![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by meltingpot on February 28, 2009, at 14:11:55
Hi,
My name is Denise from the UK and I've been coming to this board since 2001 (when my depression/anxiety) resurfaced. I haven't posted for a while but have lurked.
Back in 2001 I had very anxious depression with suicidal thoughts. I tried many drugs and combinations with limited success. The only thing that gave me respite from the awful anxiety was Zyprexa 10mg (when I took it). I worked thoughout all of this.
Then all of a sudden in 2003 40mg of Seroxat started to work, within about 4 days. I started to want to do things again, going out, getting dressed up, work was going good. I started enjoying sex again for the first time in ages and going on holidays.
Then in 2005 the Seroxat seemed to stop working in the sense that some anxiety came back and I just seemed to stop enjoying things like I had been. I wasn't too bad though (I wasn't suicidal). The pscyhiatrist tried adding Buspar, lithium, lamictal but these drugs but it didn't lift the depression, just made me feel more tired.
Over a year ago my psychiatrist put me on Lexapro and this did help somewhat, I still experienced anxiety (a kind of restlessness) but It was more focused and positive and at that time I felt more hopeful, I felt stronger in myself. However, I still didn't feel as good as I had between 203 and 2005.
Last year I had therapy, I didn't find it that helpful although I gave it my best shot but at that point it wasn't such a big deal as the Lexapro was still helping somewhat.
Anyway in November of last year, I started noticing myself going downhill. This started with my having very bad dreams, waking up screaming, falling out of bed. Three nights on the trot I didn't sleep at all and had to take a Zyprexa just to sleep. Any motivation I had seemed to go. The anxiety and suicidal thoughts came back with a vengence, with my pacing up and down for ages feeling really really worried and anxious. I have been retching a few times in the morning and I've lost a lot of weight (always a really bad sign with me)
I'd ordered some effexor off the internet so I decided to give that a try but again I experienced excrutiating anxiety on it so gave up on it. It's strange because I'd taken this before (prior to November) along with Lexapro and there was no anxiety just no difference.
I've stopped the lexapro because I just felt it wasn't working and I'm trying Clomipramine (which I ordered off the internet) but I'm still feeling very suicidal. I spent last weekend searching the internet for the best ways to kill myself using carbon monoxide. I've been looking up parachuting courses as I keep thinking of going on one and then just not opening the shute. I'm still working but am really feeling like I'm faking it all of the time and it seems to be getting harder and harder.
I'm very worried and I've booked an appointment with a private psychiatrist but I'm not sure what she can do (I'm feeling pretty negative about that) as I've tried so many medications in the past, they didn't work then, and I can't see how they will help now when I'm feeling much worst.
My depression has always had a really strong anxiety component to it. Even when I'm feeling sort of ok I always find it hard to sit still, I have to move around a lot but now it's getting worst.
I want to try ECT but I keep being told it doesn't work for my kind of depressin, I'd even try Deep Brain Stimulation but there is no way my pscyhiatrist would refer me but then I'm starting to feel completely hopeless anyway, like I'm never going to feel better (typical negative thinking I know). I do keep trying to think positively but it doesn't seem to make a lot of difference. The only thing that makes me feel any better is the thought of jumping off a cliff right now.
I look on the clinical trials. gov site quite a lot for new treatments for depression but then get despondent as the drugs with a different mode of action seem to be in Phase I still and many of the ones in Phase II seem to be me too drugs.
I'm really scared and worried. I have an appointment with this psychiatrist next weekend, I was wondering if anyone had any suggestions.
Zyprexa does help with the anxiety (when I take it). I get the most help from it when I take 10mg now and again. What seems to happen is the 10mg completely numbs me the next day and then a day or two later I start to feel a bit better. I don't want to take this drug on a continual basis but it does seem to give me a bit of a holiday (from myself) now and again at least.
I'm very very worried, I haven't felt this bad for a long time.
At least before I felt I could always at least feel somewhat better with an SSRI (whether it be Seroxat or Lexapro) but now I feel they've completely stopped working on me so it feels as though the rug has been pulled from under my feet.
Denise
Posted by SLS on February 28, 2009, at 15:08:23
In reply to Very, very worried, need advice and some hope, posted by meltingpot on February 28, 2009, at 14:11:55
Hi Denise.
Is this your first tricyclic?
Your type of depression is called endogenous or melancholic. It is often more responsive to tricyclics than SSRIs. Years ago, clomipramine was considered to be the best of the bunch with regard to the statistical response rate. It is particularly good when treating OCD. In some ways, Seroxat and clomipramine are similar in that they both inhibit the reuptake of serotonin and norepinephrine. However, clomipramine is more potent with norepinephrine. Clomipramine might be thought of as a stronger Seroxat.
If clomipramine doesn't work by itself, there are things that can be added to it. However, you cannot combine an MAOI with clomipramine as you can with desipramine or nortriptyine.
How are you doing with side effects so far? With clomipramine, you are going to get anticholinergic side effects, but these can become less troublesome as treatment progresses. It should be stated, though, that some believe the anticholinergic properties actually enhance the antidepressant potency of a drug.
At what rate do you intend to increase the dosage?
- Scott
Posted by Phillipa on February 28, 2009, at 22:56:55
In reply to Re: Very, very worried, need advice and some hope » meltingpot, posted by SLS on February 28, 2009, at 15:08:23
Scott what about the anxiety. My thought was possibly bipolar? Phillipa
Posted by Zyprexa on March 1, 2009, at 8:47:15
In reply to Very, very worried, need advice and some hope, posted by meltingpot on February 28, 2009, at 14:11:55
Have you tried a mix of zyprexa and Seroxat. Like half the dose of each or atleast the zyprexa. If that doesn't work I would suggest taking the zyprexa all the time, its better than wanting to die.
Posted by meltingpot on March 1, 2009, at 10:18:16
In reply to Re: Very, very worried, need advice and some hope » meltingpot, posted by SLS on February 28, 2009, at 15:08:23
Hi Scott,
I feel in a really bad way right now and don't know what I'm doing, the anxiety is awful but it's awful anyway with or without antidepressants.
I wasn't doing too badly last year just on the Lexapro but for some reason they seemed to stop working.
I'm not even sure about this clomipramine, I'm just having this intense anxiety all of the time which is leaving me feeling weak. I feel really suicidal and wish I could just end this, I really do.
When I was in my twenties the first drug I ever took was a tricyclic, it was prothiaden and it literally seemed to take me to heaven. I don't get how the same drug (or type of drug) can take you to heaven one time and then take you to hell when you take it again.
Thanks for getting back to me anyway. I know you know a lot of about neurotransmitters etc, are there any new drugs on the horizon that look promising?
Also, do you know how the DBS trials are going?
Yours scared....Denise
Posted by meltingpot on March 1, 2009, at 10:19:03
In reply to Re: Very, very worried, need advice and some hope » meltingpot, posted by Zyprexa on March 1, 2009, at 8:47:15
Zyprexa,
You are right, I'm going to have to take a Zyprexa, it's seems to be the only thing that helps.
How much do you take?
Denise
Posted by jms600 on March 1, 2009, at 14:52:03
In reply to Very, very worried, need advice and some hope, posted by meltingpot on February 28, 2009, at 14:11:55
Hi Denise
You said you noticed anxiety with drugs such as venlafaxine? How long were you on the medication for? Most of the SSRIs/SNRIs cause anxiety to start with which then subsides - did you get past the first three or four weeks?
Also have you considered other antipsychotics? Many people on here seem to like Seroquel as an effective alternative to Zyprexa. Furthermore, I know they are less desirable, but the older typical antipsychotics are also effective. In fact Stelazine and Haloperidol in very low doses are actually licensed for severe anxiety. Beware that movement disorders are more problematic with these two though!
You mentioned new antidepressants, have you considered the newly released agomelatine? Can't give you an opinion on it I'm afraid as I haven't tried it. I know it's chemically related to melatonin and so obviously also assists in achieving an improvement in sleep quality.
Then there is the anticonvulsants to consider. Fortunately, us Brits are lucky in that Pregabalin is licensed in the UK for GAD. Again, can't give you an opinion on it as I haven't tried it (yet).
I too suffer from severe anxiety and depression and I know how terrible those desperate episodes can be. Suicide simply is NOT the answer - don't even consider it. When times get rough you need to reach for the Valium (or another sort of benzo). Valium really has been a life saver for me.
If things get so bad that you just can't cope then get down to your nearest A & E dept as soon as you can. Going into hospital because of severe anxiety/depression is NOTHING to be ashamed of.
Your next step is to see this psychiatrist and get him to prescribe something with at least some potential for working - your paying for his services so make him earn his money! Nobody can guarantee that any drug will work but at least you have to give all the right ones a good go.
Good luck and I hope you find some relief from your troubles soon. Let us know what the psychiatrist says.
Posted by meltingpot on March 1, 2009, at 15:21:18
In reply to Re: Very, very worried, need advice and some hope, posted by jms600 on March 1, 2009, at 14:52:03
Hi,
Thanks for your support. Of the SSRIs SNRIs I've taken, I've always taken them for over a month.
It's strange really though because back in 2001 when I tried Seroxat again I got awful anxiety at start up and still later on (but not as bad).
Then when I took it again in 2003 at a higher dose I got very little anxiety and it actually started to work.When I started the Lexapro over a year ago I got some anxiety but it wasn't unbearable and then that started to work a bit.
However, since November when the Lexapro seemed to stop being effective, the anxiety has been really bad again. I feel like I have absolutely no motivation and yet a lot of anxiety.
Zyprexa has always been a God Send for me, I just hate having to take it (not for any particular reason). I just don't get why the antidepresant doesn't do what it's supposed to, alleviate the depression and anxiety that is.
I try to go as long as I can before I take the Zyprexa. I like to keep it as an emergency drug, my ace card so to speak. However, it looks like I'm going to have to use up my last life line which is worrying to me.I have tried Lyrica and to be honest didn't find it very effective for anxiety. I've tried Buspar and that doesn't seem to do anything.
I don't have the sort of anxiety that is specific to anything. I wouldn't mind if was. It's not like it's because of an interview or going on a date. It's sort of like a feeling of constantly waiting for something that never happens and it is constant, that's what makes it so hard. It does seem to ease off in the evening but I still can't seem to just relax and watch the television or just chill.Thanks for your response though, it was kind of you to write back.
Denise
Posted by SLS on March 1, 2009, at 16:10:57
In reply to To Scott (SLS), posted by meltingpot on March 1, 2009, at 10:18:16
It is encouraging that Zyprexa has been so helpful to you. I consider it just about the best anti-suicide drug out there.
You might do well to add Abilify long-term to whatever antidepressants you are trying. It acts as a sort of dopamine system stabilizer. The risk it carries for producing tardive dyskinesia appears to be markedly reduced when compared to the other antipsychotic drugs. A good sign that Abilify will help is that you feel more energy and motivation early in treatment. The biggest drawback of Abilify is that it can produce akathisia type startup side effects that include anxiety and insomnia. It can be very uncomfortable, but usually disappears. I started right at 20mg and only had some mild discomfort that lasted for about 5 days.
I am currently taking:
Parnate 80mg
desipramine 300mg
Lamictal 200mg
Abilify 20mg
If nothing comes of clomipramine, you can circle back to either Seroxat or Lexapro, add Wellbutrin, and continue with the Abilify. That's one idea.Have you ever tried Effexor, Remeron or mianserin?
- Scott
Posted by polarbear206 on March 1, 2009, at 20:12:30
In reply to Re: Very, very worried, need advice and some hope, posted by jms600 on March 1, 2009, at 14:52:03
Have you heard when agomelatine is going to be available in the U.S.?
Thanks
Posted by Neal on March 2, 2009, at 0:43:48
In reply to Very, very worried, need advice and some hope, posted by meltingpot on February 28, 2009, at 14:11:55
__
re: the Zyprexa; you having side-effect problems? is that why you said "when I take it"? cause I was wondering if you should take it every day? . . . you might do better?
. . . also sounds like you do better on serotonin meds than norepinephrine meds. . . .
don't let the anxiety go on for a long time. Pdocs have a lot of tools to deal with it. Get one and make sure he/she understands what's going on.
any recent sources of stress in your life?
__
Posted by meltingpot on March 2, 2009, at 11:47:39
In reply to Re: To Scott (SLS), posted by SLS on March 1, 2009, at 16:10:57
Hi Scott,
I was feeling awful during the day (yesterday)really anxious and suicidal and then in the evening I felt more peaceful which sometimes happens to me. I had to take a Zyprexa last night otherwise I would have felt the same today.
I still feel suicidal but not in a desperate, got to do it now way but in, maybe do it later, way.
I'm not sure whether or not to persist with the Clomipramine, I was taking half a 75mg pill. Like I said, in the evening I felt slightly better (mood wise) but still a bit sort of weak.
I have tried both Remeron and Effexor and was anxious on both of them but then I'm anxious anyway with or without drugs. I think that the anxiety comes from feeling listless, foggy headed and not having any motivation or focus.
I am worried right now because over the past 8 years I've always felt like I've had a sort of a crutch with SSRIs but now I feel like that crutch has been yanked from my hand.
My mood hasn't been this bad for ages, I see a private psychiatrist on Saturday to see if she might have any ideas on what to do but I can't see what she can prescribe when I've pretty much tried everything already.
The only medication that gives me relief from the total feeling of dispair is Zyprexa. I don't like taking it though because the day after taking it I feel really detached and disconnected (in a calm way) and it's not until about 2 days after that I start to feel more like myself again. It's always been the case.
Denise
Posted by jms600 on March 2, 2009, at 16:25:30
In reply to To JMS600, posted by meltingpot on March 1, 2009, at 15:21:18
I would give consideration to the other APs - e.g. Seroquel. I'd also consider the older typicals - some of them are licensed for severe anxiety.
Have you also considered having your thyroid checked? An over-active thyroid gland can cause excessive anxiety as can high levels of cortisol. I'm afraid I'm a bit out of my depth on this subject so you are probably best discussing it with your doctor. It may also be worth posting another question on the subject on here.
Posted by jms600 on March 2, 2009, at 16:27:29
In reply to jms600, posted by polarbear206 on March 1, 2009, at 20:12:30
I'm afraid not - I know it's available in Europe but am not sure on the release dates in the Americas. Sorry!
Posted by Zyprexa on March 3, 2009, at 9:25:52
In reply to Re: Very, very worried, need advice and some hope, posted by meltingpot on March 1, 2009, at 10:19:03
I take 10mg! Best med ever!
Posted by B2chica on March 4, 2009, at 8:29:49
In reply to Very, very worried, need advice and some hope, posted by meltingpot on February 28, 2009, at 14:11:55
it does sound like TCA's might be best for you.
however, like you zyprexa has always been my wonder drug but for various reasons i don't like to stay on it.
I also (similar to you) had a Terrible reaction to Effexor but since my options were very limited i decided to give pristiq a try. it took forever to kick in, but it finally did and it worked beautifully. i think it honestly took 8-10 weeks to get to a normal level.
the first week i felt Great, then went down for a while, then slowly got better and better.it might be an option for you.
best wishes.
and hang in there with the zyprexa for now. i truly know how frustrating it can be, but zyprexa always puts his foot inbetween me and death on i can't remember how many times.
so just hold on.
hold on to hope, to us, to knowing...KNOWING you WILL find another med that will work for you.b2c.
Posted by Meltingpot on March 6, 2009, at 13:20:54
In reply to Re: Very, very worried, need advice and some hope » meltingpot, posted by B2chica on March 4, 2009, at 8:29:49
Hi both of you,
Thanks for your support. I agree totally, Zyprexa has always felt like the drug that has stopped me from killing myself.
The thing is when I feel really bad I don't even have the confidence, strength, resolution, know how to kill myself. It's only after taking the Zyprexa that I feel capable of killing myself and by that time I don't want to.
I would, however, like to get my hands on say a drug that would enable me to kill myself fairly easily if I ever got that bad that nothing worked. Because depression and anxiety is so horrible! Nothing scares me more.
Having said that I've not experienced chronic physical pain so maybe I don't know what I'm talking about. But my experience of depression and anxiety makes me fear it greatly.
Denise
Posted by Phillipa on March 6, 2009, at 21:10:27
In reply to Zyprexa and B2Chica, posted by Meltingpot on March 6, 2009, at 13:20:54
14 years so far no relief except sleeping. If you take zyprexa did you gain weight? Love Phillipa
Posted by meltingpot on March 8, 2009, at 10:03:27
In reply to Re: Zyprexa and B2Chica » Meltingpot, posted by Phillipa on March 6, 2009, at 21:10:27
Hi Philippa,
I haven't gained weight on it but then I only take it now and again.
I can definately see how it can make people put weight on as it does increase appetite.
I would expect that anyone who does take it and wants to keep their weight down would have to exercise a lot. I think some people do it that way anyhow.
Denise
Posted by Phillipa on March 8, 2009, at 19:46:40
In reply to Re: Zyprexa and B2Chica, posted by meltingpot on March 8, 2009, at 10:03:27
Thanks Denise. Love Phillipa
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.