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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Jaynee on February 1, 2003, at 14:57:40
I have been on Celexa 10mg for about 5 days now and I am already feeling much better. I just read an article in New England Journal of Medicine that talked about Premenstrual Dysphoric Disorder. It talked about a study done with celexa and the "semi-intermittent"(a low dose during the follicular phase and a higher dose during the luteal phase), and intermittent (the full dose during the luteal phase only), apparently this worked best for PMDD, as opposed to continiuous dosing. Since my symptoms are worse during the week before my period, I am going to try the "semi-intermittent" dose.
I would like to try the "intermittent" dose, but I can't imagine doing this with Celexa. Wouldn't you get the withdrawal effects during the 2 weeks you aren't taking any Celexa. I could see how you could do this with Prozac, but Celexa?
Here is the study:Selective serotonin reuptake inhibitors for premenstrual dysphoric disorder: the emerging gold standard?
Pearlstein T.
Department of Psychiatry and Human Behavior, Brown Medical School, Providence, Rhode Island, USA. Teri_Pearlstein@brown.edu
There have been a large number of studies conducted investigating the use of selective serotonin reuptake inhibitors (SSRIs) in the treatment of patients with premenstrual dysphoric disorder (PMDD). The 12 randomised, controlled trials with continuous dose administration of SSRIs and the eight randomised, controlled trials with luteal phase dose administration (from ovulation to menses) are reviewed. All the treatment studies on fluoxetine, sertraline, paroxetine and citalopram have reported positive efficacy. Fluoxetine and sertraline have the largest literature, with a smaller number of studies endorsing paroxetine and citalopram. Mixed efficacy results have been reported with fluvoxamine. In general, adverse effects from the use of SSRIs in women with PMDD are the usual mild and transient adverse effects from SSRIs including anxiety, dizziness, insomnia, sedation, nausea and headache. Sexual dysfunction and weight gain can be problematic long-term adverse effects of SSRIs, but these effects have not been systematically evaluated with long-term SSRI use in women with PMDD. Serotonergic antidepressants have differential superiority over nonserotonergic antidepressants in the treatment of PMDD. Treatments that enhance serotonergic action improve premenstrual irritability and dysphoria with a rapid onset of action, suggesting a different mechanism of action than in the treatment of depression. It is possible that neurosteroids, such as progesterone metabolites, are involved in the rapid action of serotonergic antidepressants in PMDD. Future research needs to address less frequent dose administration regimens, such as 'symptom-onset' dose administration, and the recommended length of treatment.
Posted by jodie on February 1, 2003, at 16:48:19
In reply to Celexa - advice ( mostly PMDD related), posted by Jaynee on February 1, 2003, at 14:57:40
Have you asked your doc about Sarafem? My doc has given me these samples b4, it said when to start it, and when to stop, I think it was for like 10 days a month. I could be wrong though, its been a while. I only did it for one month though. It was my regular pcp who put me on this. I went in complaining about water retention, and somehow he ended up saying I have PMDD. Maybe true, but I have many more diagnoses. I need to help one at a time, I think. My pdoc put me on Lexapro to take everyday. She said even if I do have PMDD, it will help that too.
I do believe Sarafem is basically Prozac, am I right?
I've never heard of taking Celexa, or Lexapro off & on like that. I would think there could be a problem there. But I don't know, I've never come across that situation before.
Sorry I wasn't much help.
Jodie
Posted by jodie on February 1, 2003, at 17:06:00
In reply to Celexa - advice ( mostly PMDD related), posted by Jaynee on February 1, 2003, at 14:57:40
Well I answered my own question, yes Sarafem and Prozac are the same. I thought so.
I guess I just don't understand, why not just take it daily, everyday? Speaking of the Celexa.
I was just reading something about Sarafem, and how its approved for PMDD. Why did they have to go off & give it a new name? I believe Lilly makes both. I bet Sarafem costs more than Prozac (kinda stupid if its the exact same thing)
I could be wrong about the Lilly thing. I just thought I read that they were both from Lilly.
Posted by Jaynee on February 2, 2003, at 13:50:58
In reply to Re: Celexa - advice ( mostly PMDD related), posted by jodie on February 1, 2003, at 17:06:00
Hi Jodie:
The reason why I want to try the semi-intermittent dose of Celexa is because I can't imagine not having PMDD, until I am in menopause. And then that will cause all kinds of other problems. Because I believe I will be on an SSRI for many, many years, I would like to take the lowest dose that will work. By taking the semi-intermittent dose, I believe I will function better with less side-effects. I took Celexa for 8 months and had very minimal PMS. It was a very nice break from the monthly horror. I did like Celexa, but I did notice I wasn't as "passionate" with my husband. It was sort of like, "Are you done yet, because I've finished my nails" (ha, ha). I think if I try the semi-intermittent dose, it might help in that department. The intermittent dose sounds the best, but I don't think it would work with Celexa, because when I quit Celexa last time I got some strange side-effects, even after about the 2nd day I quit taking it.I will probably try prozac down the road, but I am a little nervous about that.
Did you ever try just the intermittent dose with Sarafem(Prozac), and how did it work?
Thanks
Posted by jodie on February 2, 2003, at 18:54:06
In reply to Re: Celexa - advice ( mostly PMDD related), posted by Jaynee on February 2, 2003, at 13:50:58
> Hi Jodie:
>
>
> The reason why I want to try the semi-intermittent dose of Celexa is because I can't imagine not having PMDD, until I am in menopause. And then that will cause all kinds of other problems. Because I believe I will be on an SSRI for many, many years, I would like to take the lowest dose that will work. By taking the semi-intermittent dose, I believe I will function better with less side-effects. I took Celexa for 8 months and had very minimal PMS. It was a very nice break from the monthly horror. I did like Celexa, but I did notice I wasn't as "passionate" with my husband. It was sort of like, "Are you done yet, because I've finished my nails" (ha, ha). I think if I try the semi-intermittent dose, it might help in that department. The intermittent dose sounds the best, but I don't think it would work with Celexa, because when I quit Celexa last time I got some strange side-effects, even after about the 2nd day I quit taking it.
>
> I will probably try prozac down the road, but I am a little nervous about that.
>
> Did you ever try just the intermittent dose with Sarafem(Prozac), and how did it work?
>
> Thanks
************************************************************Hi!!!
Yes, I tried the intermittent dose of Sarafem. I didn't really notice much because I only did it for a month.
I went to my pdoc, who took over on all of my meds (psychiatric meds). She had me stop the Sarafem. Mostly I think because I didn't have insurance at the time, and I don't think they had samples of Sarafem. Also, I have severe problems with depression, so I need to be on something all the time!!
I do notice, just before my period, and during, I am so moody. I have severe problems with bloating. I have tantrums. I do fit the description for PMDD, but I guess the Lexapro is helping that. I've also been diagnosed with different mood disorders, bipolar, now its ADD. Who knows, maybe I just have one of them, or maybe I have all the disorders. :-)
I understand what you mean about the sexual side effects. I haven't been on Lexapro very long, but when I was taking actual Celexa, I was so numb to everything, including passion. I didn't like that, but my mood swings and depression can be so bad, I can almost overlook that side effect, almost :-)
I haven't really noticed that yet with lexapro, but I'm sure it will start soon. My pdoc did tell me, since they changed Celexa slightly, which they called it Lexapro, its supposed to have reduced side effects, including sexual ones. Who knows. I have just been curious, why Celexa, and Lexapro? Why don't they just do away with Celexa, and just use the lexapro. Do you know, are they made by the same company??Jodie
Posted by Jaynee on February 2, 2003, at 23:31:21
In reply to Re: Celexa - advice ( mostly PMDD related), posted by jodie on February 2, 2003, at 18:54:06
You must be in the States, because I am in Canada and Lexapro is not available here yet. Lexapro is Celexa, with the R isomer removed. They say it has less side-effects because of this. It is made by the same company, H. Lundbeck out of Denmark, I believe. They don't get rid of Celexa, because the patent or whatever they call it is expired, so any drug company can make it and sell it, so it will become cheaper. Lexapro on the other hand will remain more expensive, until it is expired.
It sounds like we have a lot of the same symptoms. I don't have Bi-polar, or at least they haven't said so yet. I was told by a pdoc, that I have ADD, but I have never been treated for this. I probably should though. For now though I just want to get rid of the depression.
What other drugs are you on, and what has worked best for you?
Thanks.
Posted by jodie on February 3, 2003, at 2:00:28
In reply to Re: Celexa - advice ( mostly PMDD related) Jodie, posted by Jaynee on February 2, 2003, at 23:31:21
Thanks for the info on Celexa and Lexapro, I've been curious.
Yes I am in the States, Indiana as a matter of fact. We are getting all that cold air coming from Canada, have been for the past month, thanks a lot :-) LOL
Yes it sounds like we have a lot of the same symptoms. I have so many symptoms of different disorders.
I understand wanting to get rid of the depression, its not fun or anything!!!! The reason a pdoc diagnosed me with Bipolar was because I said I was impulsive. I told her I have extreme ups and downs, I get aggitated very easy, and I go through phases where I feel like I don't really need sleep, have lots of energy, followed by extreme exhaustion, and depression, almost suicidal.
For that, I was put on Depakote, and Klonopin (as needed for aggitation, irritability). I was already taking Celexa then, the highest dose, but felt it wasn't working like it used to. So she put me on Wellbutrin. My hair started to fall out from the Depakote (guess it can be a side effect), it kept getting worse. I would wash or comb my hair, and I would get handfulls of hair. There were other undesirable side effects too. She decided to try Lithium, I could not tolerate that at all!!! So, I ended up stopping mood stabilizers, and quit going to that pdoc. I have a problem with non-compliance with my pdocs and meds.I was off medicine for a while. Things started to get out of control again (depression, mood swings, tantrums). I went to go see another pdoc who put me on Lexapro, and back on Klonopin. She also prescribed me a month supply of Ambien to help me sleep. It worked for about 5 days, then it was just like taking a placebo pill. that was for severe insomnia I was having at the time.
Now, I'm seeing another pdoc, which diagnosed me with ADD. She did an evaluation, and asked lots of questions. She seemed pretty up to date on things. She tried me on Strattera, and told me to go off the Lexapro, which I thought was kind of strange. I ended up having an allergic reaction a couple of weeks ago from the Strattera (a bad rash). I had to go to the ER, they told me to stop the Strattera. I called my pdoc, she told me to start the Lexapro back up again. I was only off of it for a little over a week. She said she will probably try Adderall next, and increase my Lexapro, I'm only on 10 mg. I don't see her until Feb. 17th though. I have to wait until then to discuss the options.
I also have a history of seizures, temporal lobe seizures, and 2 grand mal seizures, which I had one of those about a month ago, my last one was 8 years ago. When I went to the ER for my grand mal seizure the Dr put me on Klonopin 1 mg twice a day (a benzo that is also an anticonvulsent), and I had to follow up with pcp. So I am on Klonopin again, which helps with the strange sensations I get from temporal lobe epilepsy, and aggitation, I guess it has mood stabilizing benefits to it also.
So thats what I'm on now, Klonopin, and Lexapro. I guess I will be on a stimulant soon. I'm interested to see how that goes. My concern is being on a stimulant, with having occassional seizures.
Besides Sarafem that one time, I've never tried prozac, or zoloft, . The only other ones is Wellbutrin, Celexa and Lexapro. I've been on a couple of different benzos, short term to help me sleep, when I had insomnia. I tried Dalmane, Trazadone, and one other one that I can't remember. I've tried Xanax 0.25 before, but it wasn't actually my prescription. It didn't seem to do a thing for me.
Of course insomnia is a problem for me right now. It's 2:40 am right where I live, and I'm on the computer. Not so much insomnia I guess, just getting to sleep. When I get to sleep around 4 or 5 am, I can sleep for 8 or more hours. If I'm left alone I could sleep all the next day, up to 12 or more hours. I've always had a problem waking up and getting motivated. When I was in grade & high school, It would take my mom almost an hour sometimes to wake me up. Obviously, I'm unemployed right now, thats why I wake up whenever throughout the day. Thats a whole story in itself. I'm trying to get motivated, and hand/send out my resumes. I'm just scared. Because of my "problems", I have a hard time keeping jobs, especially ones where I have to wake up to an alarm clock (snooze button addiction). Early morning jobs, forget it, I suck at those, rushing in at the last minute, looking like I had no sleep.
Oh well...guess I better let your eyes rest now. Sorry this post is so long. I have a problem with stopping something once I get started :-)
Talk to you soon!!!
Jodie
This is the end of the thread.
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