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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by roo on May 15, 2001, at 11:26:50
I have been taking prozac for about 5 years. Every time
I try and go off, I get really depressed again. I even
tried tapering off slowly, 5 mg's at a time, and I still
get really down. I've talked to quite a few people who began
taking antidepressants for situational depression, but then
found when the situation passed and they'd been on the drug
long enough to help the problem, they couldn't go off it
without relapsing. I'm scared that my brain has become dependent
upon antidepressants to create seratonin and can't do it
without them now. While I'm grateful that there are drugs out
there to help my depression, I never counted on having to be
on them forever--particularly since they effect my sexual life
so dramatically. It really depresses me and makes me feel bitter
that maybe I've done something to my body that has made it unable to
produce what it needs to produce naturally without chemical
help. Am I overreacting? Has anyone else had this fear or talked
with other people who took an antidepressant not for life long
clinical depression, but for a situational thing, and then was
unable to come off the drug without getting depressed?
I feel like there's so much info. out there about the drugs and
what they can do for you, but hardly any about how to handle
going off, and what happens to you physically when you go off.
Again, I'm not antidrug, and I will keep taking my prozac rather
than being depressed...but I am really disappointed that I may never
be able to go off of it and have a normal sex life again.
Posted by stjames on May 15, 2001, at 11:42:24
In reply to I'm a little scared of these drugs..., posted by roo on May 15, 2001, at 11:26:50
Sounds like the depression is here to stay, so you should stay on the Prozac.
James
Posted by Sunie on May 15, 2001, at 12:22:08
In reply to Re: I'm a little scared of these drugs..., posted by stjames on May 15, 2001, at 11:42:24
James' pronouncement sounds overly dire to me, roo, even though I have had some of the same fears that you do. I took effexor xr for about a year, it quit working, and I tried and tried to keep myself out of the depression that had already overtaken me, and could not. On the other hand, I did nothing to change the stressful pattern of my life during that time. Oh, I tried to go to the gym to get a little exercise, and I tried to eat right. But in the middle of depression, these good intentions lasted about 2 days!
Moral of the story: I am now on Wellbutrin, hoping for at least a minimal AD effect so that I can IMPLEMENT CHANGE that may help me sustain a non-depressed state when I decide to come off of it. (And I expect that I will come off v-e-r-y s-l-o-w-l-y.)
And BTW, since I have read and read about my new choice of drug, I must mention that it is often prescribed to counteract sexual side-effects, either alone or in combination with an SSRI.
For me, fears lead to more depression... positive action, even if it doesn't acheive what I had hoped for, though, generates for me a positive response.
Keep hope,
Sunie
Posted by stjames on May 15, 2001, at 13:10:12
In reply to Re: I'm a little scared of these drugs... roo, posted by Sunie on May 15, 2001, at 12:22:08
> James' pronouncement sounds overly dire to me,
James here....
Studies indicate the with 3 or more relapses/ episodes(of depression) the depression is chronic and felt to be life long. I am in this situation.
I decided to get on with it and get over it. It is what it is, so i have taken meds since 1985 and done well on them.Keep in mind that every depressive episode makes the underlying depression worse or one episode kindles another, they happen with greater frequancy, and are more significant.
James
Posted by Waterlily on May 15, 2001, at 13:36:14
In reply to I'm a little scared of these drugs..., posted by roo on May 15, 2001, at 11:26:50
I have tried going off antidepressants three times now, and each time I turned into a major grouch, kind of like my dad was (he committed suicide when I was 14). I first went on the medication after my daughter was born, so it was postpartum depression. That was over 6 years ago and I'm still taking medication. I am a little discouraged at my lack of success getting off medication, but at the same time extremely relieved that it actually helps me. I fully expect to be on meds for the rest of my life.
Posted by roo on May 15, 2001, at 15:16:01
In reply to Re: I'm a little scared of these drugs..., posted by Waterlily on May 15, 2001, at 13:36:14
James--
Do the drugs you take effect your sex life?
Posted by JasonL on May 15, 2001, at 18:30:04
In reply to I'm a little scared of these drugs..., posted by roo on May 15, 2001, at 11:26:50
> I have been taking prozac for about 5 years. Every time
> I try and go off, I get really depressed again. I even
> tried tapering off slowly, 5 mg's at a time, and I still
> get really down. I've talked to quite a few people who began
> taking antidepressants for situational depression, but then
> found when the situation passed and they'd been on the drug
> long enough to help the problem, they couldn't go off it
> without relapsing. I'm scared that my brain has become dependent
> upon antidepressants to create seratonin and can't do it
> without them now. While I'm grateful that there are drugs out
> there to help my depression, I never counted on having to be
> on them forever--particularly since they effect my sexual life
> so dramatically. It really depresses me and makes me feel bitter
> that maybe I've done something to my body that has made it unable to
> produce what it needs to produce naturally without chemical
> help. Am I overreacting? Has anyone else had this fear or talked
> with other people who took an antidepressant not for life long
> clinical depression, but for a situational thing, and then was
> unable to come off the drug without getting depressed?
> I feel like there's so much info. out there about the drugs and
> what they can do for you, but hardly any about how to handle
> going off, and what happens to you physically when you go off.
> Again, I'm not antidrug, and I will keep taking my prozac rather
> than being depressed...but I am really disappointed that I may never
> be able to go off of it and have a normal sex life again.Roo,
I understand your fears. Don't ever give your desire to heal yourself. If medicine can help you right now, then by all means, use every resource you can to help yourself.
If you are looking for other ways to help with depression, all you have to do is check out the internet under alternative health. It seems that everyone is selling something that can help with depression.
This leads me to conclude two things (at least).
1) There are a lot of people out there who suffer from depression who either do not experience full relief from anti-depressents or do not tolerate the the side effects well and
2) There is a lot of confusion as to what really works when you try alternative approaches.
I like yourself, have stuggled long and hard. I a have tried a lot of things out there. I have found an alternative to medicine that is working for myself. Dr. Bob asked me not to keep repeating my story on this baord, so I will not. See earlier posts this month. I provide proof (anecdotal of course) that there are other ways to address chemical imbalance other than psychotropic drugs.
Best Wishes,
Jason Lohr
Posted by Dr. Bob on May 16, 2001, at 11:31:36
In reply to Re: I'm a little scared of these drugs..., posted by JasonL on May 15, 2001, at 18:30:04
> Dr. Bob asked me not to keep repeating my story on this baord, so I will not. See earlier posts this month.
Thanks. BTW, the easiest way to refer someone to an earlier post is by including the URL, for example:
http://www.dr-bob.org/babble/20010507/msgs/62773.html
Bob
Posted by Cece on May 17, 2001, at 2:49:57
In reply to I'm a little scared of these drugs..., posted by roo on May 15, 2001, at 11:26:50
I was really scared of drugs for a long time, and not open to them. It took years of basket-case depressions, and finally a second major breakdown (and a doctor that I trusted) for me to decide to try and try again to find a drug to help me.
But I am BPII, and I suffered through decades of untreated depression and hypomania- I tried, and was told by psychologists that I just needed more therapy. If I had all the money now that I paid for that therapy, I'd have a good retirement fund! The therapy was helpful, the therapeutic relationships kept me alive, but I had a disease and needed medical treatment. But instead I went for years without treatment with my disease getting worse.
Well, no one drug helped me- it has taken a substantial mix, and I tried many, many along the way. It is clear to me- no question- that I am someone who will need meds for the rest of my life. As new ones come out, some of them have improved my results, and my mix gets modified. Several of the drugs that help me most now weren't even available when I began treatment. It is a lot of work to keep all my meds stocked and now my fear is that I will get old and feeble and not be able to do all this organizing and won't have anyone to do it for me. I can get really scared behind that one.
Zoloft was in my mix along the way, and I hated the sexual side effects. I was able to drop it out, luckily, as my mood stabilizers and my one other AD (Nortriptyline in a very small, 40mg/day dose) modulate if not eliminate my depressions. I also started taking testosterone supplement along with my other Hormone Replacement Therapy (I'm 52), and that helped revive my libido a LOT!
So maybe there are other effective possibilities for you besides the Zoloft. Try to get over the "guinea pig" fears- that's just the crude state that medicine is at these days. And don't judge yourself if you do need meds for life- it's okay, an inconvenience, but okay, and not nearly so inconvenient as depression.
Best wishes,
Cece
Posted by Elizabeth on May 17, 2001, at 14:37:11
In reply to I'm a little scared of these drugs..., posted by roo on May 15, 2001, at 11:26:50
> I'm scared that my brain has become dependent
> upon antidepressants to create seratonin and can't do it
> without them now.For the record (and I hope this will reassure you), antidepressants like Prozac don't create new serotonin (or act as substitutes for serotonin). Rather, they make your use of existing serotonin more efficient. Prozac does this by preventing serotonin from being reabsorbed ("uptaken") by cells (it binds to the serotonin transporter -- the cellular site where reuptake into the cell occurs (like a door that lets in serotonin) -- and blocks it, preventing serotonin from reentering the cell through it. As a result, more serotonin is available to act on receptor sites.
This is what Prozac does immediately. The reason that Prozac takes a few weeks to work is that the above-described mechanism results in gradual changes that compensate for the serotonin reuptake inhibition. This compensation is felt to be responsible for Prozac's antidepressant effects.
> While I'm grateful that there are drugs out
> there to help my depression, I never counted on having to be
> on them forever--particularly since they effect my sexual life
> so dramatically.Have you tried Wellbutrin? It's a mildly stimulating antidepressant that can be added to SSRIs and usually reverses that pesky sexual problem. It may also be used by itself (but there is no guarantee that it would work for you, since it works differently from Prozac).
> Has anyone else had this fear or talked
> with other people who took an antidepressant not for life long
> clinical depression, but for a situational thing, and then was
> unable to come off the drug without getting depressed?I think the expression "situational depression" can be misleading. It is true that a particular circumstance or event can trigger a depression that seriously interferes with your ability to function and does not go away on its own within a reasonable time. There are two general reasons that I could think of why this would happen (there can be some overlap between the two):
(1) The event or situation is so extreme that almost anybody would have an extreme reaction to it. The trauma of such events can turn your life upside down. (I'm thinking of things like being tortured as a prisoner of war, being a victim of long-lasting or severe domestic violence, etc.)
(2) The person experiencing the event or situation has a "depressive temperament" -- he or she is more likely to become depressed than the average individual. In this case the event acts as a trigger but is not the primary cause. Such depressions are likely to recur the next time such a difficult event or situation comes up. I believe that after such a depression occurs, it becomes increasingly likely that the depression will become chronic or will start to recur without triggers.
The point is, if you have a serious depression, it may be dangerous *not* to get treated for it. At the same time, I would like to see more research into the possible negative effects of long-term use of these drugs. The problem is, when research is done, it's most likely to be done or funded by the company that markets the drug. This can result in biases in the way the experiment is done and in the way the results are interpreted.
> Again, I'm not antidrug, and I will keep taking my prozac rather
> than being depressed...but I am really disappointed that I may never
> be able to go off of it and have a normal sex life again.Please do look into ways to correct the sexual problem. From what I hear, Wellbutrin doesn't need to be taken on a regular basis if you're only using it to reverse the sexual side effects of Prozac. There are also other ways to deal with the problem.
Best wishes.
-elizabeth
Posted by Elizabeth on May 17, 2001, at 14:39:57
In reply to Re: I'm a little scared of these drugs... roo, posted by stjames on May 15, 2001, at 13:10:12
> Studies indicate the with 3 or more relapses/ episodes(of depression) the depression is chronic and felt to be life long.
Yes. The odds of recurrence are thought to be about 50% after 1 episode, 75% after 2 episodes, and 90% after 3 episodes. The severity and frequency also tend to increase with recurrences.
-elizabeth
Posted by roo on May 17, 2001, at 16:46:34
In reply to Re: I'm a little scared of these drugs... » roo, posted by Elizabeth on May 17, 2001, at 14:37:11
Hey Elizabeth--
Thanks for your thoughtful response. Yeah, I've
tried Wellbutrin, and Serzone...both make me really
feel psycho, unfortunately. I've been trying to come
up with a solution to this problem with my p-doc
for a long time now. It just seems like the ad's that
work really well for me are the SSRI's, and they have
that side effect. I've tried antedotes like viagra
periactin, etc. and they don't do anything for me.
Right now I'm trying to see if I can combine a low dose
of prozac (15 mgs) with sam-e and some other natural stuff that's
supposed to boost seratonin and see if that works. So
far (a month or so on 5 mg less of prozac than I'm used to, and
2 weeks of sam-e, I feel "okay"...a little lower than
usual, but tolerable. I'm hoping that things will improve
with time. If they decline rather than improve than I'm
not sure what to do next. Maybe I could take a low dose of
prozac and a low dose of some shorter acting ssri that I could
take occasional drug holidays with. I don't have sexual side
effects at 10 mg's of prozac, but I don't have a whole lot
of support either. I don't like taking the shorter acting ssri's
and doing the drug holiday thing, b/c I start getting sick withdrawal
feelings pretty quickly...
arghh...I'm hoping for an answer soon. Maybe they'll invent one
soon that dosen't have the sexual side effects but
does the seratonin thing really well. I've really been
trying hard on this one and coming up against a lot of brick
walls.
Posted by SLS on May 17, 2001, at 21:48:01
In reply to Re: I'm a little scared of these drugs...Elizabeth, posted by roo on May 17, 2001, at 16:46:34
Hi Roo.
I'm a bit of a Pollyana here. Please forgive me if it be unjustified that I should hope my own experience can be generalized to everyone else.
For how long have you taken the same SSRI?
This is a bit embarrassing for me... Oh, well. I know this can be argued as the chicken or the egg thing, but I found that persistence "exercised" without any performance expectations, with or without a partner, led to a gradual return of orgasmia. It seemed that once I popped my first one, things came more easily thereafter. This was my experience with Paxil, Effexor, Nardil, Parnate, and a few others. In one circumstance, it took a few months. Hell, you might as well just have fun and enjoy yourself with what there is rather than lament over what there isn't. I should hope that it gives you more physical pleasure than peeling potatoes, even if you don't get your cookies. It really helps if both you and your partner consider any physical and emotional intimacy experienced as a shared success. I can't conclude whether my ability to attain orgasm would have returned on its own anyway with the passage of time, but an optimistic interpretation would be that I helped to entrain the system to use alternate routes or perhaps force a change in the dynamics of the existing ones. Perhaps using a little Ritalin as a PRN can help coax things along. You would want to use as little as you discover is necessary. No facts - just wishful thinking.
I found a little piece on strategies to treat sexual side effects of antidepressants and posted it last week. It was a bit of a pain in the butt to transcribe the table into a readable text, but I thought it might provide a good starting point. Obviously, you have already tried many of them. It would be nice if people relate their own experiences using the medications listed. I don't know if the libido/arousal/orgasmia assignments for each drug reflect real-life responses.
http://www.dr-bob.org/babble/20010507/msgs/62612.html
- Scott
Posted by Elizabeth on May 18, 2001, at 20:09:31
In reply to Re: I'm a little scared of these drugs...Elizabeth, posted by roo on May 17, 2001, at 16:46:34
> Thanks for your thoughtful response. Yeah, I've
> tried Wellbutrin, and Serzone...both make me really
> feel psycho, unfortunately.What about Remeron? That's another one that's supposed to reverse that side effect. Buspar is also sometimes used. Both of these can also potentially make the Prozac more effective so you can take less Prozac (and therefore reduce the side effects). Adding a norepinephrine-selective tricyclic (desipramine would be my choice) might also help.
I hope these ideas are helpful to you. Good luck with everything.
-elizabeth
Posted by Elizabeth on May 18, 2001, at 20:10:38
In reply to Re: I'm a little scared of these drugs...Elizabeth, posted by roo on May 17, 2001, at 16:46:34
BTW...what do you mean when you say that Wellbutrin and Serzone made you feel "psycho?"
-elizabeth
Posted by Lorraine on May 19, 2001, at 11:57:34
In reply to Re: I'm a little scared of these drugs...Elizabeth » roo, posted by SLS on May 17, 2001, at 21:48:01
Scott: You table that you linked to was really helpful. Thanks for going to the effort to put the info together (or share your "stolen" goods < vbg >).
Posted by geekUK on May 20, 2001, at 20:20:59
In reply to I'm a little scared of these drugs..., posted by roo on May 15, 2001, at 11:26:50
The way I understand it the seretonin reuptake inhibitors need time to build up to a decent level as the body doesnt tolerate them well- thus the 2 week+ action time. However (I am sure) the effect comes from the fact that outside the sinapse if the seretonin is not reuptaken into the cell it sits about, triggering the synapse more. Therefore more effect from the release. The thing that I am worryed about is the REALLY underresearched area of the effects of this extracellular seretonin. I know that a lot of research in the area of dopamine+parkinsons has pointed to desensitisation of the receptors with meds. This means the dose must be upped. Maybe (and no one really knows this) the same effect to a large or small effect may happen in SSRI's. So you have every reson to question if this is happening. Dont expect the doctors to agree with you, they dont know either. In many ways we are all guinea pigs for this batch of antideppressants. But one thing I am sure is that the brain is VERY adaptable. So taper the dose as fast as you can, but bear in mind the time you have been on the drug and the amount of time it will take to reverse the effect (if it is this, and howeverlong it takes- remember your the guinea pig!)
Hope you get off them soon with no -'ves. The sex thing is a B***D! HEHE.
M
Posted by roo on May 21, 2001, at 9:13:01
In reply to Re: I'm a little scared of these drugs...Elizabeth, posted by Elizabeth on May 18, 2001, at 20:09:31
Elizabeth--
Thanks for your responses. Haven't tried Remeron.
I'm a little scared of the weight gain. I've already
gained a bunch of weight lately (not sure, but I think
it may be due to neurotin). I have been curious about
it though.
Wellbutrin made me feel really irritated and angry and
didn't seem to give me the feeling of peace and well
being that prozac did. I simply felt suicidal on Serzone,
although it really _enhanced_ my sexuality, and I had great
sex on it.
Unfortunately with the tapering down to 15 mg's of prozac
(from 20), it seems to be enough to feel a low level
depression coloring everything a little grayer, but not
enough to notice any big difference sexually.
There's got to be some sort of solution. I've just got
to be patient....
ANyway, thanks for your responses--Ruth
Posted by Lorraine on May 21, 2001, at 9:34:00
In reply to Re: I'm a little scared of these drugs...Elizabeth, posted by roo on May 21, 2001, at 9:13:01
> Ruth: I haven't heard of weight gain on Neurontin. I'm on it. No weight gain so far.
Posted by roo on May 21, 2001, at 13:15:53
In reply to Re: I'm a little scared of these drugs...Elizabeth, posted by Lorraine on May 21, 2001, at 9:34:00
How much do you take? I feel like I didn't gain
weigh until I went up to 1800 mgs. Before that I
was on 1200.
Posted by Elizabeth on May 27, 2001, at 0:37:08
In reply to Re: I'm a little scared of these drugs...Elizabeth, posted by roo on May 21, 2001, at 9:13:01
> Thanks for your responses. Haven't tried Remeron.
> I'm a little scared of the weight gain.I understand. FWIW, I didn't have that problem with Remeron (although Nardil, Marplan, and Zyprexa all made me gain quite a bit).
> I've already
> gained a bunch of weight lately (not sure, but I think
> it may be due to neurotin).Neurontin isn't known for causing weight gain, but I'm pretty sure it gave me the munchies. (Benzos do this to me too sometimes.)
I hope you come up with something that does the trick for you without causing new problems. Take care....
-elizabeth
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