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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 12 to 36 of 36. Go back in thread:
Posted by linkadge on June 13, 2005, at 19:37:59
In reply to Re: SSRI's - question » Sarah T., posted by KaraS on June 13, 2005, at 19:04:17
I did find that clomipramine did not cause the apathy, but it made me dumb. Dumber than I though was actually possable. It was a marvalous antidepressant, but you're right - we have a life to live too, and if the side effects make living impossalbe, then the drug is no good for us.
Linkadge
Posted by Cairo on June 13, 2005, at 19:38:31
In reply to Re: SSRI's - question » SLS, posted by ed_uk on June 13, 2005, at 16:21:05
Just switched my daughter from Lexapro to Zoloft. Lexapro caused extreme fatigue, apathy, cognitive issues. So far Zoloft seems somewhat stimulating: more energy, definitely less cognitive dulling, less apathy. The only thing I'm a little worried about is that she seems a bit more irritable at times though other times she's perfectly happy. May be that we're not up to correct dosage yet (she's only on 50mg), but I worry that that the stimulating effect may be too much for her. Can't take stimulants due to worsening anxiety and Strattera induced depression in her.
Cairo
> Hi Scott!
>
> I think I might ask for Zoloft at my next appointment.
>
> >I would say that it is constipation that can become an important issue with some people.
>
> I've only been back on Celexa for a short while and I'm already a bit constipated. I seem to get constipated really easily. I might buy some Fybogel :-)
>
> Kind regards,
> Ed.
Posted by linkadge on June 13, 2005, at 19:46:40
In reply to Re: SSRI's - question, posted by BUCKEYE FAN on June 13, 2005, at 17:41:32
Yes, unfortunately. More and more doctors are admitting that these drugs do infact poop out.
Basically from a statiscal standpoint, we (as a nation) are consuming much more of them at higher doses. I suppose we could be getting more depressed :)
The longer we have been exposed to them, the more we see their effects fade.There are many many possable explainations as to why the antidepressant properties of a drug seem to stop, but in the end, nobody has been able to offer a conclusive explaination.
Personally, I don't think I ever recovered fully from that first time celexa pooped. I basically woke up to the realization that my life was just as intollerable as it once was.
Don't even think about stopping the drug at this point though.
Linkadge
Posted by linkadge on June 13, 2005, at 20:19:29
In reply to Re: SSRI's - question, posted by Cairo on June 13, 2005, at 19:38:31
I have heard that zoloft/trazadone combination can work very well.
Does she suffer any insomnia on the zoloft?
Linkadge
Posted by BUCKEYE FAN on June 13, 2005, at 20:46:09
In reply to Re: SSRI's - question » BUCKEYE FAN, posted by linkadge on June 13, 2005, at 19:46:40
> Yes, unfortunately. More and more doctors are admitting that these drugs do infact poop out.
> Basically from a statiscal standpoint, we (as a nation) are consuming much more of them at higher doses. I suppose we could be getting more depressed :)>
> The longer we have been exposed to them, the more we see their effects fade. >
> There are many many possable explainations as to why the antidepressant properties of a drug seem to stop, but in the end, nobody has been able to offer a conclusive explaination.
>
> Personally, I don't think I ever recovered fully from that first time celexa pooped. I basically woke up to the realization that my life was just as intollerable as it once was.
>
> Don't even think about stopping the drug at this point though.
>
>
> LinkadgeFunny you put that last line in Linkadge...because that is exactley what I am considering doing.
I have grown weary of this merry-go-round of Zoloft and Xanax.
I rue the day I allowed the Doctor to talk me into taking them.
I am not blaming him...he was doing his job, what he was trianed to do....but I resisted for so long because KNEW inside they were not a permanent answer.Well......here it is 6 years later and I have not gone a single day without Xanax.
I have managed to stop the anti-depressants for as long as 3 months once...only to start up again
when a "depressive episode" happened. (Im guessing they still call it that )Anyways...Im babbling.
I do know this.....I started on Xanax for Panic Attacks 6 years ago...on an as-needed-basis (ha!)and SOMEHOW I allowed anti-depressants to be thrown in the Mix.
Now I am trapped...my motivation is gone..and my once energetic, high powered personality is dulled by prescription drugs.
At least the Panic Attacks are gone....right?
BF
Posted by KaraS on June 13, 2005, at 21:09:14
In reply to Re: SSRI's - question, posted by linkadge on June 13, 2005, at 19:37:59
> I did find that clomipramine did not cause the apathy, but it made me dumb. Dumber than I though was actually possable. It was a marvalous antidepressant, but you're right - we have a life to live too, and if the side effects make living impossalbe, then the drug is no good for us.
>
>
> Linkadge
What about taking cholinergic medication along with the clomipramine (i.e. Aricept or galantamine)?
Posted by linkadge on June 13, 2005, at 21:13:55
In reply to Re: SSRI's - question, posted by BUCKEYE FAN on June 13, 2005, at 20:46:09
No, in reality you're not totally messed up.
I have been on high doses of SSRI's 60mg of celexa. Getting off of them is hard. But you can survive, and find ways to feel good.
I think they can sometimes push your brain too much in one direction. It needs time to rebound and recharge.I blameded myself a lot when I stopped celexa, because when I started it again it didn't quite work the same way. But, in reality, I was just remembering the best times, and trying to assume that they "always were".
Thats what it is all about sometimes. Not really feeling good *all the time*, but having hope. Hope that there will be reward in choosing a particular path.
Our brain is wired to convince ourselves of our fantasies, it will give us just enough to convince us that the grass is truely greener on the other side of the hill. WHen it works properly, we will fight to get on the other side.
Paradoxically, after a little while, we will fight just as hard to get back to the original side.
It's really just a journey to find a spark to keep the fire going.
Good LuckLinkadge
Posted by linkadge on June 13, 2005, at 21:26:03
In reply to Re: SSRI's - question » linkadge, posted by KaraS on June 13, 2005, at 21:09:14
I would have *loved* to do so. Unfortunately my doctor is very "old school" and would have probably tried to blame the cognative problems on depression or anxiety. I don't think he would be keen on the idea.
As well, if I am clever enough to do all this reasearch to bring to him on how aricept can negate the cognative side effects of clomipramine, then he'd get to thinking that I am not dumb enought to need it in the first place.
I just gave up.
Linkadge
Posted by Glydin on June 14, 2005, at 8:27:40
In reply to SSRI's - question, posted by Sarah T. on June 13, 2005, at 4:48:11
I have had great success on an SSRI thus far. That isn't something you hear frequently, it would seem, but I do know of others in my real world who declare the same. I have noted improvement in all aspects of my emotional status, thus making for a better me, a better life, and better overall functioning.
Posted by yesac on June 14, 2005, at 10:54:53
In reply to Re: SSRI's - question, posted by gromit on June 13, 2005, at 18:40:14
> I know that for most people these drugs do work, in a year or so they can stop taking them and move on. I'm happy for them, really, but at the same time I f*rt in their general direction.
I totally hear you-- I feel that way too. I think that probably you are right that for *most* people the drugs work. In my opinion, those are the people who aren't here on this board. Those are the smiling people on the Wellbutrin commercials saying that they are so happy they feel like themselves again. I think that those people are a different sort than the people here on Babble. We are the ones who the drugs *don't* work for +/or who have horrible unbearable side effects and just can never seem to find the right drug. We're the ones who actually have to see psychiatrists instead of just getting the prescriptions from our family doctors and then going on our merry way!Just my 2 cents!
Posted by linkadge on June 14, 2005, at 15:43:38
In reply to Re: SSRI's - question » gromit, posted by yesac on June 14, 2005, at 10:54:53
"for *most* people the drugs work"
I don't think this is true. Perhaps, for most of these people the drugs are placebo's, and work in that manner. Some peole's depression is very situational, and improves over time by itself. I think people like the idea of having something to attibute their improvement to, just like rabit's feet, q-wray bracelets etc. It gives them a sence of controll. So when things naturally get better, they feel control over the situation by attributing it to the antidepressant.I mean I know that I start to wonder why the drug companies need to work so hard to try and prove their drug is better than the placebo.
Linkadge
Posted by Cairo on June 14, 2005, at 16:23:46
In reply to Re: SSRI's - question, posted by linkadge on June 13, 2005, at 20:19:29
Linkadge,
I think you meant this for me. My daughter has a sleep phase shift: difficulty falling asleep, but sleeps throught the night, though I question her quality of sleep. Her sleep study showed some mild apnea. Tried trazodone awhile back, but stopped it b/c we thought it might be causing memory issues. Turns out it was the Lexapro we started at the same time, but didn't know it then and never tried trazodone again.
A specialist we consulted wants to add low dose Seroquel as an adjunct for social phobia, but our local doc absolutely refuses to prescribe it stating that it will make her fatigue worse (that said before we switched to Zoloft).
As her SP is only 20-30% helped by SSRI, do you think Seroquel would be worth a trial, especially since it would help sleep, rather than adding a sleep med? We've an appointment with another pdoc soon who will hopefully be more open to trying things and not on the SSRI bandwagon so much.
You've always been so helpful on this board. Thank you.
Cairo
> I have heard that zoloft/trazadone combination can work very well.
>
> Does she suffer any insomnia on the zoloft?
>
>
> Linkadge
Posted by linkadge on June 14, 2005, at 20:41:02
In reply to Re: SSRI's - question » linkadge, posted by Cairo on June 14, 2005, at 16:23:46
I personally would avoid seroquel unless it is a disorder of psychosis. All of the antipsychotics can cause memory and learning problems. I found it very hard to learn the next day when I took seroquel. It can sap energy too. But so can insomnia, which is the catch.
Zoloft seems to work well for kids. Be sure not to get the dose too high. I think low doses can work wonders, but too high a dose can cause problems. They're strong drugs, and kids often don't need a whole lot to benfit.If insomnia, and anxiety are the key issues, then trazadone might be worth another whirl either on its own or with the zoloft.
If you do end up trying seroquel take as low a dose as possable, and take it early in the evening.Linkadge
Posted by Sarah T. on June 14, 2005, at 23:39:51
In reply to Re: SSRI's - question » Sarah T., posted by Glydin on June 14, 2005, at 8:27:40
Hi Glydin,
Which SSRI are you on? Which one has been best for you? Can you elaborate?
Posted by Dave001 on June 15, 2005, at 3:39:58
In reply to Re: SSRI's - question » ed_uk, posted by SLS on June 13, 2005, at 15:32:56
> I found Zoloft to be almost free of cognitive and affective side effects, even at 200mg. It was real clean.
A couple of fairly recent articles compared sertraline (Zoloft) favorably to other SSRIs (inclusive of Effexor) on cognitive measures. I don't have the cites handy at the moment, but I can dig them up if anyone is interested.
Posted by Glydin on June 15, 2005, at 12:24:41
In reply to Re: SSRI's - question » Glydin, posted by Sarah T. on June 14, 2005, at 23:39:51
> Hi Glydin,
> Which SSRI are you on? Which one has been best for you? Can you elaborate?
I'm on Lexapro 10mgs. Prior to Lexapro I was Klonopin monotherapy for an anxiety disorder. I did do several trials of SSRI's before I utilized only Klonopin. I swore I would never touch an AD again... However, my status changed and while my anxiety was fairly well controlled, a clinical level depression became apparent, so something had to change. Some might point to my exclusive K use as the cause of the depression. Prehaps long term benzo was a factor, but I don't feel it's contribution was great. Deep down I know my status simply changed. TCA's, MAOI's, and atypicals were not appealing to me for various reasons. I had not tried Celexa nor Lexapro. So, it was decided to give one last SSRI one more chance. My depression lifted and my K use is very minimal and not daily as was previous.I do think going on Lex made a big difference for me. Others may question, but I'm living a life better than I have in, probably, years.
Posted by sedona on June 15, 2005, at 19:23:03
In reply to SSRI's - question, posted by Sarah T. on June 13, 2005, at 4:48:11
> I am one of those people who does poorly on SSRI's. The more selective they are, the more apathetic and immobile I become. I am interested in hearing from anyone who has actually improved on SSRI's. By improvement, I mean BOTH improvement in mood AS WELL AS improvement in the ability to move towards one's goals (increased motivation, drive, etc). Has anyone who takes SSRI's ever really seen this sort of improvement? I get the impression that many people who don't get worse on SSRI's, don't actually improve that much either. Rather, the improvement seems to be primarily a reduction of anxiety. The anxiolytic properties of SSRI's are not to be dismissed because, for many, anxiety is a significant component of their depression, and once anxiety is alleviated, depression may lift as well.
>
> So, my question is, does anyone actually improve on SSRI monotherapy? Improvement, to me, means improvement in mood/outlook/hopefulness, etc. AS WELL AS the ability to bring about obvious, "measurable" improvements in one's personal and professional life.
>
> Again, I'm referring to SSRI monotherapy, without augmentation by stimulants or dopaminergic antidepressants.
>
>
>Hi- Unfortunately, I too am a person that has had problems with SSRIs. I've tried a ton of drugs. Some of them have been antidepressants including two SSRIs, Prozac and Lexapro, and I've tried Wellbutrin and am currently using Cymbalta. With the exception of Wellbutrin, all have helped me with anxiety. Wellbutrin in general made me extremely irritable to a point that actually scared me. Prozac, Lexapro, and Cymbalta (an SNRI), have all left me apathetic and tired, which has always made me wonder if they were really helping my depression at all. I actually find it very hard to finish anything, to go to work, and to enjoy things in general. Furthermore, I get very frustrated with my psych who wants me stay on antidepressants despite the apathy and lethargy. In my case I am still not sure if all of these problems are side-effects of the drugs or if I am just truly med resistant. Sorry, I can't offer more suggestions for you. The one and only drug that has given me any motivation is the stimulant Adderall. But I have found after a year of use that I need to take more and more just to keep me awake and alert throughout the day. I'm just hoping that we will soon have some new drugs that don't involve serotonin.
Posted by sedona on June 15, 2005, at 19:45:28
In reply to Re: SSRI's - question, posted by linkadge on June 14, 2005, at 15:43:38
> "for *most* people the drugs work"
>
>
> I don't think this is true. Perhaps, for most of these people the drugs are placebo's, and work in that manner. Some peole's depression is very situational, and improves over time by itself. I think people like the idea of having something to attibute their improvement to, just like rabit's feet, q-wray bracelets etc. It gives them a sence of controll. So when things naturally get better, they feel control over the situation by attributing it to the antidepressant.
>
> I mean I know that I start to wonder why the drug companies need to work so hard to try and prove their drug is better than the placebo.
>
> Linkadge
>
>
>
>
>
>I agree with you, although I live in the Pacific Northwest where depression is fairly high. Of the six people I know that have been on or are on antidepressants, the results have been grim. One person became a zombie from the side-effects and had to quit, one person was doing great until he became manic and thus was pronounced to be bipolar, three people I know have tried many different antidepressant drugs (4 or more)with very little to no relief, and only one person I know -who is taking Paxil, is happier and glad to have started antidepressants. These are just people I know from work, and they are not Psycho Babblers. So, I think that there might actually be many more people like us out there that don't use the internet for imformation like we do. But, hey, that's just my opinion on the subject.
Posted by linkadge on June 15, 2005, at 20:56:22
In reply to Re: SSRI's- question » linkadge, posted by sedona on June 15, 2005, at 19:45:28
THe drugs have a powerful ability to alter the psychological experience. Like I said, I think they create a lot of fluff.
We want to think that our depression is a result of a chemical imballance. Why? Because if we believe this then the answer to our problems is simple. Take a drug.
If we believe however, the bleaker truth like perhaps, we are depressed because we are under a lot of stress at work, or because we live it a terrably poluted environment etc, then we feel helpless, because we cannot change that. But we can change our brain chemistry.
We like to entertain positive thoughts, because they sustain us throughout the bad times. But when the posative thoughts become so abstract and so untrue then it does nothing to serve your situation in the long term.
Linkadge
Ok so they rase serotonin. So what? Petting a dog raises serotonin, having a warm bath raises serotonin.
Posted by Sarah T. on June 16, 2005, at 0:37:52
In reply to I'll be glad to share, posted by Glydin on June 15, 2005, at 12:24:41
Hi Glydin,
It's good to hear that you are doing well now. I really appreciate your input here. I have an idea. . . Please clone your body chemistry and metabolism, and spread the wealth around!
Posted by Sarah T. on June 16, 2005, at 0:46:46
In reply to Re: SSRI's- question » Sarah T., posted by sedona on June 15, 2005, at 19:23:03
Hi Sedona. Thanks for your reply. May I ask how much Cymbalta you are on and how much Adderall? Does the Cymbalta seem to potentiate the effects of the Adderall and vice versa? What I mean is, I know Cymbalta is partly a norepinephrine (NE) reuptake inhibitor, and Adderall affects NE, too, a bit more than Dexedrine does, so I wondered about problems like palpitations, tremors, things like that.
I think it's possible that the SSRI portion of Cymbalta might make it necessary to raise the Adderall dose. Although I don't have enough experience with Cymbalta, I do know that whenever I tried to combine an SSRI with a stimulant, the addition of the SSRI made it necessary to increase the stimulant dosage. In fact, the SSRI seemed to negate many of the benefits of the stimulants for me; however, I have met people who've successfully combined those two, without having to continually raise the stimulant dose.
Posted by sedona on June 16, 2005, at 12:37:20
In reply to Re: SSRI's- question » sedona, posted by Sarah T. on June 16, 2005, at 0:46:46
Well, right now I am only taking 30mg of the Cymbalta because I didn't really notice a difference between 30mg and 60mg. I have always thought the Cymbalta made me a little tired. I take Adderall XR 30mg twice a day. I used to take 30mg once a day, but it seemed to have lost some of its effects and that is why I now take it twice a day. I haven't had a any problems with it, even at the higher dose. I was hoping it would help me lose some of the weight I have gained from antidepressants, but it hasn't.
> Hi Sedona. Thanks for your reply. May I ask how much Cymbalta you are on and how much Adderall? Does the Cymbalta seem to potentiate the effects of the Adderall and vice versa? What I mean is, I know Cymbalta is partly a norepinephrine (NE) reuptake inhibitor, and Adderall affects NE, too, a bit more than Dexedrine does, so I wondered about problems like palpitations, tremors, things like that.
>
> I think it's possible that the SSRI portion of Cymbalta might make it necessary to raise the Adderall dose. Although I don't have enough experience with Cymbalta, I do know that whenever I tried to combine an SSRI with a stimulant, the addition of the SSRI made it necessary to increase the stimulant dosage. In fact, the SSRI seemed to negate many of the benefits of the stimulants for me; however, I have met people who've successfully combined those two, without having to continually raise the stimulant dose.
Posted by susansister on June 16, 2005, at 23:23:00
In reply to SSRI's - question, posted by Sarah T. on June 13, 2005, at 4:48:11
I've been thinking about this very thing all week. I have been taking Effexor 300 mg/day for three years, along with Buspar to "boost" the Effexor when it began to poop out, and I feel okay, that is, not depressed, but I don't feel like doing much either. I like to nap and to read about other people doing things and living their lives. Anyway, a few days ago I stopped taking my evening dose of Effexor preparatory to getting off of the stuff all together and not going on another AD afterwards. In the seven years since I've been on antidepressants, I've gained 50 pounds and lost all of my motivation for the projects I used to love to do and the human interactions I used to thrive on. What I would love to take is a stimulant but my doctor refuses because I had a substance abuse problem with opiates ten years ago and he thinks I'll abuse them. I do have ADD but Strattera made me terribly dysphoric and nauseated. Oh, enough whining. Anyway, this thread is really fascinating to me. I wonder what I'm doing to myself, and I think I'm ready to find out who I am underneath all of this medication. ( I also take topamax for migraines but can't tolerate more than 100 mg a day--my hands and feet feel like blocks and I'm liable to call the garage "that thing out back what we put the cars in.")
Posted by Glydin on June 17, 2005, at 8:54:51
In reply to Re: I'll be glad to share » Glydin, posted by Sarah T. on June 16, 2005, at 0:37:52
> Please clone your body chemistry and metabolism, and spread the wealth around!
Hi Sarah,
I would if I could --- I really would.
Glydin
Posted by Sarah T. on June 17, 2005, at 23:28:41
In reply to I'll be glad to share, posted by Glydin on June 15, 2005, at 12:24:41
Does Lexapro interfere with your sleep? Do you take it at night or in the morning? When I took Celexa, I woke up every night at the same time and couldn't get back to sleep for several hours.
This is the end of the thread.
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