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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 barbaracat on April 6, 2005, at 23:19:19
Hi Folks,
I have a favor to ask which serves two purposes. One, a dear friend of mine is going through hard times and decided she needs an AD. She's never been on any mood med before (as a holistically inclined phys therapist, this is a HUGE admission). She asked me ones to recommend. I'm a little stumped since I haven't been in the loop recently. I'm doing great on lithium and my microdose of Cymbalta but thought I'd ask you folks.I will then create a chart based on the answers which should be interesting. Here is the template. Thanks for your help.
ANTIDEPRESSANT SURVEY:
BabbleName:
Diagnosis and Symptoms:Name of Med:
Dose: Year:
Rating (1-10)*
*1=terrible, 10=wonderful
Comments:Name of Med:
Dose: Year:
Rating (1-10)*
Comments:
Name of Med:
Dose: Year:
Rating (1-10)*
Comments:
Name of Med:
Dose: Year:
Rating (1-10)*
Comments:
Name of Med:
Dose: Year:
Rating (1-10)*
Comments:
Name of Med:
Dose: Year:
Rating (1-10)*
Comments:(Please add more if so inclined)
Posted by Phillipa on April 7, 2005, at 0:46:48
In reply to AD Survey - please contribute your exp., posted by barbaracat on April 6, 2005, at 23:19:19
Wow! That' a lot. l.luvox, about a year up to doses of 250mg, no side effects. That's the only one that I could take right away and not have problems with. My diagnosis has varied over the years from Panic attacks, GAD, Anxiety/Depression, PTSD. I didn't follow the format, sorry. But hope this helps. Fondly, Phillipa
Posted by Phillipa on April 7, 2005, at 0:47:58
In reply to AD Survey - please contribute your exp., posted by barbaracat on April 6, 2005, at 23:19:19
I really am bad. I give it a l0. Fondly, Phillipa
Posted by cache-monkey on April 7, 2005, at 1:16:40
In reply to AD Survey - please contribute your exp., posted by barbaracat on April 6, 2005, at 23:19:19
Fun stuff. Here goes...
ANTIDEPRESSANT SURVEY:
BabbleName: cache-monkey
Diagnosis and Symptoms: Originally thought I was depressive (2001-2003). Then noticed strong anxiety component, negative thinking, dysregulated reward system (2003-2004). Finally, am realizing (late 2004+) that I might have a soft bipolar with frequent dysthymia and anxiety, and occasional mixed states. During strongly anxious periods and mixed states I tend toward OCD.
Name of Med: Wellbutrin
Dose: 150-400 mg
Year: April 2002 - August 2002
Rating (1-10): 5
Comments: Found it agitating. Amplified my normally slight OCD tendencies. On the positive side: great for weight and libido. Also somewhat energizing.Name of Med: Wellbutrin + Celexa/Lexapro
Dose: 400 + 20 / 400 + 10
Year: August 2002 - February 2003
Rating (1-10): 6
Comments: Felt great on this combo. Too great, in retrospect. Definitely hypomanic. Experienced substantial weight gain and sexual dysfunction.Name of Med: Serzone
Dose: 50 - 400 mg
Year: Nov 2003 - May 2004
Rating (1-10): 3
Comments: Increased anxiety to the point of paralysis. Also increased OCD behavior. (As with Wellbutrin, this was probably a response to the higher levels of anxiety.) Great for weight and sexual function. (Quite annoying that the best two in terms of side effects actually worsened me mentally.)Name of Med: Serzone + BuSpar + Xanax
Dose: 300 mg + 10 mg + 0.25 PRN
Year: May 2004 - August 2004
Rating (1-10): 4
Comments: Adding BuSpar might have helped some with certain aspects of my anxiety (cognitive) but worsened me in terms of the physical manifestations of anxiety.Name of Med: BuSpar + Cymbalta + Xanax
Dose: 10 mg + 10-20 mg + 0.25 mg PRN
Year: Sept 2005
Rating (1-10): 1
Comments: Adding Cymbalta sent me into a very agitated anxious state. Truly horrible.Name of Med: BuSpar + Lamictal + 0.25 mg PRN
Dose: 5 mg + 12.5-50 mg
Year: December 2004
Rating (1-10): 4
Comments: Lamictal made me groggy at first, but then energizing. Increasing the dose from 25 to 50 mg sent me into a panic state. Also experienced lower back pain and erectile dysfunction.[Note: at some point during Autumn of 2004 I realized that my reactions to Serzone, BuSpar and Cymbalta might be partially explained by a liver enzyme issue -- CYP-2D6 deficiency. Got a genetic screen and found out that I was an "intermediate" (closer to deficient than extensive) 2D6 metabolizer.]
Name of Med: Xanax
Dose: 1 mg
Year: Dec 2004 - Jan 2005
Rating (1-10): 8
Comments: Worked wonders for my anxiety. Inter-dose rebounding was a problem, though.Name of Med: Klonopin + Lithium + Xanax
Dose: 1-1.5 mg + 0.25 PRN
Year: Jan 2005 - March 2005
Rating (1-10): 6
Comments: Klonopin was more sedating and less anxiolytic than Xanax. It also caused some problems with libido and sexual function. The Lithium helped greatly with stabilization. However, my psychiatrist insisted on pushing the dose to traditional therapeutic ranges. As a result, I developed nephritic diabetes insipidus and had to d/c the lithium.Name of Med: Valium
Dose: 8 mg
Year: March - April 2004
Rating (1-10): 7
Comments: Libido/sexual function returned to normal. Obtained better anxiolysis and less sedation, as compared to Klonopin. Some mixed states and hypomania remained untreated.Name of Med: Valium + Depakote
Dose: 8 mg + 250 mg
Year: April 2004 -
Rating (1-10): Too early to tell.
Comments: Just added the Depakote two days ago. Have been having minor GI issues and sweaty palms. Will post a later update on this combination...
Posted by CK1 on April 7, 2005, at 11:43:15
In reply to Re: AD Survey - please contribute your exp., posted by cache-monkey on April 7, 2005, at 1:16:40
ANTIDEPRESSANT SURVEY:
BabbleName:
Diagnosis and Symptoms: Originally treated for mild social anxiety (wanted to decrease my inhibitions) and also mild depression. I am now being treated for soft bipolar disorder with mixed states of agitation, irritability, insomnia, and depression (dysphoric hypomania). Diagnosed based on non-responsiveness to SSRI's after Paxil pooped out after two years.Name of Med: Paxil
Dose: 10 mg Year: 2002-January 2005
Rating (1-10)* 10
*1=terrible, 10=wonderful
Comments: Felt great on this drug for 3 years. It significantly decreased my social anxiety. I was able to give speeches and become the center of attention and critisizms were not taken sooo literally like before. For panic/anxiety - there is no SSRI better than Paxil, in my opinion. It did, however, make me feel "too cocky" and hypomanic. I started thinking I was better than people, got EXTREMELY confidant, and felt almost "too" good, in retrospect. Totally quit working in January leaving me very irritable, depressed, anxious, etc. Haven't been able to tolerate SSRI's since!Name of Med: Effexor
Dose: Year: 37.5 January 2005
Rating (1-10)* 1
Comments: Threw me in a constant state of panic for two weeks - what I now consider to be mixed states. Panic city!
Name of Med: Zoloft
Dose: 25 mg Year: February 2005
Rating (1-10)* 4
Comments: Tried for 5 weeks, but couldn't get above 25mg, due to EXTREME insomnia (never had before), neck pain, muscle aches, increased anxiety, etc. Milder than Effexor.
Name of Med: Lamictal + Paxil
Dose: 25mg Year: March 2005
Rating (1-10)* 5
Comments: After my reactions to the previous two AD's, my doctor prescribed this. I have 3 family members with bipolar and intolerability of SSRI's usually signifies a change in strategy(if 2 SSRI's don't work, there is very little chance that the 3rd will be any different). Lamictal is very activating for me and I'm now only sleeping 8 hours a night and have lots of energy (positive). When I up the dose to 50mg, I get extremely angry, irritable, depressed, frustrated (mixed state hell), but 25mg seems to be fine with no side effects.Name of Med: Lamictal + Lithium
Dose: 25 mg and 300mg Year: April 2005
Rating (1-10)* n/a
Comments: Haven't taken the lithium yet! This is supposed to be "the" combo for Bipolar II (soft bipolar) Lamictal increases energy and provides and acts as the main AD, while Lithium controls the anxiety and anger caused by the Lamictal (BELEIVE ME, LAMICTAL ALONE SUCKS FOR ANXIETY DISORDERS). Lithium is being used to "calm me down" and prevent hypomania (not the good kind!)So, what started out as mild social anxiety 3 years ago has seemed to have progressed to Bipolar II. SSRI's worked great (then), but don't do a thing (now). To all of you that experience SSRI poop out and can't seem to get "that feeling back" with other SSRI's you try, it might be worthwhile to change the medication approach, even if you "think" you are "simply" depressed/anxious. I NEVER thought I'd be on Lamictal much less LITHIUM (which, in my previous understanding, was for "those people" and schizohrenics). Well, now I am and I'm more confidant than ever that I'll get better. Trying 2 SSRI's and having them not work is more depressing for me than getting on mood stabilizers.
Posted by lara53 on April 8, 2005, at 19:16:06
In reply to Re: AD Survey - please contribute your exp., posted by CK1 on April 7, 2005, at 11:43:15
CK1 Off subject,just wishing you well with this combo,you have been so kind to me.
Posted by barbaracat on April 8, 2005, at 20:44:27
In reply to AD Survey - please contribute your exp., posted by barbaracat on April 6, 2005, at 23:19:19
>
> ANTIDEPRESSANT SURVEY:
>
> BabbleName: BarbaraCat
> Diagnosis and Symptoms: Bipolar I or II mixed states predominantly depression
>
> Name of Med: Microdose Cymbalta + lithium 600mg
> Dose: Year: currently January 2005
> Rating (1-10)* 9
> *1=terrible, 10=wonderful
> Comments: Can't take much of anything else so am very glad to have found this combo that works better than anything else. The low dose Cymbalta works with my chemistra and keeps the bad depressions away. Lithium has been my lifesaver and at the low dose I do not experience any side effects.
>
> Name of Med: Lamictal (with lithium)
> Dose: 75-150mg Year: 2002
> Rating (1-10)* 4
> Comments: Worked pretty well at 75 for a year then pooped. Upping the dose would give me anxiety each time and eventually I became allergic to it, a pre Rash condition.
>
>
Name of Med: Depakote
> Dose: ? Year: 2005 for a few weeks
> Rating (1-10)* 2
> Comments: Dulled, depressed, lethargic. Hated it.Name of Med: Seroquel
> Dose: 100-200mg Year: 2005
> Rating (1-10)* 2
> Comments: Ugh. Dopey depression, no anti-axiety relief as expected. Don't seem to do well on histamine blockade meds.> Name of Med: Nortriptyline (w/Lithium)
> Dose: 75mg Year: 2002
> Rating (1-10)* 8
> Comments: Except for the dry mouth and constripation, this was a great AD for me during a very difficult time after my Mom's death.
>
>
> Name of Med: Remeron
> Dose: 90mg Year: 2000
> Rating (1-10)* 2
> Comments: Worked for about 2 months very well then pooped and nothing could bring back the response. Gained 40 lbs in the 6 months I was on it.
>
>
> Name of Med: Effexor, Paxil
> Dose: small Year: 1999
> Rating (1-10)* 2
> Comments: I lump these together because they produced the same anxiety, no antidepressant effect and horrible to withdraw from. I wasn't on lithium either and experienced panic disorder on all SSRI's by this time.
>
>
> Name of Med: Wellbutrin
> Dose: 150mg Year: 1999
> Rating (1-10)* 2
> Comments: Nope. Too speedy and not AD response.
>
> (Name of Med: Zoloft
> Dose: from 50-300mg Year: 1986-1999
> Rating (1-10)* 9 then 3
> Comments: This was a good one while it lasted. Repeatedly pooped and I'd have to take a break. Was on 300mg for over two years and depression/panic kept breaking through. Should've been on a mood stabilizer but thought I was 'just' depressed.Name of Med: Trazadone
> Dose: 200mg then 50mg to sleep Year: 1983-1988
> Rating (1-10)* 6
> Comments: This was a nice gentle med, nice after the speedyness of a short trial of zoloft. Helped me sleep but couldn't wake up.Name of Med: Assorted TCAs
> Dose: assorted Year: 1978-1983
> Rating (1-10)* 4
> Comments: Terrible side effects, however, Surmontil did help me out of a terrible mixed stater.Please add more if so inclined)
>
>
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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