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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by mikes on March 28, 2001, at 22:30:12
i just started taking paxil a week ago for dysthymia. I haven't used any other drugs since I started. The first few days, up until two days ago, were very interesting. For anywhere from a minute to 45 minutes during all of those days, I experienced a rush of moderate serotonergic euphoria...my concept of "normal" was redefined, and I was very happy. I was hoping that as the paxil kicked in more strongly, I would begin to feel like that the entire day. However, the last two days weren't any good at all. I felt like crap, for the most part, plus I didn't get a rush of euphoria. I was suprised because I took my dose at an earlier than normal time on one of those days, and on the next I went from 10mg to 20mg.
Anyway, what I'm trying to find out is what I can expect from paxil/ssri's. Can the effects be strong or are they very mild at best?
Posted by JJ1844 on March 29, 2001, at 1:36:55
In reply to experiences with ssri's? what should I expect, posted by mikes on March 28, 2001, at 22:30:12
> i just started taking paxil a week ago for dysthymia. I haven't used any other drugs since I started. The first few days, up until two days ago, were very interesting. For anywhere from a minute to 45 minutes during all of those days, I experienced a rush of moderate serotonergic euphoria...my concept of "normal" was redefined, and I was very happy. I was hoping that as the paxil kicked in more strongly, I would begin to feel like that the entire day. However, the last two days weren't any good at all. I felt like crap, for the most part, plus I didn't get a rush of euphoria. I was suprised because I took my dose at an earlier than normal time on one of those days, and on the next I went from 10mg to 20mg.
>
> Anyway, what I'm trying to find out is what I can expect from paxil/ssri's. Can the effects be strong or are they very mild at best?They can be strong initially as you adapt to the medicine... most of them are pretty stimulating for the first couple days and then level off. After 3 to 4 weeks @ therapeutic dose you should start feeling better consistently... sort of a gradual lift off.
If you're getting *consistent* euphoria or it happens after then first week it might be indicative of bipolar disorder. The hypomanic euphoria in this case usually erodes into depression or irrtability on the SSRI. (Happened to me... pretty yucky.)
How old are you? Teenagers, young adults typically need a higher therapeutic dose (fast metabolizers).
Posted by SalArmy4me on March 29, 2001, at 4:13:05
In reply to experiences with ssri's? what should I expect, posted by mikes on March 28, 2001, at 22:30:12
You are either bipolar or having a placebo effect. Either way, report this to your doctor immediately.
> i just started taking paxil a week ago for dysthymia. I haven't used any other drugs since I started. The first few days, up until two days ago, were very interesting. For anywhere from a minute to 45 minutes during all of those days, I experienced a rush of moderate serotonergic euphoria...my concept of "normal" was redefined, and I was very happy. I was hoping that as the paxil kicked in more strongly, I would begin to feel like that the entire day. However, the last two days weren't any good at all. I felt like crap, for the most part, plus I didn't get a rush of euphoria. I was suprised because I took my dose at an earlier than normal time on one of those days, and on the next I went from 10mg to 20mg.
>
> Anyway, what I'm trying to find out is what I can expect from paxil/ssri's. Can the effects be strong or are they very mild at best?
Posted by Chaston on March 29, 2001, at 8:11:19
In reply to Re: experiences with ssri's? what should I expect » mikes, posted by JJ1844 on March 29, 2001, at 1:36:55
JJ1844--I have experienced the problem of Paxil, later Celexa, building my mood to hypomania, then eroding into irritability and depression, several times in the last 8 years. Hence, I concluded that I was bipolar. Have you found a way to get the benefits of SSRI's without the moodswings?
mikes--a few people do have an immediate upswing for a couple of days, and then it disappears. After a few weeks, you should be able to judge if it is working for you--not euphoria, but a definite, steady improvement in mood. It really takes 6 weeks or more to evaluate the effectiveness of an AD for you.
> They can be strong initially as you adapt to the medicine... most of them are pretty stimulating for the first couple days and then level off. After 3 to 4 weeks @ therapeutic dose you should start feeling better consistently... sort of a gradual lift off.
>
> If you're getting *consistent* euphoria or it happens after then first week it might be indicative of bipolar disorder. The hypomanic euphoria in this case usually erodes into depression or irrtability on the SSRI. (Happened to me... pretty yucky.)
>
> How old are you? Teenagers, young adults typically need a higher therapeutic dose (fast metabolizers).
Posted by mikes on March 29, 2001, at 14:43:15
In reply to Re: experiences with ssri's? what should I expect, posted by SalArmy4me on March 29, 2001, at 4:13:05
I'm 17 years old. The euphoria was only for a few minutes each time, and I haven't felt it since those first few days. I doubt it will ever come back. It was definitely not a placebo effect, it was too strong to be one.
I was thinking i might be ultra-rapid bipolar, as my day usually follows the same pattern. In the morning I feel tired and irritable. I start feeling better around lunchtime, and from then until the end of the day I'm feeling okay. On the weekends, I feel good the whole day, probably because I'm hypersomnic(sp?) and I get a longer sleep on those days.
Also, on those first few "good" days, there was an abrupt end the the "good" part at about 7PM every night. I went through what I believed to be withdrawal, and I became very very irritable for the remainder of the night, it seem like the serotonin was sucked from my synapses over a period of a few minutes (or something to that effect). These feelings would end if I took another pill, but for the most part I just stuck it out and waited until my next dose the following morning. I read that paxil is less effective if stopped and restarted. Could this be what I was doing in effect?
One more thing, when I mentioned the last few days were bad, I didn't mean normal, dysthymic days, like every day was before I began paxil. Instead of atypically depressed(irritable, restless, anxiety etc.) these last few I have had normal depression. I feel hopeless and have little motivation to do anything. For the first time in my life I am thinking about different ways to kill myself (but I'm not going to do it, it's just fun to imagine at this point).
Is the eventual mood lift noticeable, or is it very mild?
> You are either bipolar or having a placebo effect. Either way, report this to your doctor immediately.
>
> > i just started taking paxil a week ago for dysthymia. I haven't used any other drugs since I started. The first few days, up until two days ago, were very interesting. For anywhere from a minute to 45 minutes during all of those days, I experienced a rush of moderate serotonergic euphoria...my concept of "normal" was redefined, and I was very happy. I was hoping that as the paxil kicked in more strongly, I would begin to feel like that the entire day. However, the last two days weren't any good at all. I felt like crap, for the most part, plus I didn't get a rush of euphoria. I was suprised because I took my dose at an earlier than normal time on one of those days, and on the next I went from 10mg to 20mg.
> >
> > Anyway, what I'm trying to find out is what I can expect from paxil/ssri's. Can the effects be strong or are they very mild at best?
Posted by mikes on March 29, 2001, at 20:57:28
In reply to Re: experiences with ssri's? what should I expect, posted by mikes on March 29, 2001, at 14:43:15
I talked to my psychologist (more knowledgable and accessible than my psychiatrist). He said some people have bad reactions to one ssri but fare well on a similar one.
Posted by Daveman on March 29, 2001, at 21:34:01
In reply to Re: experiences with ssri's? what should I expect, posted by mikes on March 29, 2001, at 20:57:28
> I talked to my psychologist (more knowledgable and accessible than my psychiatrist). He said some people have bad reactions to one ssri but fare well on a similar one.
This corresponds to my experience. I did not respond at all to Paxil. By contrast, I'm doing well on Celexa. Go figure.
Dave
Posted by mikes on March 30, 2001, at 10:41:52
In reply to Re: experiences with ssri's? what should I expect, posted by Daveman on March 29, 2001, at 21:34:01
I didn't take my paxil today. I'm hoping that my symptoms (onset of depression when the paxil kicked in) don't mean that no ssri will work for me.
> > I talked to my psychologist (more knowledgable and accessible than my psychiatrist). He said some people have bad reactions to one ssri but fare well on a similar one.
>
> This corresponds to my experience. I did not respond at all to Paxil. By contrast, I'm doing well on Celexa. Go figure.
>
> Dave
Posted by Amy Blue on March 30, 2001, at 18:58:15
In reply to Re: experiences with ssri's? what should I expect, posted by Daveman on March 29, 2001, at 21:34:01
Dave - If you don't mind giving me some more info. I am considering going off Celexa - I am on almost 4 weeks at 10 mgs/day, for major depression and anxiety. Also taking klonopin. When did you start to have a positive effect and what are you taking it for?
Background: Prozac and Paxil had no effect on me in large doses, and Zoloft and Effexor XR had awful effects on me in small doses (thus the low dose of Celexa so far).
Grateful for your input,
Amy> This corresponds to my experience. I did not respond at all to Paxil. By contrast, I'm doing well on Celexa. Go figure.
>
> Dave
Posted by Daveman on March 31, 2001, at 0:18:11
In reply to Re: experiences with ssri's? to DAVEMAN, posted by Amy Blue on March 30, 2001, at 18:58:15
Amy:
I am being treated for depression, anxiety/panic, and insomnia. I was first placed on Paxil 20 mg. per day and Xanax, 1 mg. per day. I stayed on Paxil 4 weeks with no result, other than I was wiped out, still could not sleep without taking Xanax .5mg at bedtime, and totally lost my libido(I'm no fan of Paxil, if you can't tell:). I was then switched to Celexa, the first week at 20 mgs, then up to my current dose of 40 mgs. I noticed slight changes in my third week (second week at 40 mgs), at which point I was switched from Xanax to Klonopin, .5 mg. at bedtime, .25 twice daily, total of 1 mg. A week later, my Celexa was augmented with 15 mg. Remeron at bedtime for sleep.
I have continually gotten steadily better, have now been on Celexa 40 mgs. two months and have completely tapered off Klonopin. I am now in almost total remission, the only thing that remains is that I cannot sleep through the night, I can get to sleep but have frequent awakenings. Don't know if this is due to the underlying illness or is a side effect of Celexa. Whatever, I'm tons better on it than I was off it and am at present a satisfied customer. I have the benzos on hand for as-needed use but haven't needed one for a month now.
Sorry to have rambled on so long but wanted to give you a complete answer to evaluate. I've discussed Celexa extensively with my pdoc (who I think is excellent, btw) and he told me that both the research he's read and the clinical results he's had in his own patients have convinced him that for most patients, Celexa does not show its full effects until you get up to 40 mgs. He told me he likes Celexa best amongst the SSRI's because it has the lowest side effect profile, even in the sexual area, which allows fast titration up to the therapeutic dose (That's been my experience, too- Paxil totally eliminated my libido, which has returned, albeit not fully, under Celexa). So why was I started on Paxil? Because, he said, Paxil is the most sedating and I was having trouble sleeping. Funny thing, though- I've since read the testing info on both and Paxil, even though it is more sedating, caused more insomnia than Celexa in double-blind tests as against placebo. Go figure.
Hope this is of some use to you. I'd say if you can tolerate Celexa, talk to your doc about increasing the dose. Good luck and keep me posted on how you're doing!
Dave
> Dave - If you don't mind giving me some more info. I am considering going off Celexa - I am on almost 4 weeks at 10 mgs/day, for major depression and anxiety. Also taking klonopin. When did you start to have a positive effect and what are you taking it for?
>
> Background: Prozac and Paxil had no effect on me in large doses, and Zoloft and Effexor XR had awful effects on me in small doses (thus the low dose of Celexa so far).
>
> Grateful for your input,
> Amy
>
> > This corresponds to my experience. I did not respond at all to Paxil. By contrast, I'm doing well on Celexa. Go figure.
> >
> > Dave
Posted by grapebubblegum on March 31, 2001, at 6:53:28
In reply to Re: experiences with ssri's? Response to Amy » Amy Blue, posted by Daveman on March 31, 2001, at 0:18:11
Hmm... I am now on Paxil and it makes me unable to stay awake so I only take 20 mg., and at bedtime. I sleep like the dead. And all day I eat. I'm thinking of going off it for these reasons. Plus I'm relatively irritable.
Zoloft worked great for a long time but it made me feel only half-asleep all night, with thoughts and music racing loudly through my head. I started to get breakthrough panic attacks, which zoloft had previously controlled very well, but only under extreme stress.
A brief trial of Luvox made me SO tired and I was so depressed I was despondent, which is not like me even when I am on no meds. I'm wondering if SSRIs are not right for me at this juncture. I'm so sick of the sexual side effects I'm thinking of going off them totally. This usually results in a few months of creeping anxiety and then I re-start one or another SSRI. My son is doing well on Topomax. Anyone guess whether this might be ok for someone prone to panic attacks, not all the time but on occasion?
Posted by Amy Blue on April 1, 2001, at 17:13:38
In reply to Re: experiences with ssri's? Response to Amy » Amy Blue, posted by Daveman on March 31, 2001, at 0:18:11
Dave,
Thanks for the info - and I appreciate your detailed response. I have stopped Celexa as of Friday (today is Sunday). Some of the more troublesome side effects were actually getting worse with time, and were things I also experienced on Effexor and Zoloft - such as: contant neck and jaw pain, upper body tension, severe headaches. I was trying to be positive but I think after 4 weeks at only 10 mgs, these would have gone away.
I am extremely frustrated now. Celexa was the 5th AD I've been on and nothing has worked, or at least not with tolerable side effects. It may sound like I'm whining (which I am) but it's hard to function when I have a constant headache, and am constantly on the lookout for a migraine.
Now I am just taking Klonopin - taking this to recover from Xanax addiction and to keep anxiety in check. My anxiety is really out of control now, and I think that it was even worse while on Celexa because I am always obsessing about sides, whether it's working, when will it work, etc. The best I ever felt in the several years since I was "diagnosed," was when I was on no meds at all but exercising like crazy (like crazy for me was jogging 20-30 miles a week).
I'm very confused, scared and disillusioned. Not trying to bring everyone down. I guess the SSRI's don't work for me but I'm tentative to try anything else although I think I need something. I don't want to gain more weight, feel sluggish all the time, have no sex drive, etc. I know those are small prices to pay for feeling better, not thinking about suicide all the time, and having less anxiety. But every time I try a new med my anxiety goes thru the roof because I'm scared. And if I gain weight, I feel worse about myself, the cycle is started, yadda yadda yadda.
I don't know what to do.
Thanks for your info. I will keep you posted - hoping to see my pdoc this week - I also trust her and think she's great. I have a lot of anger towards my former pdoc due to unlimited Xanax prescribing and his constant dismissal of my feelings and side effects. Xanax withdrawal will last no more than 7-10 days??!! Ha - whatever, go back to your textbooks Dr. Schmuck. (Sorry for the animosity. GRRR. Can't keep it down sometimes.)
Amy
This is the end of the thread.
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