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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by bill on November 26, 1998, at 4:29:06
Dr Bob
I've read most of your tips and find your site to be
very informative but I haven't found any tips for my
situation. I've been on Zoloft for 4 years (50/100mg
day; I tried 150mg/day but it made me too sedated and
hypersomnia) and was doing very well with no panic
attacks or recurrence of major depression. Following
an auto accident, (I didn't lose consciousness) the
panic attacks returned along with cognitive problems
(stuttering, inability toexpress thoughts or words
clearly at times, memory problems, "sensory overload",
unable to multi-task,etc), major fatigue and anhedonia.
I've felt numb and detached/apathetic so it seemed the
Zoloft wasn't working so I tried to go up on the Zoloft
to 150mg/day but became very agitated instead of
sedated like before and even adding Klonopin 3mg/day
didn't help.
The VA psychiatrist doesn't know why the response to
Zoloft 150mg/day is now the opposite of 4 years ago.
He said he has never heard of any patient on an SSRI
feeling "numb" or that adding Wellbutrin,for example,
could conceivably help the SSRI in terms of dopamine.
I told him that my brother tried Zoloft and also
became agitated and was diagnosed as bi-polar and now
takes depakote and wellbutrin and is doing very well.
I told him that in the past there seemed to be a real
seasonal factor to my depressive episodes (worst in
winter,best in summer; sleep too much, gain weight,etc)
He doesn't see any significance to these things and so
I'm told to just stay on Zoloft 50mg/day and Klonopin
1mg/day and see how it goes.
I did reference some info I'd gained from your tips
and he told me I shouldn't read up on things because I
have OCD as well and it will make things worse! But he
didn't say anything about asking questions:)Thanks for any ideas on what else I might try to do.
Posted by Laurie on November 26, 1998, at 11:01:37
In reply to Everthing was fine and then..now what?, posted by bill on November 26, 1998, at 4:29:06
I think I'm experiencing the same thing. Zoloft works great
for a long time, but for the last year or so,
the pervasive anhedonia/sadness was replaced by strong mood
swings, awful feelings of agitation and social withdrawal.
My current
doc (a GP) who I've only known a short time
recommended that I raise the dose, but it seems
to be making matters worse. I gave it a month's trial
at the higher dosage, but its interfering with
my life so much that I think its foolish to
continue.I am sorry your doctor isn't being more supportive
and understanding; I also think that his advice that you
should not read up on matters relating to your
condition is bad and makes him seem a bit arrogant
and condescending -- sorry, but no one has
the right answers all of the time, and if he can't deal
with your input, it sounds like he has a bit of
an ego/power problem that may interfere with his
treatment of patients! I think your research shows
that you are actively interested in improving your
health, which one would think a doctor would like to
see in a patient! If he has a good reason to
be recommending the present course, as a scientist
he ought to have criteria and a timeline to judge
whether its actually working for you or not. If
you feel its not working, and he is not responsive
then its time to talk to another doctor.Good luck!
Posted by Dr. Bob on November 30, 1998, at 22:25:41
In reply to Everthing was fine and then..now what?, posted by bill on November 26, 1998, at 4:29:06
> my brother tried Zoloft and also
> became agitated and was diagnosed as bi-polar and now
> takes depakote and wellbutrin and is doing very well.That's a good point. Antidepressants can sometimes
bring out bipolar-ness. One symptom of which can be
agitation. In which case a mood stabilizer like
Depakote can really help.But agitation doesn't necessarily imply a bipolar
problem, so you can't just assume it's that...Good luck!
Bob
This is the end of the thread.
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