Psycho-Babble Medication Thread 3172

Shown: posts 1 to 7 of 7. This is the beginning of the thread.

 

Dr. Bob & others - your opinion re SSRIs

Posted by paul frank on February 23, 1999, at 19:19:26

I suffer from GAD with some symptoms of depression. My doc first put me on prozac 20mg. After 4 weeks, the depressive symptoms had improved, but the anxiety continued, so she switched me to Zoloft. I have been at 100 mg for two weeks now and depressive symptoms have not returned, but I remain anxious and worried. I have had minimal side effects from both drugs, other than excessive nervousness. In your opinion, if Zoloft doesn't work, should we go to a third SSRI (my doc says she will next try Paxil) or would it make more sense to switch to another class of anti-depressant (ie Effexor? Serzone?) My main problem has always been GAD.

Thank you for your response.

 

Re: Dr. Bob & others - your opinion re SSRIs

Posted by Victoria on February 23, 1999, at 21:10:10

In reply to Dr. Bob & others - your opinion re SSRIs, posted by paul frank on February 23, 1999, at 19:19:26

For what it's worth, my doctor prescribed Buspar in addition to Zoloft, which I gather is primarily an anti-anxiety drug with anti-depressant effects also. Can't report on effectiveness because I had some side effects to Zoloft and had to discontinue the combo.


> I suffer from GAD with some symptoms of depression. My doc first put me on prozac 20mg. After 4 weeks, the depressive symptoms had improved, but the anxiety continued, so she switched me to Zoloft. I have been at 100 mg for two weeks now and depressive symptoms have not returned, but I remain anxious and worried. I have had minimal side effects from both drugs, other than excessive nervousness. In your opinion, if Zoloft doesn't work, should we go to a third SSRI (my doc says she will next try Paxil) or would it make more sense to switch to another class of anti-depressant (ie Effexor? Serzone?) My main problem has always been GAD.
>
> Thank you for your response.

 

Re: Dr. Bob & others - your opinion re SSRIs

Posted by Matt on February 24, 1999, at 1:55:02

In reply to Dr. Bob & others - your opinion re SSRIs, posted by paul frank on February 23, 1999, at 19:19:26

> I suffer from GAD with some symptoms of depression. My doc first put me on prozac 20mg. After 4 weeks, the depressive symptoms had improved, but the anxiety continued, so she switched me to Zoloft. I have been at 100 mg for two weeks now and depressive symptoms have not returned, but I remain anxious and worried. I have had minimal side effects from both drugs, other than excessive nervousness. In your opinion, if Zoloft doesn't work, should we go to a third SSRI (my doc says she will next try Paxil) or would it make more sense to switch to another class of anti-depressant (ie Effexor? Serzone?) My main problem has always been GAD.
>
> Thank you for your response.

Have you considered Remeron? It is terrific on anxiety. There is more weight gain at 15mg than at 30mg. All the SSRIs can be quite helpful for GAD. Prozac helped me significantly. New studies on Celexa are showing that it is very good with anxiety.

If I may say, 4 weeks on an SSRI probably isn't a sufficently long trial to determine if it will help with your GAD. Also, if anxiety is your main problem, why not consider a benzodiazepine like Klonopin in addition to the SSRI. This would have the advantage of allowing you to avoid some of the weight gain that probably would come with Remeron. Also, once the depression has been gone for a sufficiently long period of time, you might consider the benzodiazepine as a better long-term solution to your GAD.

I'm not a Serzone fan, and I'm not the only one who feels this way. I think that BM-Squibb is quite good at marketing Serzone, though. (Somehow one always hears this drug mentioned in connection with anxiety; I'm really curious if any double blind studies have been done comparing it to SSRIs and TCAs as far as anxiolytic effects go.)

Matt

 

Re: Dr. Bob & others - your opinion re SSRIs

Posted by paul frank on February 24, 1999, at 17:54:47

In reply to Re: Dr. Bob & others - your opinion re SSRIs, posted by Victoria on February 23, 1999, at 21:10:10

> For what it's worth, my doctor prescribed Buspar in addition to Zoloft, which I gather is primarily an anti-anxiety drug with anti-depressant effects also. Can't report on effectiveness because I had some side effects to Zoloft and had to discontinue the combo.
>
>
> > I suffer from GAD with some symptoms of depression. My doc first put me on prozac 20mg. After 4 weeks, the depressive symptoms had improved, but the anxiety continued, so she switched me to Zoloft. I have been at 100 mg for two weeks now and depressive symptoms have not returned, but I remain anxious and worried. I have had minimal side effects from both drugs, other than excessive nervousness. In your opinion, if Zoloft doesn't work, should we go to a third SSRI (my doc says she will next try Paxil) or would it make more sense to switch to another class of anti-depressant (ie Effexor? Serzone?) My main problem has always been GAD.
> >
> > Thank you for your response.


Victoria:

Thanks for your comments. I have heard a lot of good things about Buspar but my doc says physicians in my city normally don't prescribe it due to a general lack of effectiveness. Hope you find something that works for you

Paul

 

Re: Dr. Bob & others - your opinion re SSRIs

Posted by paul frank on February 24, 1999, at 18:43:04

In reply to Re: Dr. Bob & others - your opinion re SSRIs, posted by Matt on February 24, 1999, at 1:55:02

> > I suffer from GAD with some symptoms of depression. My doc first put me on prozac 20mg. After 4 weeks, the depressive symptoms had improved, but the anxiety continued, so she switched me to Zoloft. I have been at 100 mg for two weeks now and depressive symptoms have not returned, but I remain anxious and worried. I have had minimal side effects from both drugs, other than excessive nervousness. In your opinion, if Zoloft doesn't work, should we go to a third SSRI (my doc says she will next try Paxil) or would it make more sense to switch to another class of anti-depressant (ie Effexor? Serzone?) My main problem has always been GAD.
> >
> > Thank you for your response.
>
> Have you considered Remeron? It is terrific on anxiety. There is more weight gain at 15mg than at 30mg. All the SSRIs can be quite helpful for GAD. Prozac helped me significantly. New studies on Celexa are showing that it is very good with anxiety.
>
> If I may say, 4 weeks on an SSRI probably isn't a sufficently long trial to determine if it will help with your GAD. Also, if anxiety is your main problem, why not consider a benzodiazepine like Klonopin in addition to the SSRI. This would have the advantage of allowing you to avoid some of the weight gain that probably would come with Remeron. Also, once the depression has been gone for a sufficiently long period of time, you might consider the benzodiazepine as a better long-term solution to your GAD.
>
> I'm not a Serzone fan, and I'm not the only one who feels this way. I think that BM-Squibb is quite good at marketing Serzone, though. (Somehow one always hears this drug mentioned in connection with anxiety; I'm really curious if any double blind studies have been done comparing it to SSRIs and TCAs as far as anxiolytic effects go.)
>
> Matt


Matt:

Thanks for your comments. Its nice to meet another individual with GAD who, like myself, has done some research and wants to be part of the treatment process.

Remeron is quite new and I live in a community where the medical establishment tends to be somewhat conservative. I agree with you that my doc did not give Prozac a fair chance. If the Zoloft doesn't work, do you think Paxil would be worth a try in light of the fact that 2 SSRIs didn't work? In your experience, how long does it take for an SSRI to kick in for GAD?

Every time I take Klonopin (or any other benzo for that matter), I have a favourable response to it. Not only does it eliminate my anxiety, but it also appears to lift my mood (which is probably lousy because of the GAD) and I enjoy my life again. However it will sometimes appear to lose its effectiveness after only an hour or so. The effects appear to last longer if I take it with food. Perhaps my dose is too low (1.0 mg in AM for the whole day - I am a 190lb male)). I would love to switch to Klonopin long term if I weren't so paranoid about the whole dependency thing. I don't take nearly as much of it as I probably should.

I am certainly hopeful Zoloft works for my GAD and I can once again experience some happiness in my life. However, I am quite concerned about what I have heard regarding "personality changes" with the SSRIs. With all my faults, I am still me and want to remain me - I simply want the anxiety, worry, etc to be brought under control - and nothing else. Do any of the people you know who have responded to the SSRIs, SNRIs and/or the older TCAs feel the meds altered who they were, or just relieved their symptoms?

Feel free to contact me if you would like to share experiences or if you would like my perspective on your particular struggles with GAD.


Paul

 

Re: Dr. Bob & others - your opinion re SSRIs

Posted by sean on February 24, 1999, at 20:08:02

In reply to Dr. Bob & others - your opinion re SSRIs, posted by paul frank on February 23, 1999, at 19:19:26

> I suffer from GAD with some symptoms of depression. My doc first put me on prozac 20mg. After 4 weeks, the depressive symptoms had improved, but the anxiety continued, so she switched me to Zoloft. I have been at 100 mg for two weeks now and depressive symptoms have not returned, but I remain anxious and worried. I have had minimal side effects from both drugs, other than excessive nervousness. In your opinion, if Zoloft doesn't work, should we go to a third SSRI (my doc says she will next try Paxil) or would it make more sense to switch to another class of anti-depressant (ie Effexor? Serzone?) My main problem has always been GAD.
>
> Thank you for your response.

I had good luck with amitriptyline in my 20's. It
really helped with anxiety and insomnia. I did not
notice the personality effects which happen with
SSRI's. Some people like the personality changes
that can occur with SSRI-class drugs; I find them
interesting, but shallowing overall. They also
make me sleepless and manic so, I have a problem
balancing the SSRI's.

If you can hack the
anticholinergic effects of a TCA, they are a well
studied, effective, and venerable class of meds
that have really helped alot of people. Apparently
amitriptyline is more anxiolytic than say,
desiprimine due to higher serotonin binding
(relative to dopamine)It also has a general
sedative effect which some people like and others
loathe... Good luck,

Sean.


 

Re: Dr. Bob & others - your opinion re SSRIs

Posted by Matt on February 25, 1999, at 2:18:41

In reply to Re: Dr. Bob & others - your opinion re SSRIs, posted by paul frank on February 24, 1999, at 18:43:04


>
> Thanks for your comments. Its nice to meet another individual with GAD who, like myself, has done some research and wants to be part of the treatment process.
>
> Remeron is quite new and I live in a community where the medical establishment tends to be somewhat conservative. I agree with you that my doc did not give Prozac a fair chance. If the Zoloft doesn't work, do you think Paxil would be worth a try in light of the fact that 2 SSRIs didn't work?

Well, if the Zoloft doesn't work, you really haven't found that 2 SSRIs don't work, since Prozac probably wasn't given a fair shot. I'd certainly try Celexa before trying Paxil, though. (In fact, I'd try Celexa before trying Zoloft, but that's just based on my own reactions to the two drugs.)

In your experience, how long does it take for an SSRI to kick in for GAD?

Well, I didn't experience full relief on Prozac for 6 months or so, things got bearable after a couple months.

>
> Every time I take Klonopin (or any other benzo for that matter), I have a favourable response to it. Not only does it eliminate my anxiety, but it also appears to lift my mood (which is probably lousy because of the GAD) and I enjoy my life again. However it will sometimes appear to lose its effectiveness after only an hour or so. The effects appear to last longer if I take it with food. Perhaps my dose is too low (1.0 mg in AM for the whole day - I am a 190lb male)). I would love to switch to Klonopin long term if I weren't so paranoid about the whole dependency thing. I don't take nearly as much of it as I probably should.

Yeah, it does sound as if dosages need to be higher. Klonopin usually is given bid, even though it has a long half-life. In my own case, my doc and I kept upping the dose until I felt better. That number was 2mg for me. I think that the dependency issue is hugely overplayed. Look at this way, with benzos, you need to taper off them slowly when you come off. Go as slowly as you need to. And, btw, Paxil and Effexor can be very tough to get off of, too. Benzos are quite safe, and they're well-known drugs. If I could control my symptoms long-term on just a benzo, I'd be grateful. The SSRIs are quite new compared to the benzos.


> I am certainly hopeful Zoloft works for my GAD and I can once again experience some happiness in my life. However, I am quite concerned about what I have heard regarding "personality changes" with the SSRIs. With all my faults, I am still me and want to remain me - I simply want the anxiety, worry, etc to be brought under control - and nothing else. Do any of the people you know who have responded to the SSRIs, SNRIs and/or the older TCAs feel the meds altered who they were, or just relieved their symptoms?


Many people on SSRIs (and other antidepressants--I wouldn't count on avoiding this by avoiding SSRIs) do feel different than they did prior to the depression. In my own case, I felt much more stable--some of the depths of emotion I had experienced before weren't there with the SSRIs. I regarded this as a negative. But, it certainly was something I was willing to accept for relief from anxiety and depression. There is a section in Tips on SSRIs and apathy. You might want to read it. But, I don't feel as if I'm a fundamentally different person when I'm on an SSRI, or anything like that. So, I wouldn't be too concerned with this; see what happens in your own case after trying the drug, and then you can make a decision (I suspect you'll stick with the drug if it's working).

Best,

Matt


This is the end of the thread.


Show another thread

URL of post in thread:


Psycho-Babble Medication | Extras | FAQ


[dr. bob] 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.