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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Bonnie_CA on March 24, 2007, at 18:16:00
So after being on Zoloft for about 3-4 months, I switched to Lexapro. I'm on 10 mg of Lexapro. I wish things were better.
I am always tired, and I have a hard time making it through the day without a nap. Nap or no nap, it's impossible to fall asleep at night. Of course, this is basically no change from Zoloft or anything else I've taken in the past year or so. Actually, I did okay with another stint with Celexa, and it was okay until it didn't work again. I'm surprised Lexapro isn't working the same. I don't know if I need a higher dose or I just need to be on something else. I've been on Lexapro about 6 weeks now. I am really depressed (which is not the reason I take it, I take it for anxiety), have zero libido, and I'm just too tired to do anything (even though I don't actually sleep much). Celexa never did any of those things. In fact, it probably had the least side effects of any of the SSRIs I've taken. I'm totally shocked that I feel so blah on Lexapro. For example, I really and sincerely want to clean my house right now. It's a mess. But I just can't seem to get myself to do it. And it makes me feel bad. I have papers to grade. I haven't been able to make myself do that, and they're backed up two weeks. I am so frustrated that I see so many things to be done and I just can't bring myself to do any of them. I've even been procrastinating on doing normal things, like grocery shopping and visiting friends. I have been using drive-thrus as much as possible. I haven't been terribly social. I've been trying to keep up a good face, but I feel like I'm crumbling.
I have started seeing a therapist and a pdoc. Real ones, not like I had before. I have an appointment on Monday with the T, and I'm going to tell him how I've been feeling lately. Of course his issue isn't my meds, but he is actually friends with my pdoc, and I'd have a hard time believing they don't discuss patients in common. I signed the paper saying they could, so I imagine that if a message needed to be sent to the pdoc, it will be.
My pdoc thinks I might be BP2. I've thought this also, and I think there's something I want to do before I try something that would be treating BP and not GAD. I have wondered if the reason I had dizziness and balance trouble was actually an inner ear problem. I never actually had THAT checked, and it seems so likely since I have allergies and I know my eustacian tube in the left side of my head is "wet" all the time. I never had allergies until I went to college (when I was diagnosed), and while they were mild, it seems so possible that it could have been an ear problem causing some of my symptoms. Then that would clear the idea that yes, I could be BP. If the ear thing and BP were the case, then I think things would make perfect sense. The pdoc was very interested in my reactions to the meds I took last year. I had read that my reaction can be indicitive of BP, and he brought that up. For the time being, until he gets more info, he's going to stick with my original diagnosis (GAD with panic). I'm just so glad to be seeing doctors who are NOT part of a huge exclusive group.
I guess I don't really have a question, and since I haven't been posting regularly I probably won't get but a few responses, but I figured I'd put out there how I'm doing and see if anyone can relate.
-Bonnie
Posted by football on March 24, 2007, at 22:24:16
In reply to What to do next?, posted by Bonnie_CA on March 24, 2007, at 18:16:00
A stimulant should help you with the constant fatigue. If your doc won't give you something like adderall or ritalin, ask for a non-addictive drug without abuse potential like Provigil.
As a matter of fact, I've been on over a dozen drugs, and Provigil has been one of the only moderately helpful ones. While I can't say it wiped out the fatigue completely, it was quite helpful. I no longer have to take naps and am no longer so tired that I feel like I can't function.
For your insomnia, I highly recommend Ambien. Along with Provigil, it's the only helpful drug I've been on. It helps me fall asleep and stay asleep better then I could ever manage on my own.
Good luck. You're still very early on with your drug-taking, and have very many other possible options to move onto if the Lexapro doesn't provide the relief you're looking for.
Posted by Bonnie_CA on March 24, 2007, at 22:31:09
In reply to Re: What to do next?, posted by football on March 24, 2007, at 22:24:16
I've been on many different meds, and I've been taking meds since I was 18. (Wow, that was almost 10 years ago!) My medication tryouts have been (all monotherapy):
BuSpar (I forget the dose, it was high)
Paxil, 20 mg
Celexa, 20 mg then 40 mg
Effexor XR 150 mg then 75 mg
Prozac, 20 mg
Celexa again, 60 mg
Zoloft, 100 mg
Lexapro, 10 mgI also take .25 mg of xanax as needed, and I've tried klonopin and wellbutrin. Klonopin made me depressed and wellbutrin made me bounce off the walls. I won't try Luvox or Serzone. I am excited because I think I've finally found a pdoc who is interested in actually treating me and not just trying to get me out the door. I might actually be able to find the right meds or combo.
-Bonnie
Posted by football on March 24, 2007, at 22:43:29
In reply to Re: What to do next?, posted by Bonnie_CA on March 24, 2007, at 22:31:09
I'm sorry, for some reason I was under the impression you had only been on a few meds.
Maybe it's time for you to try an MAOI like Parnate or Nardil? MAOIs generally are the most effective meds for depression/anxiety.
Many people find Parnate to very stimulating, so it may help with your fatigue as well.
Ask your doc.
Posted by Bonnie_CA on March 24, 2007, at 22:45:29
In reply to Re: What to do next?, posted by football on March 24, 2007, at 22:43:29
I'll ask for sure.
But I was mentioning that there is a possibility I'm BP2. I'll just have to see.
-Bonnie
Posted by Racer on March 25, 2007, at 13:13:17
In reply to Re: What to do next?, posted by Bonnie_CA on March 24, 2007, at 22:31:09
>
>
> BuSpar (I forget the dose, it was high)
> Paxil, 20 mg
> Celexa, 20 mg then 40 mg
> Effexor XR 150 mg then 75 mg
> Prozac, 20 mg
> Celexa again, 60 mg
> Zoloft, 100 mg
> Lexapro, 10 mg
>
>You've taken most of the SSRIs, except Luvox, and one of the dual reuptake inhibitors. You've also had a trial of Wellbutrin, which apparently didn't work out so well for you. That leaves all the TCAs and all the MAOIs, as well as a couple of other novel ADs like Remeron. You're hardly low on options.
Add in the combinations, like a middling dose of SSRI with a low dose of Wellbutrin to augment and reduce side effects, and you've got a nearly limitless set of possibilities.
And then there are the augmenting agents, like Lamictal, or Abilify.
Let's see, you're concerned that you may be BP -- forgive me, I can't remember my husband's name this morning, so I can't remember all your symptoms right now, or what you wrote about your history. I think I'd second the suggestion to discuss Provigil with your doctor. For me, it was great for augmenting my AD, and even helped a lot as monotherapy. It didn't continue to work, but while it did it was GREAT. Also, on Provigil, I slept better than I have ever slept in my life. Got into bed, turned out my light, put my head down -- and opened my eyes to the morning light coming in the window. I didn't need anything for sleep at all.
Another option might be Cymbalta, which is a pretty friendly little drug. It doesn't have as many side effects as Effexor, the doses are lower, so withdrawal is much easier, and it has a more balanced action on serotonin and norepinephrine, which helps some people. With an augmentor, like Lamictal or Provigil, it might just do the trick.
I hope that helps...
Posted by TheMeanReds on March 26, 2007, at 11:45:59
In reply to Re: What to do next?, posted by Racer on March 25, 2007, at 13:13:17
Bonnie, I was on Paxil and Lexapro (mixed with 2mg klonopin). At different times. I'm BipolarII. But while I was taking these SSRIs the BipolarII was undiagnosed.
Though Ive only tried two SSRIs, I do not like to take them because the ones I was on were not treating my depression/anxiety.
I have tried Remeron and I liked it alot. It has an issue with food cravings, but for me it was great besides that. I want to go back on it, but cannot because of $$$.
Right now I take Lamictal for BPII. And for the anxiety, I no longer take klonopin because I do think it caused some of my depression. I take 2mg xanax instead, I like it much better.
Also I take seroquel at night, and it gives me excellent sleep. I dont sit up worrying about everything any longer.
Anyhow, this is my personal cocktail for BPII. I would like to add remeron for depression if I get the chance.
Good Luck.
Posted by Ines on March 26, 2007, at 12:43:03
In reply to What to do next?, posted by Bonnie_CA on March 24, 2007, at 18:16:00
Hi Bonnie,
I found your post really interesting. I too had a really bad reaction to Lexapro a few years back- it sedated, made me feel very tired, numb and non-motivated. I've been put off trying Celexa because of that, since they're so similar, but maybe I should reconsider... The funny thing is I also have dizziness and balance problems when I'm depressed; lately I started having sharp pains in my left ear too. Apparently there is nothing wrong with my ear though.
What is it that makes your pdoc think you may have BP-2? I have atypical depression with anxiety, and had a bad reaction to reboxetine- anxiety got MUCH worse, and I started having weird 'calm' suicidal thought at random points throughout the day, also a lot of obsessive thoughts. My GP thinks that could be indicative of bipolar spectrum, so I'm waiting for referral to specialist to get proper diagnosis.
Ines
Posted by Bonnie_CA on March 26, 2007, at 15:23:53
In reply to Re: What to do next?, posted by TheMeanReds on March 26, 2007, at 11:45:59
> And for the anxiety, I no longer take klonopin because I do think it caused some of my depression.
Klonopin made me very depressed also. Xanax has been the good benzo for me, although I haven't tried any others.
Posted by Bonnie_CA on March 26, 2007, at 15:39:36
In reply to Re: What to do next? » Bonnie_CA, posted by Ines on March 26, 2007, at 12:43:03
Yeah, I can't believe how Lexapro is reacting for me. I really never had a problem with Celexa, except that it pooped out on me. What are your dizziness and balance symptoms like? I can best describe my balance problems like being on a bad airplane flight (up and down, tilting floor), and the dizziness is really more like lightheadedness, like my head is gonna float away or maybe my whole body. Interesting that you have the same feelings.
The reason my pdoc is thinking possible BP2 is because there is evidence of cycling, and my reactions to some of the medications I took last year, namely Prozac. While on Prozac I had some serious hypomania, and I was very unmotivated and depressed, and it made me feel horrible in general. I guess if you have BP and don't know it, Prozac will let you know it. I guess something about my reaction to Effexor also is making him think that I might be BP2. On Effexor i was sweating a lot, my heart was pounding, I couldn't sleep, I was eating everything I could get my hands on... I was just high, really. I read somewhere that Effexor is related to ecstacy, and according to those who have used ecstacy before, my reaction to Effexor was similar to a "bad trip". (I've never had the luxury of experimenting with illegal drugs, my brain hasn't even been "normal" enough.) I'm not sure what about my reaction to Effexor would tip him off, but the Prozac was a big telltale apparently. He's not jumping to conclusions and neither am I.
I am wondering though... they always put on your pill bottles to consult your doctor if you have new or worsening signs of depression and/or suicidal thoughts. I've been really depressed since last week, and the suicidal ideation is creeping up on me. I have no plan, so no need to sound the alarm, but I don't know if my sadness is being caused by the meds or a lack thereof. I will bring it up to the doc anyway.
I have a T appointment here in about 20 min, so I have to go. Thank you for all of the wonderful responses, you've all been super helpful.
-Bonnie
> Hi Bonnie,
> I found your post really interesting. I too had a really bad reaction to Lexapro a few years back- it sedated, made me feel very tired, numb and non-motivated. I've been put off trying Celexa because of that, since they're so similar, but maybe I should reconsider... The funny thing is I also have dizziness and balance problems when I'm depressed; lately I started having sharp pains in my left ear too. Apparently there is nothing wrong with my ear though.
> What is it that makes your pdoc think you may have BP-2? I have atypical depression with anxiety, and had a bad reaction to reboxetine- anxiety got MUCH worse, and I started having weird 'calm' suicidal thought at random points throughout the day, also a lot of obsessive thoughts. My GP thinks that could be indicative of bipolar spectrum, so I'm waiting for referral to specialist to get proper diagnosis.
> Ines
Posted by Ines on March 26, 2007, at 16:19:08
In reply to Re: What to do next? » Ines, posted by Bonnie_CA on March 26, 2007, at 15:39:36
Hi again,
Sounds like a similar situation to mine... I got high on reboxetine-sweats, heart racing, constant brain shivers, couldn't get more than 2 hours consecutive sleep . I suppose both reboxetine and effexor act on noradrenaline; that clearly didn't work for me.
My dizziness is also serious lightheadedness, like I'm on the verge of fainting but never do. Balance issue only creeps up when going down a flight of stairs, it feels like the steps move up or down, and I start feeling like I might fall. You're the first person I've come across who's mentioned these problems too...
SSRI's seem to prompt suicide ideation for me in the beginning. It never felt like it was out of control so it's never worried me unduly. But my GP insists on giving me a few Xanax pills to have there for an emergency when starting an SSRI- in case agitation gets too much. I've never resorted to that but I imagine the fact that he does this means a lot of people have that problem..
Good luck with diagnosis and finding appropriate treatment,
Ines
Posted by deniseuk190466 on March 27, 2007, at 15:16:02
In reply to What to do next?, posted by Bonnie_CA on March 24, 2007, at 18:16:00
Hi Bonnie,
I just wanted to say I'm in the same boat as you, Seroxat 40mg stopped working for me after two years and we've now decided to switch to Lexapro 10mg. I've been on it for about three weeks and i'm pretty much feeling like you describe. Although I do feel better on it than off medication completeley.
I wanted my psychiatrist to up the dose as I know I need high doses but she wants me to wait it out for six weeks and only then will she consider upping it up to 20mg. I'm really inpatient because life is just passing me by and I so want to get better.
Let us know what your Psychiatrist/Doctor decides to do.
Denise
Posted by DStupid on March 30, 2007, at 20:32:29
In reply to What to do next?, posted by Bonnie_CA on March 24, 2007, at 18:16:00
I'm glad I've found this board. Physical weakness, insomnia, lack of motivation -- these are all the symptoms I also had when I was taking Lexapro (10 mg. daily), and I took it for about one year. I took Xanax (.5 mg) for insomnia. It's not the diagnostic label that psychiatrists like to tag you with, it is the medicine they're giving you that's causing you problems. Between Lexapro and Celexa, Celexa is better. Celexa, 20 mg.= Lexapro 10 mg. Celexa is bromide based and that's why you can sleep at night while on it. I took it for a short time, though, because the other symptoms remained.
Posted by bonnie_ca on March 30, 2007, at 22:46:38
In reply to Re: What to do next?, posted by deniseuk190466 on March 27, 2007, at 15:16:02
I'm waiting to get an appointment, so as soon as I get in I will post what he decided to do.
-Bonnie
Posted by Bonnie_CA on April 4, 2007, at 2:16:04
In reply to Re: What to do next?, posted by bonnie_ca on March 30, 2007, at 22:46:38
> I'm waiting to get an appointment, so as soon as I get in I will post what he decided to do.
> -Bonnie10:20 AM Wednesday (Pacific time). I'll post tomorrow after the appointment. I'm sure you're all on the edge of your seats. ;)
-Bonnie
This is the end of the thread.
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