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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Bonnie on May 9, 2000, at 21:29:56
i am a 15 female and i have been depressed for about 8 months and two weeks ago I quit my meds and nothing is changing for the better,nothing changed on the meds either. I have taken Prozac, wellbutrin, Celexa, and Effexor. I am really sick of every thing and don't know what to do. I am feeling worse every day and don't know what I'll do, help! I really need some advice
P.S. to greg: thank you for everything. :) *hugs*
Posted by tina on May 9, 2000, at 21:39:16
In reply to should i go back on meds????help!, posted by Bonnie on May 9, 2000, at 21:29:56
Have you addressed a hormone imbalance with your doctor? As for the meds, yesyesyes. You know that saying "don't give up until you're satisfied." Don't let the system fail you, keep asking, keep trying, push till you get the help you need.
> i am a 15 female and i have been depressed for about 8 months and two weeks ago I quit my meds and nothing is changing for the better,nothing changed on the meds either. I have taken Prozac, wellbutrin, Celexa, and Effexor. I am really sick of every thing and don't know what to do. I am feeling worse every day and don't know what I'll do, help! I really need some advice
> P.S. to greg: thank you for everything. :) *hugs*
Posted by Kathie on May 9, 2000, at 22:17:22
In reply to should i go back on meds????help!, posted by Bonnie on May 9, 2000, at 21:29:56
Bonnie,
I am far from being an expert about this stuff...but....I am always willing to get bob's two cents worth! Although his 2 cents worth is worth more like $200.00 and mine really is worth 2 cents or less! So here goes...
I see one of two possible problems:
1. You have not discovered "your" med yet. Cam or someone like him can explain the whole complicated chemical complexities of the brain and how meds can (or can not) effect the brain, thus causing a change (or not) in your overall mood.2. Whatever brought on your depression 8 months ago has not been identified, dealt with, or it is still there in your face. Do you have any idea what caused you to become depressed?? Was there any traumatic event in your life? Was there a big change in your life? Was your normal routine changed in any way? Have you suffered any abuse?
Many of the people here can tell you that finding the root of the problem can make all the difference in the world. You are so young yet..try and find out the cause of your depression now, don't wait until you are in your 40's and have been suffering for years and years.
Kathie
Posted by AndrewB on May 9, 2000, at 23:06:44
In reply to Re: should i go back on meds????help!, posted by Kathie on May 9, 2000, at 22:17:22
Sometimes it helps on this board to write out a long post where you describe your history, your diagnosis and exactly how you responded to each of your antidepressants. One of the wise babblers may come up with some useful advice based on what you write.
Trust in this, almost everyone can find relief of their depression. The solutions are out there. Do not make your sufferring worse thinking that you are not destined to get well.
AndrewB
Posted by bob on May 10, 2000, at 0:30:28
In reply to Re: should i go back on meds????help!, posted by AndrewB on May 9, 2000, at 23:06:44
Hi Bonnie,
Pardon me for taking this tone (but I take it with anybody, whatever age or lack of such info, in this situation), but don't EVER stop your meds cold turkey without consulting your doctor!
You probably didn't know what a world of hurt that can bring down on your head. Ask people here about their withdrawal experiences, ask me about my own, then you'll know.
Yes, it's frustrating. Yes, you want relief now. We all have been there -- are there right now even. But this stuff literally messes with your mind. It's supposed to do that in a good way, but you gotta live by the Babble watchwords: Your Mileage May Vary. We all react differently to these meds, and nothing is guaranteed (happy Paxil TV commercials notwithstanding).
That really sucks, but that simply is the way it is.
[sorry about the overprotective tone ... I'm a Cancer, I can't help myself]
You can look at the discussion threads recently on the "6-8 week rule" and even read all the posts, if you have the patience for us ;^), but I'm one who generally falls on the "give it a good trial" side of the argument. Four meds from three different "classes" in eight months is a bit frightening to me -- not only do I generally go in for the 6-8 week trial for a new med (barring disasters -- which for me means wellbutrin) but then giving it at least another month once a med settles into its "therapeutic effect" for the effect to have a chance to build into anything assessible. I guess I'm not all that surprised by how you feel -- I can't say that any one of those meds was given a good chance to work.
Don't take that as criticism, okay? It was your doctor's job to make those decisions (until you get yourself better educated about medications and can make INFORMED decisions ... again, that's for anybody, not just because you're a teen -- making medical decisions on whims isn't a good practice). Are you getting the meds from a family doctor (GP) or a psychiatrist (pdoc)? GPs can be wonderful for a lot of things, but my GP (as much as I respect and love the man for ALL that he's done for me over the years -- he's the best doctor I've ever had by far) simply didn't know enough about psychopharmacology and I paid a price for his understandable lack of knowledge -- even the specialists don't understand this stuff half as much as we all would like them to! Anyway, if you ARE getting your meds from your GP, you may want to discuss with her and your parents going to see a specialist. Some people (like my brother, the rotten b*st*rd!) respond marvelously to the first meds their GPs give them -- others, like me and maybe you, don't have such luck. But a pdoc may recognize things a GP wouldn't, and would have a much better understanding of what meds to try based on your reactions to what you've taken. A pdoc would also know what combinations of meds might work for you ... lots of us here are on cocktails -- I'm on three (desipramine, klonopin, and ritalin), others are on more, some just (hah! "just") two.
Whatever my two cents is worth, that's what I almost always have to offer in these sorts of situations. Get thee to a pdoc. If you're not seeing a talk therapist, do that, too. Milk your parents' insurance plans for all they're worth while you can, if you can.
Bonnie, one thing "adults" dream of doing is sparing their "kids" the pains they endured. From what I remember, it was just too hard from the other end of the conversation to believe a word of those stories. But here in Babbleland, you get to see our stories as they are unfolding. I imagine that you're hearing some things that sound pretty familiar ... without any idea of how old the storyteller is (ain't e-anonymity great?). But I'll chime in as another who sees "I'm 15" and hopes you can take this all to heart right here, right now. It's not fair at all that you have to deal with this so early in your life. My depression kicked into overdrive when I was 8. Nearly 25 years passed before I got serious about getting help. Almost 30 gone, now, and I'm finally feeling some relief. Not only do people in my position have to deal with our disorder, we have to deal with all the anger, guilt, and sorrow that comes with the realization that we lost what should have been the best years of our lives to our disease and there's no way of ever getting them back. If I had started meds and therapy at 8 or 15 or 21, I doubt I'd be "cured" by now ... but I think I'd have arrived where I am right now a long time ago, and maybe I could have enjoyed those years more and hurt much less.
You're frustrated and hurting right now, but don't let it get the best of you. Take a look about you, see what support you have (including all of us here!), and USE that support to get well. You don't have to be alone in this.
cheers,
bob
Posted by Andre Allard on May 10, 2000, at 6:50:12
In reply to should i go back on meds????help!, posted by Bonnie on May 9, 2000, at 21:29:56
> i am a 15 female and i have been depressed for about 8 months and two weeks ago I quit my meds and nothing is changing for the better,nothing changed on the meds either. I have taken Prozac, wellbutrin, Celexa, and Effexor. I am really sick of every thing and don't know what to do. I am feeling worse every day and don't know what I'll do, help! I really need some advice
> P.S. to greg: thank you for everything. :) *hugs*It is probably safe to say that after four unsuccessful trials of AD's you are no longer under the care of a GP, if you ever were to begin with. With this in mind, I will assume you are seeing a psychiatrist - I hope. It is uncommon for someone to be nonresponsive to four different medications from three different classes. If you are under the care of a good psychiatrist then the following should have occured with each medication;
- It is normal practice to begin AD treatment with approximately 1/6 of the maximum dosage.
- If the drug is being tolerated well (minimal side effects) then the dosage is increased at approxiamtely 1/6th of the maximum dosage no less than every fourth day (this is how long it takes to acheive steady blood plasma levels for the AD's which you have listed with the exception of Wellbutrin which takes five days).
- At least six weeks at the maximum dosage (this is how long it takes to acheive a full theraputic response).
- If there has been either a minimal reponse or no response, the AD is then switched.
- If there is a partial response and the drug is being tolerated well, the dosage is then increase beyond the recommended maximum dosage.
- If after this, a full response (50% reduction in the overall symptoms) has still not been acheived then the AD is augmented with another AD, lithium, buspirone, pindolol, or T3.
- If after this, a full response has still not been acheived then the AD is switched to another class once again.
- By this time, if the symptoms of depression are severe enough then ECT (electroconvulsive therapy) is conducted.
Most psychiatrists follow something like what is mentioned above. Noticed I mentioned that "most" psychiatrists conduct their practice in this manner. One psychiatrist I have seen studied at the University of Garbage. If given a prescription pad, I could have done a better job. Anyways, if you were taking each AD for at least six weeks then the prozac should have been titrated to a maximum of 80 mg, the Wellbutrin to 600 mg, the Celexa to 50 mg and the effexor xr to 225 mg. When you say "nothing changed on the meds either", do you mean that you still had some depressive symptoms or that you did not note any change whatsoever while on the meds. The thing is it is uncommon to not respond to three different classes of AD's if they are given at a maximum dosage. Other AD's you could try are manerix, serzone, remeron or a combination of whatever works for you. Each doc has their favourites. It may also be that you are treatment-resistent. This means that you do not respond to medications. When these people arise, ECT can be 90% effective in releiving depression. I am sure you can find a AD that works for you. If not, there is always ECT as a last line of treatment. The likes of your depression never getting better are almost one in a million. Keep your willpower up and I can almost assure that one day you will have your life back. It might be hard for you to beleive that the depression will ever improve but this is part of your illness. The suggestions I have made as well what others have written can be of great help to you when discussing the next course of treatment with your psychiatrist. Let me know what happens. Good luck!
Posted by Greg on May 10, 2000, at 7:57:01
In reply to should i go back on meds????help!, posted by Bonnie on May 9, 2000, at 21:29:56
Bonnie,
You've gotten some real quality advise from everyone here. I agree that continuing the meds is a good idea until you start to either reap the benefits or find find the need for a change. But you've got to get the ball rolling. Unfortunetly, help won't seek you out, you've got to go looking for it. PLEASE keep us advised on how you're doing, we'll all keep you in out thoughts and our prayers.Much Love,
Greg> i am a 15 female and i have been depressed for about 8 months and two weeks ago I quit my meds and nothing is changing for the better,nothing changed on the meds either. I have taken Prozac, wellbutrin, Celexa, and Effexor. I am really sick of every thing and don't know what to do. I am feeling worse every day and don't know what I'll do, help! I really need some advice
> P.S. to greg: thank you for everything. :) *hugs*
Posted by Greg on May 10, 2000, at 8:21:02
In reply to should i go back on meds????help!, posted by Bonnie on May 9, 2000, at 21:29:56
Bonnie,
I wanted to share a poem that my most wonderful wife sent to me recently, I hope it helps you as much as it did me.
Your presence is a present to the world. You're unique and one
of a kind. Your life can be what you want it to be. Take the
days just one at a time.Count your blessings, not your troubles. You'll make it through
whatever comes along. Within you are so many answers.
Understand, have courage, be strong.Don't put limits on yourself. So many dreams are waiting to be
realized. Decisions are too important to leave to chance.
Reach for your peak, your goal, your prize.Nothing wastes more energy than worrying. The longer one
carries a problem, the heavier it gets. Don't take things too
seriously. Live a life of serenity, not a life of regrets.Remember that a little love goes a long way. Remember that a
lot... goes forever. Remember that friendship is a wise
investment. Life's treasures are people...together.Realize that it's never too late. Do ordinary things in an
extraordinary way. Have health and hope and happiness. Take
the time to wish upon a star. And don't ever forget...
for even a day... how very special you are.
This is the end of the thread.
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