![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Rick on October 1, 1999, at 10:18:58
As happy as I am with my current regimen, which includes Klonopin but no
AD, I may eventually want to experiment with an anxiety-fighting AD.I've gathered a lot of information (both anecdotal and research-based)
about the practical indications, effectiveness and side effects of each
AD, but I have no feel for which medications (or classes) are least
likely and/or most likely to poop out ("just when you least expect it",
as the late great Mr. Funt used to say).Any ideas? This could be from personal experience, acquaintances'
experiences, doctor's observations, or readings. Perhaps the "POP"
(Poop Out Potential) for a given drug varies widely by person and their
individual situation, but with enough responses I could start estimating
probabilities.Thanks in advance for your thoughts.
Rick
Posted by saint james on October 1, 1999, at 12:05:18
In reply to Ranking AD's by POP (Poop Out Potential), posted by Rick on October 1, 1999, at 10:18:58
> As happy as I am with my current regimen, which includes Klonopin but no
> AD, I may eventually want to experiment with an anxiety-fighting AD.
>
> I've gathered a lot of information (both anecdotal and research-based)
> about the practical indications, effectiveness and side effects of each
> AD, but I have no feel for which medications (or classes) are least
> likely and/or most likely to poop out ("just when you least expect it",
> as the late great Mr. Funt used to say).
>
> Any ideas? This could be from personal experience, acquaintances'
> experiences, doctor's observations, or readings. Perhaps the "POP"
> (Poop Out Potential) for a given drug varies widely by person and their
> individual situation, but with enough responses I could start estimating
> probabilities.
>
> Thanks in advance for your thoughts.
>
> RickJames here...
It has been my experience that poop out is not related to specific meds but to people. Some people get to a point where whatever med they are on no longer works. I've been on AD's since '85 and as long as an AD works, it is going to work for years, for me. I was on TCA's from 85 till they pooped out in 94-95, since then Effexor has been very effective, with no let up in sight. Some people never poop out.
Posted by Carmen on October 1, 1999, at 12:50:57
In reply to Re: Ranking AD's by POP (Poop Out Potential), posted by saint james on October 1, 1999, at 12:05:18
> > As happy as I am with my current regimen, which includes Klonopin but no
> > AD, I may eventually want to experiment with an anxiety-fighting AD.
> >
> > I've gathered a lot of information (both anecdotal and research-based)
> > about the practical indications, effectiveness and side effects of each
> > AD, but I have no feel for which medications (or classes) are least
> > likely and/or most likely to poop out ("just when you least expect it",
> > as the late great Mr. Funt used to say).
> >
> > Any ideas? This could be from personal experience, acquaintances'
> > experiences, doctor's observations, or readings. Perhaps the "POP"
> > (Poop Out Potential) for a given drug varies widely by person and their
> > individual situation, but with enough responses I could start estimating
> > probabilities.
> >
> > Thanks in advance for your thoughts.
> >
> > Rick
>
> James here...
>
> It has been my experience that poop out is not related to specific meds but to people. Some people get to a point where whatever med they are on no longer works. I've been on AD's since '85 and as long as an AD works, it is going to work for years, for me. I was on TCA's from 85 till they pooped out in 94-95, since then Effexor has been very effective, with no let up in sight. Some people never poop out.II was on Paxil for clinical depression for a number of years as well as w/therapy. After a few years didn't work. Started feeling very low again but not a clinical depression. Dr. put me on Paxil. On it for a number of years and felt wonderful w/few side affects as I remember. But then I started with manic feelings which got very bad. He felt this was drug-induced so took me off that. Now I'm on Neurontin which was just approved for social anxiety besides for mood stabilizing. Have to take Clonopin as needed for anxiety attacks which come on for no reason or before certain social occasions. So far this combo is working well for me. From reading this board just seems like you have to keep working w/your dr. and adjusting dosages or drugs as you go along. I'm consigned to the fact that this will be a life long thing for me. I wish I could be drug-free as I don't like to take meds of any kind, but I tried that and found that for me I do need some kind of medicine to make up for something lacking in the brain chemicals. Hope this helps your consideration of AD. Carmen
Posted by Carmen on October 1, 1999, at 12:54:01
In reply to Re: Ranking AD's by POP (Poop Out Potential), posted by Carmen on October 1, 1999, at 12:50:57
> > > As happy as I am with my current regimen, which includes Klonopin but no
> > > AD, I may eventually want to experiment with an anxiety-fighting AD.
> > >
> > > I've gathered a lot of information (both anecdotal and research-based)
> > > about the practical indications, effectiveness and side effects of each
> > > AD, but I have no feel for which medications (or classes) are least
> > > likely and/or most likely to poop out ("just when you least expect it",
> > > as the late great Mr. Funt used to say).
> > >
> > > Any ideas? This could be from personal experience, acquaintances'
> > > experiences, doctor's observations, or readings. Perhaps the "POP"
> > > (Poop Out Potential) for a given drug varies widely by person and their
> > > individual situation, but with enough responses I could start estimating
> > > probabilities.
> > >
> > > Thanks in advance for your thoughts.
> > >
> > > Rick
> >
> > James here...
> >
> > It has been my experience that poop out is not related to specific meds but to people. Some people get to a point where whatever med they are on no longer works. I've been on AD's since '85 and as long as an AD works, it is going to work for years, for me. I was on TCA's from 85 till they pooped out in 94-95, since then Effexor has been very effective, with no let up in sight. Some people never poop out.I
>
> I was on Paxil for clinical depression for a number of years as well as w/therapy. After a few years didn't work. Started feeling very low again but not a clinical depression. Dr. put me on Paxil. On it for a number of years and felt wonderful w/few side affects as I remember. But then I started with manic feelings which got very bad. He felt this was drug-induced so took me off that. Now I'm on Neurontin which was just approved for social anxiety besides for mood stabilizing. Have to take Clonopin as needed for anxiety attacks which come on for no reason or before certain social occasions. So far this combo is working well for me. From reading this board just seems like you have to keep working w/your dr. and adjusting dosages or drugs as you go along. I'm consigned to the fact that this will be a life long thing for me. I wish I could be drug-free as I don't like to take meds of any kind, but I tried that and found that for me I do need some kind of medicine to make up for something lacking in the brain chemicals. Hope this helps your consideration of AD. CarmenI made a mistake on my post. I was first of all on Prozac then Paxil.
Posted by Sean on October 1, 1999, at 14:19:35
In reply to Ranking AD's by POP (Poop Out Potential), posted by Rick on October 1, 1999, at 10:18:58
> As happy as I am with my current regimen, which includes Klonopin but no
> AD, I may eventually want to experiment with an anxiety-fighting AD.
>
> I've gathered a lot of information (both anecdotal and research-based)
> about the practical indications, effectiveness and side effects of each
> AD, but I have no feel for which medications (or classes) are least
> likely and/or most likely to poop out ("just when you least expect it",
> as the late great Mr. Funt used to say).
>
> Any ideas? This could be from personal experience, acquaintances'
> experiences, doctor's observations, or readings. Perhaps the "POP"
> (Poop Out Potential) for a given drug varies widely by person and their
> individual situation, but with enough responses I could start estimating
> probabilities.
>
> Thanks in advance for your thoughts.
>
> RickI had a long run on amitriptyline, but the SSRI's
seem to not last as long for me. Does anybody
have an opinion on the MAO's?
Posted by Noa on October 1, 1999, at 16:08:31
In reply to Re: Ranking AD's by POP (Poop Out Potential), posted by Sean on October 1, 1999, at 14:19:35
Rick, you have posed an excellent question, but I am sorry to say, I have no idea, despite having been on so many different meds. The reasons are 1) the first and second times on Prozac, I stopped taking it after 9-12 months, because at the time that was what was recommended (the early days of Prozac), whereas now we know that going on and off and allowing more episodes to occur has led to increased cycling. 2) I have often had side effects as I increased doses so for many of the meds I have tried, I have only had partial amelioration of my symptoms because I couldn't tolerate higher doses. I would get better enough to resume some basic functioning, but not great, and certainly not enough to prevent another episode of major depression as my depressive cycle came around again, or in response to a major stressor. Can you call this poop out? I don't think so, because I was not on enough of a dose in the first place. Which also makes me wonder if staying on an ineffective dose makes one's depression even harder to treat in the long run, kind of like spraying a little insecticide for a severe roach problem (former NYC resident here). We all know the roaches become more and more immune to the spray.
Posted by Elizabeth on October 2, 1999, at 0:47:25
In reply to Re: Ranking AD's by POP (Poop Out Potential), posted by Sean on October 1, 1999, at 14:19:35
> I had a long run on amitriptyline, but the SSRI's
> seem to not last as long for me. Does anybody
> have an opinion on the MAO's?I don't know how common it is, but I know (first-hand experience and a couple of case reports in the literature) that they do poop out sometimes. For me [Nardil] this also meant withdrawal symptoms (look up "amphetamine withdrawal" in DSM-IV for details) and an extremely bad depression that didn't respond to other meds.
I had taken Nardil for <1 year when this happened, and I tried taking it a second time and the same thing happened. On the other hand (I don't want people to get the wrong impression based solely on my experience) I know people who have taken Nardil for as long as 10 years and it still worked, so who knows?
Posted by Patty Gates on October 13, 1999, at 8:19:17
In reply to Ranking AD's by POP (Poop Out Potential), posted by Rick on October 1, 1999, at 10:18:58
I've gathered a lot of information (both anecdotal and research-based)
about the practical indications, effectiveness and side effects of each
AD, but I have no feel for which medications (or classes) are least
likely and/or most likely to poop out///Rick - Would you want to share your study results? I'd be most interested in reading what you've learned.
Posted by Rick on October 13, 1999, at 11:19:41
In reply to Re: Ranking AD's by POP - Rick's Study, posted by Patty Gates on October 13, 1999, at 8:19:17
>
> I've gathered a lot of information (both anecdotal and research-based)
> about the practical indications, effectiveness and side effects of each
> AD, but I have no feel for which medications (or classes) are least
> likely and/or most likely to poop out
>
> ///Rick - Would you want to share your study results? I'd be most interested in reading what you've learned.Patty, there's no formal study, just some personal learning -- reading and occasional printing, with info coming from the net (Medline, forums, journal articles), a couple acquaintances, books, and my pdoc.
Also, my interest is driven by Social Anxiety (and possibly mild OCD). If Depression or another disorder is your concern, a dozen other more-frequent contributors to this board could probably give you a more complete rundown (e.g., Elizabeth). In fact, one thing I've learned is that things like side effects (worse) and kick-in time (longer) can vary widely when an AD is taken by someone with Social Phobia. (For that matter, I suppose Poop-Out Potential could vary in the same way for a particular med.)
If you haven't already seen it, Dr. Bob's 1997 AD roundup (in the Tips section of this site, if I recall correctly) is a good starting place. Also be sure to visit the newsgroup alt.support.depresson, www.Medscape.com (requires free registration), and www.mentalhealthcom.
I'm personally in no hurry to find an AD for my Social Anxiety because my current Klonopin+ regimen is working just great. But I may eventually want to try a few more AD's (I've tried Nardil, but the side effects were too much and it pooped out) simply to avoid the need for carefully-timed, multiple daily dosing with the Klonopin, and possibly to help my mild OCD. I'm just trying to be gather information in advance so I'm prepared if/when decide to try the AD route again.
Rick
Posted by Patty Gates on October 13, 1999, at 11:55:25
In reply to Re: Ranking AD's by POP - Rick's Study, posted by Rick on October 13, 1999, at 11:19:41
Patty, there's no formal study, just some personal learning -- reading and occasional printing, with info coming
from the net (Medline, forums, journal articles), a couple acquaintances, books, and my pdoc.///Rick - thank you for your response. I did realize this wasn't an "official" study, but am always interested in what others have learned through their shared experiences and information gleaned from various sources. Thanks, too, for the suggestions on locating more information!
Posted by Margaret on October 14, 1999, at 12:24:54
In reply to Re: Ranking AD's by POP - Rick's Study, posted by Patty Gates on October 13, 1999, at 11:55:25
More poop: I started on Prozac in '93, and pooped out around '96, '97. I increased dosage (from 40 mg to 80mg) with no effect.
Posted by Rick on October 14, 1999, at 13:06:26
In reply to Re: Ranking AD's by POP - Rick's Study, posted by Margaret on October 14, 1999, at 12:24:54
Which AD, if any, have you tried since Prozac's effect petered out? Has it been poop-less?
Also, was there any attempt to "re-activate" the Prozac with an augmenting agent such as Pindolol or BuSpar?
> More poop: I started on Prozac in '93, and pooped out around '96, '97. I increased dosage (from 40 mg to 80mg) with no effect.
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.