![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by detroitpistons on December 9, 2005, at 14:53:28
Hi!
This is my first time posting, but I've referenced this site in the past and I think it's a great resource. My thanks to Dr. Bob for creating this site and putting in extra hours to participate on it. It's awesome that I can see dialogue here between actual MD's....Seeing a psychiatrist once per month is not always enough, and we all know how busy they can be (to the extent that you almost feel pressure to get in and out as fast as possible).
Anyways, I'm on Effexor XR 225 mg for the second time around. I have major depressive episodes that seem to get worse as I get older, and between episodes I would say that I'm dysthymic. I also believe I have GAD but I've never had a formal diagnosis (of any kind). The first time I took Effexor was my first experience with any psych drug. It seemed to work wonders at the time. Then it pooped out after about a year and a half and I was prescribed Paxil, and later Lexapro, with some Xanax (accidentally became dependent on it for sleeping, but that's a different story) sprinkled in. I never really felt that Paxil and Lexapro worked as well as the Effexor.
Just recently, in August '05, I was in the midst of a pretty bad depressive episode, and I started back on the Effexor....So here I am about 4 months later, and the deep depression has lifted. However, it just doesn't seem like the results with the Effexor are as good the second time around. I still have some degree of anxiety almost every day, and although I'm not deeply depressed, I don't get elated or even really have feelings of joy like I did the first time around. I had so much more confidence the first time I took it, and I just felt like I was in much more control over my life. I just felt flat out happy, while now I just feel sort of flat. It's so hard to really gauge what's going on because my environment has changed over the years. There are no constants, really.
The main issue is the anxiety. I have a feeling that if I bring this up with my doc at my next appointment, I may be put on a benzo or maybe buspar. I'd rather not be on a benzo because, aside from the issue of addictiveness, they really just make me tired.
Any advice, questions, or comments?
Has anyone ever taken 5HTP with an AD with any success? I'd really like to try something "natural," however I'm kind of skeptical. I tried Same-e once, and it was mostly just a waste of money.
Hope to see your responses!
Posted by john berk on December 9, 2005, at 16:01:32
In reply to Effexor user, thinking about augmentation, posted by detroitpistons on December 9, 2005, at 14:53:28
Hi, welcome,
i have lifetime dysthymia, with 2 bouts of major depression, prozac alleviated the major episodes, but i beleive with my dysthmia, i will never have complete releif of symptoms, [i also have moderate ocd]. it seems from my expeirence that prozac, [genrealizing here with ssri's]it did knockout the major symptoms, but there is always some residual depression and anxiety,
this may not be true for everyone, and i haven't tried many combo's, but i am in the same position as you. i am trying cbt to combat my ocd, and dysthmia at the moment.i have used regular trytophan,[1-2 500 mg. capsules] with prozac, it seems to help with sleep, but be very careful, 5htp or trytophan with ad's does run some risk of serotonin syndrome,
but for the past year i have not expeirenced a problem with the combination!! my first time on prozac i had complete releif of depression and dysthmia, but this time around it has been less of a "miracle", i hope you fare better with effexor!! i also take klonopin at night!!
good luck..john
Posted by Phillipa on December 9, 2005, at 22:20:37
In reply to Re: Effexor user, thinking about augmentation » detroitpistons, posted by john berk on December 9, 2005, at 16:01:32
Welcome to the land of poop out! Fondly, Phillipa
Posted by jamestheyonger on December 11, 2005, at 14:05:19
In reply to Effexor user, thinking about augmentation, posted by detroitpistons on December 9, 2005, at 14:53:28
Effexor + remeron worked for me for 10 years, the remeron was taken at night & gives great sleep.
Posted by detroitpistons on December 11, 2005, at 21:09:05
In reply to Re: Effexor user, thinking about augmentation, posted by jamestheyonger on December 11, 2005, at 14:05:19
> Effexor + remeron worked for me for 10 years, the remeron was taken at night & gives great sleep.
>I think I would be willing to try Buspar or Klonopin. I hope antipsychotics will be of last resort. But anything that reduces my anxiety usually makes me sleepy, and that's a major problem. When I get groggy, I lose my motivation and creativity which can cause me to become depressed. I just wish the Effexor would work on my anxiety as it did the first time I was on it....I just realized, when I was on Effexor the first time, I was exercising. That could have something to do with it. I wish there were some easy answers..
Posted by tarabara on December 15, 2005, at 13:11:13
In reply to Effexor user, thinking about augmentation, posted by detroitpistons on December 9, 2005, at 14:53:28
hi. you sound like you have had a past similar to mine. for the past 15 years, i have been treated with every combination of SSRI's and Effexor and Wellbutrin w/ a little Xanax thrown in the mix. everything i try "poops out" so to speak. i'm being treated for ptsd at the moment as well and have been on a wellbutrin 300/Effexor 150 for about 9 months and i have major depressive episodes as well as extreme anxiety. being irritated at all the pdocs i've seen, i went to someone who lived in the next city that i heard good things about. he pointed out a few things about my history (HE ACTUALLY LISTENED TO MY HISTORY): history of major depression WHILE being treated w/ anti depressants. he asked me why i thought i was still depressed. uhhhh........ that never occurred to me. i just thought i was a lost cause. he pointed out that i have periods of high productivity and have advanced in academia. he started asking me about my productive times and it seems that i could be hypomanic. he has diagnosed me as bipolar II. it would NEVER have occured to me however it explains my history. one of the diagnostic tests is a history of major depression that doesn't respond to medication or the medication, especially SSRI's "poop" out. the mania is hypomania which means it doesn't break reality and the manic symptoms are often expressed as anxiety and irritabiiity. check, check for me. get some more information about it. you should find a pdoc that is interested in your history w/ symptoms and medication. good luck
Posted by detroitpistons on December 15, 2005, at 13:43:49
In reply to Re: Effexor user, thinking about augmentation, posted by tarabara on December 15, 2005, at 13:11:13
Hi tara,
The first time I took Effexor, it really worked wonderfully...Not only did it lift my depression, but it helped with anxiety as well and it seemed like I had a newfound ability to be at ease, to be comfortable with myself and my environment, and to actually feel happy. I just had an overall sense of well being.
This time around, Effexor has lifted my depression, but I'm still anxious. I don't know if I've become more sensitive to the med or what. I think for most people Effexor has a stimulating effect, maybe somewhat like Wellbutrin (just my guess, I only took it very briefly). For the first month or two, I would expect some anxiety and agitation as a part of startup/ titration. But I'm now almost 4 months into this round of Effexor, and I still have anxiety...
I tried lowering my dosage from 225mg to 150mg for a couple of days, but by the second day (yesterday) I started getting symptoms of withdrawal, so now I've gone back to 225mg.
I just don't understand why it's working differently this time. I don't think I'm under any more stress now than I was the first time around, and I'm at the same dosage. However, I was exercising on a regular basis the first time (this could have a lot to do with it).
To be honest, it seems like my anxiety and depression have gotten worse since I started taking antidepressants (about 4 yrs ago). I went through an absolutely terrible withdrawal from Paxil, and it just feels like I've never been the same since then. Each episode of depression seems to get worse and worse. I'm not saying that I think the meds are totally responsible, but sometimes I wonder. My condition could just be naturally deteriorating.
Anyways, I haven't talked to my doctor about bipolarism, but I don't feel that I really go through manic or hypomanic episodes. In fact, I kind of wish I did have some hypomania. I know that I would be more productive, energetic, and happy that way. But I just feel like I'm either just really low (without AD's) or at a baseline or "neutral" state now with the Effexor...
Take care
> hi. you sound like you have had a past similar to mine. for the past 15 years, i have been treated with every combination of SSRI's and Effexor and Wellbutrin w/ a little Xanax thrown in the mix. everything i try "poops out" so to speak. i'm being treated for ptsd at the moment as well and have been on a wellbutrin 300/Effexor 150 for about 9 months and i have major depressive episodes as well as extreme anxiety. being irritated at all the pdocs i've seen, i went to someone who lived in the next city that i heard good things about. he pointed out a few things about my history (HE ACTUALLY LISTENED TO MY HISTORY): history of major depression WHILE being treated w/ anti depressants. he asked me why i thought i was still depressed. uhhhh........ that never occurred to me. i just thought i was a lost cause. he pointed out that i have periods of high productivity and have advanced in academia. he started asking me about my productive times and it seems that i could be hypomanic. he has diagnosed me as bipolar II. it would NEVER have occured to me however it explains my history. one of the diagnostic tests is a history of major depression that doesn't respond to medication or the medication, especially SSRI's "poop" out. the mania is hypomania which means it doesn't break reality and the manic symptoms are often expressed as anxiety and irritabiiity. check, check for me. get some more information about it. you should find a pdoc that is interested in your history w/ symptoms and medication. good luck
Posted by detroitpistons on December 15, 2005, at 14:06:46
In reply to Re: Effexor user, thinking about augmentation, posted by tarabara on December 15, 2005, at 13:11:13
tara,
Did you mean that you've been on 300mg WB and 150mg Effexor, and you are still depressed, and that you have extreme anxiety? I would guess that's a bad combo for an anxious person based on what I've seen, but everybody's different. I've heard that very large doses of Effexor 400+ mg can work for treatment resistent depression.
> hi. you sound like you have had a past similar to mine. for the past 15 years, i have been treated with every combination of SSRI's and Effexor and Wellbutrin w/ a little Xanax thrown in the mix. everything i try "poops out" so to speak. i'm being treated for ptsd at the moment as well and have been on a wellbutrin 300/Effexor 150 for about 9 months and i have major depressive episodes as well as extreme anxiety. being irritated at all the pdocs i've seen, i went to someone who lived in the next city that i heard good things about. he pointed out a few things about my history (HE ACTUALLY LISTENED TO MY HISTORY): history of major depression WHILE being treated w/ anti depressants. he asked me why i thought i was still depressed. uhhhh........ that never occurred to me. i just thought i was a lost cause. he pointed out that i have periods of high productivity and have advanced in academia. he started asking me about my productive times and it seems that i could be hypomanic. he has diagnosed me as bipolar II. it would NEVER have occured to me however it explains my history. one of the diagnostic tests is a history of major depression that doesn't respond to medication or the medication, especially SSRI's "poop" out. the mania is hypomania which means it doesn't break reality and the manic symptoms are often expressed as anxiety and irritabiiity. check, check for me. get some more information about it. you should find a pdoc that is interested in your history w/ symptoms and medication. good luck
Posted by tarabara on December 15, 2005, at 20:47:20
In reply to Re: Effexor user, thinking about augmentation, posted by detroitpistons on December 15, 2005, at 14:06:46
i know. it doesn't seem like i'm on the best combo for my symptoms. jackhorse pdocs. grr... i was going to mention to you that adding effexor to your regimen might put a spring in your step. it got me out of bed this spring when i couldn't make myself get out of bed by setting the bed on fire. during periods of deep depression, a new AD combo will often lift me out of it, it just stops working in 6-12 months. the new doc wants to get me to an effective dose of a mood stabilizer (topamax) before i start weaning off of the AD's. don't want to disrupt everything at oncce!! i'm already dreading the side effects of this topamax stuff.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.