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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Marty on July 23, 2008, at 13:02:40
Does anyone feel more depressed (and irritable) in the morning because of their meds ?I didn't have this problem before starting Tianeptine. But I switched Clonazepam to Xanax in the same period of time.. and Xanax half-life is very short (4 hours) compare to Clona: If I take 0.25mg Xanax before bed, could I wake up dysthimic (depressed and irritable) because of some withdrawal effect ?
Also I take 100mg Wellbutrin SR before bed as with time I realized it was better for me even if it reduce my quality of sleep. Maybe a long half-life benzo before bed was allowing me to feel OK with taking Wellbutrin at bedtime but Xanax may be too short during and so I have at least 4 hours of "Wellbutrin MINUS Benzo effect PLUS Benzo withdrawal" ?
What could be the role of Tianeptine into this ?
Any theory could help me find something to try... this is becoming very difficult to live with.
Thank you,
/\/\arty
Posted by Marty on July 23, 2008, at 22:16:26
In reply to depressed/irritable in the morning: any ideas plz?, posted by Marty on July 23, 2008, at 13:02:40
So nobody has ANY thoughts on my case ?
This is pretty depressive./\/\arty
Posted by chiron on July 23, 2008, at 22:43:03
In reply to depressed/irritable in the morning: any ideas plz?, posted by Marty on July 23, 2008, at 13:02:40
Sorry, don't know. I've never been on Tianeptine, but I have had depression that was worse in the mornings months ago. I was on the same meds I am on now, but I have increased doses...? Lately I haven't had the horrid morning depression, and I still take Xanax XR in the am. So for me, the Xanax withdrawal doesn't seem to be an issue.
I have been more irritable in the mornings this last week, which usually goes along with tightness in my head & shoulders. I'm trying to figure it out. Hormones? Caffeine? The Deplin I just tried? This game sucks.
Posted by Jay_Bravest_Face on July 23, 2008, at 22:50:17
In reply to depressed/irritable in the morning: any ideas plz?, posted by Marty on July 23, 2008, at 13:02:40
Hi Marty..
Well, I certainly can relate! Even with 7-8 hours of sleep, if I have to get up anytime before 8 am, I am just a wreck! Even then, mornings are not my thing. Meds may have helped a tiny bit. You questioned about Xanax and, personally, I think it is an excellent med that is prescribed in way too low doses. 1-2mgs 4x a day seems more what I would like to see be taken. I have been on 2 mg of clonazepam 4x a day for the past 12 years, and I lower my dose when I dont need it, and up when I do need it. I could easily go cold turkey with it, and actually have gone many weeks and even months without it.
I honestly think your Tianeptine may cause some morning problems. Since it dis-inhibits serotonin re-uptake, and serotonin being a part of melatonin, you may not be getting the melatonin you need to feel refreshed. Melatonin by itself is a relaxing chemical. Serotonin may have been overrated in the past few decades, but it is still an important neurochemical. Have you considered a trial of say nefazadone (aka generic Serzone..only available in the U.S. generically)? It does a great job at blocking those 5htp2a and sub receptors that cause many problems with SSRIs (I.E. sexual dysfunction, sleep, loss of affect.) I am a social worker in a program for autistic kids, and we are finding some amazing results with this med.
Also, Wellbutrin can easily cause irritability, especially if you are trying to disinhibit serotonin reuptake.
What other recent meds have you tried?
Thanks,
Jay
Posted by Marty on July 23, 2008, at 22:52:48
In reply to Re: depressed/irritable in the morning: any ideas plz?, posted by chiron on July 23, 2008, at 22:43:03
> I was on the same meds I am on now, but I have increased doses...?
---
What are you taking aside Xanax XR ? What was the dosing before and after ?The game sucks indeed. We should have done pretty sick things in our previous life to have this happening to us... (sarcasm) -_-
Hell is not a place, it's a state of mind.
/\/\arty
Posted by Phillipa on July 23, 2008, at 23:21:33
In reply to Re: depressed/irritable in the morning: any ideas plz? » chiron, posted by Marty on July 23, 2008, at 22:52:48
Marty Karma???? Just Kidding I always feel worse in the morning and that is late morning so stay up till 2am posting ebay. Doesn't help but feel best them. Write Sometime. Love Phillipa ps I hope you figure out the problem as I've never taken it either. But I couldn't ignore you.
Posted by Marty on July 23, 2008, at 23:46:58
In reply to Re: depressed/irritable in the morning: any ideas plz? » Marty, posted by Jay_Bravest_Face on July 23, 2008, at 22:50:17
> Hi Marty..
Hi Jay> I think it is an excellent med that is prescribed in way too low doses. 1-2mgs 4x a day seems more what I would like to see be taken. I have been on 2 mg of clonazepam 4x a day for the past 12 years, and I lower my dose when I dont need it, and up when I do need it. I could easily go cold turkey with it, and actually have gone many weeks and even months without it.
---
I agree Xanax is a good drug. I'm currently only taking 0.25mg BID but for me it's already alot as I'm pretty sensitive on benzos. Clonazepam was good for my social anxiety but even at dose as low as .25mg at bedtime it makes me feel depressed in the long run. Withdrawing from 4 years of Clonazepam 0.5mg/day was a nightmare for me and I cant imagine what it would have been if it would have been 2.0mg TID .. just to give you an idea I have weird sensation (sometimes pain) in my face and scalp since I had this withdrawal 2.5 years ago. ... I wish we had Xanax XR in Canada as it would be much better. BTW is the dosage you're talking about for the XR formulation ? I would expect the dosage of the XR formulation to be significantly higher than the old formula.
> I honestly think your Tianeptine may cause some morning problems. Since it dis-inhibits serotonin re-uptake, and serotonin being a part of melatonin, you may not be getting the melatonin you need to feel refreshed.
---
Interesting.. I'll do a research to do if there's any research/link between Tia and Mel. If have some Melatonin but it made me depressed when I gave it a short trial a couple years ago. Maybe it could help but I'll put some more thoughts into it before taking a chance of becoming even more depressed.
> Have you considered a trial of say nefazadone (aka generic Serzone..only available in the U.S. generically)? It does a great job at blocking those 5htp2a and sub receptors that cause many problems with SSRIs (I.E. sexual dysfunction, sleep, loss of affect.)
---
Unfortunately it's not available anymore in Canada since the Serzone removal from the market a couple years ago. That said I'm sure I can find some and I expect it to be cheaper than Tianeptine. If it doesn't cause sexual dysfunction and loss of affect and not too much cognitive impairement it could be a great med for me as I'm a relatively good responder of serotonergic drugs.. it's just that I CAN'T live with their side effects. I forgot about that med.. thanks for remembering me. I'll think about it.> I am a social worker in a program for autistic kids, and we are finding some amazing results with this med.
---
Really ? I wonder what effects it has on autistic kids. Are they more pro-social ?
> Also, Wellbutrin can easily cause irritability, especially if you are trying to disinhibit serotonin reuptake.
---
Yes no doubt. And I know I'm quite sensitive to this side effect since I tried Parnate a couple years ago... I was raging inside for nothing. It was very difficult for my girlfriend and it almost destroyed our couple in a couple days.Here's an excerpt of those days:
GirlF.- "Hi sugar! How was your day today ?"
Marty.- "F**k You" -_-Here's another:
GirlF.- "Please, Could you pass me the butter ?"
Marty.- "F**k You" -_-.. okay enough :P seriously it was awful but I don't think wellbutrin ALONE depress/irate me in the morning since I took it alone many times. So I think you may be right: It could be Tia+Wel that do this in a synergic way. It would mean a low dose Serzone at bedtime could help a lot with that .... Wel/Serzone/Tianeptine could be it for me since those are the 3 ADs with the LESS side effects of all.
Thanks for your ideas Jay. I usually has a lot of idea and theory but right now I had, for the first time, none.
> What other recent meds have you tried?
---
Alot. Didn't touch the typical TCAs which I suspect would be very bad for me because of the side effects.A quick sketchy resume would be...
- Every SSRI except for Prozac. Paxil = 4 years
- SNRI Effexor XR (Not interested in Duloxetine)
- Wellbutrin, Tianeptine, Mirtazepine
- MAOI's: Nardil, Parnate, Moclobemide
- Clonazepam, Alprazolam(Xanax), Ativan, Bropazepam and 2 other benzo I can't remember.
- Lamictal, Lyrica, Neurontin, Topomax, Epival and other memory killer that I can't remember of. :S
- Lithium
- Buspar
- Tryptophan, 5-HTP, St-John Worts, Rhodiola, Gaba, bonded Gaba, Theanine, Gotu Cola and many more natural supplements the best being oddly : Chromium and Evening Prim Rose which I continue to take.
- Orap, Risperdal, Seroquel and Zyprexa
- Many ADs Sexual side effect antidotes such as Amantadine, Testosterone, Cyphroheptadine, Yohimbine, supplements and etc.
-Recent quick experimentation: Phenytoin, Vinpocetine, Picamilon, Nootropil... Gerovital is in my desk, but I don't want to touch it since I fear it may make me feel like Moclobemide (BAD).I'm sure I'm forgetting about ~15-20%..
> Thanks,
> Jay
---
No, Thanks to you./\/\arty
Posted by Marty on July 24, 2008, at 0:16:59
In reply to Re: depressed/irritable in the morning: any ideas plz? » Marty, posted by Phillipa on July 23, 2008, at 23:21:33
> Marty Karma???? Just Kidding I always feel worse in the morning and that is late morning so stay up till 2am posting ebay. Doesn't help but feel best them. Write Sometime. Love Phillipa ps I hope you figure out the problem as I've never taken it either. But I couldn't ignore you.
---
Hi Phil.. how's your ebay business ? as someone who would love being able to make money from home (social phobic) I wonder if it works .. What are you selling ?Thanks for you kind words :)
/\/\arty
Posted by Phillipa on July 24, 2008, at 20:17:08
In reply to Re: depressed/irritable in the morning: any ideas plz? » Phillipa, posted by Marty on July 24, 2008, at 0:16:59
Marty me personally boutique kid's clothes, husband high dollar real deal purses, shoes, golf clubs, high dollar wierd looking jeans that are limited editions and anything else he figures will make money. Also purchase where we can return as can't afford to not be able to and eat the costs. I will give you our ebay seller number 252gregb Love Phillipa
Posted by Marty on July 24, 2008, at 22:23:38
In reply to Re: depressed/irritable in the morning: any ideas plz? » Marty, posted by Phillipa on July 24, 2008, at 20:17:08
> Marty me personally boutique kid's clothes, husband high dollar real deal purses, shoes, golf clubs, high dollar wierd looking jeans that are limited editions and anything else he figures will make money. Also purchase where we can return as can't afford to not be able to and eat the costs. I will give you our ebay seller number 252gregb Love Phillipa
---
Ok I'll check it out. Is this a good way for someone partly 'housebound' to make a living ?
(I'm talking about me btw)/\/\arty
Posted by Phillipa on July 24, 2008, at 23:57:08
In reply to Re: depressed/irritable in the morning: any ideas plz? » Phillipa, posted by Marty on July 24, 2008, at 22:23:38
Marty it depends on if you research and see what's selling and find a place to get stuff cheap that is quality. Right now my line if doing the best. You know you're very smart, first must love the product, know which brands of whatever. Hey you could do an ebay seach and check to see what's selling the most . Also do they have Craig's list where you live? As we've sold bikes, strollers on it and it's free. They come to your house to check the item. A lot of neighbors have used it and for big items it's great. And what's a living to you as we all seem to have different needs. Love Phillipa ps just did my nightly posting as sleep late and late to bed. Best part is setting your own hours and no boss.
Posted by Marty on July 25, 2008, at 8:31:54
In reply to Re: depressed/irritable in the morning: any ideas plz? » Marty, posted by Phillipa on July 24, 2008, at 23:57:08
> Marty it depends on if you research and see what's selling and find a place to get stuff cheap that is quality. Right now my line if doing the best. You know you're very smart, first must love the product, know which brands of whatever. Hey you could do an ebay seach and check to see what's selling the most . Also do they have Craig's list where you live? As we've sold bikes, strollers on it and it's free. They come to your house to check the item. A lot of neighbors have used it and for big items it's great. And what's a living to you as we all seem to have different needs. Love Phillipa ps just did my nightly posting as sleep late and late to bed. Best part is setting your own hours and no boss.
---
Ok thanks Phillipa! I'm in a rush because I'm going camping for the weekend and I'm very late in my preparation but when I'll come back we'll continue this discussion if you feel to.Have a nice weekend!
/\/\arty
Posted by Marty on July 25, 2008, at 10:25:21
In reply to depressed/irritable in the morning: any ideas plz?, posted by Marty on July 23, 2008, at 13:02:40
I'm writing this on the portable device of my girlfriend while in route to some camping action this weekend. :)I just want to post an update concerning my depressed/anxious morning.
I switch Xanax at bedtime for Clonazepam at bedtime and it works! So the hypothesis is that the Xanax with his 4 hours half-life isn't long/strong enough to take care of the wellbutrin/lack of Tianeptine while I'm sleeping and when I wake up. Clonazepam having an half-life of 18 hours (can go as far as 50 hours) do the job all the way... Now this is great but I fear the Clonazepam will worsen or induce some more depression. Because it did in the past I switched to Xanax a couple weeks ago.. I may have to find something else to switch to.
Xanax Xr isn't available in Canada .. any idea ?
One thing I'm doing is to take Clona at bedtime and only Xanax in the day has I think it could help reduce the Clonazepam induced depression/irritability./\/\arty
Posted by bleauberry on July 25, 2008, at 20:25:28
In reply to Update » Marty, posted by Marty on July 25, 2008, at 10:25:21
If klonopin worsens depression, another choice might be lorazepam. Its halflife is longer than xanax and doesn't have quite the reputation for depression that klonopin does. I've tried all three of these, and I would put lorazepam somewhere in the middle between klonopin and xanax, in terms of the feel of the halflife and effects on mood.
Posted by chiron on July 27, 2008, at 0:31:33
In reply to Re: depressed/irritable in the morning: any ideas plz? » chiron, posted by Marty on July 23, 2008, at 22:52:48
I'm guessing these were my doses around the time when mornings were extra hard for me
PREVIOUS CURRENT
100 Lamictal..........300 Lamictal
30 Celexa.............40 Celexa
.0125 Synthroid.......same
150 Wellbutrin........200 Wellbutrin
2mg Xanax XR..........samemaybe we are not being punished, but special souls chosen to gain immense wisdom through this painful game. *B*S*
This is the end of the thread.
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