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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by sregan on October 20, 2006, at 17:19:15
When starting an AD twice now I've had a really good day at the very beginning (day 2 or three) of the treatment then have worse days.
Is this typical?
Are the receptors downregulating on me then I have to keep upping the dose until it is high enough to leap over the downregulation?
Posted by bassman on October 21, 2006, at 9:32:31
In reply to Starting an AD, does it get better than worse?, posted by sregan on October 20, 2006, at 17:19:15
I wouldn't try to figure it out theoretically, myself-but empirically, I find the same thing: an almost immediate stimulation that feels good, then back to fatigue or worse. I think it is just the expected initial effect of an AD side effect-sleepiness and being tired, but with a bit of "teaser" at the beginning. There is some thought that if you get the initial good feeling that the AD has a good chance of working, eventually. Sometimes, that's months. Best of luck!
Posted by Phillipa on October 21, 2006, at 10:45:37
In reply to Re: Starting an AD, does it get better than worse?, posted by bassman on October 21, 2006, at 9:32:31
Guess that's why they don't work for me never had a teaser just felt worse. Anxiety sky high. Love phillipa don't know anything technical about them.
Posted by sregan on October 21, 2006, at 13:02:07
In reply to Re: Starting an AD, does it get better than worse?, posted by bassman on October 21, 2006, at 9:32:31
> I wouldn't try to figure it out theoretically, myself-but empirically, I find the same thing: an almost immediate stimulation that feels good, then back to fatigue or worse. I think it is just the expected initial effect of an AD side effect-sleepiness and being tired, but with a bit of "teaser" at the beginning. There is some thought that if you get the initial good feeling that the AD has a good chance of working, eventually. Sometimes, that's months. Best of luck!
I had enough trouble getting through one day feeling that bad I can't imagine months. The good feeling means you are feeding the right receptors then they upregulate from being hammered then you end up short again or possible shorter than you were before so you feel worse?
Posted by bassman on October 21, 2006, at 13:11:25
In reply to Re: Starting an AD, does it get better than worse? » bassman, posted by sregan on October 21, 2006, at 13:02:07
There's no mistaking feeling better with an AD, at least in my experience. It's sort of a rush of enthusiasm, energy, and self-confidence that I didn't know was gone until it appears. As I mentioned, I felt that way for three years with Paxil...which sort of spoiled me, actually (after three AD's that made me so anxious and dizzy that I could hardly stand them at all...)
Posted by sregan on October 21, 2006, at 13:36:42
In reply to Re: Starting an AD, does it get better than worse?, posted by bassman on October 21, 2006, at 13:11:25
> It's sort of a rush of enthusiasm, energy, and self-confidence that I didn't know was gone until it appears. As I mentioned, I felt that way for three years with Paxil...which sort of spoiled me, actually (after three AD's that made me so anxious and dizzy that I could hardly stand them at all...)
That's pretty much how I felt on Wednesday. It was like (thought bubble: "This is how my brain used to feel"). It was nice for that particular day. Thursday was bad and Friday (yesterday) was very bad. I didn't take my pill last night and am feeling better today than the previous two days.
Posted by bassman on October 21, 2006, at 17:37:14
In reply to Re: Starting an AD, does it get better than worse? » bassman, posted by sregan on October 21, 2006, at 13:36:42
What's when you have to keep taking the Little Stinkers for a few weeks and see if the feeling comes back...(not fun)
Posted by sregan on October 21, 2006, at 18:28:24
In reply to Re: Starting an AD, does it get better than worse?, posted by bassman on October 21, 2006, at 17:37:14
> What's when you have to keep taking the Little Stinkers for a few weeks and see if the feeling comes back...(not fun)
Do you think it would if I stuck through the misery? I don't know how I would go about living anything close to a "normal" life. I'm also not crazy about the palpitations the exess NE gave me.
Shawn
Posted by bassman on October 21, 2006, at 19:47:30
In reply to Re: Starting an AD, does it get better than worse? » bassman, posted by sregan on October 21, 2006, at 18:28:24
Lower the dose until life can be reasonably normal-don't be afraid to start REALLY low. I started Paxil at 1.5 mg/day instead of the usual 10 and it took me almost a year to build up to 20 mg/day.
Posted by sregan on October 21, 2006, at 20:05:37
In reply to Re: Starting an AD, does it get better than worse?, posted by bassman on October 21, 2006, at 19:47:30
> Lower the dose until life can be reasonably normal-don't be afraid to start REALLY low. I started Paxil at 1.5 mg/day instead of the usual 10 and it took me almost a year to build up to 20 mg/day.
Do you cut the pills or do they make a dose that small? I've got 25g imipramine tablets and they are tiny. If they made 5mg they would be tiny!
Posted by Phillipa on October 21, 2006, at 20:08:44
In reply to Re: Starting an AD, does it get better than worse?, posted by bassman on October 21, 2006, at 19:47:30
Bassman did you really? Wow!!!!And did it do anything at that low a dose? Love Phillipa
Posted by bassman on October 21, 2006, at 20:48:43
In reply to Re: Starting an AD, does it get better than worse?, posted by bassman on October 21, 2006, at 19:47:30
Paxil changed my life when I got to 5 mg...just amazing (in combination with Xanax). That's why I hope you'll try another SSRI (like Prozac) at a low dose...maybe it will help you. Us anxious folks have to stick together. :>}
Posted by bassman on October 21, 2006, at 20:53:01
In reply to Re: Starting an AD, does it get better than worse? » bassman, posted by sregan on October 21, 2006, at 20:05:37
A single-edged razor works well. Pill cutters (you can get one at your pharmacy) work O.K. as long as you're just cutting a tablet in half..someitmes, they kind of demolish the tab. :>} Starting very low is a must for us panic disorder folks or we can get profoundly anxious from just a normal starting AD dose.
Posted by sregan on October 21, 2006, at 22:51:46
In reply to Re: Starting an AD, does it get better than worse?, posted by bassman on October 21, 2006, at 20:48:43
> Paxil changed my life when I got to 5 mg...just amazing (in combination with Xanax). That's why I hope you'll try another SSRI (like Prozac) at a low dose...maybe it will help you.
I did try Paxil, Prozac and Effexor all of them pretty much sent me through the roof but I did take them as prescribed. I don't even remember the dosage. My brain seems very chemically sensitive. (I can take Xanax or Klonopin at very low dose (1/2 .5 klonopin or 1/2 .25 xanax) and get relief from pretty substantial anxiety). I did try tablet cutting with bupropion it didn't help that drug work for me.
>Us anxious folks have to stick together. :>}
Amen brother, no one knows what it's like except someone who's been there. God bless you.
Shawn
Posted by sregan on October 21, 2006, at 22:52:24
In reply to Re: Starting an AD, does it get better than worse?, posted by bassman on October 21, 2006, at 20:53:01
> Starting very low is a must for us panic disorder folks or we can get profoundly anxious from just a normal starting AD dose.
Been there, done that ;)
Posted by chiron on October 27, 2006, at 20:05:16
In reply to Starting an AD, does it get better than worse?, posted by sregan on October 20, 2006, at 17:19:15
I've had that happen to me, especially with Wellbutrin. For me, I am very observant about what is physical & what is psychological, and it is definitely physical.
I have read in many places, including here, that this kind-of fits into the Bipolar II category. I have no idea what mania feels like, it's just a spectrum of "somewhat depressed" to "very depressed."
I'm just throwing this out there as a possibility.
fyi: my Dr. recently suggested Geodon to even things out (in addition to the Zoloft & Wellbutrin). So far (it's only been 4 days), it seems to have given me a little boost.
Posted by sregan on October 27, 2006, at 22:39:24
In reply to Re: Starting an AD, does it get better than worse?, posted by chiron on October 27, 2006, at 20:05:16
> I've had that happen to me, especially with Wellbutrin. For me, I am very observant about what is physical & what is psychological, and it is definitely physical.
Wellbutrin was one of the two I was referring to. It's been very hard for me to differentiate between what is physical and not (physical meaning brain chemistry vs. psychological thoughts etc.) I'm thinking lately that we're all robots responding to our brain chemicals like programs would instruct a computer.
> I have read in many places, including here, that this kind-of fits into the Bipolar II category. I have no idea what mania feels like, it's just a spectrum of "somewhat depressed" to "very depressed."
I've read about a type of bipolar that could describe my depression/anxiety. I think some people feel mania as a type of anxiety. I knew a guy who was manic you knew when he wasn't taking his meds. You could tell his mind was running wild and being expressed in his actions. Hyper and kind of drunk describes my friend pretty well.
Posted by chiron on October 28, 2006, at 1:54:53
In reply to Re: Starting an AD, does it get better than worse? » chiron, posted by sregan on October 27, 2006, at 22:39:24
> I'm thinking lately that we're all robots responding to our brain chemicals like programs would instruct a computer.
Ya, it's interesting to see how much chemistry can alter someone's personality. And if I'm in a certain biochemical state, my thoughts or the weight of those thoughts are different than in another biochemical state. I know my cognitive psychiatrist disagrees, but I feel like my thoughts are the secondary output of my software and hardware. Of course they are somewhat moldable, but I can repeat affirmations all day, and I am going to be no where near how good I felt after my hardware/software jump of ECT :)
Posted by chiron on October 28, 2006, at 2:09:51
In reply to Re: Starting an AD, does it get better than worse? » chiron, posted by sregan on October 27, 2006, at 22:39:24
...and as an afterthought, because you seem to have responded the same way I did to Wellbutrin, which is a dopamine-boost, you may want to be weary of Adderall if you haven't tried it. It also gave me an initial boost (higher than the Wellbutrin & helped me study all day), but eventually sent me lower than I had ever been. (hence, the ECT)
This is the end of the thread.
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