![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by SueG on July 9, 2000, at 20:17:19
I am taking 20mg Prozac and am in my fourth week. After (and coinciding with) the initial side-effects of dizziness and sleepiness, I have noticed definite improvement in some areas i.e. mood stabilisation, more confidence and more talkative, and the ability to concentrate has increased. I have noticed I am slightly more interested in things, however, not to the extent that i am happy with. I still have days where i just sit on the couch and want to do nothing, even though I feel fine. I had a few days early on where i felt that i had some drive and motivation however, this goes up and down. I really want to change careers and begin studying but i am really afraid that i'll start and won't continue because i don't have the motivation/drive and i'll lose interest. I have done this with a lot of things in the past. I seem to get bored easily and i lose focus easily. I don't know why - I know i have the ability but i start to question myself when this happens.
I don't really want to increase the dose of Prozac as I am afraid that the sexual side-effects will become unmanageable. (At the moment i notice a definite delay in orgasm, but at least it is still there. My sex drive is almost zero, although it was before-hand too. That went along with the lack of interest in all things.) Also, i have a problem with insomnia, although i am tending to alternate between insomnia and sleepiness with Prozac. I take temazepam at night when i can't sleep.
I am wondering if augmenting the Prozac with something else may be beneficial for gaining some drive and motivation? I've heard good things about Wellbutrin in combination with Prozac (and that this may help sexually), also reboxetine, adrafinil, and amisulpride. I don't think any of these things are available in Australia however, so I would have to convince my doc that they would be of benefit. If that is the case, i can import them in.
Any ideas would be greatly appreciated.
Thank you.
Posted by stjames on July 9, 2000, at 21:15:15
In reply to Do I need to augment for motivation and drive?, posted by SueG on July 9, 2000, at 20:17:19
4 weeks is a little early to deside for sure Prozac is not doing everything you want it to do.
At 4 weeks you just beginning to see the positive effects. In terms of raising the dose do remember that the sexual side effects are reversable and delayed O to me is not a minus but a plus. If in a few weeks Prozac is not helping with all problems you could raise it and watch for improvement of increased side effects.james
Posted by KarenB on July 9, 2000, at 23:50:21
In reply to Do I need to augment for motivation and drive?, posted by SueG on July 9, 2000, at 20:17:19
SueG,
Quotes from you:
>>...and the ability to concentrate has increased.
>>...I really want to change careers and begin studying but i am really afraid that i'll start and won't continue because i don't have the motivation/drive and i'll lose interest. I have done this with a lot of things in the past.
>>...I seem to get bored easily and i lose focus easily. I don't know why - I know i have the ability but i start to question myself when this happens.Hey all you ADD women,
Wow, does this sound like ADD, without hyperactivity and the resulting depression from a lifetime of misdiagnoses, or what?? I could be wrong but to me, this has ADD written all over it. What do you think, Janice, CarolAnn, Sarah, Renee, others?
Sue: Check out www.CHADD.org, follow the links and take some tests. You may be surprised at what you find.
Have you had problems getting to bed at night but then can't seem to drag yourself out of bed in the morning, YOUR WHOLE LIFE? Did you get in trouble for "daydreaming," even in second or third grade? Have problems with those really looooong Algebra equations? Reading music? Do you get "lost" in your own house, suddenly realizing that you have five or six unfinished tasks going at once, because you keep getting distracted? You run out the door to buy milk and your husband says, "Don't forget the milk?!" Test with a very high I.Q. but have only mediocre grades to show for it? Get completely overwhelmed (not panic attacks) in a department or clothing store and finally go home, exhausted, accomplishing nothing? Any of this sound familiar?
Another great article is on differentiation between ADD and Bipolar. Go to www.addclinic.org and find the article entitled 296 vs 314. You may see yourself there. I found an article there...or on one of the links which was a test specifically for teenage girls. I could identify with the symptoms they listed - it was like going back to my childhood and saying, "THAT'S WHY THAT HAPPENED!!!" What a revelation.
My change in diagnosis from Major Depression, to Bipolar Disorder to ADD, innattentive type without hyperactivity has certainly been a revelation to me. I am on new meds and the past few days have been an encouragement. I feel good - REALLY good in a natural, unwired, unzombielike, unsleepy kind of way. I am trialing 100mg Adrafinil (wakefulness, motivation and brighter mood) 2x a day, plus 10mg Adderall 2x a day (energy and focus) and just 5mg of Zyprexa, at bedtime and lunch has helped with racing, scattered thoughts, "broken record" type obsessing and irritability. I DO feel good...and it's been a long time coming. I only pray that it continues (oh pleeeease...). In three weeks, it will stand the ultimate test: PMS/PMDD (also known as "PMS from hell"). If this combo still works during THAT week, it's a bonafide miracle. I believe in miracles. How 'bout you guys?
I have a GYN appt. this week, to check into hormone therapy as well. No human being should have to endure once a month INSANITY. And I mean COMPLETE MELTDOWN. This past week, I felt like my 2 year old at 5pm, when he hasn't taken a nap all day. We call that "baby meltdown," around our house. You mommies know what I mean.
Karen
Posted by SueG on July 10, 2000, at 1:06:20
In reply to Re:augment?ADD?SueG,Janice,CarolAnn,Sarah,Renee?, posted by KarenB on July 9, 2000, at 23:50:21
> Wow, does this sound like ADD, without hyperactivity and the resulting depression from a lifetime of misdiagnoses, or what??Well, funny thing is, that my therapist (she is not a psychiatrist, but a psychologist experienced in eating disorders - which is why i am seeing her), doesn't think that i am depressed. I filled out a Beck Depression questionnaire and only came up with "mild" depression. However, my symptoms were: insomnia (couldn't fall asleep, just thinking random thoughts at night and couldn't relax), then waking sometimes 5 or 6 times each night, sad mood (yet sometimes i was happy also, but it was like something was missing, I was empty). When i was sad, it was like there wasn't any hope, nothing to look forward to and I wasn't living, I was just being. I was very sensitive to criticism or anything i remotely saw as criticism. I would over-react at the stupidest things. I would then get extremely upset with myself for being so emotional. Concentration was a big one with me too. I had trouble just doing my work, i wasn't interested, i was bored, it would take me forever to do something. I would just sit here and play on the internet most times. When I read a book I often have trouble with the info not sinking in. I will read the same pages over and over without it making sense. I can be in a meeting and people are talking - I'll be thinking about something completely different, realise it, and think if I was asked a question, that i would have no idea what they were talking about. Obviously i have trouble retaining information (this could be an ADD symptom? I'm about to read the info you suggested after i finish this). When i am watching a movie, or a tv show, I can appear to be watching it, but my mind wanders - next thing i realise i don't know what's going on. The worst thing is when my husband says "what did he say?" (on the movie) and I have to say I don't know!! (I pretend i didn't hear it!).
Also when i go walking with my mother, she talks to me and i just zone out and i say "mmm", "yeah" etc, but i realise after she's said it, i have no idea what she was on about! The awful thing is though, that i'm not particularly interested in what she is saying.
> Have you had problems getting to bed at night but then can't seem to drag yourself out of bed in the morning, YOUR WHOLE LIFE?Yes, i tend to be a person who would rather stay up late at night and sleep late in the morning. I suppose i am getting into the habit of getting up early in the mornings but it is still a struggle. When i was about 10-18 (at school) I would sleep on the weekends and holidays sometimes until early afternoon. I don't do this anymore, thankfully! I rarely feel like i am wide awake though, always feel "foggy" and that my mind is unclear (the prozac seems to be helping).
When i was young (up to 13) I used to love school, and i would get really good grades. But after that, it started to go downhill, I lost all interest and couldn't be bothered with it. I never knew what i wanted to be, however, i had the ability.
Sometimes I forget things that I just started i.e. i turned the iron on last night, then while waiting for it to warm up, I started doing something else in the kitchen and completely forgot about the ironing. Is that what you mean? I have this little notebook that i carry with me everywhere that is my saviour - whenever i think of anything that i have to do, i write it on the appropriate page so i don't forget to do it.
I have never ever thought of ADD as a possibility - in fact i don't know anything about it really. Do you think that prozac would help me at all if this was the case? i.e. have seen some improvements with it.
Other examples i can give you would be:
I start projects all enthused but in about 2 weeks the novelty/excitement wears off and i just let them go. i.e. I started a correspondence course in fitness and in travel, and both of these fell by the wayside. It's like i lose track and just can't get back on. I bought myself a horse one time (my 2nd horse) and the novelty wore off that too, and i ended up selling her within a few months. All these things end up costing me money. The trouble is, i am also thinking of relocating to another State, however, i'm worried that if we go, the novelty might wear off that too, and i'll wish we never did. I just hate doubting myself all the time. I feel like i don't want anything bad enough or aren't interested enough in things to go through with them. It scares me.> My change in diagnosis from Major Depression, to Bipolar Disorder to ADD, innattentive type without hyperactivity has certainly been a revelation to me.<
What meds had you tried previously and did they help at all?
Hey, thanks a lot for that post, I'm intrigued now. Please reply to this when you get a chance. Also anyone else who has any thoughts.
Sue.
Posted by KarenB on July 10, 2000, at 1:46:04
In reply to Re:augment?ADD? » KarenB, posted by SueG on July 10, 2000, at 1:06:20
Sue,
It's late here, so I can't answer individually for now BUT everything you say sounds like what I have come to realize is ADD. Read the information and you'll see what I mean. A good book to read is Driven to Distraction (don't remember the author because I must have been distracted at the time). There's also one I haven't read yet about ADD in women by Sari Solden which I hear is worth reading. But, then again, how often do you sit down and read a book? I read articles and everything SHORT I can get my hands on but read a book? A monumental feat.
I went to a Psychiatrist in the Philippines who diagnosed me Bipolar II and had me try Paxil, Effexor, Zoloft and Lithium (not all together). When I didn't respond (all made me SLEEPY), he said, "Well...you just must not be depressed..." I laughed out loud. Can you believe that one? The thought flashed through my mind to lunge across the desk at him and explain that, "No... I MUST BE MANIC!!!!!" Glad I have some impulse control.
I have tried Buspar (recently), Depakote, Prozac, Serzone, Wellbutrin and Amitriptyline as well.
Please don't settle for feeling a little better. Trust me, when you are on the right meds, you will say things like, "So, this is what NORMAL feels like - this is VERY, VERY GOOD..." not, "Well, I don't feel like suicide now, that would take too much energy..." Big difference. Big, Big difference.
I never even though about ADD until a couple of months ago. Now, with the new meds, I feel closer to getting well than I ever have.
I saw a huge daisy at the side of the road yesterday and said to myself, "I'm going to get that flower." After I finished at the grocery store I drove right back to it and picked it. It's in a vase on my table, now. The point is, I remembered to get it. Not only that, but I wanted to get it, had the energy and motivation to do it and the simple beauty of it actually meant something to me. I haven't felt that way in a long time.
That Filipino doctor...well, let's just say he had his head, as my husband likes to say, "completely soiled."
Goodnight Sue. Enjoy your research.
Karen;^)
Posted by SLS on July 10, 2000, at 9:36:54
In reply to Re:augment?ADD? » SueG, posted by KarenB on July 10, 2000, at 1:46:04
Dear Sue,
I am not familiar enough with ADD to comment as to whether or not it should be ruled out based on your description. However, I don't see anything in your description that would point in that direction. Taking a self-examination on the ADD websites might be good idea. It would help give you some indication as to whether you should pursue this possibility with your doctor. Depression and ADD do have some features in common. Both can impair memory and concentration.
From what I do see in your description, everything you describe is consistent with depression or dysthymia (sometimes called minor depression). I don't see anything in your description as being inconsistent with these diagnosis. Perhaps someone with a better understanding of ADD will see something I don't. I think it is prudent to remain on Prozac and see how well it can make you feel. Even if you do have ADD, it seems as if depression is present comorbidly (at the same time). Ritalin can make an excellent augmenting agent to Prozac or the other SSRIs. If you have ADD, adding Ritalin may be a perfect answer for treating such a comorbid condition. If you do not have ADD, adding Ritalin can help increase motivation and energy in addition to mitigating the sexual side effects of the SSRI. However, four weeks is probably not enough time to make decisions like this. Check out the ADD in the meantime.
> I am taking 20mg Prozac and am in my fourth week. After (and coinciding with) the initial side-effects of dizziness and sleepiness,
Have these side effects begun to disappear?
> I have noticed definite improvement in some areas i.e. mood stabilisation, more confidence and more talkative, and the ability to concentrate has increased.
This is consistent with the improvements seen when someone suffering from depression responds to Prozac or any other antidepressant.
> I have noticed I am slightly more interested in things, however, not to the extent that i am happy with. I still have days where i just sit on the couch and want to do nothing, even though I feel fine. I had a few days early on where i felt that i had some drive and motivation however, this goes up and down.
Sometimes, the progressive response to an antidepressant can look like an inclined saw-blade. The teeth represent improvements and set-backs, but the direction is always up. The peaks of each successive tooth is higher than the one preceding it, and the setbacks not as low.
> I really want to change careers and begin studying but i am really afraid that i'll start and won't continue because i don't have the motivation/drive and i'll lose interest.
This is understandable, and it is probably too early to plan and commit to such things. I would wait until you are feeling better and remain stable for awhile before making any of these decisions. However, you seem to be headed in this direction. Based on what you are experiencing right now, you should be optimistic, in my opinion.
> I have done this with a lot of things in the past. I seem to get bored easily and i lose focus easily. I don't know why
Depression or dysthymia can explain this. Perhaps ADD would explain it also. If your "moderately depressed" state has been constant for years, it may be dysthymia.
> - I know i have the ability but i start to question myself when this happens.
I imagine you don't have a track record of success that would give you the confidence that you will complete a chosen task.
With my limited knowledge, I wouldn't want to rule out a diagnosis of ADD (or anything else), but I don't see that anything you describe lies outside the features of depression.
Good luck. It looks like you are responding to Prozac.
- Scott
Posted by SarahB on July 10, 2000, at 12:36:14
In reply to Re:augment?ADD?SueG,Janice,CarolAnn,Sarah,Renee?, posted by KarenB on July 9, 2000, at 23:50:21
Hi there, everyone... All those symptoms could be ADD or depression... I have taken Prozac and it never worked for me and it also had the awful side effect of the allusive big O! It was awful! I have also tried Effexor XR and that was the worst!! (scribed for ADD) The only AD that has ever come close to working for me was Elavil and it is/being studied/scribed for ADD. It relieved my mild depression that was a by product of untreated ADD. Once I was on Adderall, I had no need for an AD. As for Sue's lack of motivation and drive, hopefully, as the meds start kicking in and working, that will start to resolve it's self. I have been there and it is hard to dig yourself out of depression. All I can say is to try to force yourself to get out and maybe walk around the block a few times a day, it really does help! I hope all goes well for you!
SarahB
Posted by CarolAnn on July 11, 2000, at 9:21:47
In reply to Re:augment?ADD?SueG,Janice,CarolAnn,Sarah,Renee?, posted by KarenB on July 9, 2000, at 23:50:21
Karen, your description of ADD is right on target with mine. In fact, I'm now wondering if we could be the same person, since I also have a two yr old AND a Gyn appt this week! Ha, Ha, and Ha!
When I finally figured out the ADD thing,(which I never would have done, if I hadn't found out that it could be "without hyperactivity"), I also, had a huge revelation. It was actually a huge sense of relief! To know that all my childhood 'oddities' were the result of a brain glitch and not the result of a defective personality, wow what a concept!
Do you have a Pdoc, and does he know about the Adrafinil? I am thinking about switching from AD's to Provigil, since I can get that prescribed and my insurance will pay for it. But, if the provigil doesn't work, I think the Adrafinil will be worth the money. I just don't know how to bring up the subject of using something that is not ok'd in the US, with my Pdoc.
Would you mind if I E-mailed you? We seem to have so much in common, and I'd love to get to know you even better. Let me know. CarolAnn
Posted by Sara T on July 11, 2000, at 10:58:22
In reply to Re:augment?ADD?SueG,Janice,CarolAnn,Sarah,Renee?, posted by KarenB on July 9, 2000, at 23:50:21
> SueG,
>
> Quotes from you:
>
> >>...and the ability to concentrate has increased.
> >>...I really want to change careers and begin studying but i am really afraid that i'll start and won't continue because i don't have the motivation/drive and i'll lose interest. I have done this with a lot of things in the past.
> >>...I seem to get bored easily and i lose focus easily. I don't know why - I know i have the ability but i start to question myself when this happens.
>
> Hey all you ADD women,
>
> Wow, does this sound like ADD, without hyperactivity and the resulting depression from a lifetime of misdiagnoses, or what?? I could be wrong but to me, this has ADD written all over it. What do you think, Janice, CarolAnn, Sarah, Renee, others?
>
> Sue: Check out www.CHADD.org, follow the links and take some tests. You may be surprised at what you find.
>
> Have you had problems getting to bed at night but then can't seem to drag yourself out of bed in the morning, YOUR WHOLE LIFE? Did you get in trouble for "daydreaming," even in second or third grade? Have problems with those really looooong Algebra equations? Reading music? Do you get "lost" in your own house, suddenly realizing that you have five or six unfinished tasks going at once, because you keep getting distracted? You run out the door to buy milk and your husband says, "Don't forget the milk?!" Test with a very high I.Q. but have only mediocre grades to show for it? Get completely overwhelmed (not panic attacks) in a department or clothing store and finally go home, exhausted, accomplishing nothing? Any of this sound familiar?
>
> Another great article is on differentiation between ADD and Bipolar. Go to www.addclinic.org and find the article entitled 296 vs 314. You may see yourself there. I found an article there...or on one of the links which was a test specifically for teenage girls. I could identify with the symptoms they listed - it was like going back to my childhood and saying, "THAT'S WHY THAT HAPPENED!!!" What a revelation.
>
> My change in diagnosis from Major Depression, to Bipolar Disorder to ADD, innattentive type without hyperactivity has certainly been a revelation to me. I am on new meds and the past few days have been an encouragement. I feel good - REALLY good in a natural, unwired, unzombielike, unsleepy kind of way. I am trialing 100mg Adrafinil (wakefulness, motivation and brighter mood) 2x a day, plus 10mg Adderall 2x a day (energy and focus) and just 5mg of Zyprexa, at bedtime and lunch has helped with racing, scattered thoughts, "broken record" type obsessing and irritability. I DO feel good...and it's been a long time coming. I only pray that it continues (oh pleeeease...). In three weeks, it will stand the ultimate test: PMS/PMDD (also known as "PMS from hell"). If this combo still works during THAT week, it's a bonafide miracle. I believe in miracles. How 'bout you guys?
>
> I have a GYN appt. this week, to check into hormone therapy as well. No human being should have to endure once a month INSANITY. And I mean COMPLETE MELTDOWN. This past week, I felt like my 2 year old at 5pm, when he hasn't taken a nap all day. We call that "baby meltdown," around our house. You mommies know what I mean.
>
> KarenJust my 2 cents worth. I think everything Sue G. describes falls within the ADD experience, as well as depression. I think its worth pursuing. I think it was a great relief to me to find out about my own ADD, although my pdoc has said he thought it was mild and intertwined with depression and anxiety, but all that's commonly comorbid with ADD.
But no matter what you want to call it, augmentation to treat all of the symptoms can be a good thing. Its worked for me. I now take Zoloft and Metadate (extended release of ritalin).
Drugs , however, aren't the total answer, it also takes developing new ways of coping and recognizing your maladaptive habits.The two books DRIVEN TO DISTRACTION, authors Hallowell and Ratey, WOMEN AND ADD, by Sari Solden are great books. Also, YOU MEAN I'M NOT CRAZY, LAZY, OR STUPID, by Kate Kelly and Peggy Ramundo is an excellent source book. There's tons of info on the web too.
Good luck with your trials,
Sara T.
Posted by KarenB on July 11, 2000, at 14:34:26
In reply to Re:augment?ADD? to KarenB from me!, posted by CarolAnn on July 11, 2000, at 9:21:47
> Karen, your description of ADD is right on target with mine. In fact, I'm now wondering if we could be the same person, since I also have a two yr old AND a Gyn appt this week! Ha, Ha, and Ha!
> When I finally figured out the ADD thing,(which I never would have done, if I hadn't found out that it could be "without hyperactivity"), I also, had a huge revelation. It was actually a huge sense of relief! To know that all my childhood 'oddities' were the result of a brain glitch and not the result of a defective personality, wow what a concept!
> Do you have a Pdoc, and does he know about the Adrafinil? I am thinking about switching from AD's to Provigil, since I can get that prescribed and my insurance will pay for it. But, if the provigil doesn't work, I think the Adrafinil will be worth the money. I just don't know how to bring up the subject of using something that is not ok'd in the US, with my Pdoc.
> Would you mind if I E-mailed you? We seem to have so much in common, and I'd love to get to know you even better. Let me know. CarolAnnCarol Ann,
Yes - please e-mail me!
If you want to bring up the overseas meds with your doc, be pre-armed. What I did to get him to trial an off-label use of Provigil is to copy web pages written by other respected doctors on the subject, plus an article written by the manufacturer regarding current testing (dated 05/00)for use as an ADD drug. I faxed them to p-doc's office several days before my appt. and told his assistant what I was wanting to try. He read them, contacted another p-doc who has trialed this med for ADD and let me give it a try. I also asked him, because I have treatment resistant depression, if he would be willing to write a prescription for an overseas med, should our trials of US drugs fail. He said yes. Trying Zyprexa was his idea - and so far, a good one.
The more prepared you are the more he/she will be willing to listen. Documents written by other doctors will command some respect more than just what we (the lowly patient) may say.
Karen
Posted by SLS on July 11, 2000, at 21:28:09
In reply to Re:augment?ADD?SueG,Janice,CarolAnn,Sarah,Renee?, posted by Sara T on July 11, 2000, at 10:58:22
> Just my 2 cents worth. I think everything Sue G. describes falls within the ADD experience, as well as depression. I think its worth pursuing. I think it was a great relief to me to find out about my own ADD, although my pdoc has said he thought it was mild and intertwined with depression and anxiety, but all that's commonly comorbid with ADD.
> But no matter what you want to call it, augmentation to treat all of the symptoms can be a good thing. Its worked for me. I now take Zoloft and Metadate (extended release of ritalin).
> The two books DRIVEN TO DISTRACTION, authors Hallowell and Ratey, WOMEN AND ADD, by Sari Solden are great books. Also, YOU MEAN I'M NOT CRAZY, LAZY, OR STUPID, by Kate Kelly and Peggy Ramundo is an excellent source book. There's tons of info on the web too.
Dear Sarah,Is ADD in women generally different than it is in men?
Is ADD responsive to Prozac or Zoloft monotherapy?
How did you respond to Zoloft alone, and what symptoms not improved by Zoloft were improved by Metadate?
Thanks.
- Scott
Posted by SarahB on July 11, 2000, at 23:34:23
In reply to Re:augment?ADD?SueG,Janice,CarolAnn,Sarah,Renee?, posted by SLS on July 11, 2000, at 21:28:09
Hi, Scott... Yes, ADD in women is usually different from ADD in men. Women tend to be the inattentive type, while men are/were ADHD. There is no evidence that Prozac or Zoloft help nor hinder ADD. I did not respond at all psycologically to Zoloft. I did get all it's bad side effects, though. I'm not on Metadate, I'm on Adderall 30mgs/day. Most everyone of my ADD symptoms have improved within the time I have been taking it! I am much more focused, happy, "normal" person than I ever have been in my life!! It actually saved me from my "Life"! It has been a God Send! Don't get me wrong, it is still a fight to keep from going back to my old way, but it sure is MUCH easier!! I hope that answered your questions! Thank You,
Sarah...
Posted by SueG on July 12, 2000, at 18:35:25
In reply to Re:augment?ADD?, posted by SLS on July 10, 2000, at 9:36:54
> Dear Sue,
>
> I am not familiar enough with ADD to comment as to whether or not it should be ruled out based on your description. However, I don't see anything in your description that would point in that direction. Taking a self-examination on the ADD websites might be good idea. It would help give you some indication as to whether you should pursue this possibility with your doctor. Depression and ADD do have some features in common. Both can impair memory and concentration.
>
> From what I do see in your description, everything you describe is consistent with depression or dysthymia (sometimes called minor depression). I don't see anything in your description as being inconsistent with these diagnosis. Perhaps someone with a better understanding of ADD will see something I don't. I think it is prudent to remain on Prozac and see how well it can make you feel. Even if you do have ADD, it seems as if depression is present comorbidly (at the same time). Ritalin can make an excellent augmenting agent to Prozac or the other SSRIs. If you have ADD, adding Ritalin may be a perfect answer for treating such a comorbid condition. If you do not have ADD, adding Ritalin can help increase motivation and energy in addition to mitigating the sexual side effects of the SSRI. However, four weeks is probably not enough time to make decisions like this. Check out the ADD in the meantime.
>
> > I am taking 20mg Prozac and am in my fourth week. After (and coinciding with) the initial side-effects of dizziness and sleepiness,
>
> Have these side effects begun to disappear?
>
> > I have noticed definite improvement in some areas i.e. mood stabilisation, more confidence and more talkative, and the ability to concentrate has increased.
>
> This is consistent with the improvements seen when someone suffering from depression responds to Prozac or any other antidepressant.
>
> > I have noticed I am slightly more interested in things, however, not to the extent that i am happy with. I still have days where i just sit on the couch and want to do nothing, even though I feel fine. I had a few days early on where i felt that i had some drive and motivation however, this goes up and down.
>
> Sometimes, the progressive response to an antidepressant can look like an inclined saw-blade. The teeth represent improvements and set-backs, but the direction is always up. The peaks of each successive tooth is higher than the one preceding it, and the setbacks not as low.
>
> > I really want to change careers and begin studying but i am really afraid that i'll start and won't continue because i don't have the motivation/drive and i'll lose interest.
>
> This is understandable, and it is probably too early to plan and commit to such things. I would wait until you are feeling better and remain stable for awhile before making any of these decisions. However, you seem to be headed in this direction. Based on what you are experiencing right now, you should be optimistic, in my opinion.
>
> > I have done this with a lot of things in the past. I seem to get bored easily and i lose focus easily. I don't know why
>
> Depression or dysthymia can explain this. Perhaps ADD would explain it also. If your "moderately depressed" state has been constant for years, it may be dysthymia.
>
> > - I know i have the ability but i start to question myself when this happens.
>
> I imagine you don't have a track record of success that would give you the confidence that you will complete a chosen task.
>
> With my limited knowledge, I wouldn't want to rule out a diagnosis of ADD (or anything else), but I don't see that anything you describe lies outside the features of depression.
>
> Good luck. It looks like you are responding to Prozac.
>
>
> - ScottHi Scott, and thank you for your thoughts. From my (very!) limited knowledge, I agree that my symptoms could be from depression, or ADD, however, I am thinking that depression is probably the cause. I never had problems as a young child with concentration and interest in school work, it just came on later in life.
Something of interest though, my sister was always a slow learner at school and really struggled, and now, one of her twin sons (6 yo) is about to see a specialist on ADD. He is also the innatentive type and a bit of a troublemaker to boot. My mother also complains of not being able to concentrate and retain information (that's why she doesn't read books).
Any thoughts on this? Is ADD something that can come on later in life, or you have it from childhood?Back to me....The Prozac seems to be doing quite well for me so far, so I plan to stick with this for a while (particularly as I am going on holidays for 4 weeks soon).
The side-effects don't seem to be too bad, I am even sleeping sometimes without the help of my temazepam and this is a major breakthrough for me who has had a big problem with sleeping over the years.
The sexual side effects - I lost my drive as part of my depression but I think that this is actually starting to pick up again. Not great, but at least i'm having some thoughts about it now.
A couple of things I have noticed - I have this annoying muscle twitch in my left eye, something i have only noticed in the past couple of weeks. It started happening maybe once or twice during the day, but now is happening quite a lot.
Also, I am noticing that i have to urinate a lot more than i used to. Sometimes i wake up 3 times during the night to go to the bathroom. I used to sleep through, or wake up to go once.
Would either of these have anything to do with the medication? I can put up with these relatively minor side-effects though.I have only just finished my fourth week of Prozac, so I may even improve some more (only taking 20mg). Depending on how things pan out i might try some Ritalin later on, and see how it feels.
Thanks for your input.
Sue.
Posted by Renee N on July 12, 2000, at 22:01:29
In reply to Re:augment?ADD?SueG,Janice,CarolAnn,Sarah,Renee?, posted by KarenB on July 9, 2000, at 23:50:21
ADHD, depression, anxiety...which came first the chicken or the egg? Heck, if I know...Renee N
Posted by Libby on July 13, 2000, at 11:02:42
In reply to Re:augment?ADD?SueG,Janice,CarolAnn,Sarah,Renee?, posted by Renee N on July 12, 2000, at 22:01:29
> ADHD, depression, anxiety...which came first the chicken or the egg? Heck, if I know...<
For awhile, I got lost trying to figure out what diagnosis fit best... depression, Bipolar, ADD...
After trying so many different drugs and feeling like crap for so long, I finally decided all I really wanted was to be able to FUNCTION!It seemed to me that meds should be able to help me with that... so I did research on which meds addressed which symptoms. What I found was that for concentration, memory, and motivation in all kinds of depression, stimulants seemed to be most effective.
When I approached my doc with the research and told him I no longer cared about the CAUSE... I just wanted to FUNCTION, I got my trial of Ritalin and it worked!
I have since been evaluated by an Adult ADD specialist and diagnosed with ADD. Although the diagnosis is extremely helpful, it was the MEDS, not the DIAGNOSIS that improved my quality of life...
I'm actually looking forward to being in therapy now that I can actually participate... I want to learn how to deal with this stuff and get on with it...
Hope this helps...
L.
Posted by Sara T on July 13, 2000, at 21:28:28
In reply to Re:augment?ADD?SueG,Janice,CarolAnn,Sarah,Renee?, posted by SLS on July 11, 2000, at 21:28:09
Hi Scott-
Sorry to take so long to get back to you.> Dear Sarah,
>
Scott, I don't spell my name with an h, I'm Sara and there is another person named Sarah who also posts. But since you responded to my post I assume you are addressing me, Sara T.> Is ADD in women generally different than it is in men?
>
From what I have read ADD may express itself more subtly in women than in men. Generally, women are not as agressive and so women's behavior overall is more subdued. Not that there aren't exceptions. There was a little girl in my daughters pre-school class who is very hyper and gets aggressive and out of control easily. They even have to sit on her at naptime to get her to stay on her mat and not go to the other kids. This little girl fixated on my daughter and they were best friends until the other girl's behavior got to be intolerable and then she told my daughter that if she wouldn't be her friend she'd take a knife and stab her in the throat. I'm sure it was poor impulse control, right?But I think the main difference is in the kind of lives women lead. Women are often the organizers of the family and that can be a tough almost impossible job if you have ADD. Many women may be ADD/without Hyperactivity and therefore were never diagnosed and when the children come, things really fall apart.
> Is ADD responsive to Prozac or Zoloft monotherapy?
>
I don't think the AD's are that effective for ADD as a monotherapy. Stimulants are still first line treatment and are often used as monotherapy. I took Prozac for a long time and because it helped my depression it also relieved some of the ADD symptoms, such as impulsvity, to a degree. I still couldn't really sit down and read without getting easily distracted and still didn't have the follow through on alot of things. Procrastination was still a problem.> How did you respond to Zoloft alone, and what symptoms not improved by Zoloft were improved by Metadate?
>
I was already taking the ritalin when I went on the Zoloft. I doubt that it would work on the ADD that well by itself, but it does keep my moods steady and I read that moodinesss goes along with ADD. My son has severe ADHD and also takes Zoloft, and I can tell you that when he takes his Adderall, it makes a big difference. Without it he cannot concentrate or focus at all and is basically all over the place.
The Metadate is a recent change from the Ritalin SR. I notice that without it I do not process thoughts as fluidly, and I notice a definite drop off in attention, I lose track of what other people are talking about, I tune out, I can't focus myself on reading. I definitely function better with the ritalin than on the Zoloft by itself.> Thanks.
>
>
> - Scott
Thank you, Scott, for asking.Sara T.
This is the end of the thread.
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