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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 Shirley on November 8, 2000, at 17:00:04
As you all know, I am transitioning to prozac and I think it is starting to work pretty well. Good news?
Not quite.Unfortunately, I have had the continuing saga of experiencing monthly agiatation a few days after my period starts. As a result, I have used more sick leave this year than in five years.
Usually, it goes away until the next month where the "fun" begins again. A few months ago, while I was still on Zoloft, Adderall, and Remeron, I thought I escaped but the agiation came about a week later than I expected and showed no signs of letting up.
As a result, I switched to prozac and hoped that maybe everything would be different. I cut back my chocolate and caffeine intake drastically and exercised more. But the same thing happened again today.
All my psychiatrist has been able to suggest is taking a small dose of Zanax when it happens to ride the storm. But I don't think that's been helpful and as a result, I have not been taking it.
Any ideas as to what is going on? I have found nothing on the internet about this. Since Dr. Jensen says that medications like lithium are helpful when destabalization occurs, is that an option? If it is, then the other side of the coin is I'm concerned I would start gaining weight again, which I hated with the Zoloft. Or should I explore an alternative to Adderall like Afranil? Dexedrine caused severe depression during PMS and Ritalin has done what Adderall does regarding agiatation.
Today, I weathered the storm by taking a brisk walk at lunch. But I am so tired and worn down by this that I need some help deciding my options.
Since I like my psychiatrist, I don't want to switch but seeking a second opinion is definately an option. However, I still want to be informed just like I was in deciding that Prozac was my next choice which I'm happy with in spite of this monthly problem.
Thanks for your help.
Shirley
Posted by S. Howard on November 8, 2000, at 19:16:45
In reply to Desparately need your thoughts , posted by Shirley on November 8, 2000, at 17:00:04
Well, how about getting rid of your period? Either Norplant or Depro-Provera injections will accomplish this. I've enjoyed great success with both for many years...no pills, no period, no PMS.
-SGH
Posted by shellie on November 8, 2000, at 20:08:42
In reply to Desparately need your thoughts , posted by Shirley on November 8, 2000, at 17:00:04
Shirley, have you tried discontinuing the adderall (or any stimulent you are taking) during the days you are experiencing the agitation? That would be the simplest thing to try, since it seems the stimulents are helpful during the rest of the month.
Posted by danf on November 8, 2000, at 22:52:04
In reply to Re: Desparately need your thoughts , posted by shellie on November 8, 2000, at 20:08:42
another option is trying a Ca & Mg supplement
Posted by JohnB on November 9, 2000, at 3:40:48
In reply to Desparately need your thoughts , posted by Shirley on November 8, 2000, at 17:00:04
This from: Depression Research
at the National Institute of Mental Health
Fact Sheet
---------------------------------------------------------------
The influence of hormones on depression in women has been an active area of NIMH research. One recent study was the first to demonstrate that the troublesome depressive mood swings and physical symptoms of premenstrual syndrome (PMS), a disorder affecting three to seven percent of menstruating women, result from an abnormal response to normal hormone changes during the menstrual cycle. Among women with normal menstrual cycles, those with a history of PMS experienced relief from mood and physical symptoms when their sex hormones, estrogen and progesterone, were temporarily "turned off" by administering a drug that suppresses the function of the ovaries. PMS symptoms developed within a week or two after the hormones were re-introduced. In contrast, women without a history of PMS reported no effects of the hormonal manipulation. The study showed that female sex hormones do not cause PMS – rather, they trigger PMS symptoms in women with a preexisting vulnerability to the disorder. The researchers currently are attempting to determine what makes some women but not others susceptible to PMS. Possibilities include genetic differences in hormone sensitivity at the cellular level, differences in history of other mood disorders, and individual differences in serotonin function.
Posted by Therese on November 9, 2000, at 4:05:33
In reply to Desparately need your thoughts , posted by Shirley on November 8, 2000, at 17:00:04
Talk to your GYN instead, but make sure the Dr. is sympathetic to PMS. I had very bad bouts with it, and was surprised when they all but disappeared after having one of my overies removed during a hysterectomy. I had the surgery because of a fibrous tumor on my uterus, and the ovary was taken because it was badly scarred from cysts that would develop during ovulation. The "PMS fix" was a wonderful bonus! My green monster shows itself occasionally, but I feel so much more "normal" since.
Just thought looking down a different road might help :)
Posted by Blue Moon on November 9, 2000, at 18:31:00
In reply to Re: Desparately need your thoughts , posted by Therese on November 9, 2000, at 4:05:33
Less drastic than Norplant, etc.--how about the Pill? PMS has never been debilitating by me, but I do notice less of the night-before-starting weepiness and agita that I get w/o the Pill. I am on Ortho-Tri-Cyclen and Paxil 20mg, FYI.
Best, Blue Moon
Posted by Shirley on November 12, 2000, at 9:59:26
In reply to Re: Desparately need your thoughts , posted by Blue Moon on November 9, 2000, at 18:31:00
I wanted to let everyone know that I greatly appreciate the responses you provided. Sorry, I haven't responded until now but I have been so obscessed with the US Presidential Race. Also, as soon as I got through that particular drug crisis, another one popped up that I have been trying to figure out. It just never ends but I guess like the race, sooner or later, I'll know what the deal is.
Again, thanks for everything.
Shirley
Posted by Tori on November 12, 2000, at 11:11:12
In reply to Re: Desparately need your thoughts , posted by S. Howard on November 8, 2000, at 19:16:45
Hi there,
just from my own personal experience both ortho trycylen (spelling?) and depro-provera made the depression worse and also caused weight gain. Again, just my own experience. I stopped the depro after 3 months and duringthat time no MP's at all.
Pro's of trycyclen - reduction in acne. Cons from depro - increase in acne (really bad) for me.
Each person reacts differently so this option could be hopeful for you!
Good luck.
:-) Tori
> Well, how about getting rid of your period? Either Norplant or Depro-Provera injections will accomplish this. I've enjoyed great success with both for many years...no pills, no period, no PMS.
> -SGH
Posted by S. Howard on November 12, 2000, at 13:56:14
In reply to Re: Desparately need your thoughts » S. Howard, posted by Tori on November 12, 2000, at 11:11:12
The pill isn't an option for me personally because I'm 40 and I smoke. I really liked Norplant...not having to worry about periods or birth control for 5 years was great. However I'll be honest and admit it was a b**** to get those things out. MY HMO wouldn't pay for new implants so now I use Depro-Provera which, compared to Norplant, is kind of a hassle. Every 3 months I had to pick up the medicine from a pharmacy and
return to my gyn's office for the injection, for which they charged me $20. Now I just give it to myself (I work in a doctor's office).
I'm not positive, but I believe that if you have a PPO instead of an HMO, you just have to go to
the doctor's office and get the injection without having to pick it up from the pharmacy or paying for the shot. This is just an option for someone who can't or doesn't want to take BC pills. -SGH
Posted by Shirley on November 14, 2000, at 20:27:30
In reply to Re: Desparately need your thoughts , posted by S. Howard on November 12, 2000, at 13:56:14
I thought you all might like to know that I found a possible answer to my problem. Dr. Valerie Raskin, in one of her books (sorry I forgot the title and left the book in my car)explained that a woman's menstrual cycle can affect the medicine blood level particularly in the last part of the PMS Phase. She goes on to say, that in rare cases, this happens to women at the start of ovulation, which is what my experience has been.
Dr. Raskin explains that if a woman sees a pattern with this situation, blood tests should be done at precisely the same time, when the person feels pretty good and when they feel the crash from the possibility of a low med level. If Dr. Raskin's theory is correct, there should be a a much lower med level during the PMS phase.I plan to chart my cycle and symptoms for the next two months to see if there is a consistent pattern. If there is, I will ask my internist for these blood tests plus alerting my psychiatrist to what is going on.
I am so happy that finally, a professional has a possible solution to what has been a very frustrating problem. By the way, this woman seems to have other good ideas such as using liquid prozac to slowly increase the dosage if increasing it by 5mg is too much. I think John L. had something similar but it's nice to see a professional thinking in the same way.
When I get the book out of my car, I'll quote exactly the phrase she used and give everybody the title of the book. I think it will be quite useful.
Again, thanks for your responses.
Shirley
Posted by Tori on November 17, 2000, at 11:36:08
In reply to Re: Desparately need your thoughts , posted by S. Howard on November 12, 2000, at 13:56:14
There must be another Tori registered on this site. I don't know how that is possible, I thought there were unique names. I didn't respond to this thread; I am the 26-year old with no children to avoid any confusion - cornflakegirl99@mail.com. Dr. Bob? Do I need to change my handle?
> The pill isn't an option for me personally because I'm 40 and I smoke. I really liked Norplant...not having to worry about periods or birth control for 5 years was great. However I'll be honest and admit it was a b**** to get those things out. < < < snipped > > >
Posted by Dr. Bob on November 18, 2000, at 10:34:30
In reply to Re: DUPLICATE HANDLE - DR BOB? » S. Howard, posted by Tori on November 17, 2000, at 11:36:08
> There must be another Tori registered on this site. I didn't respond to this thread; I am the 26-year old with no children
Sorry, what makes you think there's another Tori? What you quoted was posted by S. Howard:
http://www.dr-bob.org/babble/20001102/msgs/48721.html
Bob
Posted by S Howard on November 18, 2000, at 22:42:16
In reply to Re: DUPLICATE HANDLE?, posted by Dr. Bob on November 18, 2000, at 10:34:30
> > There must be another Tori registered on this site. I didn't respond to this thread; I am the 26-year old with no children
>
> Sorry, what makes you think there's another Tori? What you quoted was posted by S. Howard:Correct, I'm not Tori, I'm Gracie.
Posted by Tori on November 18, 2000, at 23:21:16
In reply to Re: DUPLICATE HANDLE?, posted by S Howard on November 18, 2000, at 22:42:16
No problemo!
> > > There must be another Tori registered on this site. I didn't respond to this thread; I am the 26-year old with no children
> >
> > Sorry, what makes you think there's another Tori? What you quoted was posted by S. Howard:
>
> Correct, I'm not Tori, I'm Gracie.
Posted by S Howard on November 18, 2000, at 23:42:15
In reply to Re: DUPLICATE HANDLE? - phew! » S Howard, posted by Tori on November 18, 2000, at 23:21:16
That's not to say I don't sometimes WISH I was a 26-year-old with no children...
-Gracie
This is the end of the thread.
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