![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Flopka on June 30, 2002, at 19:32:34
Kind of a strange question here, but here goes. Does anyone know if it's unsafe to use buspirone (or SSRI's, although I know Buspar isn't one of those) on short-term basis only, but months apart? What I mean is, if one took a low dosage (up to 5 mg) of Buspar for a week or two, then tapered off and didn't use it for several months, then did the same thing over again, would it really screw up one's brain in the long term?
Posted by Fuscia on July 1, 2002, at 12:22:07
In reply to Repeated short-term use of buspirone?, posted by Flopka on June 30, 2002, at 19:32:34
Hi Flopka,
More than likely not. In my thinking, this just might be a better way to take one of the SSRI's, Tricyclics, Effexor, Wellbutrin, BuSpar, Remeron, or Serzone. This would avoid drug poop out. The brain sees any foreign substance that affects it as a toxin and tries as hard as it might to counteract the effects of a drug's action. Eventually poop-out often results as the brain readjusts. Other factors are involved, but mainly what is called "down-regulation". All the transmitters must be in balance. You manipulate this fine balance through brain chemical altering drugs, and as a result, increases in one brain chemical through selectivety can cause a decrease of another, which can increase another. For instance, by increasing serotonin, dopamine usually decreases, which in turn can increase prolactin, which can decrease testosterone. It's the domino effect.
Firstly, drug manufacturers know a patient will continue to take a medicine more regularly if they take it daily - easy to remember to take your med, whereas once every other month or so has the chance that many will not go back on the med, or not take it regularly. The pharmaceutical companies wouldn't make as much money, for certain!
A good example of the pluses of off and on dosing concerns amino acid supplements and ginseng. These may be available over the counter, but they are powerful substances and should be taken seriously. Researchers advise one not take singular amino acid supplements for long periods of time. A good rule to follow is to alternate between the individual amino acids that fit ones needs and back them up with an amino acid complex, taking the supplements for two months and then discontinuing them for two months. Moderation is the key with these substances. Some amino acids have potentially toxic effects when taken in high doses and may cause neurological damage. In Russia the approach to using ginseng is to take it for fifteen to twenty days, followed by a rest period for two weeks. These precautions are taken so as to keep the body from becoming desensitised, as it were, from long term use. Long term use can result in the body having a difficult time remembering how to synthesise and manufacturer chemicals and other bodily actions on its own, as these substances effect all sorts of bodily functions.
I've read that for a bi-polar patient taking lithium for mania, that if the lithium is discontinued too soon as happens quite often due to annoying side effects, that the patient doesn't respond to lithium when it is restarted for a manic episode, and can actually result in a more difficult to treat manic episodes. It is not fully understood why this occurs.
It is an interesting thought, and should be taken on by researchers to find the answers. I have heard of PreMenstrual Syndrome patients taking a SSRI for two weeks prior to the start of their period. I don't know if this is more effective than daily dosing. Also, monthly or weekly alternating of a drug can depend on the drugs half life. Prozac for instance has a secondary metabolite that can last in the body for roughly 5 weeks. That's a long time! Even this secondary metabolite can have antidepressant/antianxiety effects. I for one take Prozac by E.L. 20mg capsule twice a week and it works very well for me (I may have borderline personality disorder or bi-polar, doc still diagnosing me - Zoloft, Celexa, and Wellbutrin didn't work well for me). Anyway, Prozac's major metabolite can last in the body for 100 hours. Who needs Weekly Prozac!
Thanks for the interesting question.
Take care, Fuscia
Posted by hildi on July 4, 2002, at 14:19:21
In reply to Re: Repeated short-term use of buspirone?, posted by Fuscia on July 1, 2002, at 12:22:07
> Hi Flopka,
>
> More than likely not. In my thinking, this just might be a better way to take one of the SSRI's, Tricyclics, Effexor, Wellbutrin, BuSpar, Remeron, or Serzone. This would avoid drug poop out. The brain sees any foreign substance that affects it as a toxin and tries as hard as it might to counteract the effects of a drug's action. Eventually poop-out often results as the brain readjusts. Other factors are involved, but mainly what is called "down-regulation". All the transmitters must be in balance. You manipulate this fine balance through brain chemical altering drugs, and as a result, increases in one brain chemical through selectivety can cause a decrease of another, which can increase another. For instance, by increasing serotonin, dopamine usually decreases, which in turn can increase prolactin, which can decrease testosterone. It's the domino effect.
>
> Firstly, drug manufacturers know a patient will continue to take a medicine more regularly if they take it daily - easy to remember to take your med, whereas once every other month or so has the chance that many will not go back on the med, or not take it regularly. The pharmaceutical companies wouldn't make as much money, for certain!
>
> A good example of the pluses of off and on dosing concerns amino acid supplements and ginseng. These may be available over the counter, but they are powerful substances and should be taken seriously. Researchers advise one not take singular amino acid supplements for long periods of time. A good rule to follow is to alternate between the individual amino acids that fit ones needs and back them up with an amino acid complex, taking the supplements for two months and then discontinuing them for two months. Moderation is the key with these substances. Some amino acids have potentially toxic effects when taken in high doses and may cause neurological damage. In Russia the approach to using ginseng is to take it for fifteen to twenty days, followed by a rest period for two weeks. These precautions are taken so as to keep the body from becoming desensitised, as it were, from long term use. Long term use can result in the body having a difficult time remembering how to synthesise and manufacturer chemicals and other bodily actions on its own, as these substances effect all sorts of bodily functions.
>
> I've read that for a bi-polar patient taking lithium for mania, that if the lithium is discontinued too soon as happens quite often due to annoying side effects, that the patient doesn't respond to lithium when it is restarted for a manic episode, and can actually result in a more difficult to treat manic episodes. It is not fully understood why this occurs.
>
> It is an interesting thought, and should be taken on by researchers to find the answers. I have heard of PreMenstrual Syndrome patients taking a SSRI for two weeks prior to the start of their period. I don't know if this is more effective than daily dosing. Also, monthly or weekly alternating of a drug can depend on the drugs half life. Prozac for instance has a secondary metabolite that can last in the body for roughly 5 weeks. That's a long time! Even this secondary metabolite can have antidepressant/antianxiety effects. I for one take Prozac by E.L. 20mg capsule twice a week and it works very well for me (I may have borderline personality disorder or bi-polar, doc still diagnosing me - Zoloft, Celexa, and Wellbutrin didn't work well for me). Anyway, Prozac's major metabolite can last in the body for 100 hours. Who needs Weekly Prozac!
>
> Thanks for the interesting question.
>
> Take care, Fuscia
Hi Fuscia. What do you mean you take prozac by E.L.? What is EL? Also, you mentioned taking it only twice a week- you do not feel any strange effects like the med leaving your system? If you take more often than this do you feel side effects of the prozac? Just wondering . . . trying to figure out correct dosage of meds for me and since discovering PB I am learning that a lot of people, besides me, seem to do better on less, rather than more (which is what my pdoc alway recommends-more)
Hildi
Posted by hildi on July 5, 2002, at 12:27:28
In reply to Re: Repeated short-term use of buspirone?, posted by Fuscia on July 1, 2002, at 12:22:07
Hi fuscia. this is sort of a add-on to the other post I wrote you . . .
I am thinking of going back on prozac. Your posts, and some others, have confirmed the idea I already had that I might have been taking too much of the med, and thats why it pooped out, that also could be why I started to get undesirable effects after taking it for while.
My question to you is: in your opinion, should I take it daily for only a little while to let it 'build up' a bit before going to bi-weekly (I'm thinking of trying 10mg, not 20) dosing? Or, should I just start off taking prozac a couple of times a week? What worked for you?
Did you reduce to your bi-weekly dosing, or did you always do it that way?
I'm interested to hear how you approached this.
Thanks much, Hildi
Posted by Fuscia on July 5, 2002, at 16:24:24
In reply to Fuscia, please respond, posted by hildi on July 5, 2002, at 12:27:28
> Hi fuscia. this is sort of a add-on to the other post I wrote you . . .
> I am thinking of going back on prozac. Your posts, and some others, have confirmed the idea I already had that I might have been taking too much of the med, and thats why it pooped out, that also could be why I started to get undesirable effects after taking it for while.
> My question to you is: in your opinion, should I take it daily for only a little while to let it 'build up' a bit before going to bi-weekly (I'm thinking of trying 10mg, not 20) dosing? Or, should I just start off taking prozac a couple of times a week? What worked for you?
> Did you reduce to your bi-weekly dosing, or did you always do it that way?
> I'm interested to hear how you approached this.
> Thanks much, HildiHi Hildi,
Prozac, name brand, by Eli Lilly, but actually it is made by Dista labs.
I'm one to experiment, and, to listen to my body. I tend to be sensitive to drugs. I was taking 20mg of Celexa prior to starting Prozac. I went cold turkey off of Celexa and by day 7 I was going through a topsy turvy emotional roller coaster ride. I didn't have to do this, but could have directly switched to Prozac. Anyway, I started taking Prozac capsule 20mg daily for one month. I began feeling it's positive effects immediately. I then started taking it every other day since I was doing well. I order my main purchase of prescription medicines from a Canadian pharamcy - much less expensive than our local pharmacist. So, I would have to wait about 2 - 4 weeks for my refill to arrive in the post. In the meantime, I went ahead and got a month's refill of generic fluoxetine made by Geneva Labs. 20mg tablets. I took these every other day for one month, but for me it didn't seem to work as well as the Prozac name brand. I became depressed quite often. So, after about 2 1/2 months of beginning date of starting on Prozac, I started back on Prozac name brand and within two weeks I started taking it on Mondays and Thursdays, and so far this has been very good. I have been taking this dosing schedule for about 1 month now. Celexa didn't cause anorgasmia, but once on Prozac, the anorgasmia came back (as it did when I took low dose of Zoloft). That was one main reason for twice weekly dosing, to reduce this effect of not being able to have an orgasm. I think it frustrates my husband more than me. Anyway, I chose that scheduling so as to have a 3 day drug-free holiday over the weekend. Since Prozac has such a long half-life in the body, it really doesn't reduce too many of any side effects, so I am still working on the anorgasmia part. My doc was fine with this dosing schedule when I mentioned it to him over a month ago. In the future, I plan to switch to 10mg of Prozac and try it twice weekly, and then once a week to see how it goes. My doc wants me to start taking BuSpar (buspirone) 10mg twice a day to see if this will counteract any anorgasmia side effects, and possibly get a better response from me and my problems with depression, anxiety, impulsiveness, and anger outbursts. BuSpar works differently in that it "stimulates serotonin receptors on postsynaptic receptors" (Feeling Good, by David Burns, M.D.). I did have one anger outburst recently and it quite shocked me for I haven't lost my temper in quite a long time. I'm also trying to eat healthier (avoiding too much caffeine, which I've lowered drastically, and eating less snack foods and eating more quality protein, besides taking a vitamin/mineral complex, besides vitamin B -complex, Nutritional yeast, Green Magma green food drink (for enzymes), and I occasionally take Dong Quai, Black Cohosh, Red Clover, and Sarsasparilla for hot flashes - it works great for this, as well as menstrual cramps for which I used to take Ibuprofin. I'm also using progesterone cream, FemGest brand. I use it for two weeks every month prior to start of my period. I've been using this for about 3 months. It also works great for hot flashes. I began experiencing these prior to SSRI meds. I am 39 yrs old.
It's interesting to note that if you follow a supplementation program for longer than a year, that one should change brands periodically so that one does not develop an intolerance or build up a resistance to one or more ingredients in one supplement. Why not for antidepressants and antianxiety medicines?
My doctor thinks I have either borderline personality disorder, which is difficult to treat, or bi-polar disorder.
Here is some intersting reading that may better answer your questions: The best to you, Fuscia
Feeling Good, by Dr. David D. Burns, M.D.
"Doses of SSRI's. The doses of the five SSRI's are listed on page 520. Unlike the other antidepressants, which are often prescribed in doses that are too low, the SSRI's are often prescribed in doses that are unnecessarily high. Because they have so few side effects, doctors feel comfortable prescribing high doses and may prescribe more than is really needed. For example, although 20mg to 80mg per day was the dose range initially recommended for Prozac, a single dose of 10mg per day will be sufficient for many patients. Once they are feeling better, many patients need only 5mg per day, or even less. These smaller doses are much less expensive and will produce fewer side effects.
These low doses are effective because Prozac stays in the body for a much longer period of time than most other drugs--as long as several weeks. When you take Prozac, your blood level continues to increase each day because the Prozac leaves your body so slowly. After a while your blood level becomes quite high. This is why you may need only a tiny dose if you have been taking Prozac for several weeks or more.
To understand this better, lets go back to the bathtub analogy I introduced in Chapter 19 to explain drug interactions. Let's imagine that the Prozac you are taking is like the water going into the bathrub, but the hole in the bottom of the tub is tiny. Over time, the water level increases, because more water goes into the tub than goes out. The water level can be compared to the level of the Prozac in your blood. After four to five weeks, the water level finally gets up to the correct theappeutic range. Now you can turn the faucet down quite a bit so that the level in the tub does not continue to increase and overflow. This would be analogous to reducing the dose of Prozac after you have been on it for several weeks. Paradoxically, you are not tkaing much smaller doses than when you first started taking Prozac, but your blood level is far higher.
Techincally, we say that "steady state" has been reached. Steady state means that the blood level remains more or less constant, because the amount you take each day is similar to the amount that your body eliminates each day. The other four SSRI's do not have this property, because they leave the body much faster than Prozac. You generally cannot reduce the doses after several weeks.
The effectiveness of very low doses of Prozac is now well known among the psychiatric profession, but I first learned this from my patients soon after Prozac was released onto the market. Many patients reported that after they had been on Prozac for a month or two, they seemed to need only tiny doses, often as little as one tenth of a tablet per day, and sometimes even less. At first I thought these patients had overly lively imaginations, but soon many patients were reporting the same thing. I advised them to take one Prozac tablet, grind it up, and dissolve it in water or apple juice to store in the refrigerator. Then they adjusted their dose of Prozac by drinking a certain amount of the fluid each day. So, for example, if you have dissolved one 20 mg pill in some apple juice and you drink one tenth of the juice each day, this would correspond to a dose of 2 mg per day. But if you try this, make sure you label the juice clearly so that no one drinks your Prozac for breakfast! Also, make sure you talk it over with your doctor and that she or he approves of what you are doing.
It is also important for you to know that after you stop taking Prozac, it will stay in your body for a long time because it leaves your body so slowly. This would be like a bathtub that takes an extraordinarily long time to empty out after you pull the plug because the drain is clogged up. After you are no longer taking the Prozac, significant levels will remain in your blood for as many as five weeks or more before the drug is entirely cleared out of your system. Many medications can be dangerous to mix with Prozac. You must not take these specific medications until you have been off the Prozac entirely for at least five weeks. For example, tranylcypromine (Parnate) is an antidepressant knowns as an MAO inhibitor. This as well as other MAO inhibitors can cause dangerous and potentially fatal reactions if mixed with Prozac. After you stop taking Prozac, a delay of at least five to eight weeks will be necessary before you can safely start taking tranycpromine (Lisa's note: does any doctor prescribe MAO inhibitor antidepressants these days?).
The other SSRI's, such as citalopram (Celexa), fluvoxamine (Luvox), sertraline (Zoloft), and paroxetine (Paxil), leave the body more rapidly than Prozac but they are still metabolised rather slowly. For example, if you stop taking one of these drugs, it will take your body approximately one day to get rid of one half of the amount in your body. It will take approximately four to seven days for most or all of the drug to leave your body. This is much faster than Prozac. Therefore, these other SSRI drugs do not build up to such high levels in your blood after you have been taking them for more than a few weeks. Because they go in and out of your blood more rapidly, they are usually taken once a day, some taken several times per day, whereas Prozac can be taken once a day, twice a week, or even once a week, or very small doses once daily. Once again, consult your doctor concerning Prozac dosing.
Age can also influence your dose requirements if you are taking an SSRI. For examply, levels of citalopram (Celexa), fluoxetine (Prozac), and paroxetine (Paxil) are approximately twice as high in older individuals. If you are taking one of these drugs and you are over 65, you will need a lower dose. Blood levels of sertraline (Zoloft) are also higher in older individuals, although the differences are not as pronounced. In contrast, fluvoxamine (Luvox) blood levels do not seem to be affected by age. (Lisa's note: Does any doctor prescribe Luvox?-it seems like the most untried SSRI. I guess it is because one must take several doses a day due to its very short half-life).
Sometimes gender can play a role as well. For example, the blood levels of fluoxetine (Prozac) are 40 percent to 50 percent lower in males than in females. Similarly, young men develop blood levels of sertraline (Zoloft) that are 30 to 40 percent lower, on the average, than young women. Men may need relatively higher doses of these drugs, whereas woman may need relatively lower doses."
Posted by hildi on July 5, 2002, at 19:04:44
In reply to Re: Fuscia, please respond-Hildi, posted by Fuscia on July 5, 2002, at 16:24:24
Posted by Fuscia on July 6, 2002, at 13:41:06
In reply to Thank You Fuscia! Very helpful info!!! (nm), posted by hildi on July 5, 2002, at 19:04:44
(Paradoxically, you are not tkaing [should read, "now taking"] much smaller doses than when you first started
taking Prozac, but your blood level is far higher.)I read an earlier post of yours concerning Zoloft at 50mg. I had to share my experience with Zoloft. About 2 years ago I went to my gynecologist with complaints of premenstrual syndrome. I was terrible just before my period, but deep down I also knew I had other emotional problems that occurred at any time of the month, and had bothered me since late childhood. But, I had never been to a psychiatrist and I was afraid to go, besides afraid of the cost. Anyway, I complained to my gyn of PMS. She put me on Zoloft, to take 50 to 100 mg daily. I was given some free samples by my doctor. These were samples for Panic Disorder. I started taking this before I got my prescription filled. I followed the instructions and started out on 25mg a day for one week. It worked so great that I stayed on 25mg for over a year. I eventually went up to 50 mg and began having problems with my temper outbursts. I lost my temper big time with a young dog we had and I went into a deep depression afterward and had insomnia. My doctor suggested increasing Zoloft to 75mg and he also prescribed 50 mg trazadone (Desryl) antidepressant (it's actions are more like a tricyclic) for the insomnia, as trazadone has sedative qualities. So, I increased to 75mg and started the trazadone. Boy, the 50 mg of trazadone made my nose so stuffy for the first hour after taking it that I couldn't sleep, but after that wore off, I was in deep sleep, all night long. After a few days of trazodone nose stuffiness, I decided to divide the dose in half to 25mg. It worked great for insomnia, but I still experienced the stuff nose effect, though less severe. Eventually I reduced it to 12.5 mg and this was perfect. I took this dose off and on for insomnia, but I haven't needed it in quite some months now. It seems that I sleep very well on Prozac twice weekly. I slept good on daily Prozac as well. Anyway, I wanted to mention that when the dose of Zoloft was upped to 75 mg. my hands began to shake and I felt anxious all the time. I didn't like that feeling, so my doc switched me to Wellbutrin SR 150 mg. which made me relaxed but irritable, and I could only take this irritability for one month, so then was switched to 20mg of Celexa. I was on the for about 4 months, but I felt depressed too often, not to mention lethargic during the day. So, I switched to Prozac. I just wanted to mention about the Zoloft experience for I read your post about how when your dose was increased to 50 mg it was too much. This can be very true if you suffer from Panic Disorder, as individuals with this are very sensitive to medicines. It only takes a little bit to do the trick. But, most doctors will urge their patient to stick it out, to weather the storm after increasing the dosage, for they know that usually the side effects will subside as the body adjusts to the medicine. I just couldn't handle the hand shakiness and anxiousness and didn't want to see if sticking through would eventually see these side effects subside, and an increase in benefits from the drug. I would rather take a lower dose or switch to another drug.
Well, that's about it. Take care Hildi. Fuscia
Posted by hildi on July 7, 2002, at 17:49:25
In reply to Re: Typing correction-and had to add about Zoloft, posted by Fuscia on July 6, 2002, at 13:41:06
> (Paradoxically, you are not tkaing [should read, "now taking"] much smaller doses than when you first started
> taking Prozac, but your blood level is far higher.)
>
> I read an earlier post of yours concerning Zoloft at 50mg. I had to share my experience with Zoloft. About 2 years ago I went to my gynecologist with complaints of premenstrual syndrome. I was terrible just before my period, but deep down I also knew I had other emotional problems that occurred at any time of the month, and had bothered me since late childhood. But, I had never been to a psychiatrist and I was afraid to go, besides afraid of the cost. Anyway, I complained to my gyn of PMS. She put me on Zoloft, to take 50 to 100 mg daily. I was given some free samples by my doctor. These were samples for Panic Disorder. I started taking this before I got my prescription filled. I followed the instructions and started out on 25mg a day for one week. It worked so great that I stayed on 25mg for over a year. I eventually went up to 50 mg and began having problems with my temper outbursts. I lost my temper big time with a young dog we had and I went into a deep depression afterward and had insomnia. My doctor suggested increasing Zoloft to 75mg and he also prescribed 50 mg trazadone (Desryl) antidepressant (it's actions are more like a tricyclic) for the insomnia, as trazadone has sedative qualities. So, I increased to 75mg and started the trazadone. Boy, the 50 mg of trazadone made my nose so stuffy for the first hour after taking it that I couldn't sleep, but after that wore off, I was in deep sleep, all night long. After a few days of trazodone nose stuffiness, I decided to divide the dose in half to 25mg. It worked great for insomnia, but I still experienced the stuff nose effect, though less severe. Eventually I reduced it to 12.5 mg and this was perfect. I took this dose off and on for insomnia, but I haven't needed it in quite some months now. It seems that I sleep very well on Prozac twice weekly. I slept good on daily Prozac as well. Anyway, I wanted to mention that when the dose of Zoloft was upped to 75 mg. my hands began to shake and I felt anxious all the time. I didn't like that feeling, so my doc switched me to Wellbutrin SR 150 mg. which made me relaxed but irritable, and I could only take this irritability for one month, so then was switched to 20mg of Celexa. I was on the for about 4 months, but I felt depressed too often, not to mention lethargic during the day. So, I switched to Prozac. I just wanted to mention about the Zoloft experience for I read your post about how when your dose was increased to 50 mg it was too much. This can be very true if you suffer from Panic Disorder, as individuals with this are very sensitive to medicines. It only takes a little bit to do the trick. But, most doctors will urge their patient to stick it out, to weather the storm after increasing the dosage, for they know that usually the side effects will subside as the body adjusts to the medicine. I just couldn't handle the hand shakiness and anxiousness and didn't want to see if sticking through would eventually see these side effects subside, and an increase in benefits from the drug. I would rather take a lower dose or switch to another drug.
>
> Well, that's about it. Take care Hildi. Fuscia
Hi Fuscia. Good to hear from you again. After I read your previous post I went out and bought the book "Feeling Good" and read through parts of it yesterday. I took 20mg of prozac yesterday AM in the belief that maybe I'll try that route again. Years ago I had been on prozac, actually got too euphoric (but loved it and dr. wasn't concerned) and I stayed on the prozac until it pooped out about a year later. At that point I went on the zoloft because the good feelings had given way to anxiety. It really makes sense now- I was on too much prozac, way too much. I think your right, too, about the possible additional benefits of not taking the meds every day- not only will it not build up in our system, maybe our bodies won't get used to the med and stop working.
I have always been on 50mg zoloft- at least as far as I can remember. Throughout the years I have had trouble at certain times with this drug, and whenever I would ask the dr. he would always say I should up the dose- typical response!
When I tapered off the drug, rather recently, (in the belief I was going to go off prescription A/D's) and I was at 25mg I remember thinking I felt pretty good. What you said about your experience with zoloft, in addition to how I felt at the low dose, makes me think that maybe my emotional outbursts (I can be very hot tempered), my anxiety, and my lethargy and apathy MIGHT have to do with me needed a smaller dose.
When I recently tried to start zoloft again, I felt nausea and 'stoned' after taking a very small dose-only 25. So I tried again at half that and I STILL felt bad from the zoloft. I am afraid to try it again! It could be my body just responding to all the changes/meds I've put it throught lately, or maybe I've developed an intolerance or allergy to it. It is worth a try again, though. As far as the celexa goes, I'm with you on the depression-I have added depression and added anxiety- just don't feel that it would be worth it to try this med any further. It was only 3-4 weeks on it, but still!
Thanks for bring this up to me Fuscia. This might be the case.
One last thing- Whith the zoloft, I noticed it was working differently around my period. I could feel wierd feelings in my head, sensations in my brain, and my emotions started getting out of wack around my period-worse than usual. Could be hormones? Made me think the zoloft wasn't strong enough for me. Could too high of a dose have affected this ,too you think?
Hmmm. So many questions.
Hildi
Posted by Fuscia on July 8, 2002, at 13:41:54
In reply to Re: Typing correction-and had to add about Zoloft, posted by hildi on July 7, 2002, at 17:49:25
Hi Hildi,
Can you believe that someone I had met over at the Zoloft message board at RXlist had sent me that book, Feeling Good, by Dr. Burns. He's a good friend and his sister gave it to him, but he thought I'd get some help from it. He has panic disorder.
I was actually taking 12.5 mg of Zoloft for about two months during my 1 + years experience with it. I would say yes, it is hormones that caused the effects you mentioned. I find it hard to remember, but I do remember Zoloft worked pretty good prior to period time, especially at the beginning of drug treatment, but for Celexa 20mg, no way. If I had to choose which SSRI to start with and stay with it would be Prozac for me, but it's true we are all unique in how these drugs effect us, and also true that each SSRI works slightly different - some are more selective on serotonin than others, and others have a slightly higher effect on norepinephrine, even though it is very small effect. Drug poop-out is definitely a problem for these drugs. I wonder if by switching from higher to lower dosage (instead of the usual lower to higher dosage), if this would counteract this effect by keeping the brain guessing as it tries to build a resistance to the drug's effects.
I did forget to mention that after a year of being on Zoloft, I switched from a gynecologist being my SSRI drug provider to a psychiatrist. My gyn was too busy to be bothered with side effects from SSRI's, as she was delivering babies most of the time! I see my psychiatrist about every two months now.
It's good to hear from you as well! Take care, Fuscia
Posted by hildi on July 9, 2002, at 20:19:38
In reply to Re: Yep, hormones Hildi, posted by Fuscia on July 8, 2002, at 13:41:54
> Hi Hildi,
>
> Can you believe that someone I had met over at the Zoloft message board at RXlist had sent me that book, Feeling Good, by Dr. Burns. He's a good friend and his sister gave it to him, but he thought I'd get some help from it. He has panic disorder.
>
> I was actually taking 12.5 mg of Zoloft for about two months during my 1 + years experience with it. I would say yes, it is hormones that caused the effects you mentioned. I find it hard to remember, but I do remember Zoloft worked pretty good prior to period time, especially at the beginning of drug treatment, but for Celexa 20mg, no way. If I had to choose which SSRI to start with and stay with it would be Prozac for me, but it's true we are all unique in how these drugs effect us, and also true that each SSRI works slightly different - some are more selective on serotonin than others, and others have a slightly higher effect on norepinephrine, even though it is very small effect. Drug poop-out is definitely a problem for these drugs. I wonder if by switching from higher to lower dosage (instead of the usual lower to higher dosage), if this would counteract this effect by keeping the brain guessing as it tries to build a resistance to the drug's effects.
>
> I did forget to mention that after a year of being on Zoloft, I switched from a gynecologist being my SSRI drug provider to a psychiatrist. My gyn was too busy to be bothered with side effects from SSRI's, as she was delivering babies most of the time! I see my psychiatrist about every two months now.
>
> It's good to hear from you as well! Take care, FusciaHi Fuscia. I Thought the hormones were to blame!
Getting older can be a real pain-in- the -butt.
I think I'm in perio-menopause and need some extra help. I will know at the end of the month.
Prozac used to be the BEST for PMS. I remember not even realizing it was close to my period, thats how good I felt.
However, my body did not like the prozac-at first I felt great, at first, but looking back on it I realize it was an euphoric mania. I 'crashed' on it and felt worse than ever. I cannot help nut wonder, though, what it would have been like had I been on the correct dose. . .20mg. a day was too much-especially for me!
I saw my dr. yesterday because I've been going nuts trying to figure out what to do, I demanded to try something different. I insisted I was not going to spend another minute even talking about the celexa. I justed nardil, he suggested either zyprexa or effexor. . .
I took 37.5 mg. effexor yesterday afternoon and it completely knocked me out! I felt I had been given a sleeping pill, also was incredibly thirsy with dry nouth. Otherwise, it actually made me feel good.
Now comes today . . This regular effexor is supposed to be taken twice a day because of a short half-life and I'm thinking to myself this day will be a waste- I'll be incredibly tired and sleepy all day. So, instead of popping another effexor I took 25mg. of zoloft this morn.
I feel really shaky and have a stomach-ache.
The SSRI's are getting me sick and shaky lately.Maybe I should give this effexor a fair try. . .
Have you tried this?Hildi
PS-Boy, I really have my brain doing guessing games here. I take one thing one day-another thing the next. I don't think that doing it THIS way is good!
Posted by hildi on July 9, 2002, at 21:01:03
In reply to Re: Yep, hormones Hildi-Fuscia, posted by hildi on July 9, 2002, at 20:19:38
Hi again- this is sort of an "add-on" to post I just submitted to you, above . .
Since the effexor has only something like a 5 or 6 hour half-life (that's what I read on the package insert-could this be right??), do you think taking only once a day (at night) be along the same theory we have about delaying the dosage- I mean, would this be too LONG between doses and (not be effective) or would it be even be better at not letting it build-up in my body and therefore increase side effects and stop working??I was wondering if I screwed up my brain, switching from a higher to a lower dose of zoloft, then taking it, stopping , and then starting over again . .it isn't working as good as before- I'm only gettin side effects, and many I've never had before!
Yuck! This is messing up my theory- it should be working even better than ever.
I don't know if I should give it more time on the zoloft (but I feel so physically ill- I felt fine today, only sleepy, until I took thie zoloft), or give effexor a real try. I'm going to post an effexor post and see if anyone does the regular effexor only once a day.
Hildi
Posted by Fuscia on July 14, 2002, at 16:08:37
In reply to Fuscia, please read, posted by hildi on July 9, 2002, at 21:01:03
Hi Hildi,
Sorry to be so late in returning your post.
The side effects you mentioned, the dry mouth is because of anitcholinergic effects. Other anticholinergic effects include rapid heart rate, inability to urinate, and constipation.
In my opinion, I would not take Zoloft since you don't want to be mixing two serotonergic drugs, especially since you are beginning the Effexor.
Split the Effexor tablet in half and take that twice a day. If you still have nausea then go to pharamcist and get the 25mg of Effexor and split that in half and take 12.5 mg twice daily until annoying side effects pass. Then if you need to you can increase. The secret to starting Effexor is to start out very low. In my opinion, I tend to dislike the short half-life drugs, such as Effexor, Paxil, and Xanax. The shorter the half-life, the more difficult time (as in side effects or withdrawal symptoms). I wouldn't take the Zoloft, though, with the Effexor. You might cause side effects of which you wouldn't be able to figure out which drug or what dose was the culprit.
Consider taking Natural Nutritional Yeast by Twinlabs. There are other brands of yeast drinks, as well as Brewer's Yeast, but I like this brand for it tastes the best and the amount required is only 1 tbsp. mixed with liquid. This way, you'll be getting many of the amino acids, including those that increase dietary dopamine, and you'll be getting complex B vitamins that may help with the dry mouth problem.
The sleepy effect will probably go away as your brain adjusts to the effects of the drug, or especially when dosage is increased, since Effexor acts mainly as a serotonin reuptaker at low doses, whereas at higher doses, norepinephrine and to a small extent, dopamine, is increased. This can counteract the sleepy feeling.
Also, since you are premenopausel you'll want to consider taking a progesterone creme. You can read much about it using a search engine. I use Fem Gest by Home Health from vitaminshoppe.com. It does contain progesterone. Wild Yam extract does not convert into progesterone in the body, so avoid products that claim they increase progesterone that only contain wild yam. It needs to say "progesterone" on the ingredients list. Go to your library and check out the following books: What Your Doctor May Not Tell You About Menopause, by John R. Lee, M.D., Jesse Hanley, M.D., and Virginia Hopkins. I have their book, What Y.D.M.N.T.Y.About Premenopause, and it is an excellent source of information for women of all ages.
Here is a link you'll find very interesting:
http://www.all-natural.com/estrog-1.html
Hormone Heresy by Sherrill SellmanTake care Hildi, Fuscia
Posted by Hildi on July 22, 2002, at 12:59:39
In reply to Re: Hildi, about Effexor dose, posted by Fuscia on July 14, 2002, at 16:08:37
Hi Fuscia. I just read this post today- I'm a bit behind, too.
That is a great article. You know, I have a book by Dr. Lee and a bottle of natural, transdermal progesterone . . I haven't read the book or used the hormone yet, but I had planned to some day.
What about all the HRT talk about the progesterone being the culprit? What I've heard about these lastest findings is that estrogen alone is supposed to be safe and it's the estrogen/progesterone pill like premarin that is supposed to be the 'risky' one.
What do you make of all this??Thanks for the advice on the Effexor. Actually, though, I stopped taking it. I really wasn't getting nausea as much as feeling very, very drugged, having tremors, also having mania. I see the pdoc today, but in the meantime I've been on 50mg zoloft (again). The zoloft makes me spacy and apathetic, also a bit manic- but it's nothing compared to what I felf on the Effexor.
Please let me know what you think of all this new information on HRT, and the 'findings' that estrogen alone is supposed to be safer than progesterone.
Thanks,
Hildi
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.