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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by studentx on January 9, 2005, at 1:44:32
Hi. I'm a 20 year-old male college student who has been through quite a few ADs over the past year. I was on Zoloft for 4 months and withdrawn because my doctor said I had lost weight (I was skinny to start with). Up next was Remeron, which lasted 2 days (I have had problems with hypersomnia and it completely knocked me out). I then took Wellbutrin XL, both 150mg and 300mg, for a month at which point Lexapro was added to the mix. I quit Wellbutrin about 7 months ago, and was on Lexapro until about 2 months ago. I have been taking Provigil for about 4 months.
I have had some pretty deep bouts of depression over the past year (especially while on Wellbutrin) in addition to the crippling hypersomnia, fatigue, and complete lack of motivation. I am a very knowledge-hungry person, but I've been so lethargic and unmotivated my grades and friendships have slipped. I guit Lexapro because I assumed it was at least contributing to my fatigue (plus it completely smashed any sexual desire or drive, which made my wonderful relationship seem iffy). I tapered off of it, but the fatigue-related stuff didnt go with it. Provigil has helped to an extent, but my drive and motivation is nil. I'm home for winter break now and feeling some major blues. Where should I go from here? What would be a good treatment for a student with fatigue, attention, motivation, and depression-based needs?
Thanks in advance.
Posted by Dan Perkins on January 9, 2005, at 2:15:56
In reply to After Lexapro: What Next?, posted by studentx on January 9, 2005, at 1:44:32
My opinion, just a few years out of College, is to cut to the chase and try an MAOI. I always thought of MAOIs (Parnate & Nardil) as taboo, outdated meds until about a year ago when I found a pdoc who had great success with them on a number of patients
I'm just bringing this topic up briefly with you because it is my guess that while you may have heard of MAOIs, that you never paid them much attention, haven't done any research on them and have never considered taking one of them. My advice to you would be to look into MAOIs (this message board is a fairly good place to start).
In my experience (and I just posted something to this effect earlier today) MAOIs seem to be the only medications that nobody regrets trying (this is most definitely not the case for Lexapro, Wellbutrin and the other meds that you have mentioned).
Posted by studentx on January 9, 2005, at 2:33:20
In reply to Re: After Lexapro: What Next?, posted by Dan Perkins on January 9, 2005, at 2:15:56
Thanks so much for responding. I havent done enough research on ADs in general, let alone MAOIs. The little I know is that there is a "cheese effect", which may or may not conflict with my vegetarianism. I really know nothing about it. I will do some board-scanning on the meds you suggested. Thanks!
Posted by Emily Elizabeth on January 9, 2005, at 19:10:55
In reply to Re: After Lexapro: What Next?, posted by Dan Perkins on January 9, 2005, at 2:15:56
You also might consider using a tricyclic antidepressant (TCA) either in addition to an SSRI like Lexapro or alone. This is what people used before the newer SSRI's (Prozac, Paxil, Lexapro, etc.) came out. The don't have dietary restrictions like MAOI's, but do have more side effects than the SSRI's.
Hope that helps!
EE
Posted by Bill LL on January 10, 2005, at 9:13:12
In reply to After Lexapro: What Next?, posted by studentx on January 9, 2005, at 1:44:32
Did the Zoloft work for you other than the weight loss problem? If it did, I would recommend going back on it.
But first, I would ask your doc about adding either Ritalin or Adderal to your Provigil. As a student, you at least need to be alert and able to concentrate. In general, neither drug as sexual side effects.
Posted by studentx on January 11, 2005, at 4:29:31
In reply to Re: After Lexapro: What Next?, posted by Bill LL on January 10, 2005, at 9:13:12
> Did the Zoloft work for you other than the weight loss problem? If it did, I would recommend going back on it.
>
> But first, I would ask your doc about adding either Ritalin or Adderal to your Provigil. As a student, you at least need to be alert and able to concentrate. In general, neither drug as sexual side effects.
>
>
First, I would like to thank Emily Elizabeth and Dan Perkins for their responses--I never even considered MAOIs and now I will definately take that option to my pdoc for her opinion.The Zoloft worked fairly well for me. I noticed a bit of sexual problems on it, but not as significant as on Lexapro. I'm not entirely sure this was connected to the Zoloft, but while taking it my fatigue-related stuff really took off. I felt kinda zonked out on it, as well. Again, these problems were less significant than on Lexapro. Returning to the Zoloft with Provigil in hand may take care of those concerns. I will certainly discuss that alternative with my doctor.
I do attend a very academically-demanding school that tends to attract more creative-depressed types, so I have come into contact with many people taking Ritalin and Adderall. Some people seem helped by these drugs, but many more have turned to abuse. I have never abused my prescription medications and do not have an abuse-prone personality, but I'm worried if prescribed a stimulant I will succumb to the collegiate snorting habit the next time a big paper or test approaches. How addictive are these meds? Which one is most effective while being less-addictive as possible? I will certainly ask my doctor in a few weeks when I return to school, but for the time being I am very happy to get good, constructive input.
Thanks so much.
Posted by appadoo on January 12, 2005, at 20:54:16
In reply to Re: After Lexapro: What Next?, posted by studentx on January 11, 2005, at 4:29:31
It becomes addictive when you begin to use the drugs in a way they are not supposed to use.
If the amphatamine is not working regularly see your pdoc and get approval to up the dosage.
I am on concerta and its long acting but for the first few hours it doesn't seem to work as we.
I told my pdoc whether I can combine it with 20mg dexemphatamine.It has been a godsend now I can concentrate and work better and the like.
But if I was to experiment with the drug to give me a high or whatever then your pdoc will realise it report you then you never get the correct medication you need to help you suceed.Think about consequences rather than having fun for a few minutes that can destroy your prospects.So the potential addiction is no problem if you put it in prospective.
If you don't abuse drugs now its very unlikely you will start now.
For me Zoloft with dex was a good combination and my weight stayed steady.If anything Zoloft increase my appetite and motivation.Whereas when Lexapro came out it was considered the wonder drug,full of hype but never really lived up to it to me any way
This is the end of the thread.
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