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Dr. Bob is Robert Hsiung, MD,
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Posted by IsoM on December 25, 2001, at 1:10:53
In reply to Re: James tangent, posted by stjames on December 24, 2001, at 23:59:41
I do agree with you, James. Neurochemistry is such a complicated subject & we've hardly begun to scratch the surface. What we know about neurotransmitters is just at the beginning stage. I did understand that SSRIs just inhibit the reuptake of serotonin (like the acronym says) but I wonder if it doesn't perhaps "reset" something in our brain chemistry still.
I noticed something about my use of antidepressants & because I'm open about my use of them, many other people that I know who may never have talked about their need of them, have opened up to me. I've seen a similar pattern develop among many users. If someone has been on ADs for a relatively short period & then tapers off them after their depression is judged clinically better, or "cured", the relapses seem to be much less than those who are on ADs for a couple of years or more.
I initially went on tricyclics to control my migraines. I had them as often as once or twice a week. Beta-blockers did nothing but give me a severe asthma attack as the dose was increased. Actually, the tricyclics didn't help the migraines, but I was surprised at my mood change. I wasn't seriously depressed before but felt really low in winter & had difficulty controlling my frustration & irritation if things didn't work out right. While the AD made a remarkable difference, I wouldn't have said my life was unbearable before.
But when I try to go off ADs now, my rage, irritation, & bleakness are SO powerful - frightening so. I can feel such a rage over little things, that I'd gladly drag a person from their car & beat them for failing to signal a left-turn at a light. I'm just a slight-boned woman but people honestly stepped around me when I felt like that. I'd always been easily stressed before & pretty low many times but could still feel real laughter & joy other times.
Now, it's as if the ADs are absolutely necessary. I DO like feeling as I do now (with the ADs working), but why the extreme change? And I'm not unique this way. Many others I've asked have also said the same thing.
**What's caused this change in our brains?**
And I KNOW & INSIST that it's not just that I can't properly remember how I felt before. I do remember never feeling so horribly negative before I ever started meds.
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> > IsoM - I would think that SRIs would force our bodies to produce more serotonin. SRIs block the reuptake of serotonin back into the presynaptic neuron, so the body is unable the reuse the neurotransmitter. The serotonin "trapped" in the gap is, for the most part, metabolized, but the levels of serotonin in the gap are still going to be higher while taking the antidepressant than they would be after the antidepressant is stopped. This would result in the serotonergic withdrawl syndrome that is seen; and the less serotonin the body is producing would result in more severe withdrawl effects.
>
> james here....
>
> If mental illness were simply a lack or too much of something, I would suspect most of us would be cured. To me it is about regulation, stopping the meds means the body must rebalance itself, but not in the sence of making more or less NT.
>
> Neurology is far from simple, so more NT=better/worse is also too simple. The end result
> of mood is not a one step process from synaptic gap functions to mood changes. There are many other steps to the end result, mood.
>
> AD's seem to act at the gap but I have long felt AD's do not get at the root cause of clinical depression. If they did the sucess rate would be higher. Sometimes you can work out a problem by starting in the middle; AD's do work for many. The sucess of dirty drugs and polypharm seems to indicate, again, that the root cause is missed but by a shotgun approach can knock the system into a better state of functioning.
>
> Or I could reason that there is no one root cause/treatment for clinical depression; those that do well on AD's are a "good fit". Agents that effect different parts of the chain of events resulting in mood are needed to treat
> the non-responders and hard to treat.
>
> Cam, comments ?
>
> j
Posted by stjames on December 25, 2001, at 2:06:16
In reply to Re: James' Ideas - A Question » stjames, posted by IsoM on December 25, 2001, at 1:10:53
I noticed something about my use of antidepressants & because I'm open about my use of them, many other people that I know who may never have talked about their need of them, have opened up to me. I've seen a similar pattern develop among many users. If someone has been on ADs for a relatively short period & then tapers off them after their depression is judged clinically better, or "cured", the relapses seem to be much less than those who are on ADs for a couple of years or more.
I tend to feel if one has more than 3 relapses, it is a cronic depression. While AD's control depression, they do not halt it. This is much like diabetes; the meds control but do not halt
the progress of disease. So in the case of the person on AD's for years; I would say their depression has progressed and returns with greater effect. People who can get off the meds
quickly probably do not have as significant depresson, starting out.Chronic illness is measured in lifetimes, so it is difficult to draw conculsions based on a few years data. Now with 50 years data on AD's we will be able to draw better protocals for treatment. I am leaning toward treating it sooner and aggressively as being key to keeping people from lapsing into a chronic condition.
j
Posted by Cindylou on December 25, 2001, at 7:09:11
In reply to Re: James' Ideas - A Question » stjames, posted by IsoM on December 25, 2001, at 1:10:53
I started on ADs in 1988. The doctor told me after about 5 or 6 months, my brain would be "reset" as you put it, and my depression cured.
I relapsed back into depression within a few months after stopping the med.
Every time I've been on ADs and stopped, whether on them for a short time or a long time, the depression has come back. For me, it is a chronic illness.
I agree with James, that perhaps if I was treated earlier (when I was 13 instead of 25) I may have been able to overcome the illness -- maybe my brain would have been maleable (spelling on that one??) enough at age 13 to be able to be "reset."
Just a thought,
cindy
If someone has been on ADs for a relatively short period & then tapers off them after their depression is judged clinically better, or "cured", the relapses seem to be much less than those who are on ADs for a couple of years or more.> > james here....
> >
> > If mental illness were simply a lack or too much of something, I would suspect most of us would be cured. To me it is about regulation, stopping the meds means the body must rebalance itself, but not in the sence of making more or less NT.
> >
> > Neurology is far from simple, so more NT=better/worse is also too simple. The end result
> > of mood is not a one step process from synaptic gap functions to mood changes. There are many other steps to the end result, mood.
> >
> > AD's seem to act at the gap but I have long felt AD's do not get at the root cause of clinical depression. If they did the sucess rate would be higher. Sometimes you can work out a problem by starting in the middle; AD's do work for many. The sucess of dirty drugs and polypharm seems to indicate, again, that the root cause is missed but by a shotgun approach can knock the system into a better state of functioning.
> >
> > Or I could reason that there is no one root cause/treatment for clinical depression; those that do well on AD's are a "good fit". Agents that effect different parts of the chain of events resulting in mood are needed to treat
> > the non-responders and hard to treat.
> >
> > Cam, comments ?
> >
> > j
Posted by IsoM on December 26, 2001, at 1:35:27
In reply to Re: James' Ideas - A Question, posted by Cindylou on December 25, 2001, at 7:09:11
Ah well, I gave the idea a shot. I'm always trying to look at things from a new angle, perhaps get a different or new understanding of how things work.
I was just surprised to see how it had grown, untreated, from a mild depression & irritation, to such full-blown depression & irritation bordering on rage, untreated, over a period of 10 years or so. Always looking for answers.
Posted by Cam W. on December 26, 2001, at 18:19:26
In reply to Re: James tangent, posted by stjames on December 24, 2001, at 23:59:41
James - I see the NT thing as a side effect (coincidental effect? result?) of what is/are the true malfunction(s) we call depression. Adding back NTs to the system (however we do it) seems to resolve some of the "symptoms" of depression. As for Tx-resistant depression, I feel that, even though there may be a resulting lack of NTs in the synaptic gap, adding the appropriate NT does not circumvent the malfunction to enough (or any) extent in these instances.
We get back to that old problem (of which we have talked of, in the past) of the resulting symptoms of what we call "depression" are arrived at via multiple, independent pathways. We are still "splicing wires" in all of our treatments of any mental disorder, and we are doing it with "ice" (ie. none of our treatments, in themselves, are cures, therefore we must keep adding "ice" to the spliced wires, to replace the "melted ice", so that the symptoms do not return (as readily).
Just a thought - Cam
Posted by dove on December 28, 2001, at 11:49:15
In reply to Re: James' Ideas - A Question, posted by stjames on December 25, 2001, at 2:06:16
> If someone has been on ADs for a relatively short period & then tapers off them after their depression is judged clinically better, or "cured", the relapses seem to be much less than those who are on ADs for a couple of years or more.
>
>I just read an article or abstract within the last two months that stated quite a different opinion on this subject. It stated that extending the length of time on the AD treatment proved to lessen the number of relapses significantly in those who had either suffered from a relapse in the past; or, were at risk (in their opinion) for a relapse in the future due to circumstance, genetics, and/or any co-morbid diseases, even if they had been clinically dxed as "better".
I *believe* I read this somewhere on http://psychiatry.medscape.com . If I find it I will post it ASAP.
dove
Posted by stjames on December 29, 2001, at 14:36:31
In reply to Re: James' Ideas - A Question, posted by dove on December 28, 2001, at 11:49:15
> > If someone has been on ADs for a relatively short period & then tapers off them after their depression is judged clinically better, or "cured", the relapses seem to be much less than those who are on ADs for a couple of years or more.
To be honest, I have never found the above to be true.
> I just read an article or abstract within the last two months that stated quite a different opinion on this subject. It stated that extending the length of time on the AD treatment proved to lessen the number of relapses significantly in those who had either suffered from a relapse in the past; or, were at risk (in their opinion) for a relapse in the future due to circumstance, genetics, and/or any co-morbid diseases, even if they had been clinically dxed as "better".
And the above to be very true.Treating for 6 months to a year gives a better outcome that just a few months. Treating for just a few months makes it more likely to relapse.
j
Posted by OldSchool on December 30, 2001, at 17:28:50
In reply to Re: Effexor Withdrawl » CMG, posted by Lucas on December 23, 2001, at 16:16:47
I have found the best way to deal with antidepressant "withdrawal" is to taper methodically and slowly. Never taper off fast as in cold turkery. And do a lot of aerobic exercise as you go off the AD, as Ive found intense exercise helps a lot to deal with those bad feelings I get from AD withdrawal.
I use aerobic exercise to "augment" my antidepressants. Aerobic exercise helps to smooth out those adjustment side effects when you go on and off ADs.
Old School.
Posted by slantie on June 1, 2002, at 17:57:23
In reply to Re: Effexor Withdrawl, posted by john on March 28, 1999, at 20:52:30
i'm coming of 37.5 efexor going cold turkey and feeling like one, dizzy fuzzy brain feels like its at sea if a force 10 flashing lights feeling hungry and sick feel flu like can't move too quick feel like my head has to catch up
took efexor feb2000 because of bad Pre natal depression ( don't get post ) baby 2 now seems ok & bright but i'm scared and guilty . I had high bp and post partum cardiomyopathy after . My docs as much use as a chocolate tea pot an not as tasty and the phyco help in my country is so bad. will some one out there help
regards
Posted by johnlund on June 2, 2002, at 21:30:51
In reply to Re: Effexor Withdrawl, posted by slantie on June 1, 2002, at 17:57:23
I have experience Effexor withdrawl. It is not the greatest thing in the world to go through, but the bad feelings do go away eventually. I would not let the fact that the withdrawl symptoms being bad effect my decision to take the medication, especially if it helps the depression.
Posted by slantie on June 3, 2002, at 17:32:26
In reply to Re: Effexor Withdrawl » slantie, posted by johnlund on June 2, 2002, at 21:30:51
thanks for reply, i came of efexor summer last year but had to go back on because i could feel a clinical depression creeping back. i've never had this in the past and i'm a bit worried at the moment that this will happen again.
i was on gammanal (not sure of spelling) and amitriptyline for past depressions and never had problems with withdrawl
I'm thinking of trying natural remedies maybe fish oils or st johns wort.
Posted by Xevious on June 3, 2002, at 20:11:57
In reply to Re: Effexor Withdrawl, posted by slantie on June 3, 2002, at 17:32:26
Effexor was a dream and a nightmare for me... I went on it after exhausting all of the other SSRIs that were available at the time, and had absolutely wonderful results initially. The first sign of trouble was that my doc and I had to aggressively manage my dosage to keep it working, but the really nasty problems didn't show until I went on vacation and forgot to take the pills with me. (By the way, I've since been diagnosed with ADD, which explains why the occasional missed med was such a regular thing with me...)
Results were a foggy head, followed by tunnel vision, "neural static," as I put it, then dissociation, disorientation, and the grand finale, a grand mal seizure. Scared the hell out of the family, and that was only on the second day! My doc called in an emergency supply to the local pharmacy, and within hours - no kidding, hours - I was feeling 80% back to normal.
That and the twenty pounds I had packed on while on Effexor were enough reasons to discontinue the med, but it took me about six months to taper off of it, as my doc's initial guidelines for discontinuation caused petite mal seizures and all kinds of creepy changes to my conscious and dreaming perception. The final score was six months of bliss followed by six months of symptom regression followed by six months of utter hell. Ick.
-Steven
Posted by johnlund on June 3, 2002, at 22:16:23
In reply to Re: Effexor Withdrawl, posted by slantie on June 3, 2002, at 17:32:26
> thanks for reply, i came of efexor summer last year but had to go back on because i could feel a clinical depression creeping back. i've never had this in the past and i'm a bit worried at the moment that this will happen again.
>
> i was on gammanal (not sure of spelling) and amitriptyline for past depressions and never had problems with withdrawl
>
> I'm thinking of trying natural remedies maybe fish oils or st johns wort.I was on Elivel (Amitriphyline) for many years off and on also. I started taking ADs in the mid 70s. Elivel finally pooped out. So did Prozac, Zoloft, etc. etc. The only thing left was Effexor. Fortunately, it worked. It has worked for 3 years now. I really don't plan to go off of it. Plus, going off and on ADs makes one resistent. It is just better to stay on them if you have a chronic type depression like I have. I figure it is like taking High Blood pressure medication. You have to live with it.
Posted by BadEffects on July 7, 2002, at 13:31:21
In reply to Re: Effexor Withdrawl, posted by john on March 28, 1999, at 20:52:30
I've been on Effexor for over 6 years. It works fabulously for me. I was been diagnosed with chronic depression with acute episodes in 1987 and have tried several antidepressants since, including Prozac. None have worked as well. But the withdrawal effects are beyond awful. I am on 300 mg. per day. A few times I've gone off as a result of forgetting to refill a prescription and now am going off because of a change in insurance. It is brutal. There has to be a better way. I get dizzy. I can't focus. Nauseated, achy, fatigued,
etc. I've read a few of the postings, including one that said that the flu like symptoms last about a week or two. I don't think I could take this for a week or two. A day is too long. It is miserable. I read one woman's message which said that she would rather endure back surgery again. I can relate. My doctor tried to talk me out of going off it although I would have to pay for it on my own. I acquiesced. But it's too expensive. He's going to have to come up with a way for me to go off it without this misery. If anyone has found a way to withdraw without the symptoms, I'd love to hear it.I've read more of the postings and it appears that withdrawal symptoms are unavoidable. Combine that with the length of time that you have to endure them and it's a miserable prospect.
Posted by Shawn. T. on July 9, 2002, at 0:53:31
In reply to Re: James' Ideas - A Question, posted by stjames on December 25, 2001, at 2:06:16
I read that one can quit taking Paxil by beginning treatment with Wellbutrin and dropping the Paxil after the Wellbutrin has started working. I really wanted off the Paxil, so I dropped it a week after I started taking Wellbutrin. I had zero side effects, and I didn't even taper off of 20mg/day.
Posted by suji on July 10, 2002, at 14:42:39
In reply to Try Wellbutrin, posted by Shawn. T. on July 9, 2002, at 0:53:31
Really interested in your experience going off Paxil and on to Wellbutrin.... I'm trying to get off Paxil basically because it just didn't seem to be very effective... But coming off it has been horrendous...even though I'm tapering it down...(I'm down to 5mg/day)I've had GI problems, my brain feels as though it's floating loose in my skull, nauseau, and major, major irritability!
Just wondering how you determined that Wellbutrin would be your next AD choice? Was Paxil not working or too many side-effects?
Thanks for anything you feel you can share--I'm trying to make a decision re: what next?
Thanks,suji
Posted by Shawn. T. on July 10, 2002, at 17:29:35
In reply to Re: Try Wellbutrin » Shawn. T., posted by suji on July 10, 2002, at 14:42:39
I wanted to quit smoking. I also didn't like the sexual side effects and sedation.
Posted by AL G. on August 16, 2002, at 23:25:23
In reply to Re: Effexor Withdrawl, posted by john on March 28, 1999, at 20:52:30
I see that some people find Prozac helpful in dealing with Effexor withdrawal due to it's longer half-life. Would Celexa maybe work instead in the same way as Prozac? Because I'd rather not take Prozac. I've already experienced bad withdrawal from Paxil and by missing a dose of Effexor. I'm now tapering of Effexor and I'm especially afraid of extreme anxiety during withdrawal. The phyical aspects of withdrawal don't worry me as much. Also, which symptoms does Benadryl help?
Posted by sleepy lizard on August 19, 2002, at 0:14:51
In reply to Re: Effexor Withdrawl, posted by AL G. on August 16, 2002, at 23:25:23
Prozac stays in the system about a week. Celexa has a much shorter half-life. I think Prozac is unique in that respect amoung the SSRI's.
Posted by jewlz on August 19, 2002, at 2:00:03
In reply to Re: Effexor Withdrawl, posted by john on March 28, 1999, at 20:52:30
I had terrible withdrawals also which included unbelievable dizziness and "static vision" where everything would look like static on a t.v. Furthermore, I had a patch of skin on my leg that went numb (that skin still feels dead) and a joint on one finger which went numb also. My doctor swore these effects were not caused by the medication but I know they were as when I would take the pills all of this would stop. It took a long time to "come down" off the stuff and I think effexor is dangerous and messes with your central nervous system.
Posted by sleepy lizard on August 20, 2002, at 21:11:35
In reply to Re: Effexor Withdrawl, posted by jewlz on August 19, 2002, at 2:00:03
What has happened to you is really scarry. I had no idea that could happen. It sounds like the sensory nerves got harmed! I know a couple of people that have had nerves come back, one from an injury, and one from a virus. Maybe some of those will return, it takes about 6 months or longer sometimes. I'm sorry to hear that you are suffering so much.
Posted by AL G. on August 21, 2002, at 5:19:03
In reply to Re: Effexor Withdrawl, posted by sleepy lizard on August 20, 2002, at 21:11:35
I'm currently tapering off of Effexor and feel that I've had it with SSRI's. There are only a few anti-depressants/mood stabilizers that I haven't tried. I would like to know if anyone has had any experiences, good or bad, with Lamactil, Topamax, or the reversible MOAI/RIMA, Aurorix(Moclobemide). I suffer from depression, some bipolar tendencies, and extreme anxiety disorder(including social phobia, panic attacks, etc.).
Posted by Dysfunk on December 26, 2002, at 14:08:22
In reply to Re: Effexor Withdrawl » john, posted by BadEffects on July 7, 2002, at 13:31:21
I assume the only way to ween off of this medication is to do it slowly. I am just starting to ween myself off of 225 mg. I cut back on my coffee intake since I was getting so jittery. I also took more xanax to control the anxiety and tenseness. Unfortunately, I felt it was easier to stay inside and not deal with the public. Not everyone can do that. It is a matter of waiting it out, and it sucks!
Posted by wla on June 21, 2003, at 17:28:02
In reply to Re: Try Wellbutrin » Shawn. T., posted by suji on July 10, 2002, at 14:42:39
>I was wondering I am trying to get off Effexxor and have not gotten my period in 2 months very bad side effects and still on 37.5 mg per day am thinking of adding prozac to help? Anyone ever (woman) stop getting there period when going off any meds.
Thanks.
Wla
Posted by maryengland on July 6, 2003, at 0:19:26
In reply to Re: Effexor Withdrawl, posted by Matt on March 28, 1999, at 7:07:16
I've been on effexor for two and a half years (175 mg/day) now. I first notiiced the withdrawl effects when I accidentally skipped a dose. Without knowing what my withdrawl symptoms were caused from I worried that I had some neurological dissorder. Later I found out that Effexor does not stay in the body long at all as does Prozac, in turn, causes withdrawl symptoms when doses are skipped. I don't nkow why but just lately I have started to have the same symptoms even if I haven't missed any doses. Has anyone else experienced this. I am boing to begin to taper off Effexor because I feel the withdrawl is as bad as the depression and I might be getting these symptoms when I haven't missed doses due to the length of time I have been on the drug. If any one has any comments please write.
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