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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Racer on September 22, 1998, at 13:27:36
Hi, me again. I wonder if anyone out there, preferabley a doctor, could offer some advice?
My appetite, while still not good, is better. (And damn it, how could I gain weight when I didn't eat for days? It's not fair.) To start with, I was getting the pre-migraine "aura" with no headache, now I'm having excrutiating headaches daily. I'm also not sleeping. I can't get to sleep, and then can't stay asleep all night. I'm miserable. I'm also starting to feel as though I may as well be dead, which isn't necessarily a good thing. (Maybe it is having some effect on the depression? At least I think that maybe it's bad that I want to kill myself?)
If you remember my first post, you may remember that I really don't trust my doctor, but don't have any alternatives. Can anyone out there throw out a few suggestions of drugs for me to look into and then discuss with my doctor? I'll tell you a few specifics that may or may not help.
I've been on nortriptyline and Paxil in the past. Both were effective against the depression, but the nortriptyline required L-tryptophan to work, had bad effects on my sleeping, and also put 70# on me. Weight gain like that would be devastating right now, since I'd have to join a Naturists camp, since I wouldn't have any clothes.
The Paxil was effective, but it made me too sleepy to get through an entire day without a nap, which is not great if you are trying to work. It also put weight on me, about 50# (better than the nortriptyline, but not by much), and destroyed my sex life.
Most drugs list hypotension as a possible side effect, my blood pressure is low to start with, and lowering it further leads to fainting, falling, and problems with proprioception. Weight gain is a problem not only from a practical standpoint, but also because I'm a former anorexic, and any weight gain still can make me frantic. Sleep is a problem for me anyway, but there must be something that can hit the line between not able to sleep and not able to stay awake. I really want to have orgasms, that might be too much to ask, but I really want them. The frustration of Paxil, where I could get aroused, but couldn't DO anything about it, was worse than I can say. (I also know that I'm not nearly as responsive today, 4 years after stopping the medicine, as I was before I started it.)
Thanks for any suggestions of directions for me to explore.
Posted by Toby on September 24, 1998, at 10:50:01
In reply to Serzone problems, suicidal again, help? (Toby?), posted by Racer on September 22, 1998, at 13:27:36
Taking the full dose of Serzone at night may be helpful for your sleep. Medications for sleep that don't cause weight gain are not too plentiful because the way they induce sleep has a lot to do with antihistamine effects and that is what leads to weight gain. Nonetheless, small doses of sinequan or trazodone can induce sleep and help prevent arousals during the night. the new antidepressant Remeron is quite sedating and helps sleep very well. It does have a reputation for weight gain (although for some odd reason I can't figure out, none of my patients have gained weight on it) but that seems to be at doses lower than 30 mg per day. Start for several days at 15 mg to get your sleep back on track and then increase to 30 mg and your sleep will stay good, but you take away the likelihood of weight gain and it can really augment the antidepressant effect of Serzone.
Posted by Racer on September 24, 1998, at 21:35:55
In reply to Re: Serzone problems, posted by Toby on September 24, 1998, at 10:50:01
Part of my problem is physical. I finally went to the local free clinic for a cold that wouldn't go away (while thinking that I was lazy and looking for an excuse not to do anything) and it turns out I have mononeucleosis. JOY!
I feel a little better knowing that it isn't just bad character holding me back.
Posted by Toby on September 25, 1998, at 8:52:29
In reply to Guess what?, posted by Racer on September 24, 1998, at 21:35:55
Mono can be treated better than it used to be. Take your medications as directed (I'm sure you do anyway), get plenty of rest for now, fluids are good, eat as many fruits and veggies as you can, meditate, when the infection is gone begin slowly to increase activities and build up your stamina.
Keep up the Serzone since the serotonin does do something for the recovery process in mono (don't ask me what, I forget).
Posted by Racer on September 25, 1998, at 11:29:09
In reply to Re: Mono, posted by Toby on September 25, 1998, at 8:52:29
The medical doctor said she didn't think that taking the Serzone was a good idea, because it's processed by the same liver that may be inflamed by the mono. The psychopharmacologist whom I still don't trust said, "well, but you need to take anti-depressants" and went on to admit that she didn't know anything about how mono would interact with the drugs. So, your comments, even without remembering exactly what happens, makes me feel better about taking the drugs.
Thanks again.
Posted by md on October 30, 1999, at 7:08:14
In reply to Re: Serzone problems, posted by Toby on September 24, 1998, at 10:50:01
> Taking the full dose of Serzone at night may be helpful for your sleep. Medications for sleep that don't cause weight gain are not too plentiful because the way they induce sleep has a lot to do with antihistamine effects and that is what leads to weight gain. Nonetheless, small doses of sinequan or trazodone can induce sleep and help prevent arousals during the night. the new antidepressant Remeron is quite sedating and helps sleep very well. It does have a reputation for weight gain (although for some odd reason I can't figure out, none of my patients have gained weight on it) but that seems to be at doses lower than 30 mg per day. Start for several days at 15 mg to get your sleep back on track and then increase to 30 mg and your sleep will stay good, but you take away the likelihood of weight gain and it can really augment the antidepressant effect of Serzone.
I have been taking serzone since the end of August. I have been experiencing severe lower back pain and my joints have been aching in my hips, knees and calfs. I do have fibromyalgia, but have not had any problems with my low back at all. I am thinking of getting off the serzone, because I am suspicious of it being the culprit. What is your opinion?
Posted by Noa on October 30, 1999, at 8:03:39
In reply to Re: Serzone problems, posted by md on October 30, 1999, at 7:08:14
Hmmm...this makes me wonder. For the past two weeks, I have had problems with my ankles. They are swollen, for no reason that is apparent to me. My left ankle aches, especially when I walk more than 100 feet or so. Come to think of it, I have a bit of achiness in my hips. Have been on Serzone since July or August.
> I have been taking serzone since the end of August. I have been experiencing severe lower back pain and my joints have been aching in my hips, knees and calfs.
Posted by Judy on October 30, 1999, at 10:23:25
In reply to Re: Serzone problems, posted by md on October 30, 1999, at 7:08:14
>
> I have been taking serzone since the end of August. I have been experiencing severe lower back pain and my joints have been aching in my hips, knees and calfs. I do have fibromyalgia, but have not had any problems with my low back at all. I am thinking of getting off the serzone, because I am suspicious of it being the culprit. What is your opinion?md (and Noa),
Having recently had the "flu" for about six weeks (aches in all my joints, kidney area, etc.), I was 'miraculously' cured when I stopped taking Effexor. My Pdoc confirmed that flu-like symptoms and muscle/joint aches are indeed a side effect of AD's for some people. I can't comment on how or if your fibromyalgia plays into it; but your suspicions about Serzone could be on the mark.
Judy
Posted by Racer on October 30, 1999, at 14:04:32
In reply to Re: Serzone problems, posted by Judy on October 30, 1999, at 10:23:25
After all that stuff last year, it finally got to the point that I couldn't walk across the room, nor keep any food down at all, because of the Serzone. I was so miserable that I couldn't function at all.
I'm on other drugs now, and they're working. It could be that Serzone just simply ain't the drug for you. Talk to your doctor about trying something else.
Posted by Noa on October 30, 1999, at 14:58:16
In reply to The followup of my experience on Serzone, posted by Racer on October 30, 1999, at 14:04:32
Judy, interesting. More recently than starting the serzone, I had a major increase in the effexor xr. Could that be causing my swollen ankles?
Posted by Judy on October 30, 1999, at 17:00:01
In reply to Effexor problems......Hmmmmmm, posted by Noa on October 30, 1999, at 14:58:16
Noa,
After playing this AD 'game' for over 15 years now, I wouldn't put *anything* past an AD. By ankle swelling, I you're referring to fluid retention (Edema)? I didn't have edema while taking Effexor (although I wasn't on it all that long); BUT I suffered such serious swelling in my ankles, breasts and face while taking Nardil that I had to discontinue it - even though it is the ONLY drug that's ever worked for my depression.
I CAN almost guarantee you that IF the Effexor is causing swelling, you can test it by dropping your dose back to pre-increase level for a few days to see if the swelling subsides. (It should quickly if it's a dose-dependent side effect). That will answer one question for you, but could present another: Are higher doses of Effexor going to cause problems for you?
Hope this helps some.
Judy
> Judy, interesting. More recently than starting the serzone, I had a major increase in the effexor xr. Could that be causing my swollen ankles?
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