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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by Theta99 on December 14, 2003, at 20:26:54
Sorry if this topic has been dealt with in the past, but I couldn't find anything that was close to my situation using the search feature:
I have explosive angry outbursts as a result of tiny irritants. Dropping a sock on the way from the dryer, my toddler touching something with sticky-gooey hands, coming home to a messy house etc.
I have been to see a psychiatrist, and he has started me on Zoloft. First he put me on 50mg daily. Sure I had some side effects, mostly tingly feelings sometimes and a week of bad headaches, but I stuck with it and it seemed to help. I have been reading some anger management texts, and the Zoloft seems to be letting me think before I react to the irritation before I explode. I still sometimes feel overly angry, but I haven't reacted. After my last appointment we upped my dosage to 100mg to see if that helps with the feelings of extreme anger.
My question is has anyone else heard of treating what my Dr. has described as a Mood Disorder non-specific, with an SR1? He said it sounded like my angry outbursts were similar to a borderline, but I didn't have a lot of the other symptoms association with BPD.
Posted by Mariposa on December 14, 2003, at 20:58:04
In reply to Anger and Medication, posted by Theta99 on December 14, 2003, at 20:26:54
You sure it's not PMS or PMDD?
Posted by Theta99 on December 14, 2003, at 21:19:10
In reply to Re: Anger and Medication » Theta99, posted by Mariposa on December 14, 2003, at 20:58:04
> You sure it's not PMS or PMDD?
Pretty sure. I'm male.
Posted by PhoenixGirl on December 14, 2003, at 23:16:01
In reply to Re: Anger and Medication, posted by Theta99 on December 14, 2003, at 21:19:10
*LOL* Sometimes I think men are in a state of perpetual PMS.
Your anger problem may be the depression itself. For me, the more depressed I am, the more pissed off I am. Sometimes I just want to hit someone. Even though I know it's depression, I still feel it. I'll get furious if someone brushes against me slightly walking through a store. I totally understand what you're going through, my friend.
Posted by HappyGirl on December 14, 2003, at 23:24:19
In reply to Anger and Medication, posted by Theta99 on December 14, 2003, at 20:26:54
Hi:
Strange to say, but it often happens, ... in order to find the problem,...is whether the med. is working on you or not. Then, the following quote is very interesting, ....
>>>> After my last appointment we upped my dosage to 100mg to see if that helps with the feelings of extreme anger.<<<<<
If the increase of Zoloft would help your anger/extreme irritation, I feel that your problem is somewhere related to 'Depression.' However, this, the increase does not help you, then you might have some other mood-disorder, like Borderline your pdoc. mentioning. Practically, BPD and Bipolar is very similar. In my personal experience as Bipolar, there is anger/rage(extreme anger outbursts) that is called 'dysphoric mania. However, if you don't have manic episodes, probably the depression causing you to get so irritable.
It sounds to me like your pdoc. has yet no 'real' clue for your problem, 'extreme anger.' Sometimes, it needs the time to find an appropriate name for the problem. In the meantime, anti-dep. regimen only, Zoloft.
However, in case you have Borderline, then you might need to add a mood-stabilizer, such as Depakote, Lithium, Tegretol, Lamical and some more that alleviates symptoms.
In my case, Zyprexa is a miracle med. for my extreme anger/rage outburst. Since this med., my anger is NON-existent.
H.G.
Posted by Ron Hill on December 14, 2003, at 23:36:07
In reply to Anger and Medication, posted by Theta99 on December 14, 2003, at 20:26:54
Hi Theta,
> My question is has anyone else heard of treating what my Dr. has described as a Mood Disorder non-specific, with an SR1? He said it sounded like my angry outbursts were similar to a borderline, but I didn't have a lot of the other symptoms association with BPD.
Yes, the use of SSRI's for this symptom is common. Please click and read the following; it may be of interest to you:
http://www.dr-bob.org/babble/alter/20031104/msgs/281539.html
-- Ron
Posted by Theta99 on December 15, 2003, at 7:00:21
In reply to Re: Anger and Medication, posted by HappyGirl on December 14, 2003, at 23:24:19
Thanks for the information everyone. I couldn't really find anywhere else where Zoloft could help with the anger I sometimes feel. I'm not sure how my anger flashes are related to depression (I'm not sure that I feel depressed), but it's comforting to know that my doc just isn't throwing something up at the problem at random. He did mention that if the SR1 treatment didn't work, we would try other mood stablizers.
Thanks again
Posted by linkadge on December 15, 2003, at 7:12:30
In reply to Re: Anger and Medication » Theta99, posted by Ron Hill on December 14, 2003, at 23:36:07
Like was posted before, you may suffer from depression, or more likely dysthemia (chronic symptoms of low grade depression) Dysthemia, also does not always fully express all the symptoms of major depression, but it can be very dabilitating.
The reason the doctor prescribed Zoloft is clear. With or without an exact diagnosis, it has been well known for a while, that antidepressants show specific benefit to those with anger problems. Serotonin is an inhibitory neurotransmitter that will calm certain parts of the brain, and can facilitate more prudent, rational thinking. Increased serotonin levels can help one to plan ahead, to put their pleasure off for later. in terms of irritability, it helps you understand that everything doesn't need to go perfectly in the momement.
I had many problems with irriability that were helped by SSRI's
Linkadge
Posted by DanielJ on December 15, 2003, at 7:44:21
In reply to Anger and Medication, posted by Theta99 on December 14, 2003, at 20:26:54
A word about Zoloft. I have a relative with Schizophrenia. Unreasoning anger is often a symptom of that illness as it is with him. Very explosive and unfounded outbursts. He takes Zyprexa as an anti-psychotic and Zoloft as an anti anxiety drug. The Zoloft is very effective, but it can take a few weeks before the effects are that beneficial. Also, for many, 75 mg works best and 100 mg is too much. Your dosage may be low or has not taken full effect yet. Work with P Dr. to get dosage right if necessary, just 5mg either way and the change in effectivity can be quite significant. We on the forum have all been through difficult times. Things will get better I promise!
Posted by moose100 on December 15, 2003, at 10:26:58
In reply to Anger and Medication, posted by Theta99 on December 14, 2003, at 20:26:54
> Sorry if this topic has been dealt with in the past, but I couldn't find anything that was close to my situation using the search feature:
>
> I have explosive angry outbursts as a result of tiny irritants. Dropping a sock on the way from the dryer, my toddler touching something with sticky-gooey hands, coming home to a messy house etc.
>> I have been to see a psychiatrist, and he has started me on Zoloft. First he put me on 50mg daily. Sure I had some side effects, mostly tingly feelings sometimes and a week of bad headaches, but I stuck with it and it seemed to help. I have been reading some anger management texts, and the Zoloft seems to be letting me think before I react to the irritation before I explode. I still sometimes feel overly angry, but I haven't reacted. After my last appointment we upped my dosage to 100mg to see if that helps with the feelings of extreme anger.
>
> My question is has anyone else heard of treating what my Dr. has described as a Mood Disorder non-specific, with an SR1? He said it sounded like my angry outbursts were similar to a borderline, but I didn't have a lot of the other symptoms association with BPD.
Hi Theta; Anger(irritability) drove me to the Doctor. I was angry all the time and would fly off the handle constantly. I did not feel depressed either. The doctor prescribed effexor which has done the trick in my case. I have not snapped at anyone in weeks and I am actually glad to wake up in the morning. So in answer to your question, yes, Zoloft(in my case Effexor)does wonders for a mood disorder.
Posted by Interject79 on December 15, 2003, at 14:53:00
In reply to Re: Anger and Medication, posted by moose100 on December 15, 2003, at 10:26:58
As a clarification, though this is counterintuitive serotonin acts as a post-synaptic excitatory neurotransmitter (in that it excites neural activity). On mood, it tends to inhibit aggressive behaviors in depressed individuals.
SSRIs can be helpful for mood disorders in some cases, if the cause is mostly a lack of serotonin. Mania or hypomania, also associated with irritability, is often made worse by SSRIs. Stabilizers sometimes do the trick here, boosting GABA, a distinctly inhibitive neurotransmitter.
My mood is made worse by SSRIs except Lexapro at a low dose. But it's also made worse by mood stabilizers, implicating a problem with dopamine production/uptake. Neuroscience is notoriously full of surprises.
Best,
interject
Posted by Theta99 on December 15, 2003, at 19:22:44
In reply to Re: Anger and Medication, posted by Interject79 on December 15, 2003, at 14:53:00
Thanks everyone for your very helpful information. It is nice to know that the treatment my doctor has started me on can work for my problem. It is also great to get some insight into the relationship between my anger and the reason why I'm taking an "anti-depressant" for it.
Posted by katia on December 16, 2003, at 23:54:44
In reply to Re: Anger and Medication, posted by Theta99 on December 15, 2003, at 19:22:44
Ever consider a bipolar diagnosis? There is dysphoric mania - which is a rageful agitated one.
Posted by Theta99 on July 13, 2004, at 22:45:53
In reply to Anger and Medication, posted by Theta99 on December 14, 2003, at 20:26:54
Sorry this is long, first a refresher in my situation...
> I have explosive angry outbursts as a result of tiny irritants. Dropping a sock on the way from the dryer, my toddler touching something with sticky-gooey hands, coming home to a messy house etc.
>
> I have been to see a psychiatrist, and he has started me on Zoloft. First he put me on 50mg daily. Sure I had some side effects, mostly tingly feelings sometimes and a week of bad headaches, but I stuck with it and it seemed to help. I have been reading some anger management texts, and the Zoloft seems to be letting me think before I react to the irritation before I explode. I still sometimes feel overly angry, but I haven't reacted. After my last appointment we upped my dosage to 100mg to see if that helps with the feelings of extreme anger.
>After over 6 months on Zoloft 100mg/day it seems to have helped a bit. Most of the little irritants no longer result in me flying off the handle. Things like dropping a sock, or sticky hands, or a messy house don't even cause internalised anger. I attribute the improvement to Zoloft and psychotheraphy.
My three year old however is another story. He's not a bad three year old, he's just an active three year old. As a result my wife has noticed that especially at the end of long weekends, I am easily irritated by him. While I don't rage or get destructive anymore, I over employ disciplinary actions (time outs, yelling, etc).
It reached a boiling point over the last weekend, when the three of us were in a store, and my wife wasn't answering her cellphone (I needed the car keys from her), and my son would absolutely not walk with me, or hold my hand. or let me carry him without a major temper tantrum. I stood in the same spot in the store for several moments while my wife was unaware that I was trying to get her attention, and my son was twenty feet away looking for little plastic tags on the ground that they use on the hangers for sizes.
I had this immense feeling of being overwhelmed. So I opted to make daddy take a time out. I went outside the store before I lost my temper. I could see my son, and my wife from where I was outside, but my wife justifiably was upset with me.
I had a Pdoc appointment the next day, so I explain the situation to him, and he said that the meds might have tapered off, and suggested I either up to 150mg Zoloft per day, or start on Effexor XR. He even gave me instructions for upping my dose on Zoloft, and then coming off Zoloft gradually incase I wanted to switch to Effexor XR (my choice).
I've been on the 150mg Zoloft per day for a few days now. Not too many side effects that I had when I started 50mg and 100mg, just the skin tingly feelings occasionally.
My question to you all is what is your opinion? Try 150mg Zoloft or try Effexor XR. I am aware of the very difficult withdrawl symptoms associated with Effexor.
Thanks in advance.
Posted by Theta99 on July 13, 2004, at 22:51:02
In reply to Re: Anger and Medication, posted by Theta99 on July 13, 2004, at 22:45:53
Forgot to mention, before I went on Zoloft I had lost 50lbs about a year before. After being on Zoloft I've gained back 35 of them, and its just on the way up.
This of course doesn't help my self-image any.
Posted by jay on July 14, 2004, at 20:16:01
In reply to Up dosage or switch meds?, posted by Theta99 on July 14, 2004, at 18:56:19
Well...I'd say try to find, or add, something to tone down the anger. *Sometimes*, a relaxing med like a benzo or a beta-blocker do it, and many are also turning to atypical antipsychotics for this. The good thing is there is little risk, and you only need a small dose. They would work well with either Effexor or Zoloft. (I've been on both drugs...so I know them pretty well.)
The antidepressants haven't really been shown to have much effect on anger, and could possibly lead to a manic angry state. That's why I'd highly suggest trying out one of the above meds.
Let us know if you need more info.Best,
Jay
Posted by Sebastian on July 15, 2004, at 10:30:38
In reply to Re: Anger and Medication, posted by Theta99 on July 13, 2004, at 22:45:53
I would first try the higher zoloft and hope it works. If it realy does not work a month or two down the road, then try something else.
I just tried switching to another AD, in the hopes it would be better than the other. It was a big waste of time.
Posted by AndyDrew on July 15, 2004, at 21:20:30
In reply to Re: Anger and Medication » Theta99, posted by Sebastian on July 15, 2004, at 10:30:38
I would be lery of Effexor because I had serious rage withdrawal issues on it, and I know many others who did. I never had big side effects with Zoloft, but the Effexor was bad news (for me and my family). On Zoloft I never noticed any reduced anger, more like a placebo effect, but I did have the manic states, swinging right through extreme happy highs to anger at my lows (anger rather than depression). Took 3 years and a lot of therapy, but I'm a little better at controlling my anger. Tried Prozac for awhile too with no luck. Antidepressants just never really helped with anger for me.
Posted by karen m. on July 17, 2004, at 1:05:12
In reply to Re: Anger and Medication, posted by HappyGirl on December 14, 2003, at 23:24:19
i can so totally relate to this anger issue. it scares me frankly. we have a puppy that i love so much, but sometimes when it comes up and chomps down on my arm or jumps up and down on my back when i'm sitting on the floor and he scratches his nails into my back....eeekkkk! i would never do anything but i do feel pushed to the edge sometimes. i think mine may actually be more irritability that gets mushed into anger. lamictal is what i am taking and i am starting to wonder how much longer i should stay on it with these types of feelings it induces. granted it isn't 24-7 or anything but i don't like feeling i could snap. at least on the ssri's i didn't have this feeling of snapping. i had a lot of other things on ssri's like sleeping alot, muscle tension, sleeping so deeply i didn't get up to go to the bathroom at night (trust me, this is not a good thing!)
Posted by Sebastian on July 17, 2004, at 18:11:29
In reply to Re: Anger and Medication, posted by karen m. on July 17, 2004, at 1:05:12
A lot of my anger resurfaced when I was increasing meds, in particular the celexa from 60 mg to 80 mg. It lead me to belive the anger was from the increase and I decreased the dose. I still have some anger. I've had anger bouts that just come on out of nowhere, over the last 6 years. Always I want to: beat someone up, but get talked out of it, as badly as I want to. So the anger just comes out wherever, like talking to someone, me being a prick. Then a week later I could be the happiest person. Guess it realy depends on how I feel.
Posted by AndyDrew on July 18, 2004, at 9:30:17
In reply to Re: Anger and Medication, posted by Sebastian on July 17, 2004, at 18:11:29
My anger would sort of bubble up suddenly and just as quick as it happened it would be gone. Unpredictable moods, I'd be mad and yelling one minute and then laughing at something the next. Sometimes I wouldn't even notice when I was storming around seriously pissed off because of something trivial, like my wife not cleaning the lint trap on the dryer. It was hard because being irritated felt normal to me if you can imagine and it really seemed like people around me were deliberately trying to upset me, or sort of a "why me" feeling. I still feel that way a lot, but learned to let some things go, and I know it's not about what's going on around me, but my reaction that's a problem. Of course it took years to learn that, and that irritates me too.
Posted by Theta99 on July 18, 2004, at 22:01:45
In reply to Re: Anger and Medication, posted by AndyDrew on July 18, 2004, at 9:30:17
> My anger would sort of bubble up suddenly and just as quick as it happened it would be gone. Unpredictable moods, I'd be mad and yelling one minute and then laughing at something the next. Sometimes I wouldn't even notice when I was storming around seriously pissed off because of something trivial, like my wife not cleaning the lint trap on the dryer.
This sounds a lot like me. My wife comments on how I can be angry and storm around, but then just a few minutes later it's as if it never happened.Weird Weird Weird
This is the end of the thread.
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