same results. SSRI's have such an array of effects on people certainly the same cannot be said for other classes of drugs not to the same extent. Very unpredictable...physically and emotionally not to mention spirituallly.
> If the depression/anxiety did not result in a decrease of serotonin and you add an SSRI, then, yeas, you are going to get side effects associated with excess serotonin. These side effects are similar to the start-up side effects and really, the only way to tell the difference is (sometimes) the intensity of the side effect and if the side effect does wane over 2 to 3 weeks.
Cam I really respect your intelligence and committement to this board but this whole lack of seratonin theory came to be the most popular theory once the ssris came into play. Look at the efficacy of lithium isn't it like thirty some percent for unipolar depression. All the other mood stabilzers and now all of a suddeen the anti pyschotics are back with a vengeance soon we will have a new thoery to supprot use of these meds it gets to be like squeezing the stepsisters foot into cinderellas slipper...if by chance the drug works then we come up with biochemical theories to explain why the slipper should fit... I really think we just don't know why some of this works. How does lithium effect seratonin. To belay every new physiological disorder with a mental twist to seratonin deficiency is getting old. OCD, Depression, Panic, Social anxiety, PMDD, Agressive Behaviour, Sexual Preditors, on and on. It seems to me the seratonin pharmacuetical companies have really done their jobs. That is not to say they have not helped millions I know they have.
> Let's compare side effets profiles (in no particular order):
>
> Rivotril™ (clonazepam - Klonopin™ -U.S.)
> Most Common - CNS depression in approx, 50% of people, respiratory depression, aggressiveness, argumentative behavior, hyperactivity, agitation, depression, euphoria, irritability, forgetfulness, confusion, nystagmus, unsteady gait, slurred speech, dysarthria, vertigo, palpitations, gynecomastia, hallucinations, muscle weakness, low back pain, increased appetite, nocturia, hypersecretion in upper respiratory tract, urinary retention, enuresis....
>
> Prozac™ (fluoxetine)
> Start-up side effects - headache, nervousness insomnia, anxiety, emotional lability, nausea, tremor, dizziness, diarrhea/constipation, myalgia, flu-like sympoms, anorexia.....
>
> Long-term side effects - decreased libido, anorgasmia, increased appetite, excessive sweating, fatigue, twitching, change in accomodation, acne, back pain, joint pain, dry skin, urinary tract infection, painful menstruation....
>
> Choose your poison. (ref. Compendium of Pharmaceuticals and Specialties, 2000).
Last but not least Cam we all know the side effect profiles you have just listed are not the real world just a sample of some people at some point in time with questions asked by the drug companies marketing people. Look at the change in ssri sexual dysfunction from what is listed. It is the way the questions are asked and by whom. Anyone who has tried differernt classes of drugs can tell you from personal experience the side effect lists are bogus. As for side effects dissapating over time there has been some very serious side effects associated with long term ssri use in "some" individuals. I don't want to scare people who are having success with them God Bless Them I would be willing to take the risk as well if they worked for me. They are not benign to overdose either. I know most people who overdose do so on a mix of narcotics and benzos or booze and benzos not just benzos. You can OD on booze and Luvox too if you try. The whole point is that once again it sounds like you justify ssri use based on brain chemistry and a chemical imbalance.... if it were that simple they would draw blood diagnose and dose us up. That benzo use is just a mask for symptomolgy. What about gaba shortage...Now I have also worked with addicts and alcohlics for a good 20 years and most people still kill themselves the good old fashioned way.....on booze. Slowly or quickly.Gil
Posted by Cam W. on June 9, 2001, at 15:12:59
In reply to Re: Response to Cam, posted by gilbert on June 9, 2001, at 14:35:10
> - Yes, I have heard of several suicide deaths from from overdoses of benzodiazepines mixed with alcohol, resulting in respiratory depression. Also, more people have died from taking taking overdoses of benzodiazepines alone (granted, it is rare), while people who have taken massive overdoses of SSRIs alone have recovered without any problems. There have only been a few deaths reported in which someone has died from ingesting overdoses of SSRIs alone, but less than 10 worldwide (I believe).
>
> I can overdose on most of my blood pressure meds and certainly taking a bottle of beta blockers won't keep you breathing too long but no stigma with those. Also very very hard to predict how many suicides take place because of use of either of the above mentioned drugs. I think spontaneous suicidal ideation is a listed side effect on most ssris. Now a toxic dose of the drug did not kill them but what about the drugs effect on their decision to take their own life. This will not show up in a toxicology report but we all know the web is full of this data....some of which are not Christian Scientists sponsored web sites.....LOL
>
• SSRIs do not induce a change in a person's thoughts toward suicide. I believe that the suicidal tendencies are in place before the person takes the SSRI. The drug alleviates some of the depressive symptoms, including increased energy, where the person is more able to act on their suicidal thoughts.
>
> > As to considering the side effects profiles, the top ten side effects listed for any SSRI usually describe the start of side effets of these drugs, and disappear within 2 weeks in a vast majority of people.
>
> If that were true this board would be non existent. Look at these posts week after week month after month almost all are side effect related most of which are long time users of ssris
>
• The people on this board are no where near the number of people who take SSRIs and we tend to hear much more from people who are having problems with the SSRIs. Besides, the long term side effects that we hear about on this board are pretty much the same handful, as with any effective antidepressant (sexual dysfunction, apathy, lack of energy, etc.).
>
> > The body has adjusted to a lack of serotonin by altering the mix of the other neurotransmitters. With an increase in serotonin, as a result of taking an SSRI, one must expect that the body would have to readjust the mix of other neurotransmitters, hence, the start up side effects.
>
> Are you sure this is what happens. The med research I have read isn't even really defining how other neurotransmitters are effected. They don't even know why wellbutrin works. If the predictable of brain chemistry were so certain we could just dose by body weight and everyone would have the same results. SSRI's have such an array of effects on people certainly the same cannot be said for other classes of drugs not to the same extent. Very unpredictable...physically and emotionally not to mention spirituallly.
>
• I am absolutely positive that the concentration of other neurotransmitters change when you change one of them. This has been shown time and again in many of the geek journals (eg check out some of the journal articles under the neurotransmitter section of http://www.neuroscion.com ). I do not believe that this change in neurotransmitter &/or concentration of specific receptors results in alleviation of depressive symptoms and a reconnection of the HPA axis, but is one part of a more wholesale changes that results from this initial increase in a specific neurotransmitter. I think that there is something going on inside the cells with second messengers relaying different information to produce variations in what mRNA is produced and thus what signals, (in the form of proteins, enzymes) that cell sends out. This could have something to do with the altering of the sensitivity of ACTH receptors in the adrenal gland; perhaps changes in concentration and sensitivity of glucocorticoid receptors; &/or changes in adrenal gland corticosteroid output. Also, hypothalamic changes in the output of CRH or pituitary output of ACTH could mediate the renormalization of the HPA axis, thus alleviating depressive symptoms. There is no need to stop here, though. Other endocrine systems are probably involved. It would be silly to think that altering on neurotransmitter would effect all of the changes that occur when one goes from a depressive state to a euthymic state. The body does not work in such a reductionist way. Play with one part of the system and you are playing with all of them.
>
> > If the depression/anxiety did not result in a decrease of serotonin and you add an SSRI, then, yeas, you are going to get side effects associated with excess serotonin. These side effects are similar to the start-up side effects and really, the only way to tell the difference is (sometimes) the intensity of the side effect and if the side effect does wane over 2 to 3 weeks.
>
> Cam I really respect your intelligence and committement to this board but this whole lack of seratonin theory came to be the most popular theory once the ssris came into play. Look at the efficacy of lithium isn't it like thirty some percent for unipolar depression. All the other mood stabilzers and now all of a suddeen the anti pyschotics are back with a vengeance soon we will have a new thoery to supprot use of these meds it gets to be like squeezing the stepsisters foot into cinderellas slipper...if by chance the drug works then we come up with biochemical theories to explain why the slipper should fit... I really think we just don't know why some of this works. How does lithium effect seratonin. To belay every new physiological disorder with a mental twist to seratonin deficiency is getting old. OCD, Depression, Panic, Social anxiety, PMDD, Agressive Behaviour, Sexual Preditors, on and on. It seems to me the seratonin pharmacuetical companies have really done their jobs. That is not to say they have not helped millions I know they have.
>
• Yes, lithium does cause changes in in neurotransmitter signalling. Lithium interferes with the phosphoinositol pathway, which changes intracellular calcium ion levels (at the nerve cell wall and from the endoplasmic reticulum), thus changing the responsivity of the cell membrane to electrical signals. Basically, lithium calms the cell from firing sporatically and evens out the flow of electricity down an axon.
>
> > Let's compare side effets profiles (in no particular order):
> >
> > Rivotril™ (clonazepam - Klonopin™ -U.S.)
> > Most Common - CNS depression in approx, 50% of people, respiratory depression, aggressiveness, argumentative behavior, hyperactivity, agitation, depression, euphoria, irritability, forgetfulness, confusion, nystagmus, unsteady gait, slurred speech, dysarthria, vertigo, palpitations, gynecomastia, hallucinations, muscle weakness, low back pain, increased appetite, nocturia, hypersecretion in upper respiratory tract, urinary retention, enuresis....
> >
> > Prozac™ (fluoxetine)
> > Start-up side effects - headache, nervousness insomnia, anxiety, emotional lability, nausea, tremor, dizziness, diarrhea/constipation, myalgia, flu-like sympoms, anorexia.....
> >
> > Long-term side effects - decreased libido, anorgasmia, increased appetite, excessive sweating, fatigue, twitching, change in accomodation, acne, back pain, joint pain, dry skin, urinary tract infection, painful menstruation....
> >
> > Choose your poison. (ref. Compendium of Pharmaceuticals and Specialties, 2000).
>
> Last but not least Cam we all know the side effect profiles you have just listed are not the real world just a sample of some people at some point in time with questions asked by the drug companies marketing people. Look at the change in ssri sexual dysfunction from what is listed. It is the way the questions are asked and by whom. Anyone who has tried differernt classes of drugs can tell you from personal experience the side effect lists are bogus. As for side effects dissapating over time there has been some very serious side effects associated with long term ssri use in "some" individuals. I don't want to scare people who are having success with them God Bless Them I would be willing to take the risk as well if they worked for me. They are not benign to overdose either. I know most people who overdose do so on a mix of narcotics and benzos or booze and benzos not just benzos. You can OD on booze and Luvox too if you try. The whole point is that once again it sounds like you justify ssri use based on brain chemistry and a chemical imbalance.... if it were that simple they would draw blood diagnose and dose us up. That benzo use is just a mask for symptomolgy. What about gaba shortage...Now I have also worked with addicts and alcohlics for a good 20 years and most people still kill themselves the good old fashioned way.....on booze. Slowly or quickly.
>
• Agree with everything that you are saying, but depression is a set of disorders which have a common manifestation, the depressive symptoms. Some people react to medications and their depression becomes worse. Obviously the breakdown of the HPA axis is at a different point than in someone for who that medication works. Depending upon the reaction, this should be a clinical marker to help the doc to decide on which drug to use next. This type of clinical deciding is still in its infancy, but is being used more and more by astute psychopharmacologists.
Posted by gilbert on June 9, 2001, at 16:29:49
In reply to Re: Response to Cam » gilbert, posted by Cam W. on June 9, 2001, at 15:12:59
Cam,
I agree with much of your data however to say that you beleive that suicidal ideation is present prior to the use of an ssri and that the ssri is simply the catalyst is just "your belief". I know the cases have all been lost against Lilly but I don't think all of them were without merit. The first time I took prozac I had very vivid violent dreams, I also had very atypical outbursts of anger, and found myself involved in aggressive fantasies like thinking about fighting etc. These did subside and then prozac almost had a calming effect on me but for that initial period I was definitely not myself. I think the case could be made that someone on klonopin could have a depressive response and if the depression remained untreated and they committed suicide would it have occurred without the klonopin? I think to let the ssris off the hook for personality changes sufficient to cause violent behavior toward oneself or others is negligent. To say well that was a preexisting condition prior to meds or that person was wired to do this anyways is still conjecture. You yourself mentioned to me that a patient came in with mood swings and erratic behavior on an ace inhibitor of all things. You said once the drug was stopped all symptoms of bipolar disappeared. Now the drug must have been the culprit. Where in any medical journals or studies have ace inhibitors been shown to produce mania or bipolar tendnencies. But I do believe your story... we are all differnt and all react to meds differntly. You are giving the ssris a pass that you wouldn't give to a blood pressure med. I think the facts are clear in that ssris do effect and have an effect on all neurotransmitters. It is the preciseness and predictability of that effect that is in question. After all we are playing with one's brain chemsitry here....there should be effects on behavior and tendencies.
Lithium is a differnt way to achieve the same goal. Lithium may effect calcium channels and help neurotransmitters to operate more efficiently but lithium does not operate the same way an ssri does. So once again the whole seratonin shortage theories are simply that theories. They are looking at the egg and saying wow this came from the chicken. I think that the progress that has been made has been wonderfull and don't get me wrong I do believe that ssris are a very beautifull thing for some. However they are not manna from God or drugs from heaven and I think all too often you are willing to give them a pass especially versus benzos. I am not one of those who beleives the whole FDA is on the grassy knoll with Eli Lilley. I do believe however unfortunate that in a small few....let me repeat, a small few people the drugs have caused fatal side effects and personality changes that were not pre-existing or the behavior would have peeked it's ugly little head out at some prior time. IF you read some stories from the survivor groups there was dramtic changes in personality after adding the ssri to the mix. To be able to unequivically say well that person was suicidal prior to the med is as unprovable as it is to prove the med caused the suicide. The families who have been effected by one of these tragedies would disagree as well. There are more suicides caused by alcohol than any other drug. From my own experience with being an aloholic I was not suicidal prior to drinking but once alcohol was induced in chronic doses for long periods of time I was very suicidal. My only pre-existing condition may have been alcoholism......suicide was not.Thanks for the back and forth,
Gil
Posted by Elizabeth on June 9, 2001, at 22:30:09
In reply to Re: Elizabeth what works for you, posted by gilbert on June 8, 2001, at 23:57:14
> Are you saying that if staying on ssri's long enough the side effects become less.
Yes, usually. You start at a minimal dose and don't raise it until you feel comfortable on the little dose. This takes forever, of course. The sexual dysfunction, unfortunately, isn't something that goes away.
This doesn't apply to everyone. The side effects you mention sound pretty typical for the drugs that caused them, except for the sex problem on Serzone and Remeron. Stimulants are supposed to be good for anorgasmia, BTW. Buspar might be too. People who have experience can give better advise than I could.
Middle age is hard for men...you start losing your sex drive (desire and functioning) and at the same time your partner starts becoming more interested.
-elizabeth
Posted by Elizabeth on June 9, 2001, at 22:31:28
In reply to Your medicines » gilbert, posted by SalArmy4me on June 9, 2001, at 2:00:41
> I was thinking of desipramine or an MAOI/RIMA for you. MAOI's are some of the most effective and potent antidepressants still on the market.
Yeah, I was thinking of Parnate because it has an amphetamine-like action that may cancel out some of the sexual side effects of Nardil and Marplan.
-elizabeth
Posted by Elizabeth on June 9, 2001, at 22:36:47
In reply to Re: Happen to be lurking around, Cam? » gheld, posted by Cam W. on June 9, 2001, at 10:33:50
> Gordon - Yes, I have heard of several suicide deaths from from overdoses of benzodiazepines mixed with alcohol, resulting in respiratory depression.
When I was in the hospital recently (comatose), the initial dx was benzo overdose (wrong, BTW). I was breathing irregularly and had lung damage and low pulse oxidation.
> Also, more people have died from taking taking overdoses of benzodiazepines alone (granted, it is rare), while people who have taken massive overdoses of SSRIs alone have recovered without any problems.
True, but it's still a very small risk with either one. Mixing alcohol is the big problem with benzos in depressed patients, which is why I think that Klonopin and the low-potency benzos should be avoided.
> As to considering the side effects profiles, the top ten side effects listed for any SSRI usually describe the start of side effets of these drugs, and disappear within 2 weeks in a vast majority of people.
Not the sexual dysfunction and apathy. Those are long-term side effects. Benzos are really better tolerated in anxiety patients without depression and probably are useful (with an AD) in patients with both.
-elizabeth
Posted by Elizabeth on June 9, 2001, at 22:39:08
In reply to Re: Xanax vs. Klonopin - Thanks all, posted by Greg on June 9, 2001, at 10:38:49
> I have an extremely addictive personality and have some concerns about withdrawals effects I'll have coming off the Xanax.
Unless you mean cravings, withdrawal symptoms aren't exclusive to addictive personalities. Xanax is hard to get off of, but if you need it long term and are concerned about depression from Klonopin or other benzos, it's worth it.
-elizabeth
Posted by gilbert on June 10, 2001, at 1:27:52
In reply to Re: what works for you » gilbert, posted by Elizabeth on June 9, 2001, at 22:30:09
Elizabeth,
I tried all of the slow titration measures and still had other side effects stick around besides sexual ones. I had raise in blood pressure from both effexor and celexa. I had heart rythym disturbances from tricyclics. I had vivd dreams and anger outbursts on prozac. I was too dizzy to drive on both buspar and trazadone. There is the inherent risks of cholesterol problems with remeron. My decsions were based on more side effects than libido although as a guy that's the one that smacks your ego the hardest.
I have a pretty great wife who is very understanding and up to this point in our life our sex life has only been interupted by ssri use. She has been exceptional through it all. We have an active normal intimate relationship and are both on the same wavelength there although I am sure as I head into my mid forties I will slow down and she may speed up, we have not gotten to that role reversal as of yet......I know it will come.
The funny thing really isn't the sex it just seems so odd to me I really have tried most antidepressants except for maoi's and I have never felt good on them. I never really felt like me. I have had some pretty distubing side effects and stuck it out through long slow dosing periods only to be dissapointed time after time. There should be more caution exercised on this board....it feels and sounds as if everyone is so sure side effects will dissappear or lessen my experience has been the opposite. I have put myself through a fair amount of self med induced self torture in hopes that the side effects would wear off. I think the broad brushes being used to paint people into an ssri colored corner can be misleading and dangerous at times.
If I match side effect for side effect the safest drugs I have used have been the benzos. They have given me the most bang for the buck. I become more functional without having to give up something. This may be greedy on my part but of all places you would think the stigma of benzo use would be tolerated most here. The people who would understand most would be fellow sufferrers who would applaud each others progress. Many decisions about what drugs to try are made based on what people read here. I know I tried many drugs because of reading posts here. I just wish I had trusted how I felt more than some of the contributors to the board...I could of saved myself some pain. It is one thing to be optimistic about what to expect it is completely another to be misleading. I don't mean people are misleading in a bad way......just by accident...by thinking they know. I think this is a wonderfull service and there are great people here and I will certainly continue to read the posts. But my guinea pig days are over.
Thanks,
Gil
Posted by gheld on June 10, 2001, at 9:24:21
In reply to Re: Happen to be lurking around, Cam? » gheld, posted by Cam W. on June 9, 2001, at 10:33:50
> Gordon - Yes, I have heard of several suicide deaths from from overdoses of benzodiazepines mixed with alcohol, resulting in respiratory depression. Also, more people have died from taking taking overdoses of benzodiazepines alone (granted, it is rare), while people who have taken massive overdoses of SSRIs alone have recovered without any problems. There have only been a few deaths reported in which someone has died from ingesting overdoses of SSRIs alone, but less than 10 worldwide (I believe).
Cam: Is that as even comparison in that you mention death with benzo's AND alcohol and are comparing to SSRI's with no mention of alcohol. How about deaths from benzo OD'ing alone or SSRI's and alcohol. Enough alcohol alone can cause death.
>
>
> Let's compare side effets profiles (in no particular order):
>
> Rivotril™ (clonazepam - Klonopin™ -U.S.)
> Most Common - CNS depression in approx, 50% of people, respiratory depression, aggressiveness, argumentative behavior, hyperactivity, agitation, depression, euphoria, irritability, forgetfulness, confusion, nystagmus, unsteady gait, slurred speech, dysarthria, vertigo, palpitations, gynecomastia, hallucinations, muscle weakness, low back pain, increased appetite, nocturia, hypersecretion in upper respiratory tract, urinary retention, enuresis....
>
> Prozac™ (fluoxetine)
> Start-up side effects - headache, nervousness insomnia, anxiety, emotional lability, nausea, tremor, dizziness, diarrhea/constipation, myalgia, flu-like sympoms, anorexia.....
>
> Long-term side effects - decreased libido, anorgasmia,Go no farther. I doubt anyone who is sexually active would take the Prozac, (read SSRI), side effects when compared to those above. I rest my case.
> BTW - If your doc does not spend time with you, find one that does; one that you can trust and trusts you. My pdoc and I work closely together to monitor my progress. He is only a phone call away, day or night.Mine, too. He is actually one of the few psychiatrists left who does his own therapy.
Again I'm referring only to those with anxiety, not anxiety connected with depression. I agree that benzo's are a risk factor for depressives. I suspect most people who are clinically depressed don't have much sex life anyway so that side effect of the SSRI's isn't going to hurt much initially. The issue is; will the sex life return once the depression is cured and the SSRI's stopped?
Gordon
Posted by Snowie on June 10, 2001, at 9:40:11
In reply to Re: thanks elizabeth, posted by gilbert on June 10, 2001, at 1:27:52
Gil,
I understand where you and others are coming from. In my search for the perfect med or combo in order to have a functional life in spite of panic and/or anxiety, I've tried several benzos, every SSRI except for Paxil, as well as Serzone, Neurontin, and a few others that I've probably forgotten. I was with my first pdoc for over 5 years and occasionally I'd want to try something new that I'd heard someone was having great success with. My pdoc finally told me to take a hike. He felt that I should stick with what works and forget what other people are taking. Maybe he had a point, but he was also unprofessional, so I'm better off without him.
I now augment Xanax with low doses of Neurontin, which allows me to keep my Xanax intake fairly low and works better for me than Xanax alone. Neurontin alone was making me feel as if I was in a brain fog, but if I take .5 mg. of Xanax first and later follow that with 300 mg. of Neurontin twice a day, I don't get the brain fog effect. For some reason Neurontin seems to extend the life of Xanax in my body.
I think everyone has to be attuned to their own bodies. I'm not afraid to try something new or give a med I've tried before another chance as long as well-known side effects don't include weight gain or loss of libido. If it doesn't work, I'm not afraid to say so. After all, it's my body and I'm the one experiencing the side effects, not my pdoc or anyone else.
Snowie
> Elizabeth,
>
> I tried all of the slow titration measures and still had other side effects stick around besides sexual ones. I had raise in blood pressure from both effexor and celexa. I had heart rythym disturbances from tricyclics. I had vivd dreams and anger outbursts on prozac. I was too dizzy to drive on both buspar and trazadone. There is the inherent risks of cholesterol problems with remeron. My decsions were based on more side effects than libido although as a guy that's the one that smacks your ego the hardest.
>
> I have a pretty great wife who is very understanding and up to this point in our life our sex life has only been interupted by ssri use. She has been exceptional through it all. We have an active normal intimate relationship and are both on the same wavelength there although I am sure as I head into my mid forties I will slow down and she may speed up, we have not gotten to that role reversal as of yet......I know it will come.
>
> The funny thing really isn't the sex it just seems so odd to me I really have tried most antidepressants except for maoi's and I have never felt good on them. I never really felt like me. I have had some pretty distubing side effects and stuck it out through long slow dosing periods only to be dissapointed time after time. There should be more caution exercised on this board....it feels and sounds as if everyone is so sure side effects will dissappear or lessen my experience has been the opposite. I have put myself through a fair amount of self med induced self torture in hopes that the side effects would wear off. I think the broad brushes being used to paint people into an ssri colored corner can be misleading and dangerous at times.
>
> If I match side effect for side effect the safest drugs I have used have been the benzos. They have given me the most bang for the buck. I become more functional without having to give up something. This may be greedy on my part but of all places you would think the stigma of benzo use would be tolerated most here. The people who would understand most would be fellow sufferrers who would applaud each others progress. Many decisions about what drugs to try are made based on what people read here. I know I tried many drugs because of reading posts here. I just wish I had trusted how I felt more than some of the contributors to the board...I could of saved myself some pain. It is one thing to be optimistic about what to expect it is completely another to be misleading. I don't mean people are misleading in a bad way......just by accident...by thinking they know. I think this is a wonderfull service and there are great people here and I will certainly continue to read the posts. But my guinea pig days are over.
>
> Thanks,
>
> Gil
Posted by Elizabeth on June 10, 2001, at 9:55:38
In reply to Re: thanks elizabeth, posted by gilbert on June 10, 2001, at 1:27:52
> I tried all of the slow titration measures and still had other side effects stick around besides sexual ones.
Well, it doesn't work for everybody; the initial jitteriness was what I was thinking of in particular, with a starting dose of at most half of the lowest strength tablet (Zoloft and Luvox are my favourites for pill splitting). I totally agree that benzos are easier to tolerate than *any* of the antidepressants.
> I had raise in blood pressure from both effexor and celexa.
That's unusual from Celexa. How does your BP run normally?
> I had heart rythym disturbances from tricyclics.
That's one of the serious risks from these drugs. Do you remember what type of arrhythmia you had?
> I had vivd dreams and anger outbursts on prozac.
The anger is surprising. Vivid dreaming is common on SSRIs and Effexor.
> I was too dizzy to drive on both buspar and trazadone.
Again, not unheard of. This is the kind of thing that I would expect to go away after a few days, though. You would start out taking the med only at bedtime, when you don't need to be alert or operate machinery.
> There is the inherent risks of cholesterol problems with remeron.
I'm getting the impression that cardiovascular disease is a serious concern for you. True?
> My decsions were based on more side effects than libido although as a guy that's the one that smacks your ego the hardest.
That's hard to deal with for people of any gender. It's good to hear that your wife is dealing with it so well.
> The funny thing really isn't the sex it just seems so odd to me I really have tried most antidepressants except for maoi's and I have never felt good on them.
I think that's a strong indicator for MAOIs, myself. You know that the side effects aren't *guaranteed* to happen to everyone who takes them. Parnate is probably the one that I would suggest you try, based on its typical side effect profile (less likely to cause weight gain, sexual problems, etc. than Nardil or Marplan). The main advantage of Nardil is that it's a terrific anxiolytic and is less likely to cause overactivation than is Parnate.
> There should be more caution exercised on this board....it feels and sounds as if everyone is so sure side effects will dissappear or lessen my experience has been the opposite.
Most side effects do *usually* disappear with time. But that doesn't mean always, nor does it invalidate your experience.
> I become more functional without having to give up something. This may be greedy on my part but of all places you would think the stigma of benzo use would be tolerated most here.
I don't think it's greedy. I think it's completely reasonable. The reason we take meds is to be functional, no?
> Many decisions about what drugs to try are made based on what people read here. I know I tried many drugs because of reading posts here. I just wish I had trusted how I felt more than some of the contributors to the board...I could of saved myself some pain.
There's no way you (or they) could have known that your reactions to the meds would be different from typical reactions. It does seem that some people are sensitive to side effects in general, but otherwise there's no way to predict who will have problems with what.
-elizabeth
Posted by Elizabeth on June 10, 2001, at 10:00:19
In reply to Re: Happen to be lurking around, Cam?, posted by gheld on June 10, 2001, at 9:24:21
> Go no farther. I doubt anyone who is sexually active would take the Prozac, (read SSRI), side effects when compared to those above. I rest my case.
Believe it or not, I took Prozac for somewhere between two and three years and never experienced that side effect. Must be one in a million, huh? < g >
> Again I'm referring only to those with anxiety, not anxiety connected with depression. I agree that benzo's are a risk factor for depressives.
I agree, with the exception of alprazolam. I would like to see adinazolam (a benzo with proven antidepressant activity) approved in the US, but the patent on it has expired so it's not likely.
-elizabeth
Posted by Lorraine on June 10, 2001, at 11:09:28
In reply to Re: thanks elizabeth » gilbert, posted by Snowie on June 10, 2001, at 9:40:11
> > I have a pretty great wife who is very understanding and up to this point in our life our sex life has only been interupted by ssri use. She has been exceptional through it all. We have an active normal intimate relationship and are both on the same wavelength there although I am sure as I head into my mid forties I will slow down and she may speed up, we have not gotten to that role reversal as of yet......I know it will come.
Maybe it's just the crowd I hang with, but I haven't seen women in their mid-forties becoming more randy. Even when I am off meds, that's not the case for me (course I'm depressed....still) Nor have I seen it with other women I know. My personal view is that Masters and Johnson were wrong about this.
> > it feels and sounds as if everyone is so sure side effects will dissappear or lessen my experience has been the opposite.My experience is they don't go away either.
> >
> > If I match side effect for side effect the safest drugs I have used have been the benzos. They have given me the most bang for the buckI'm glad you are writing this. I suspect they should be on my "to try" list, but I'm leary of them. Funny though, I'm on amphetamines now. I'm also leary of MAOs, though again I suspect part of this is ignorant fear.
> > I don't mean people are misleading in a bad way......just by accident...by thinking they know.
Isn't that the way of life? A persons position depends on where they sit?
> >But my guinea pig days are over.
I hope that means you have found something that works well for you:-)
Lorraine
Posted by gilbert on June 10, 2001, at 11:46:32
In reply to Re: Gill, posted by Lorraine on June 10, 2001, at 11:09:28
Elizabeth,
I am sensitive to cardiac concerns a part of my anxiety triggers but I am also aware when it is drug induced. My panics were the result of being overly afarid of death lost my brother when he was one from heart defects. I was 4 at the time. Doesn't take a rocket scientist to figure out my presdiposition. That being said I did have a calming effect from prozac after the intitial rage period so that really ins't the big issue. With prozac the longer I was on it the less a.m. erections I had the less functional I could become....so it got to be like putting a wet noodle through a spaghetti strainer. OOPPPs!
Th remeron chloesterol connection is from my internest.....I looked it up I think it was around 15% had increased lipids and other had elevated triglycerides. I run 25 miles per week I have good cholesterol around 158 total......I eat like a hermit......It has taken me 3 years of very disciplined effort to establish that kind of health profile. I don't want to risk it for the sake of a med that when I did try it made me so tired it was like I took 3 xanax. I figure it feels like xanax so I will take the xanax without the risk. Plus mom was on rmeron for about 8 months her trigylcerides went through the ceiling her weight jumped 35 pounds and her cholseterol went up about 20 points so I figure I have gentics working against me with that one. The cardiac symptoms i got from the other meds was mostly tachycardia in the middle of a dead sleep...it would wake me. I would take a xanax and boom back to normal. I have had all the cardiac work ups so I know it was med induced. it is the only time it happens. I figure now I got to take the xanax to reduce other med side effect...I might as well just take the xanax. It is sooooo frustrating I know I would do well on a ssri mentally......especially prozac but I am not willing at 42 and in shape to give up sex.
I tried some of the sexual anecdotes lited here while on prozac and did not get good results. I mean without getting to deatiled the whole sex thing on a ssri is either you feel very randy and can't climax or you can climax but your head is not in the game you might as well be playing checkers. I kind of like my sex where it has both ....you know how it used to be prior to meds.P >S > you mentioned male mid life sexual decline....If off anti depressants I would describe my sex drive as above average not to stroke my ego but just because I take pretty good care of myself and just don't feel a decline in that area.....yet.
I keep talking about xanax like it is some wonder drug....it has it's faults too.....just seems they are less than other. I ac get a little depressed if I have to dose change up or down. It has a way of letting you know it's time for a pill.
Thanks for all of your insights I really enjoy your perspectives.
Gil
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