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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 3 to 27 of 29. Go back in thread:
Posted by JohnB on April 29, 2000, at 13:46:34
In reply to Remeron - BAD side-effects - help!, posted by Tony P on April 29, 2000, at 0:39:11
Tony- Do some searches on previous periods of this board. I do recall reading some posts on Remeron that said that some of the side effects went away after a few weeks, as is true of most meds. Sometimes side effects don't go away, though. Stay off anything that has caffeine in it.
On Remeron, sometimes raising the dose will get rid of the sedation side effect, but the irritablility, I'm not sure. Get all the info you can on this med, from web, this board, drug company website, that'll help you make an informed decision, since you say your pdoc has no experience with this med.
I am starting 7.5 Remeron for sleep and have noticed some irritability too. i'm going to give it a few weeks to see how it shakes out. But if it's going to ruin your marriage or your work, then it's not worth it.
Hopefully some more experienced Remeron users will chime in too.
Posted by Tony P on May 1, 2000, at 23:10:13
In reply to Re: Remeron - BAD side-effects , posted by JohnB on April 29, 2000, at 13:46:34
Thanks for the responses. I feel so much better since stopping the Remeron and returning to the Serzone I had been on (half dose for now), that I really think Remeron is not for me. I know one should usually take 2 to 6 weeks to really judge the effects of an a/d, but this felt so completely wrong - and looking back with a couple of days perspective I really think I was right out of my skull for two or three days, and getting worse.
My reasons for switching off the Serzone in the first place were not that strong - some suspicion of its contributing to sexual problems, a bit of a lessening of its sleep-regulating effect, and (to be honest) just a desire to try something different after 4 or 5 years! (I guess I got to try something different, all right!).
Posted by brucee on March 18, 2002, at 21:21:42
In reply to Re: Remeron - BAD side-effects , posted by Tony P on May 1, 2000, at 23:10:13
My experience with remeron (30mg) may be slightly "tainted" because I also take 30mg of dexedrine daily, and 40mg of paxil-although I've only been taking the paxil for a couple months. I've been taking the remeron for seven and a half months. The tingling sensation in my hands, and sometimes my wrists as well, has been going on for six months. I was thinking it was from the type of work i do, but knowing that others have the same side effect leads me to believe that the remeron is a possible cause. I was having problems with irrational and angry thoughts for months, and began taking the paxil for that reason. It helped the unwanted thoughts, and the anger. The remeron makes me drowsy, and I sleep very well...but feel groggy and disoriented when I awake. Does anyone else use another SRI in conjunction with remeron?
brucee
Posted by Triss on March 19, 2002, at 21:05:12
In reply to Re: Remeron - BAD side-effects - Experienced User, posted by brucee on March 18, 2002, at 21:21:42
>[...] The remeron makes me drowsy, and I sleep very well...but feel groggy and disoriented when I awake. [...]
>
> bruceeSince you mentioned you also take Dexedrine, a med I myself have been on (prior to January) for years... Does your Remeron induced grogginess improve at all (or satisfactorily) once your morning dose of Dexedrine kicks in?
Triss
Posted by BarbaraCat on March 21, 2002, at 14:16:32
In reply to Remeron - BAD side-effects - help!, posted by Tony P on April 29, 2000, at 0:39:11
I've had the best response to Remeron of all the AD's I've tried. They all poop out after a while, and Remeron was no exception. It worked beautifully for 2 months then gave out. I'm now augmenting it with lithium and it's working great again (hope it lasts). I have never felt agitated on it, and overly sedated only the first week, although it still takes a while to get going in the morning. I take 45 mg at night. It's the only SSRI where I don't feel clenching in the gut or jaw. I feel calm and am recognizing glimmerings of true joy as I get my life back on track. The only drawback is the weight gain.
Interestingly, I had a TERRIBLE reaction to Serzone. Gave it 2 months and I couldn't shake off the weird wooziness and the feeling of getting more depressed on it. Guess that goes to show how all of us are wired differently.
Posted by mair on March 21, 2002, at 17:02:27
In reply to Remeron works for me, posted by BarbaraCat on March 21, 2002, at 14:16:32
Have you been able to control or moderate the weight gain? Does it arise because of an increase in appetite? My pdoc wants to try remeron next, although I'd rather wait until things get so bad on my current regimen that I have no choice but to try something different. I hate meds changes.
Your post struck me because my experiment last year was serzone. I stayed with it as long as I could because I really wanted it to work, but I too felt that my mental acuity and motor skills were always off, and I got so suicidal that my therapist started talking alot about hospitals, a subject that had never been broached in 6 or 7 years of trying to manage depression.
Mair
Posted by BarbaraCat on March 21, 2002, at 18:20:58
In reply to Re: Remeron works for me » BarbaraCat, posted by mair on March 21, 2002, at 17:02:27
Hi Mair,
I'm really not sure what the reason behind the weight gain is and nobody else seems to either. I seem to have more of an appetite, but not so much to warrant the 20 lbs I've put on since December. I get powerful cravings every now and then that make me feel like a wild beast (thank God they're relatively rare). For instance, last night at 8:30pm I had such a ravenous craving for a chocolate Dove ice cream bar that I drove into town, bought it and was literally snarling as I wolfed it down in the parking lot! I used to get these chocolate crazies when I was pre-menstrual, but that was long ago.I was very inactive during the worst of my depression and am just now getting back to exercising, so I'm hoping I'll be able to up the metabolism and work it off. I'm also taking lithium so that Remeron doesn't poop out and lithium is notorious for weight gain PLUS, lithium makes hypothyroidism, which I have, worse. Sigh. So, it's a good incentive to work out which is a good thing anyway. I will find a way to burn it off and get it under control now that I'm sane again. I'd truly rather feel like I do lately than to be thin and feel as awful as I did before.
Posted by brucee on March 23, 2002, at 8:44:44
In reply to Re: Remeron - BAD side-effects - Experienced User, posted by Triss on March 19, 2002, at 21:05:12
> >[...] The remeron makes me drowsy, and I sleep very well...but feel groggy and disoriented when I awake. [...]
> >
> > brucee
>
> Since you mentioned you also take Dexedrine, a med I myself have been on (prior to January) for years... Does your Remeron induced grogginess improve at all (or satisfactorily) once your morning dose of Dexedrine kicks in?
>
> Triss
I usually drink a couple cups of coffee after breakfast, and then take my morning dose of dexedrine. Once I have taken the dexedrine the heavy feeling goes away, and the rest of my day is pretty clear...until the dexedrine wears off. Once I have metabolized my afternoon dose, I need to drink lots of coffee to stay focused, although the coffee doesn't always work. I always sleep well though. I've been thinking I need to increase the dexedrine to three times (15mg X 3) a day.bruce
Posted by Triss on March 23, 2002, at 16:20:08
In reply to Re: Remeron - BAD side-effects - Experienced User, posted by brucee on March 23, 2002, at 8:44:44
Thanks for your reply, Bruce. The reason for my asking is that my pdoc is going to start me on Remeron this coming Monday, and then at some time later on add my old Dexedrine (55 mg/d) regimen to it. I'm very ambivalent about trying this antidepressant because of its particular side effect profile (somnolence and weight gain). I'm only hoping against hope that, given my partial *disappointment with Dexedrine in the past, that somehow the Dexedrine will successfully counter these side effects of Remeron.
Triss
*(My long experience with Dexedrine [which, btw, had always been accompanied by Luvox 200 mg/d, which I wonder, may or may not have partially antagonized the Dexedrine, I don't know...] has consistently... let's just say, NOT been that of the "strong" stimulant which Dexedrine is normally described to be.)
> I usually drink a couple cups of coffee after breakfast, and then take my morning dose of dexedrine. Once I have taken the dexedrine the heavy feeling goes away, and the rest of my day is pretty clear...until the dexedrine wears off. Once I have metabolized my afternoon dose, I need to drink lots of coffee to stay focused, although the coffee doesn't always work. I always sleep well though. I've been thinking I need to increase the dexedrine to three times (15mg X 3) a day.
>
> bruce
Posted by brucee on March 25, 2002, at 9:01:44
In reply to Re: Remeron - BAD side-effects - Experienced User » brucee, posted by Triss on March 23, 2002, at 16:20:08
Have had mixed feelings about the remeron. In spite of the dexedrine, I wake up groggy and sometimes even confused. Dexedrine doesn't stimulate me, I'm just able to focus on what I'm doing. The addition of the paxil first thing in the morning has made a big difference in my mood. I no longer feel depressed all the time (which the dexedrine/remeron wasn't helping). Also, my head is pretty much empty of negative thoughts swarming like angry bees after starting paxil. I've been considering quiting the remeron, but need to talk with my pdoc.
brucee
Posted by Latinlover on October 21, 2002, at 15:16:47
In reply to Remeron - BAD side-effects - help!, posted by Tony P on April 29, 2000, at 0:39:11
Damn! I feel like if my nose is going to explode!
Posted by wcfrench on October 21, 2002, at 15:45:30
In reply to SO MUCH PREASSURE IN MY NOSE!, posted by Latinlover on October 21, 2002, at 15:16:47
Hi
I took Remeron. I know what you mean about the pressure in the nose. It was hard for me to tell if it was in my head or more focused in the center of my nasal cavity. I remember pulling on my temples to try and relieve the pressure. Anyway, it went away after several weeks. Not sure how many, it could have been 3, could have been 8, but it went away.
Antidepressants aren't like antibiotics. Though you can build a resistance, it usually doesn't happen from taking a higher dosage. And even if it does "poop out," you can usually find another that works since they are all unique.
The way my doc put it, you have to find the right dosage for you, otherwise it will not be nearly as effective. It is not a gradual relief, like with tylenol, it's more like a jump. For example, someone might not be affected at all by 15mg Remeron, but at 45mg, they completely respond. So you have to find the right dosage for you, the most effective dosage. And yes, sometimes more is worse. For me, 30 wasn't enough and 60 was too much, it just depends on the person. But don't worry, taking 45mg instead of 15mg will not make you any more resistant to medicine. And if you don't respond at 15mg, it doesn't mean you are "resistant" to it, it just means it's not enough.
Take care,
Charlie
Posted by wcfrench on October 21, 2002, at 16:09:06
In reply to Re: SO MUCH PREASSURE IN MY NOSE!, posted by wcfrench on October 21, 2002, at 15:45:30
Also, I made the transition from Effexor to Remeron, and I remember getting angry mood swings. Don't know how long they lasted, but they went away. I remember walking through the city in San Francisco and a homeless guy asked us for some money. We said "sorry" and he said "F--- you" and I wanted to go up and punch him in the face, really badly. It's hard to tell if it was Effexor withdrawal or just my raw nerves from being fresh off an antidepressant to on one that hadn't really kicked in yet.
Interesting times.
-Charlie
Posted by BarbaraCat on October 21, 2002, at 19:49:27
In reply to Re: Remeron works for me » mair, posted by BarbaraCat on March 21, 2002, at 18:20:58
Remeron stopped working, nothing new there. I'm still on a shaving of it and will probably remain so, but am having very good luck with Lamictal. I'm titrating very slowly and am currently at 37.5 and feeling better than I have in a very long time. It's not consistent, however. Some days are just as bad as ever, but all in all, it's good to be a member of the living again. My particular demon seems to be bipolar mixed states depression and SSRI type meds are not the best for me. You all might have better luck if your dx is SSRI responsive major depression. - BarbaraCat
Posted by McPac on October 21, 2002, at 22:06:49
In reply to Remeron - adios. Lamictal hello » BarbaraCat, posted by BarbaraCat on October 21, 2002, at 19:49:27
BarbCat "My particular demon seems to be bipolar mixed states depression"
>>>>>>>Barbara, what do you mean by "mixed states depression"?
Also, does Lamictal 'calm' your nerves?
Thanks!
Posted by wcfrench on October 21, 2002, at 22:11:36
In reply to Remeron - adios. Lamictal hello » BarbaraCat, posted by BarbaraCat on October 21, 2002, at 19:49:27
Barbara,
Lamictal is a mood stabilizer, right? Have you ever been on Neurontin? Does the Lamictal really make you feel a whole lot better? I took Neurontin and didn't notice too much of a change, but I've heard good things about Lamictal. Of course, I'm not sure if I am bipolar, and I don't think I am. Just wondering if it's typical for people to feel much better depression-wise from the addition of Lamictal.
Thanks,
Charlie
Posted by BarbaraCat on October 22, 2002, at 1:39:40
In reply to Re: Remeron - adios. Lamictal hello » BarbaraCat, posted by wcfrench on October 21, 2002, at 22:11:36
Hi Charlie,
Yes Lamictal is a mood stabilizer and was originally for epilepsy. I have been on neurontin and it was pleasant at first but then I didn't notice a thing. I was taking it primarily for fibromyalgia pain but it didn't do squat for it so I weaned off. I'm still taking a small dose of lithium and a pinch of Remeron as well because I'm going to go off slowly, but I plan to just use Lam and a benzo eventually. Lamictal is a very powerful antidepressant, at least for me. I've mainly heard about the AD effect in regards to the depressive end of bipolar, but I believe that Dr. Ivan Goldberg has had good results in unipolar therapy.I also don't know if I'm bipolar II or not, but pretty much diagnosed myself as such with my pdocs concurrence because of my resistant depression and hypomanic episodes. Bipolar has become the malady-du jour and it's a very fuzzy line between it and anxious depression. Even so, I believe my depression is the 'mixed states' category of bipolar where black crashing hopeless depression collides with anxiety and panic disorder. It's always had an electric 'static-y' feel to it, like wiry fear and despondency, and doesn't fit the standard descriptions of major depression. I sometimes get the lovely giddy hypomanias, but mainly the bleak scary crap - not fair! So, I think I'm responding to Lamictal because it acts upon the voltage gates of the neuron, i.e., the electrical system rather than the receptor/chemical end of things. I noticed a difference within 2 days of taking it. I still need an anti-anxiety, however, because stress can override any drug's potential benefit. Hope this helps and ask away. I'll answer as best I can. - BarbaraCat
> Lamictal is a mood stabilizer, right? Have you ever been on Neurontin? Does the Lamictal really make you feel a whole lot better? I took Neurontin and didn't notice too much of a change, but I've heard good things about Lamictal. Of course, I'm not sure if I am bipolar, and I don't think I am. Just wondering if it's typical for people to feel much better depression-wise from the addition of Lamictal.
>
> Thanks,
> Charlie
Posted by BarbaraCat on October 22, 2002, at 2:00:43
In reply to Re: Remeron - adios. Lamictal hello, posted by McPac on October 21, 2002, at 22:06:49
Mixed states is a term particular to bipolar whereby there isn't much of a typical continuum of depression/mania/depression. It's more like depression and mania collide and it's very very nasty. It's like being stuck in an Edgar Allen Poe story or maybe a Stephen King horror. Very nightmarish, bleak, anguish, cataclysmic doom and dread.
I've been 'depressed' as well and know that state well, whereby one can't get out of bed, or motivate, or care about anything and everything is dreary and flat. Mixed states is different, it verges on psychosis with extreme hypersensitivity and heightened awareness of suffering. I can barely take a walk outside without getting assaulted with vibrations of violence and pain. You can imagine what hearing the news does (I NEVER read the newspaper or watch TV news). Probably Vincent Van Gogh with his swirling black skies and black jagged outlines is what my world looks like in this state. Thank God it's not an always thing, but happens too often for my liking.
Lamictal doesn't calm me as such, but allows things to regain perspective, like letting the light in instead of only the dark. I still need lorezapam because my poor nervous system is fried. But for the first time today I was able to think about the lobster tank at the supermarket without losing it. The next step will be to walk past the tank without falling apart and sobbing in the aisle. I kid you not, I've done this too many times and for Pete's sake, I KNOW I can't save all the lobsters of the world.
> BarbCat "My particular demon seems to be bipolar mixed states depression"
>
> >>>>>>>Barbara, what do you mean by "mixed states depression"?
> Also, does Lamictal 'calm' your nerves?
> Thanks!
>
>
Posted by wcfrench on October 22, 2002, at 4:48:36
In reply to Re: Remeron - adios. Lamictal hello » McPac, posted by BarbaraCat on October 22, 2002, at 2:00:43
Barbara,
I am heartened by your lobster story, I know what you mean about the sympathy! I was a vegetarian until I was 21, and even now I just eat poultry and occasionally fish. One time I was in a restaurant and a couple of flies were buzzing around. I flicked the one that was on my plate and he landed nearby, disabled and unable to fly. He just moved around and couldn't fly anymore and I felt so bad. The poor guy was just trying to get some food.
I am interested to hear how you are doing with the Lamictal, please keep us posted. It may be something I talk to my doc about, seeing as I am slowly treading down the path of repeated attempts and alterations to help my depression. I've not yet tried MAOIs or tricyclics, and benzos didn't seem to help much, except it took the edge off a bit. Your story gives me hope, march on!
Posted by Latinlover on October 22, 2002, at 10:02:06
In reply to Remeron - BAD side-effects - help!, posted by Tony P on April 29, 2000, at 0:39:11
I'm very concerned about that. I'm 25 and I have a lot of hair but I also have entries. I have heard that Remeron have been related in some cases with hair loss, but not in a lot of cases. I don't want to get bald. I'm just starting to take Remeron and want to be well informed about that. In how much percentage of cases is Remeron related to hair loss? Is that even true? How severe is it? At which dose (Im taking 30 mg.)? If so, when does hair begins to fall? Does it grow again? Should I worry?
Information is wellcomed.
Posted by Ponder on October 22, 2002, at 19:06:06
In reply to Re: Remeron - adios. Lamictal hello » McPac, posted by BarbaraCat on October 22, 2002, at 2:00:43
BarbaraCat...
What an awesome description of bipolar II and mixed states. That's my dx also and my experience exactly. This feeling that the wiring is fried is something I continue to feel. I can't seem to handle much stress anymore without ativan or alcohol. I used to carry tons of stress and perform beautifully...well, anxiously, but effectively. I have always wondered about the connection between the anxiety and the bipolar depression. Does heading off the anxiety with benzos help you to prevent depression? Mixed states suck so much; while I'm in that condition, a benzo would knock me out and a stimulant would put me through the roof. I hardly know what to do other than tough it out; I feel exhausted and wound up at the same time. It almost always ends up crashing into hypersomnulence and despair. If you have any further remarks about the anxiety component and how it is related to depression, I would be most interested.
Posted by BarbaraCat on October 22, 2002, at 20:34:29
In reply to Lucid Description » BarbaraCat, posted by Ponder on October 22, 2002, at 19:06:06
Hi Ponder,
Yes, taking a benzo prophylactically seems to be the key in heading off a mixed state. I definitely think that anxiety is the trigger that sets off the whole cascade for me. I too used to sail through anxious situations and was very much an adventurous spirit who relished the 'aliveness' in dicey situations. I was confident of my ability to find a way through or out of any thing. Even though I was going through depressions during this time, I wasn't the scaredy cat I've since become.Sometimes I think that the bipolar manifested itself more black and white back then and my high times were bordering on mania and my depressions were the standard variety. Now the spectrum has blurred toward the middle and anxiety has become excrutiating and debilitating. The reason I don't think it's one of the anxiety disorders is because of the sheer violence and terror in the black hole. My fears become very vivid and fueled by the mixed states nightmarish quality. I used to wonder if it was a schizoid disorder, but it's too cyclical and besides, Lamictal seems to be doing the trick.
Hopefully a respite from psychic trauma courtesy of the right meds will reset the fear circuits and allow me to rediscover that sense of adventure, faith, and self confidence.
Please tell me your experience with mixed states. Sometimes I feel pretty alone and kinda weird with this dx. - Barbara
Posted by BarbaraCat on October 22, 2002, at 20:43:06
In reply to Re: Remeron - adios. Lamictal hello, posted by wcfrench on October 22, 2002, at 4:48:36
I encourage you to give it a try. You could always start very slowly and see where it goes. I can well relate to multiple med hell. I'm amazed at the good it seems to be doing for me, at a very low dose (37.5mg vs the standard therapeutic 100mg dose). I love your fly story. I still eat fish but was having major problems with it until recently. Heck, I was beginning to hear the broccoli crying as they were being cut from the stock and see the lettuce's life force withering before my eyes. A girl's gotta eat, so the Lamictal came just in time.
> Barbara,
>
> I am heartened by your lobster story, I know what you mean about the sympathy! I was a vegetarian until I was 21, and even now I just eat poultry and occasionally fish. One time I was in a restaurant and a couple of flies were buzzing around. I flicked the one that was on my plate and he landed nearby, disabled and unable to fly. He just moved around and couldn't fly anymore and I felt so bad. The poor guy was just trying to get some food.
>
> I am interested to hear how you are doing with the Lamictal, please keep us posted. It may be something I talk to my doc about, seeing as I am slowly treading down the path of repeated attempts and alterations to help my depression. I've not yet tried MAOIs or tricyclics, and benzos didn't seem to help much, except it took the edge off a bit. Your story gives me hope, march on!
Posted by Ponder on October 22, 2002, at 21:49:47
In reply to Re: Lucid Description » Ponder, posted by BarbaraCat on October 22, 2002, at 20:34:29
> Hi Ponder,
> Yes, taking a benzo prophylactically seems to be the key in heading off a mixed state. I definitely think that anxiety is the trigger that sets off the whole cascade for me. I too used to sail through anxious situations and was very much an adventurous spirit who relished the 'aliveness' in dicey situations. I was confident of my ability to find a way through or out of any thing. Even though I was going through depressions during this time, I wasn't the scaredy cat I've since become.
>
> Sometimes I think that the bipolar manifested itself more black and white back then and my high times were bordering on mania and my depressions were the standard variety. Now the spectrum has blurred toward the middle and anxiety has become excrutiating and debilitating. The reason I don't think it's one of the anxiety disorders is because of the sheer violence and terror in the black hole. My fears become very vivid and fueled by the mixed states nightmarish quality. I used to wonder if it was a schizoid disorder, but it's too cyclical and besides, Lamictal seems to be doing the trick.
>
> Hopefully a respite from psychic trauma courtesy of the right meds will reset the fear circuits and allow me to rediscover that sense of adventure, faith, and self confidence.
>
> Please tell me your experience with mixed states. Sometimes I feel pretty alone and kinda weird with this dx. - Barbara
Barbara,
I, too, used to have better definition between states. My euthymic and hypomanic times allowed me to make up for lost (depressive) time, thereby making it possible to sustain a demanding career. As the years went by with no effective treatment in sight, the illness progressed--more frequent bouts of debilitating depression, more anxiety and irritability, much less time feeling decent at all.A few years ago, I was put on Effexor. This drug, without a mood stabilizer, was the death of my career. I felt better for awhile, then the horrible mixed states--the restlessness, irritability, need to dominate every business meeting, getting unreasonably angry with people, getting fixated on a specific point and holding up the progression of a meeting by harping on it, pacing, pouting, crying, complaining -- all this from someone who had earned an exemplary leadership award the year before for positive leadership and role modeling!
After awhile, more OCD-like symptoms emerged making me feel even more driven and out of control. The whole damned thing finally came crashing down so hard, I couldn't think straight enough to do laundry. I was terrified and overwhelmed in just going to the grocery store, had trouble leaving the house at all. Through in a series of earthquakes and 9-11 and my memories of that period of my life are a seamless black sphere.
Extended medical leave turned into long-term disability. I got admitted to a study protocol at a major university for severe treatment-resistant bipolar depression. Finally, like you, I found some relief in Lamictal. I take it in combination with Wellbutrin. I am much better than I was, but it is still a struggle to stay healthy. Recently, because my hair is falling out and because I was having a recurrence of depressive symptoms, I got disgusted with everything. Seems that when things go south, doctors always want to add something. Pretty soon you've got 6 different components to your treatment and there is no way to tell what's working and what isn't. Some days nothing seems to be working. So, I recently reduced my WB dose from 400 mg/day to 300 and reduced my Lamictal from 150 mg to 125. I have a bottle of Topamax on the counter which I still haven't worked up the courage to try -- scared of the "dumbing" effect and the psychomotor slowing that so many people on this board have experienced.
I also take vitamins, fish oils, zinc, selenium, biotin. I exercise an hour and a half a day, use a light box, do yoga --jeesh, it's nearly a full time job just doing all the stuff that's supposed to help!
Do you also experience "loss of insight" when your illness worsens? I look back on the last year of my career and can't believe I didn't realize something awful was happening. I just kept taking the Effexor and getting worse. I'd call my shrink and he would tell me to increase the dose. I did not recognize the mixed states for what they were and would complain to him about depression because I felt like heck, so he would just up the dose. What a horrible downward spiral I was in!
Anyway, I don't know if I answered your question or am just rambling on. I appreciate your observations and insights and hope to hear more.
Posted by McPac on October 22, 2002, at 23:34:52
In reply to Re: Lucid Description » BarbaraCat, posted by Ponder on October 22, 2002, at 21:49:47
Ponder "A few years ago, I was put on Effexor. This drug, without a mood stabilizer, was the death of my career. I felt better for awhile, then the horrible mixed states--the restlessness, irritability, need to dominate every business meeting, getting unreasonably angry with people, getting fixated on a specific point and holding up the progression of a meeting by harping on it, pacing, pouting, crying, complaining -- all this from someone who had earned an exemplary leadership award the year before for positive leadership and role modeling!
>>>>>>>>>>>>>>>>This same thing happened to me...but I may have a 'twist' to add to the story. Let me explain. I was taking my Zoloft along with a very small Lithium dose for YEARS. Then, I decided to try to go off the Lithium. I went through a terrible withdrawal-like state after stopping the Lithium (EXTREME anger). Then, after quite a long while, I felt more 'normal'...in the sense that I felt like the withdrawal was over. But still, even long after the Lithium withdrawal effects were over and done with, I still had frequent bursts of terrible, terrible anger/temper.....that wasn't the 'real' me at all. Well, during this time I constantly figured that I had a terrible anger/temper/irritability problem and that I definitely needed something for it. And then I read a few posts here that got me thinking...and I reflected on things a lot and REALLY began getting curious..........I recalled how I never had much of a temper problem before, if at all, even during all the years I had terrible depression and OCD......then, about 10 years ago, I was put on Prozac...along with the Lithium...the Prozac made me absolutely "Mr. Volcano", erupting with terrible anger and unreal temper and agitation (although it is a great med for many, I can CLEARLY see how it could cause somebody to go off the deep-end and go totally haywire!)....I got off that crap very fast! A while later, I was put on Zoloft...also along with the very low Lithium dose.....and for 9 years I had the best years of my life. It was then, about a year or more ago, that I quit the Lithium and experienced the (anger) withdrawal effects...then the terrible anger, terrible irritability came back...and I thought that I must have a terrible anger problem...BUT....here is the question for me (and maybe for you as well Ponder?)-------Do "I" have the terrible anger problem OR does the Zoloft (another SSRI, like Prozac) CAUSE the anger??? When I take a small lithium dose, the anger is kept under control well (even the lithium though was NO match for the Prozac however..I STILL felt ANGRY!)....so that is my $64,000 question! How can I tell which it is.."me" or the Zoloft? Well, I stopped the Zoloft and started Remeron in its place...even WITHOUT the lithium...and...no anger! Which leads me to believe that maybe I DON'T have the anger component...maybe my med (Zoloft,Prozac) gave it to me! I had NO anger the brief time on the Remeron. I have read here, and on Dr. Amen's site, that Zoloft and other SSRI's can INDUCE that anger. Unfortunately for me, the adrenaline side effect from the high-dose Remeron SUCKS and I now take my Zoloft, with lithium, again. If a non-SSRI anti-dep. EVER comes out on the market that works for BOTH OCD and depression, then maybe I can switch and finally see for sure if the anger was med-induced.
Ponder "After awhile, more OCD-like symptoms emerged making me feel even more driven and out of control. The whole damned thing finally came crashing down so hard, I couldn't think straight enough to do laundry. I was terrified and overwhelmed in just going to the grocery store, had trouble leaving the house at all. Through in a series of earthquakes and 9-11 and my memories of that period of my life are a seamless black sphere."
>>>>>>>>>>>Are you taking anything for OCD?Ponder "I also take vitamins, fish oils, zinc, selenium, biotin. I exercise an hour and a half a day, use a light box, do yoga --jeesh, it's nearly a full time job just doing all the stuff that's supposed to help!"
>>>>>>>>>>>>>>>>>I would suggest taking Folic Acid as well.
Ponder "Do you also experience "loss of insight" when your illness worsens? I look back on the last year of my career and can't believe I didn't realize something awful was happening.
>>>>>>>>>>>>>>YES! Looking back after the 'storm', I always clearly see what I wasn't clearly able to see during the 'storm'!
Take care my friends!
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Dr. Bob is Robert Hsiung, MD,
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Script revised: February 4, 2008
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