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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 11 to 35 of 35. Go back in thread:
Posted by Izzy50 on August 19, 2006, at 23:52:17
In reply to Re: New person » Izzy50, posted by Phillipa on August 19, 2006, at 23:21:03
> Mitral Valve Prolapse can cause anxiety. Love Phillipa. ps I think you really need to discuss it with your cardiologist.
Yes, hat's true. I checked it out.
I have a barely negligible MVP. I have had a Thallium stress test, echocardiogram and 48 hour holter monitor with in this last year. Normal results.The first cardiologist I saw 10 ten years ago said the electrical impulses that cause heart rhythem sometimes go crazy and no one knows why. He did not want to put me on beta blockers because they cause quality of life issues and my palps were not as bad back then.
Currently, both my primary and my pdoc suggested prop. I hate it, works minimally and the side effects are awful.
Posted by Izzy50 on August 19, 2006, at 23:58:38
In reply to Re: New person, posted by Jost on August 19, 2006, at 18:16:30
> Why BP2? having a family member might predispose you, but do you have any manic symptoms, ie highs?
>
>
> I have trouble sleeping, often ambien, or ambien and xanax, doesn't work. But I;m not bipolar. Just very prone to anxiety.
>
> Has you pdoc suggested another AD?
>
> JostSee, this is a perfect example of my problem. It is 12AM and I am doing wash, cleaning the floors, and typing on the computer. During the day I literally drag my *ss around, extremely fatigued.Can't sleep either. Now, I can think of a million things to do.Not good for my job
OR I may be exhusted, go to bed at 10PM sleep like a rock for 8 hours and wake up exhausted. Feel sleep deprived all day.
What the hell is that? Clearly I am not going into rem sleep. Is it the Ambien? the heart palps? my crazy mind?
Who knows...
Posted by linkadge on August 20, 2006, at 0:25:51
In reply to Re: New person, posted by Izzy50 on August 19, 2006, at 23:00:54
Tachycardia and elevated blood pressure are documented side effects of effexor. The medication increases the levels of norepinephrine which can result in these side effects.
Linkadge
Posted by linkadge on August 20, 2006, at 0:27:47
In reply to Re: New person, posted by Izzy50 on August 19, 2006, at 23:58:38
Seems as though your sleep wake cycle has been thrown completely out of whack.
Work to reduce the effexor, you might find that an atypical antipsychotic could help with that for the time being.
Linakdge
Posted by Racer on August 20, 2006, at 0:45:08
In reply to Re: New person, posted by Izzy50 on August 19, 2006, at 18:25:50
There's a newish idea out there that most people who have depression AND anxiety are actually bipolar. I don't agree, because I think it's very possible to have both anxiety and depression -- they've been known to buddy up, you know?
As for what you're describing, I'd say it's mostly medication related -- the fuggy feeling during the day? I got that from Effexor, it's why I rarely take Ambien anymore, and propranalol knocked me out -- I could barely get enough adrenaline going to sit up on the sofa, let alone move off of it. Insomnia? Effexor is known for that, too. Effexor is also known for blood pressure and other cardiac effects. And it did help me get in touch with my inner witch...
I think I'd advise talking to your doctor about swapping the Effexor for something more friendly, maybe even trying Cymbalta, which has a similar mechanism of action. Or one of the other SSRIs, which might work better for you than the ones you've tried.
Here's the thing: the SSRIs do often stop working. They'll work for a few years, and then stop working -- at which point another SSRI often will work, and you can rotate through the two or three or four meds that work. By this time, Prozac might work for you again, for that matter.
Of course, Lamictal has shown good results for a lot of people. It knocked me out, but that's me and I'm weird. (Hey, this aluminium hat really does protect me from space aliens and reality shows...) It's well worth giving it a solid try. I noticed an effect at 150 mg, and again at 200mg.
Good luck, and I hope this helped.
Posted by Izzy50 on August 20, 2006, at 0:45:15
In reply to Re: New person, posted by linkadge on August 20, 2006, at 0:25:51
> Tachycardia and elevated blood pressure are documented side effects of effexor. The medication increases the levels of norepinephrine which can result in these side effects.
>
> LinkadgeI was thinking about that myself-I don't have elevated blood pressure. But I don't doubt the EffexorSR is related.
I read about Effexor and did not see anything about tachycardia. Another good reason to get off it. What great hope I have that I won't need a beta blocker the rest of my life.
Posted by Izzy50 on August 20, 2006, at 0:48:46
In reply to Re: New person, posted by linkadge on August 20, 2006, at 0:25:51
> Tachycardia and elevated blood pressure are documented side effects of effexor. The medication increases the levels of norepinephrine which can result in these side effects.
>
> LinkadgeIt's funny you should say that. Last time I was at my shrink, I told him I felt as though I was "hemmerogaing adrenaline." That is exactly what it feels like.
Posted by Izzy50 on August 20, 2006, at 0:53:17
In reply to Re: New person » Izzy50, posted by Racer on August 20, 2006, at 0:45:08
> There's a newish idea out there that most people who have depression AND anxiety are actually bipolar. I don't agree, because I think it's very possible to have both anxiety and depression -- they've been known to buddy up, you know?
>
> As for what you're describing, I'd say it's mostly medication related -- the fuggy feeling during the day? I got that from Effexor, it's why I rarely take Ambien anymore, and propranalol knocked me out -- I could barely get enough adrenaline going to sit up on the sofa, let alone move off of it. Insomnia? Effexor is known for that, too. Effexor is also known for blood pressure and other cardiac effects. And it did help me get in touch with my inner witch...
>
> I think I'd advise talking to your doctor about swapping the Effexor for something more friendly, maybe even trying Cymbalta, which has a similar mechanism of action. Or one of the other SSRIs, which might work better for you than the ones you've tried.
>
> Here's the thing: the SSRIs do often stop working. They'll work for a few years, and then stop working -- at which point another SSRI often will work, and you can rotate through the two or three or four meds that work. By this time, Prozac might work for you again, for that matter.
>
> Of course, Lamictal has shown good results for a lot of people. It knocked me out, but that's me and I'm weird. (Hey, this aluminium hat really does protect me from space aliens and reality shows...) It's well worth giving it a solid try. I noticed an effect at 150 mg, and again at 200mg.
>
> Good luck, and I hope this helped.I have an apt at the end of the month-follow up on the lamictal. I will definitely insist on trying to get off Effexor. It's a real bitch to do. If I miss more than one dose I feel like I've been hit with Electric Malaria.
Posted by linkadge on August 20, 2006, at 2:01:30
In reply to Re: New person » Izzy50, posted by Racer on August 20, 2006, at 0:45:08
I don't agree with that theory too. They base the theories on how people respond to meds. So, if the antidepressants make people anxious, then they change the categories around not the meds.
Depression and anxiety have always occured together. Even our earlies accounts of what we consider depression have often been comorbid with anxiety.
That asside, you can give meds from other classes a try, and if they work, then who cares about the exact diagnosis.
Linkadge
Posted by Izzy50 on August 20, 2006, at 6:50:49
In reply to Re: New person » Racer, posted by linkadge on August 20, 2006, at 2:01:30
> I don't agree with that theory too. They base the theories on how people respond to meds. So, if the antidepressants make people anxious, then they change the categories around not the meds.
>
> Depression and anxiety have always occured together. Even our earlies accounts of what we consider depression have often been comorbid with anxiety.
>
> That asside, you can give meds from other classes a try, and if they work, then who cares about the exact diagnosis.
>
> Linkadge
>Exactly.
Posted by Racer on August 20, 2006, at 15:01:59
In reply to Re: New person, posted by Izzy50 on August 20, 2006, at 0:53:17
> >
> I will definitely insist on trying to get off Effexor. It's a real bitch to do. If I miss more than one dose I feel like I've been hit with Electric Malaria.Been there, done that, burned the t-shirt...
We have a whole withdrawal board here, with a lot of information about what's helped other people get off these drugs with a minimum amount of discomfort. One thing to remember is that tapering down isn't like missing a dose, so it's not *as* horrible. (I remember being sick in the bathtub when I ran out for a couple of days, once -- I was so weak and miserable that I only made it as far as the tub before I gave up. Tapering down wasn't anything like as awful.)
And if your doctor is helping you, a dose or two of Prozac at the end will help a lot with the last little bit, once you get there. Prozac has such a long half life, it's kinda like taking a self-tapering medication.
Take care, and good luck.
Posted by linkadge on August 20, 2006, at 15:08:02
In reply to Re: New person, posted by Izzy50 on August 20, 2006, at 0:53:17
Take your time, and go slowly. This medication can cause complete and utter adrenal exhaustion (It did in me at least).
As you come off, you may want to supplement with things like vitamin C.
Linkadge
Posted by SLS on August 20, 2006, at 15:23:47
In reply to Re: New person, posted by linkadge on August 20, 2006, at 15:08:02
> Take your time, and go slowly. This medication can cause complete and utter adrenal exhaustion (It did in me at least).
Was the adrenal exhaustion something that occurred while taking the drug or a result of the drug withdrawal?
- Scott
Posted by linkadge on August 20, 2006, at 16:36:33
In reply to Re: New person, posted by SLS on August 20, 2006, at 15:23:47
I found that effexor made me always on edge. It seemed to accentuate the adrenaline rushes I would get from stressfull situations.
Over time, I felt increasingly exhausted, and my tollerance for stress decreased significantly.
While adrenal exhaustion is not exactly something there are specific tests for, its just what I have come to believe was happening. The same thing happened to me after methylphenidate use.
Effexor, and the TCA's, were really the ones that seemed to accentuate the adrenaline.
Linkadge
Posted by llrrrpp on August 20, 2006, at 17:36:33
In reply to Re: New person, posted by linkadge on August 20, 2006, at 16:36:33
Hi Izzy, I've been reading this post with some interest. I'm not on Effexor, but I'm on a somewhat high dose of cymbalta (90mg), which is also an SNRI. A few times a week I get a lot of heart thumping palpitations (pulse rate around 90-100, my normal pulse rate is about 70). I got palpitations a LOT when I first started cymbalta at 30 mg, and they have gradually decreased, except for the few days after I increase my dose.I take cymbalta in pm. I also have been taking seroquel 25 mg in the pm, because the cymbalta makes me ever so slightly hyperactive. When do you take Effexor? Have you tried taking it at different times during the day?
Perhaps as you taper the Effexor, you will find that you can get a good response with a lower dose.
In the meanwhile, it sounds like you could really do with something to help you get a good night's sleep. I HIGHLY recommend seroquel. Although it's approved for use as a mood-stabilizer/ antipsychotic, it also augments the AD response from the SNRI (according to my pdoc). You will know the very first night if it's strong enough to calm your busy mind!
best of luck to you & welcome,
-ll
Posted by Phillipa on August 20, 2006, at 18:54:05
In reply to Re: New person » Racer, posted by linkadge on August 20, 2006, at 2:01:30
Link seriously I really didn't know that. So are you saying everyone with anxiety or depression are one in the same. And I agree about the bipolar thing with meds. And I apologize for not changing the subject when I welcomed our new poster. Love Phillipa
Posted by linkadge on August 20, 2006, at 19:27:47
In reply to Re: New person » linkadge, posted by Phillipa on August 20, 2006, at 18:54:05
Depression and anxiety have always gone together. Its the same sort of thing when you analyze animal models of these disorders it seems the animal exhibit symptoms resembling human depression and anxiety.
The big problem is that people don't react to the treatments the way that doctors assume they should. Some doctors are honest and admit that certain antidepressants can increase anxiety. Amphetamines and cocaine are notorious for causing anxiety, an effect probably mediated through noradrenergic systems. Cocaine and amphetamine block the uptake of norepenephrine, like effexor and the TCA's. Most research says that those with anxiety have hyperactive noradrenergic systems, and elevated plasma adrenaline etc.
It doesn't make a lot of sence. Beta blockers, which block adrenaline are used for anxiety and panic, and yet so are NRI's, drugs which increase norepenephrine. So, either norepinephrine causes anxiety or extinuishes it.
Its kindof like how you've got SSRI's and Tianeptine, drugs with opposite mechanisms, approved for the same purpose.
The best rule is "trust yourself" and "know yourself". I've been labled with every disorder out there.
Linkadge
Posted by Izzy50 on August 20, 2006, at 20:30:20
In reply to Re: New person, posted by SLS on August 20, 2006, at 15:23:47
I have had adrenal exhaustion as a result of being undertreated for hashimoto's with $ynthroid for 10 years.
I was near death when I found Armour and Deltacortril.
Currently I take 4.5 grains of Armour every day as well as 5 mg of Deltacortril.Nothing has healed me more than these two hormones.
Posted by Izzy50 on August 20, 2006, at 20:49:46
In reply to Re: New person, posted by linkadge on August 20, 2006, at 16:36:33
I am thinking of asking for Provigil until we get the whole thing straightened out. I may loose a few pounds as a bonus.
Posted by Jost on August 20, 2006, at 21:28:13
In reply to Re: New person, posted by Izzy50 on August 19, 2006, at 23:58:38
Maybe someone else suggested this, but do you possible have Delayed Sleep Phase Syndrome?
This is essentially a well known disorder (or condition, or way of life, depending on your sleep-politics) in which people have their greatest energy at night and can't sleep until say 2-5,6 am --or even later. then they're exhausted all day.
I have a strong tendency toward this myself. It's a circadian rhythm problem, which can be easier or harder to correct, from person to person.
Again, you're not me-- but I definitely have great energy from about 10pm to 6 am and am low energy all day. I absolutely could be up all night and do better work than if I have to get up by say the awful hour of 11 am. I try to get to sleep early (2 am is v. good, 1 am is great for me)-- but I don't have a 9-5 job, for obvious reaons. Even if I get to sleep early, I feel awful during the day. My body just doens't get going, even with enough sleep.
People with DSPS often have trouble keeping regular day jobs.
Also, it's quite common for depressed people to have much better energy late at night.
Jost
Posted by Izzy50 on August 20, 2006, at 21:30:59
In reply to Re: New person, posted by llrrrpp on August 20, 2006, at 17:36:33
>
> Hi Izzy, I've been reading this post with some interest. I'm not on Effexor, but I'm on a somewhat high dose of cymbalta (90mg), which is also an SNRI. A few times a week I get a lot of heart thumping palpitations (pulse rate around 90-100, my normal pulse rate is about 70). I got palpitations a LOT when I first started cymbalta at 30 mg, and they have gradually decreased, except for the few days after I increase my dose.
>
> I take cymbalta in pm. I also have been taking seroquel 25 mg in the pm, because the cymbalta makes me ever so slightly hyperactive. When do you take Effexor? Have you tried taking it at different times during the day?
>
> Perhaps as you taper the Effexor, you will find that you can get a good response with a lower dose.
>
> In the meanwhile, it sounds like you could really do with something to help you get a good night's sleep. I HIGHLY recommend seroquel. Although it's approved for use as a mood-stabilizer/ antipsychotic, it also augments the AD response from the SNRI (according to my pdoc). You will know the very first night if it's strong enough to calm your busy mind!
>
> best of luck to you & welcome,
> -llI am definitely going to ask him about a few diffierent things. Mainly getting off the Effexor. I can start to feel mydepression lifting from the Lamictal but the agitation and anxiety are still prresent.
Posted by Izzy50 on August 20, 2006, at 21:37:11
In reply to Re: New person » Izzy50, posted by Jost on August 20, 2006, at 21:28:13
> Maybe someone else suggested this, but do you possible have Delayed Sleep Phase Syndrome?
>
> This is essentially a well known disorder (or condition, or way of life, depending on your sleep-politics) in which people have their greatest energy at night and can't sleep until say 2-5,6 am --or even later. then they're exhausted all day.
>
> I have a strong tendency toward this myself. It's a circadian rhythm problem, which can be easier or harder to correct, from person to person.
>
> Again, you're not me-- but I definitely have great energy from about 10pm to 6 am and am low energy all day. I absolutely could be up all night and do better work than if I have to get up by say the awful hour of 11 am. I try to get to sleep early (2 am is v. good, 1 am is great for me)-- but I don't have a 9-5 job, for obvious reaons. Even if I get to sleep early, I feel awful during the day. My body just doens't get going, even with enough sleep.
>
> People with DSPS often have trouble keeping regular day jobs.
>
> Also, it's quite common for depressed people to have much better energy late at night.
>
> JostThis is not normal behavior for me.
Last year I was up at the gym at 5:30 in the morning and then came home, showered and went to work all day.
The agitation, profound insomnia and anxiety are new. Depression is lifting, thank God. Maybe the Lamictal is kicking in after three weeks.
Time will tell.
Posted by SLS on August 21, 2006, at 9:23:42
In reply to Re: New person, posted by linkadge on August 20, 2006, at 16:36:33
I don't know whether I experienced adrenal exhaustion from excessive cortisol production, but after 6 days or so of mifepristone 600mg, I felt very washed-out with a flat affect. Different kind of adrenal output, I know. Perhaps there was too much CRH floating around in the brain. I know it has effects other than just stimulating the secretion of ACTH. It might be depressogenic. I did feel somewhat more energized at day 3 of treatment, so something must have changed.
- Scott
Posted by Izzy50 on August 21, 2006, at 18:55:04
In reply to Re: New person, posted by Izzy50 on August 19, 2006, at 18:25:50
I have been feeling a little bit better these past two days. Mood is better, energy a little better. I got some sleep last night.Day 17 on Lamictal.
Heart pounding is still bad.
Posted by linkadge on August 22, 2006, at 15:43:49
In reply to Re: New person » linkadge, posted by SLS on August 21, 2006, at 9:23:42
Yeah, Its a complex system, I'd like to learn more.
Linkadge
This is the end of the thread.
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