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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by denise1966 on October 5, 2005, at 3:37:45
Ok, I'm pretty sure that this Paxil (been on it two weeks) is not working as it had pretty much stopped working when I came off it about three months ago.
Although it's helping a bit, I feel that awful numbness, lack of motivation, poor concentration, difficulty listening, reading etc. Tense jaw, a lot of pressure in my chest, like I'm suffocating etc etc, I took 15mg of Remeron last night and that seemed to help a little but not a lot.
I have an appointment with a new Psychiatrist on the NHS in probably over a month and I'm not sure what direction to try and steer him/her in.
Not sure what to do either:-
Ask him to add a stimulant and a thyroid hormone (but I doubt that they'll go for that).
Switch to another SSRI completely and go on a high dose.
Switch to another SSRI and augment it with a stimulant or thyroid hormone.
Switch to Remeron or Effexor (high dose)
Ask him to add Naltrexone or Pindolol to the Paxil.
I get sick of this, all this trying and waiting, whilst my life just whittles away.
Well at least I have Zyprexa, that's one thing but God Forbid it ever stops helping.
Anyone have any suggestions.
Kind Regards....Denise
Posted by SLS on October 5, 2005, at 6:23:32
In reply to Not sure what to do next? Advice Needed, posted by denise1966 on October 5, 2005, at 3:37:45
Hi Denise.
What drugs have helped in the past - no matter how little?
What drugs have made you feel worse in the past?
What drugs have you not tried?
- Scott---------------------------------------------\
> Ok, I'm pretty sure that this Paxil (been on it two weeks) is not working as it had pretty much stopped working when I came off it about three months ago.
>
> Although it's helping a bit, I feel that awful numbness, lack of motivation, poor concentration, difficulty listening, reading etc. Tense jaw, a lot of pressure in my chest, like I'm suffocating etc etc, I took 15mg of Remeron last night and that seemed to help a little but not a lot.
>
> I have an appointment with a new Psychiatrist on the NHS in probably over a month and I'm not sure what direction to try and steer him/her in.
>
> Not sure what to do either:-
>
> Ask him to add a stimulant and a thyroid hormone (but I doubt that they'll go for that).
>
> Switch to another SSRI completely and go on a high dose.
>
> Switch to another SSRI and augment it with a stimulant or thyroid hormone.
>
> Switch to Remeron or Effexor (high dose)
>
> Ask him to add Naltrexone or Pindolol to the Paxil.
>
> I get sick of this, all this trying and waiting, whilst my life just whittles away.
>
> Well at least I have Zyprexa, that's one thing but God Forbid it ever stops helping.
>
> Anyone have any suggestions.
>
>
> Kind Regards....Denise
Posted by denise1966 on October 5, 2005, at 7:15:25
In reply to Not sure what to do next? Advice Needed, posted by denise1966 on October 5, 2005, at 3:37:45
Hi Scott,
Well they all seem to work differently depending when I take them. OK here's the list and my responses accordingly but I think at the time the doses were too low and I had nothing to quell the excruciating anxiety that I got with each drug so gave up on them. Fortunately I know now that I have Zyprexa for the really tough times.
Mirtazapine (Remeron)15mg - took for approxamately a month awful anxiety and appetite loss, felt like a zombie on it at times also. No desire to talk to anyone.
Effexor (about 75mg I think) again for a couple of months - Still depressed, more relaxed though but not much motivation.
Zooloft 100mg - Can't remember how long I took it - Still depressed and anxious.
Lithium - Can't remember how much I took but got up to a blood level of 0.5 - Nothing at all, didn't feel as though I was taking anything.
Dothiapen and Sertraline (not sure of the doses) -Passed out.
Lamictal - not sure of the dose but got up quite high - No response at all.
Tegretal - No response.
Nardil - very relaxed at times but absolutely no motivation on a low dose and not wanting to talk to anyone. Very motivated at a high dose (105mg) but also very sleepy and a feeling of wouldn't it be nice to just sleep and die.
Finally Paxil 40mg - Seemed to work after about 3 days, felt a sudden sense of peace after the third day. After two years seem to stop working.
Tried Nardil again and same sort of response but more out of it.
Back to Paxil - And it is sort of helping me from hitting rock bottom but I have all the symptoms I desribed above.
Zyprexa 10mg - The one and only drug I can seem to count on (fingers crossed) for lifting of mood, more motivation and better concentration but I don't want to rely on it as if I develope a tolerance to it at some point then I'll have nothing to count on.
I need something to either make this Seroxat work again like it worked before or to take something else that will work.
I was thinking about thyroid hormone or stimulant but not sure a psychiatrist here in the UK would be willing to prescribe it.
Denise
Posted by denise1966 on October 5, 2005, at 8:45:53
In reply to Re: Not sure what to do next? Advice Needed, posted by denise1966 on October 5, 2005, at 7:15:25
Scott,
Forgot to mention that although I had anxiety on 15mg of Mirtazapine on it's own when I took it about 4 years ago. I've had no anxiety on it when added to the 40mg of Paxil, it actually seems to be making me think clearer but not really improving my mood that much.
Denise
Posted by ed_uk on October 5, 2005, at 14:41:30
In reply to Re: Not sure what to do next? Advice Needed, posted by denise1966 on October 5, 2005, at 8:45:53
It's time to try Abilify or Seroquel Denise!
~Ed
Posted by Phillipa on October 5, 2005, at 18:54:14
In reply to Re: Not sure what to do next? Advice Needed » denise1966, posted by ed_uk on October 5, 2005, at 14:41:30
I did have a pdoc at one time who used cytomel to help with depression. Fondly, Phillipa
Posted by denise1966 on October 6, 2005, at 6:09:52
In reply to Re: Not sure what to do next? Advice Needed » denise1966, posted by ed_uk on October 5, 2005, at 14:41:30
Hi Ed,
I do like Zyprexa but don't want to take it regularly or long term, the same thing would apply to abilify or seroquel.
The reason is and you might not see the logic in this but:-
I suffered from mild unmedicated depression from 17 to 24, I could still function ok but didn't really look forward to or enjoy anything, then it seemed to get worse. I finally burst into tears at the Doctors office and he prescribed dothiepin which I didn't want to take because I didn't believe I was depressed, I thought I was physically ill.
Anyway, I succumbed and took the dothiepin and I felt wonderful on it. Suddenly I felt extremely fortunate that I had an illness that was so instantly treatable. Years later the dothiepin (prothiaden) seemed to stop working so I switched to Paxil which also worked brilliantly and in a very short space of time.
When I finally came off Paxil when I was about 30, I thought my depression was just a thing of the past, something that I just suffered from when I was younger. And I thought to myself if I ever did get depressed again it would be simple, I'd just hide away for a couple of weeks until the Paxil (Seroxat) started working again.
The thing is it never turned out like that, I got suicidally depressed and everything I took bar (Zyprexa) just seemed to make me worse. I spent 2 years resisting taking zyprexa just because I wanted the ADs to work like they used to and couldn't understand why they didn't. I've lost that sense of security I used to have now about Ads, about it being that simple and it scares me.
I don't want to take Zyprexa, Abilify or Seroquel regularly and then suddenly become tolerant to it because then I wouldn't have anything to fall back on. Does that make any sense?
All I want to do is find something to augment an AD with to make the ad work again. I was relieved two years ago when the Paxil seemed to start to help a bit because it made me feel that little bit less resistant.
Kind Regards....Denise
Posted by Emme on October 6, 2005, at 9:04:59
In reply to Re: Not sure what to do next? To Ed, posted by denise1966 on October 6, 2005, at 6:09:52
Hi Denise,
I hope you don't mind if I butt in.
> I do like Zyprexa but don't want to take it regularly or long term, the same thing would apply to abilify or seroquel.
>
> The reason is and you might not see the logic in this but:-Your logic makes sense. You don't want to burn up your last hope. I also haven't had good luck with retrials of ADs. They either don't work, or my side effects are worse.
I took Abilify a couple of years ago for depression with good results. But it faded out and I eventually stopped it. I started it again recently and it's working. I'm having trouble with some side effects, but it's no worse than it was the first time. This makes me wonder if it's easier to recapture therapeutic effects of APs than ADs. Perhaps Ed or Scott or someone else will have some input on this.
emme
Posted by ed_uk on October 6, 2005, at 13:53:36
In reply to Re: Not sure what to do next? To Ed, posted by denise1966 on October 6, 2005, at 6:09:52
Hi Denise,
Have you tried amitriptyline?
~ed
Posted by 4wd on October 7, 2005, at 20:54:27
In reply to Re: Not sure what to do next? To Ed » denise1966, posted by Emme on October 6, 2005, at 9:04:59
> Hi Denise,
>
> I hope you don't mind if I butt in.
>
> > I do like Zyprexa but don't want to take it regularly or long term, the same thing would apply to abilify or seroquel.
> >
> > The reason is and you might not see the logic in this but:-
>
> Your logic makes sense. You don't want to burn up your last hope. I also haven't had good luck with retrials of ADs. They either don't work, or my side effects are worse.
>
> I took Abilify a couple of years ago for depression with good results. But it faded out and I eventually stopped it. I started it again recently and it's working. I'm having trouble with some side effects, but it's no worse than it was the first time. This makes me wonder if it's easier to recapture therapeutic effects of APs than ADs. Perhaps Ed or Scott or someone else will have some input on this.
>
> emme
>
Emme,Could you tell me your experiences with Abilify? Dosage, how long it took to work, how you felt before it and after it started to work? ANd what were the side effects? Did they get better over time? Did it help with anxiety? Were yo prescribed it to help augment an AD? Lots of questions, I know but I've been prescribed Abilify after failed trials of other APs and I'm a bit leery of it.
Thanks,
Marsha
Posted by Emme on October 8, 2005, at 11:43:16
In reply to Re: Not sure what to do next? To Ed » Emme, posted by 4wd on October 7, 2005, at 20:54:27
Hi Marsha,
> Could you tell me your experiences with Abilify?
>Dosage,I take 2.5 mg every other day.
> how long it took to work,
About 4-5 days. It has a long half life (72 hours? something like that...)
> how you felt before it and after it started to work?
Tired and more tired, unmotivated, apathetic. It improved my mood and motivation. Suddenly I was able to get things done. It was really remarkable.
> ANd what were the side effects?
The main s/e that I'm having is insomnia. I wake up a lot in the night and don't get much quality sleep. I'm still working on finding a solution to this. I'm trying Rozerem for a few days.
> Did they get better over time?
My pdoc says the sleep problem should improve. I'm still waiting for that to happen.
> Did it help with anxiety?
No, but it doesn't hurt either. I have other things on hand to deal with anxiety anyway. I find Abilify activating. I needed perking up and I find the stimulation I have with Abilify easier to manage than what I've had with stimulants. I've read that Abilify may help some people with anxiety.
> Were yo prescribed it to help augment an AD?
I'm taking Lamictal and memantine.
> Lots of questions, I know but I've been prescribed Abilify after failed trials of other APs and I'm a bit leery of it.
It feels different from Seroquel or Zyprexa. I'm not sedated by it. If you are apprehensive about increasing your anxiety, maybe try 1.25 mg or take the 2.5 mg every other day. Expect a few days' lag time between dose changes and effects.
What went wrong with Seroquel?
emme
Posted by Sebastian on October 8, 2005, at 15:44:19
In reply to Not sure what to do next? Advice Needed, posted by denise1966 on October 5, 2005, at 3:37:45
Zyprexa will never stop working I took it for 7 years. And still take it. You may get sick of the side-effects though. That is why I'm cutting down.
Posted by 4wd on October 8, 2005, at 16:23:21
In reply to Re: Not sure what to do next? » 4wd, posted by Emme on October 8, 2005, at 11:43:16
Nothing really went wrong with the Seroquel. It just didn't do what it was prescribed for - to help alleviate anxiety. I've been able to keep my depression pretty much under control with SSRIs or Effexor (until it pooped out) but the anxiety that started up when I came off Effexor 6 months ago has been a killer.
Thanks for the information. My pdoc is hoping the Abilify might help with anxiety since Zyprexa really knocks it out. I think I have too much dopamine. All dopaminergic meds make me anxious (Wellbutrin, Provigil stimulants). Unfortunately I can't take Zyprexa on a regular basis because I am in recovery from bulimia and the zyprexa sends me right back to the refrigerator/pantry/grocery store.
Marsha
Posted by Emme on October 8, 2005, at 17:11:24
In reply to Re: Not sure what to do next? » Emme, posted by 4wd on October 8, 2005, at 16:23:21
Hi Marsha,
> Nothing really went wrong with the Seroquel. It just didn't do what it was prescribed for - to help alleviate anxiety.
Were you taking a high enough dose? What other things have you tried for anxiety? I can't recall if you said you've taken a benzo.
> Thanks for the information. My pdoc is hoping the Abilify might help with anxiety since Zyprexa really knocks it out.
> All dopaminergic meds make me anxious (Wellbutrin, Provigil stimulants).Good luck. Start low and see how it goes. Provigil and stimulants do make me overstimulated after a while. Very low dose abilify is stimulating but a little easier for me to manage (with a benzo for anxiety as needed).
Oh, I found an added plus with Abilify. I think I have a mild case of restless legs. After my second dose of Abilify it was completely gone.
emme
Posted by 4wd on October 8, 2005, at 22:07:55
In reply to Re: Not sure what to do next? » 4wd, posted by Emme on October 8, 2005, at 17:11:24
> Hi Marsha,
>
> > Nothing really went wrong with the Seroquel. It just didn't do what it was prescribed for - to help alleviate anxiety.
>
> Were you taking a high enough dose? What other things have you tried for anxiety? I can't recall if you said you've taken a benzo.
>
> > Thanks for the information. My pdoc is hoping the Abilify might help with anxiety since Zyprexa really knocks it out.
> > All dopaminergic meds make me anxious (Wellbutrin, Provigil stimulants).
>
> Good luck. Start low and see how it goes. Provigil and stimulants do make me overstimulated after a while. Very low dose abilify is stimulating but a little easier for me to manage (with a benzo for anxiety as needed).
>
> Oh, I found an added plus with Abilify. I think I have a mild case of restless legs. After my second dose of Abilify it was completely gone.
>
> emme
>
It's weird, it's not a fear kind of anxiety I get from stimulants. It's that tired but wired feeling. I have physical energy but my mind is not the least bit interested in doing anything with it. A sort of world weary jitteryness.I know you've been posting here quite a while, Emme. I'm glad you seem to be doing well and that you have apparently found a med combo that's right for you.
Marsha
>
Posted by Emme on October 9, 2005, at 0:26:22
In reply to Re: Not sure what to do next? » Emme, posted by 4wd on October 8, 2005, at 22:07:55
> It's weird, it's not a fear kind of anxiety I get from stimulants. It's that tired but wired feeling.Bingo. That simultaneously exhausted but revved up jittery feeling.
> I know you've been posting here quite a while, Emme. I'm glad you seem to be doing well and that you have apparently found a med combo that's right for you.Thanks. The insomnia's still a problem - I'm taking two drugs that cause it. But yes, if we get the insomnia sorted out, then the situation will be decent. I hope you find a combo that works for you.
emme
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