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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 Automated Lady on May 5, 2002, at 9:02:10
Just wanted to ask Americans... is it not really weird and scary to take such big combinations of drugs? In the UK it's rare to get prescribed more than one at a time (certainly not combinations like Efexor/Wellbutrin, which I've had suggested on this site). Prescribing 1 at a time doesn't work for me because i have real problems with motivation on just SSRIs, but doctors I've suggested combining to have been horrified at the idea (but the expense may have been something to do with that reaction) ;-) Do you not find you just get a huge raft of side effects?
I'm also a bit worried by what I've heard about SSRIs.. that because they increase the amount of neurotransmitters in the brain the brain responds by reducing the number of receptors... taking you back to square one (in fact worse when you come off them). is this true? then what's the point?
Posted by Phil on May 5, 2002, at 9:55:34
In reply to These scary drug cocktails, posted by Automated Lady on May 5, 2002, at 9:02:10
I take 4 drugs-Wellbutrin, Celexa, Adderall XR, and Klonopin. Run that by your doc.
Less side effects than when taking only Amitriptyline. Two, three, four or more drugs isn't that unusual.
I don't think I've read that about SSRI's and am not concerned. I've got today to deal with.Effexor+Wellbutrin or
Effexor+Remeron can be extremely effective combos.I would not want to live in the UK with a mood disorder and have doctors like that to deal with.
Go here: key in Effexor Remeron or whatever and print out a few abstracts. Somehow I don't think it will help.
Wonder how our country's compare in suicide?
Posted by JohnX2 on May 5, 2002, at 18:39:00
In reply to These scary drug cocktails, posted by Automated Lady on May 5, 2002, at 9:02:10
> Just wanted to ask Americans... is it not really weird and scary to take such big combinations of drugs? In the UK it's rare to get prescribed more than one at a time (certainly not combinations like Efexor/Wellbutrin, which I've had suggested on this site). Prescribing 1 at a time doesn't work for me because i have real problems with motivation on just SSRIs, but doctors I've suggested combining to have been horrified at the idea (but the expense may have been something to do with that reaction) ;-) Do you not find you just get a huge raft of side effects?
>
> I'm also a bit worried by what I've heard about SSRIs.. that because they increase the amount of neurotransmitters in the brain the brain responds by reducing the number of receptors... taking you back to square one (in fact worse when you come off them). is this true? then what's the point?Usually an augmentation to a base medication is used to
address some side effect or issue that the base medication
does not address. Its a bit easier to test out augmentation
because you can bail on the medicine rapidly if you find
it uncomfortable (you still have your base med backing you
up).The SSRIs are effective medicines. It is believed that some
sub-types of serotonin receptors are downregulted (less
receptor density), but those particular receptors have been
linked to depression and anxiety, so down regulating them
may be useful.John
Posted by Elizabeth on May 7, 2002, at 0:49:09
In reply to These scary drug cocktails, posted by Automated Lady on May 5, 2002, at 9:02:10
My impression (from the reports of people in treatment in the UK and from articles by UK researchers) is that the attitudes there are very conservative. I don't think that UK psychiatrists are very aggressive about treating mood or anxiety disorders. I wouldn't want to have to be treated in the UK; it seems like the attitudes of doctors there are very rigid and uncompromising,
and I've encountered a lot of people from the UK who have reported difficulty getting adequate treatment as a result. I think that doctors and patients on the east side of the pond would do well to overcome their fears.Effexor/Wellbutrin (for example) is hardly a strange or exotic "cocktail," although I'm sure your doctor believes it is. The first thing that comes to mind if I see that someone is taking a combination like this one is that they might have experienced sexual dysfunction or other side effects ("sfx") on the Effexor, and the Wellbutrin was added to treat the sfx and to augment the Effexor. Some people also have specific symptoms, such as fatigue, lethargy, and overeating, that may not improve with the Effexor alone but for which Wellbutrin can be helpful.
Personally, I've tried various drug combinations, and I only rarely found side effects difficult to manage. When sfx were a problem, it was due to one drug which had a lot of sfx (or really problematic sfx), and dropping all the other drugs wouldn't have helped. In any case, I've found that most sfx can be managed or treated in some way. (Weight gain and sexual dysfunction are the sfx that people seem to have the most trouble managing.)
> I'm also a bit worried by what I've heard about SSRIs.. that because they increase the amount of neurotransmitters in the brain the brain responds by reducing the number of receptors... taking you back to square one (in fact worse when you come off them). is this true? then what's the point?
Any time you take a centrally-acting drug on a daily basis, your brain is going to try to make adaptive changes. (The cardiovascular system also works very hard to compensate for drug effects. This is why lots of people with essential hypertension take as many drugs as some people here take for complicated psychiatric disorders.) Adaptive changes are not the same as tolerance: they don't send you "back to square one." In fact, adaptive changes are believed to be responsible for the therapeutic effects of most existing antidepressant drugs (which is why they take so long to start working, BTW).
-elizabeth
Posted by Cecilia on May 7, 2002, at 3:13:53
In reply to Re: These scary drug cocktails, posted by Phil on May 5, 2002, at 9:55:34
According to WHO, the suicide rate in the UK is 11 per 100,000 males and 3.2 per 100,000 females. In the US it`s 19.3 per 100,000 males and 4.4 per 100,000 females. Highest rate in the world is Lithuania with 73,7 males and 13.7 females per 100,000, lowest rate is in Sao Tome Principe, wherever the heck that is. Cecilia
Posted by Cecilia on May 7, 2002, at 3:54:09
In reply to Re: Suicide Rates » Phil, posted by Cecilia on May 7, 2002, at 3:13:53
Posted by Cecilia on May 7, 2002, at 4:00:23
In reply to Re: Suicide Rates » Phil, posted by Cecilia on May 7, 2002, at 3:13:53
Of course, I know those statistics aren`t very accurate since so many suicides are attributed to accidents or other causes. And I`m sure the lower rate in the UK probably is mostly due to the lessened availability of guns Cecilia
Posted by Automated Lady on May 7, 2002, at 14:27:39
In reply to Re: Suicide Rates » Phil, posted by Cecilia on May 7, 2002, at 3:05:46
> According to WHO, the suicide rate in the UK is 11 per 100,000 males and 3.2 per 100,000 females. In the US it`s 19.3 per 100,000 males and 4.4 per 100,000 females. Highest rate in the world is Lithuania with 73,7 males and 13.7 females per 100,000, lowest rate is in Sao Tome Principe, wherever the heck that is. Cecilia
Anyone any ideas why it's higher in the US than UK even though far less meds are dished out? (although the female rate isn't that different). Does that mean I should give up on the whole medication thing?
Posted by Automated Lady on May 7, 2002, at 14:32:56
In reply to Re: Suicide Rates, posted by Cecilia on May 7, 2002, at 4:00:23
I think you're right about the guns. I know it would be dangerous for me if I had easy access to one. Solves that one for me.
This is the end of the thread.
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