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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Tina1 on May 27, 2000, at 9:40:01
The psychopharmacologist was 100% sure that celexa is the right med for me. 100%. Then why do I feel like crap? Is it possible that it has pooped out at one month? Anyone? The anxiety is worse than ever and I'm regressing to my "head-in-the-toilet" frame of mind. This sucks--What do I do now?
P.s. Man! I miss Greg, anyone else?
Posted by Noa on May 27, 2000, at 11:00:11
In reply to Celexa--Right or Wrong????, posted by Tina1 on May 27, 2000, at 9:40:01
Tina, didn't you just start Serzone?
Posted by Tina1 on May 27, 2000, at 11:49:05
In reply to Re: Celexa--Right or Wrong????, posted by Noa on May 27, 2000, at 11:00:11
Ya, I did just start serzone. It was in addition to the celexa though. Doc thought I was developing serotonin syndrome and thought the serzone might allow some uptake of serotonin to counter the activating effects of celexa. I don't understand it either but he promised me it would work. Well, guess what--Big nope there. It just makes me sick. I'm lost now.
What do YOU think of Paxil(paroxetine) Z swears by it but a lot of people don't like it.> Tina, didn't you just start Serzone?
Posted by Noa on May 27, 2000, at 12:02:52
In reply to Re: Celexa--Right or Wrong? To Noa, posted by Tina1 on May 27, 2000, at 11:49:05
I know people with social phobia for whom it has been a great help.
I took it for a while a few years back...It worked for my depression for about a year, but then started to poop out. Problem was, raising the dose brought on side effects that were hard to tolerate--insomnia, myoclonus (muscle jerks and twitches), etc. That is when I switched to effexor.
Posted by CarolAnn on May 27, 2000, at 13:27:23
In reply to Celexa--Right or Wrong????, posted by Tina1 on May 27, 2000, at 9:40:01
Don't give up on the Celexa until you get the Serzone out of your system. I was on Wellbutrin, and not really improving, my Pdoc added Serzone, and I got so freaking depressed from it that I came closer than I have ever been in my life to committing suicide. About two weeks after I got off the serzone, I was back to normal. Well, my normal level of depression, but at least I wasn't thinking about my husband's shot gun anymore!
Also, have you tried going up to 40mgs. Celexa? I got no effect from it at all until I went to that dose. Best wishes! CarolAnn
Posted by Tina1 on May 27, 2000, at 18:26:07
In reply to Re: Tina, I bet it's the Serzone..., posted by CarolAnn on May 27, 2000, at 13:27:23
I didn't take to serzone last night and I felt a little less anxious today. I'm not going to take it anymore. What I am wondering though is should I try something other than the celexa? When do I give up on it? Been a little over a month now and have seen no improvement in mood or anxiety syndrome. Any suggestions?
I know I'm complaining a lot lately and I'm sorry but previous episodes have never been this bad and I'm at my wits end. All I get from my doc is give it time but shouldn't it have made SOME difference by now?
Also, I am gaining weight by the tonne and I hate it. Can't stop eating cookies!!!!!HELP....> Don't give up on the Celexa until you get the Serzone out of your system. I was on Wellbutrin, and not really improving, my Pdoc added Serzone, and I got so freaking depressed from it that I came closer than I have ever been in my life to committing suicide. About two weeks after I got off the serzone, I was back to normal. Well, my normal level of depression, but at least I wasn't thinking about my husband's shot gun anymore!
> Also, have you tried going up to 40mgs. Celexa? I got no effect from it at all until I went to that dose. Best wishes! CarolAnn
Posted by dove on May 27, 2000, at 20:46:17
In reply to Re: Celexa--Right or Wrong? To Noa, posted by Tina1 on May 27, 2000, at 11:49:05
> Doc thought I was developing serotonin syndrome and thought the serzone might allow some uptake of serotonin to counter the activating effects of celexa.
Hopefully someone can disagree with me, but, your doctor's reasoning for adding the serzone just blows me away. Everything I've read states that there is a real danger adding serzone to other serotonin reuptake inhibitors, as it *causes* serotonin syndrome. Anyone care to adjust my vision? Or is this true?
dove
Posted by Tina1 on May 27, 2000, at 20:52:05
In reply to serotonin syndrome and serzone, posted by dove on May 27, 2000, at 20:46:17
Thanks dove. That's what I thought but I of course trusted my doc. I'm not taking the serzone because of this and I see my doc again on wednesday.
> > Doc thought I was developing serotonin syndrome and thought the serzone might allow some uptake of serotonin to counter the activating effects of celexa.
>
> Hopefully someone can disagree with me, but, your doctor's reasoning for adding the serzone just blows me away. Everything I've read states that there is a real danger adding serzone to other serotonin reuptake inhibitors, as it *causes* serotonin syndrome. Anyone care to adjust my vision? Or is this true?
>
> dove
Posted by CarolAnn on May 28, 2000, at 9:37:19
In reply to Re: serotonin syndrome and serzone, posted by Tina1 on May 27, 2000, at 20:52:05
Tina, I think Dove is right, my Pdoc prescribed Serzone in order to increase my serotonin levels, since I was on Wellbutrin, which does not effect serotonin.
I wish I could tell you what to try next, but I'm just not sure, however; based on your doc's suggestion of the Serzone, it might be a good idea to do some research of your own or try to get another doctor. Try asking a pharmacist, if you can catch one who isn't busy, I have found that some of them can be more knowledgeable than a lot of doctors when it comes to medications. Take care! CarolAnn
Posted by kath on May 29, 2000, at 9:26:24
In reply to Re: Tina, I agree with Dove...., posted by CarolAnn on May 28, 2000, at 9:37:19
>This is my 3rd day on Celexa & I'm nervous about what will happen when I eventually go off it. I'm having talk therapy also & hope to eventually go off medication and use the tools I'll have gained during therapy to cope better with my life. (I assume seratonin syndrome means too much seratonin in one's brain. What are the symptoms?) Kath
Posted by Tina1 on May 29, 2000, at 13:32:42
In reply to Re: Tina, I agree with Dove...., posted by kath on May 29, 2000, at 9:26:24
I hope the celexa works out for you. My symptoms of serotonin syndrome are extreme tremors, I can't keep my knees still, extreme dizziness-can't get up out of bed in the morning until I lie there for 30 mins adjusting my eyes and body a little at a time, lethargy to the point that I can't hold a coffee(decaf) cup without it being too heavy and when I sit still and quiet my body feels like I'm on a boat--it sways and rocks with waves and makes me very nauseous. Could be the serotonin syndrome and maybe just anxiety/depression but it's very uncomfortable. Changing meds this week I think, don't want to listen to the docs anymore. I'm going to tell THEM what I want to do. Good luck on celexa, it works for some as you can see from this board.
> >This is my 3rd day on Celexa & I'm nervous about what will happen when I eventually go off it. I'm having talk therapy also & hope to eventually go off medication and use the tools I'll have gained during therapy to cope better with my life. (I assume seratonin syndrome means too much seratonin in one's brain. What are the symptoms?) Kath
Posted by brian on May 29, 2000, at 14:16:19
In reply to Re: Symptoms--To Kath, posted by Tina1 on May 29, 2000, at 13:32:42
> I hope the celexa works out for you. My symptoms of serotonin syndrome are extreme tremors, I can't keep my knees still, extreme dizziness-can't get up out of bed in the morning until I lie there for 30 mins adjusting my eyes and body a little at a time, lethargy to the point that I can't hold a coffee(decaf) cup without it being too heavy and when I sit still and quiet my body feels like I'm on a boat--it sways and rocks with waves and makes me very nauseous. Could be the serotonin syndrome and maybe just anxiety/depression but it's very uncomfortable. Changing meds this week I think, don't want to listen to the docs anymore. I'm going to tell THEM what I want to do. Good luck on celexa, it works for some as you can see from this board.
>
>
> > >This is my 3rd day on Celexa & I'm nervous about what will happen when I eventually go off it. I'm having talk therapy also & hope to eventually go off medication and use the tools I'll have gained during therapy to cope better with my life. (I assume seratonin syndrome means too much seratonin in one's brain. What are the symptoms?) KathTina 1,
I'm also on Celexa and I have some similar symptoms. At night, I have a very difficult time getting to sleep. I lie there, mentally tired but key up -- my muscles just won't release tension easily. Sometimes, I lie in bed until 4-5 in the morning before I fall asleep.
In the morning, regardless of how long I've slept, I have a hard time getting out of bed. My eyes don't want to adjust, there's this pervasive tiredness in my body, and I'm usually pretty depressed. Once I get up I'm OK, but it often takes a lot of coffee to keep me going throughout the day. I usually poop out for about an hour in the afternoon. If I lie down "for a few minutes" I can zonk out for a few hours.
I'm not so sure about this Celexa -- I've been on this for about 3 1/2 weeks. I feel like I've "enjoyed" side effects without the benefits. I'm still hopefull (I've heard lots of great things about celexa) but I'm also wondering if it's for me.
Well, this is sort of a vent. Just letting you know that I've had physical agitation and morning adjustment problems you've described.
Posted by Kath on May 31, 2000, at 8:16:15
In reply to Re: Symptoms--To Kath, posted by Tina1 on May 29, 2000, at 13:32:42
> I hope the celexa works out for you. My symptoms of serotonin syndrome are extreme tremors, I can't keep my knees still, extreme dizziness-can't get up out of bed in the morning until I lie there for 30 mins adjusting my eyes and body a little at a time, lethargy to the point that I can't hold a coffee(decaf) cup without it being too heavy and when I sit still and quiet my body feels like I'm on a boat--it sways and rocks with waves and makes me very nauseous. Could be the serotonin syndrome and maybe just anxiety/depression but it's very uncomfortable. Changing meds this week I think, don't want to listen to the docs anymore. I'm going to tell THEM what I want to do. Good luck on celexa, it works for some as you can see from this board.
..............
Thanks Tina. I'm already experiencing benefits from Celexa at Day 4. It's helping with my anxiety & compulsiveness, so if I can ride out the initial (I'm told) side effect period, I'm hoping it's the right nedication to help me. It's the first A/D I've ever taken. Hope you're well.
Kath
Posted by SLS on May 31, 2000, at 16:25:27
In reply to serotonin syndrome and serzone, posted by dove on May 27, 2000, at 20:46:17
> > Doc thought I was developing serotonin syndrome and thought the serzone might allow some uptake of serotonin to counter the activating effects of celexa.
>
> Hopefully someone can disagree with me, but, your doctor's reasoning for adding the serzone just blows me away. Everything I've read states that there is a real danger adding serzone to other serotonin reuptake inhibitors, as it *causes* serotonin syndrome. Anyone care to adjust my vision? Or is this true?
>
> dove
Serzone + SSRI is supposed to be a good combination when dealing with a situation in which depression and OCD occur together. Often, Serzone will bring about a robust improvement of depression, but not improve the OCD. Adding an SSRI can do the trick. I have seen this combination strategy recommended by some very good doctors. It might also work well for treatment-resistant depression. As with the SSRIs, Effexor is another potent reuptake inhibitor of serotonin for which serotonin syndrome infrequently develops when it is combined with other drugs. There is someone here who has gleaned some improvement by combining Effexor with Serzone.There is a risk of developing serotonin syndrome for quite a few other drug combinations, including SSRI + lithium. This combination seems to be generally safe. However, as in many, many situations in which there is a potential of a dangerous reaction to a medication, precautions should be taken to screen for it.
SSRIs and Effexor should NEVER be combined with an MAO inhibitor.
- Scott
Posted by dove on June 1, 2000, at 9:47:01
In reply to Re: serotonin syndrome and serzone, posted by SLS on May 31, 2000, at 16:25:27
> Serzone + SSRI is supposed to be a good combination when dealing with a situation in which depression and OCD occur together.
I agree with the statement above, I have only seen real improvement in my own depression by combining meds, the biggies being Amitriptyline and Nefazodone (Serzone); the concern was the fact that her doc said he wanted to counteract the possible "Serotonin Syndrome" by adding Serzone.
That is what disturbs me, the doc thinking that she may be building a case of serotonin syndrome. Unless she misunderstood the doc's explanation, which I myself have done, then this treatment protocol, as designed by the doc is kinda frightening to me.
dove
Posted by Cindy W on June 1, 2000, at 10:07:55
In reply to Re: serotonin syndrome and serzone, posted by SLS on May 31, 2000, at 16:25:27
> > > Doc thought I was developing serotonin syndrome and thought the serzone might allow some uptake of serotonin to counter the activating effects of celexa.
> >
> > Hopefully someone can disagree with me, but, your doctor's reasoning for adding the serzone just blows me away. Everything I've read states that there is a real danger adding serzone to other serotonin reuptake inhibitors, as it *causes* serotonin syndrome. Anyone care to adjust my vision? Or is this true?
> >
> > dove
>
>
> Serzone + SSRI is supposed to be a good combination when dealing with a situation in which depression and OCD occur together. Often, Serzone will bring about a robust improvement of depression, but not improve the OCD. Adding an SSRI can do the trick. I have seen this combination strategy recommended by some very good doctors. It might also work well for treatment-resistant depression. As with the SSRIs, Effexor is another potent reuptake inhibitor of serotonin for which serotonin syndrome infrequently develops when it is combined with other drugs. There is someone here who has gleaned some improvement by combining Effexor with Serzone.
>
> There is a risk of developing serotonin syndrome for quite a few other drug combinations, including SSRI + lithium. This combination seems to be generally safe. However, as in many, many situations in which there is a potential of a dangerous reaction to a medication, precautions should be taken to screen for it.
>
> SSRIs and Effexor should NEVER be combined with an MAO inhibitor.
>
>
> - ScottScott, I take Effexor-XR 375 mg/day in the morning and 50 mg/day of Serzone, at night (to help me sleep). I don't think the combination is dangerous, since I've been taking the two in combination for about six months. From what I've read, serotonin syndrome is more a danger when there is a very high dose of two SSRI's (neither Serzone or Effexor-XR is an ssri), and when SSRI's are combined with an MAO inhibitor, which you pointed out. So people on this board who are afraid of combining Serzone and Effexor-XR can probably do so without worrying about serotonin syndrome (at least from my limited personal experience and IMHO).--Cindy W
Posted by SLS on June 1, 2000, at 15:58:47
In reply to Re: serotonin syndrome and serzone, posted by dove on June 1, 2000, at 9:47:01
> > Serzone + SSRI is supposed to be a good combination when dealing with a situation in which depression and OCD occur together.
> I agree with the statement above, I have only seen real improvement in my own depression by combining meds, the biggies being Amitriptyline and Nefazodone (Serzone); the concern was the fact that her doc said he wanted to counteract the possible "Serotonin Syndrome" by adding Serzone.
> That is what disturbs me, the doc thinking that she may be building a case of serotonin syndrome. Unless she misunderstood the doc's explanation, which I myself have done, then this treatment protocol, as designed by the doc is kinda frightening to me.
> dove
Ooh. Sorry. I hadn't read the whole thread. I feel a bit nervous about this situation too.Dove - How are you doing now? Seeing your name always gives me warm-fuzzies.
Are you still taking the AMI SRZ combination? I have never come across a combination of Sersone with a tricyclic. I would be interested to know more about your case to see if there is any similarity to mine in terms of symptoms and previous drug responses. I have been looking for an effective treatment for a long time.
I guess that probably sounds like I want you to write a book.
Anything would help. I need to make some treatment decisions soon.
Thanks.
- Scott
This is the end of the thread.
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