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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by ravenstorm on October 22, 2004, at 20:43:18
Oh God, I don't know what to do! Over a year ago I went through severe paxil withdrawal after taking over five months to drop down the last 2mg. Ended up worse than I was before paxil.(Severe, severe anxiety and suicidal depression)
I've been on the med merry go round since last December.
Ended up on Remeron 15mg (can't get any higher without lapsing into a coma) which got rid of the anxiety but didn't do much for the depression and left me very apathetic.
Added in WB, which at first made me very tired, then had a week of anxiety. Then felt as close to normal as I have in a long time (NOT quite normal but incredibly good compared to how I had been--suicidal and pretty non functional).
My brilliant pdoc then decided that I should just get off remeron all together and go to 300mg WB since I was still having some side effects from the remeron. I bumped up to 250mg on the WB for a couple of weeks and started having heart palpitations but no out and out anxiety. Since this had happened when I first started on WB I wasn't too concerned. Then I bumped up to 300mg while simultaneously cutting back on the remeron and had a huge anxiety surge. Started at night and then woke up in the morning totally out of control. Bumped back down to 250mg and back up on the remeron and things calmed down but I still had the palpitations. Then, a week or so later, I had another huge anxiety surge--. I was going out of town for an extended weekend, so I dropped WB to 200mg started taking 1.0mg Lorazapam at night with the remeron and that squashed the anxiety back down. (Pdoc was notified of this and I made an appointment to see him on Monday). My husband was freaking out over addiction so I dropped to .5mg for two days then to nothing that Sunday night. Anxiety returned. Saw pdoc and he thought maybe the remeron was contributing to anxiety (!!!) so he prescribed neurontin 100mg capsules that I was to take at night starting with one and working up to three. For a week I took the 1.0mg Lorazapam and worked up to 300mg neurontin and again my anxiety seemed under control. The next week I cut the remeron in half and within eight days my mood had deteriorated rapidly, severe anxiety, crying all the time borderline suicidal etc etc. Bumped back up on the remeron and dropped the WB to 100mg and doctor prescribed xanax which he wants me to take three to four times a day!!!!!!!!! Ever since I tried the drop in remeron, addition of neurontin my anxiety has gotten worse. I only used to get flares in the evening which then sometimes impacted me the next day, but they always cleared up on their own (and that was only when I went above 200mg WB. Now I have anxiety all day long even though I am only taking 100mg WB and am back up to te 15mg remeron. I have been trying to only take the xanax once or twice a day, but I feel it wear off and then feel even more anxious and I think I will have to take it three times a day because I feel like I'm about to die. How could this have happened. Is my body so sensitive that I got bounce back anxiety immeditately from the neurontin/xanax?? (My previous pdoc indicated that none of her clients had had as much of a problem with paxil as I did) Now i feel like I'm not going to have achoice about taking the xanax because I can't function with this level of anxiety(It is very physical, not worrying, but not panic attacks either. To make matters worse, I have never done real well with benzos (I actually feel more anxious for anywhere from 15mins to an hour after taking them)
I would understand how I could get worse when I bumped up on the WB and down on the remeron, but now I am taking even less WB than I was when I wasn't having any anxiety on it and I'm having worse anxiety!!
That first weekend when I dropped to 200mg WB stayed on 15mg remeron and added 1.0 lorazapam my anxiety was totally under control. And when my anxiety had flared up the two times previously it was always at night. Now I have it all day long.
Did the neurontin or xanax do something really bad to me?? I know this sounds impossible but it has happened.
Also, the neurontin mellows me out more than the benzos but is way too sedating for me to take during the day.
I don't know what to do. I never wanted to take a benzo long term.
Basically, I was given WB to counteract side effects of remeron (and to help my depression) and now am being given anti-anxieties to counteract WB side effects, but my anxiety has gotten more pervasive with the addition of the anti anxieties.
Also, I don't know what is causing what because everytime I upped something, i cut or added something else. It seems like dropping the WB so low and reinstating the remeron should have taken care of things. What is going on???????????
Posted by ravenstorm on October 23, 2004, at 9:51:42
In reply to Please help. What the h*ll has happened?, posted by ravenstorm on October 22, 2004, at 20:43:18
How could I be fine on 200mg WB and 15mg remeron, screw around with the doses and get worse anxiety so return to where I was EXCEPT even less WB (only 100mg) and still be crawling out of my skin. The anxiety is totally destabilizing me. HELP. I am feeling like this is the end of the line for me. I just wanted to limp through the winter on the remeron and WB until spring and re-evaluate. I can't be like this with the days getting shorter. I can't make it through another winter like this. I had a somewhat normal life for four weeks out of a whole year. I can't go through this again.
Posted by Ritch on October 23, 2004, at 11:44:53
In reply to PLEASE HELP., posted by ravenstorm on October 23, 2004, at 9:51:42
> How could I be fine on 200mg WB and 15mg remeron, screw around with the doses and get worse anxiety so return to where I was EXCEPT even less WB (only 100mg) and still be crawling out of my skin. The anxiety is totally destabilizing me. HELP. I am feeling like this is the end of the line for me. I just wanted to limp through the winter on the remeron and WB until spring and re-evaluate. I can't be like this with the days getting shorter. I can't make it through another winter like this. I had a somewhat normal life for four weeks out of a whole year. I can't go through this again.
I read that history of meds and the thing that stands out is dropping a serotonergic (Paxil) and the presence of Wellbutrin. I've had similar experiences with Wellbutrin. While at small doses it works OK short-term (a few days) to pick my energy level back up.. I find over weeks that my anxiety starts to worsen a LOT. Wellbutrin has several metabolites that tend to accumulate over time so that the ratio of the parent drug to the metabolites is reduced quite a bit-I think those metabolites are very anxiogenic. Another thing I found is that while Remeron worked well for my panic symptoms and sleep, it made me really agitated and restless.. kind of like taking a bunch of yohimbine and Benadryl together. In short it sounds like you and Wellbutrin don't mix well and adding Remeron to it isn't helping. It might be best to cut the Wellbutrin drastically to see if the anxiety lifts, or stop it for one day and see if you feel a lot better. It sounds like the WB is the root of the problem.
Posted by ravenstorm on October 23, 2004, at 15:35:25
In reply to Re: PLEASE HELP. » ravenstorm, posted by Ritch on October 23, 2004, at 11:44:53
Yeah, I've already cut the WB from 250mg to only 100mg. Waiting two weeks to drop it entirely, but then will become pretty non functional on the remeron alone in terms of sedation and not enough AD coverage. I can't understand why adjusting my dosage on the two drugs has not taken care of this.
The paxil was dropped over a year ago. My husband and I wanted to have children. I have pretty much told him to divorce me, as a year later I am either never going to get well or am going to end up on drugs that would harm a fetus. Wish I had just had the guts to end it all last winter when I had severe suicidal ideation for about six months. I held the pills in my hand every night along with the garbage bag and duct tape. I somehow always managed to think of how badly it would hurt my family and not do it. Better for me to suffer than everyone to. But I just don't see the continued point of all this anymore.
Posted by stresser on October 23, 2004, at 22:30:11
In reply to Re: PLEASE HELP., posted by ravenstorm on October 23, 2004, at 15:35:25
DONT DO ANYTHING TO HARM YOURSELF. OMG I just read your post and I must tell you that things will get better. Maybe not this month, but they will. I myself have been going through alot of ups and downs, mostly downs now, but things will get better. How old are you? Is it really important to have children right now? Have them later....they do cause stress and maybe you don't need that extra worry right now. There is a medication out there for you, you just haven't found it yet. I am on Wellbutrin and after reading your post, I now know why I have more heart palpatations than ever before. (You helped me with that part, thanks) My anxiety is overwhelming and I am taking myself off slowely over the next couple of weeks. I take klonipin for Restless Leg Syndrom, and I am thinking of taking a small amount in the am for the anxiety also. Depression is also hitting me, and the Wellbutrin isn't helping at all. Ending your life would be a disaster for everyone, because you will never know how great things can really be once you are past this critical point in your life. Just thinking....do you think you need a mood stablizer? Something like Topamax? you might want to research that. It's interesting. Let me know how you are doing, OK. I will be keeping an eye out for you. Feel free to babble mail me. -L
Posted by Ritch on October 24, 2004, at 16:11:04
In reply to Re: PLEASE HELP., posted by ravenstorm on October 23, 2004, at 15:35:25
I'm sorry you are having to consider dropping meds for a pregnancy. I read the thread above about possibly being better to stay on some meds while pregnant despite the risk. Maybe you could use something different than Wellbutrin that could improve your energy just as well or better? What about Provigil or even a stimulant? I've not tried Provigil, but I an guarantee you that Ritalin and Adderall (and esp. dexedrine) provoked MUCH less anxiety than Wellbutrin did. I wish you well.
Posted by hope4best on October 24, 2004, at 17:35:19
In reply to Re: PLEASE HELP., posted by ravenstorm on October 23, 2004, at 15:35:25
I was on Remeron and Wellbutrin but went up to 90 mg on the Remeron. My dr told me in Europe it is commonly prescribed at much higher doses than it is here in the US. At higher doses Remeron does not make you as tired or as hungry. Have you thought about increasing the Remeron?
Posted by Sebastian on October 25, 2004, at 19:14:48
In reply to PLEASE HELP., posted by ravenstorm on October 23, 2004, at 9:51:42
Add something for anxiety, I take zyprexa.
Posted by ravenstorm on October 25, 2004, at 22:17:28
In reply to Re: PLEASE HELP., posted by hope4best on October 24, 2004, at 17:35:19
hope for best: I can't get above 15mg, I am one of the few people who actually gets more tired the more they take. That was the first thing I tried before adding WB, as I didn't want to go through start up side effects for a new drug if I could just bump up on the original.
Sebastian: Pregnancy is so far off the agenda right now, it isn't even funny. I have pretty much given up that I will be able to have them. If I had it to do all over again, I would stay on the 5mg paxil I was on. I'd probably have a baby by now, instead of a year down the pike with no hope in sight.
Posted by ravenstorm on October 25, 2004, at 22:22:00
In reply to Re: PLEASE HELP. » ravenstorm, posted by Ritch on October 24, 2004, at 16:11:04
Sorry last comment about pregnancy was to Rich.
Sebastian: so far have not been able to tolerate any of the anti-anxieties I've tried.
Have opposite reaction to benzos and am afraid of them in general. Neurontin knocked me out even at low doses. Will not take an atypical antipsychotic because of what my husband has seen happen to people on them. (I'm a med sensitive freak--so if there is a chance of something really sucky happening on a drug it will happen to me)
This is the end of the thread.
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