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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by g_g_g_unit on March 7, 2008, at 19:37:29
hi i apologise if i start too many threads but i feel really lost at the moment ... for like the past month and a half i've been getting a weird brain-foggy feeling. basically when it first hit i was so scared that i just ceased working. then i started taking prozac (20mg) which either cut through the fog or made me not care, but either way was enough to get rid of it and i was able to start working again (i'm a freelance journalist). but the prozac was giving me insomnia so i had to come off it - which was 4 days ago - and now the fog is back. i feel like i'm going crazy because it's impossible to tell whether this is something created by my OCD (like a self-fulfilling prophesy) or a real symptom (e.g. akin to backpain) which my mind has latched on to. in any case, i feel motivationless ... my memory has gone (i forget close friends' names sometimes) .. and i'm scared because i'm at a total crossroads; i know that in a way if i could just let go and keep going as normal i might be okay. but it feels so ReAL. i have 3 weeks worth of lexapro samples which my gp gave me, and i want to try them , but i don't know if that could just make it worse - i don't wanna get stuck on SSRI's for fear of turning back to reality. my gp was aware of this since he was highly reluctant to give me anything but i said i was feeling suicidal. my other instinct, after reading earlier posts on here about brain fog, was to try out NADH or one of the amino acids for the sake of some clarity and give the prescription meds a break ... but it's hard to tell if that could just be feeding a 'non-existent' problem further by paying attention to it, and the best thing to do might conversely be to just ignore it, since i do recall a point where i felt relatively normal ... or at least in the grip of 'normal' ocd fears ...
i have also been speaking to a therapist over the phone at a CBT centre in new york (not about brainfog .. more about phobias), which has been good but highly $$$ and i just found out that there's a centre in my city, but i'm not sure if it's advisable to interrupt a CBT course midway ... ?
Posted by elanor roosevelt on March 7, 2008, at 20:37:41
In reply to So confused about where to go next :(, posted by g_g_g_unit on March 7, 2008, at 19:37:29
wht don't you just go on the lexapro for the 3 weeks and see how you feel?
it got me through a few tough timesssri's are best thought of as a temporary solution for many of us
lexapro lifted the fog and the fear for me
good luck
Posted by Phillipa on March 7, 2008, at 21:41:50
In reply to Re: So confused about where to go next :(, posted by elanor roosevelt on March 7, 2008, at 20:37:41
I feel you should ask you doc first or why not cut the prozac to a much smaller dose? Love Phillipa
Posted by g_g_g_unit on March 8, 2008, at 0:10:23
In reply to Re: So confused about where to go next :(, posted by Phillipa on March 7, 2008, at 21:41:50
hey phillipa,
i already tried prozac @ 10mg but i couldn't sleep either. it's like i wasn't energized by it per se - i felt totally flat, but at the same time just awake at night. i even tried switching the time i took it, but no diff.
Posted by g_g_g_unit on March 8, 2008, at 0:12:46
In reply to Re: So confused about where to go next :(, posted by elanor roosevelt on March 7, 2008, at 20:37:41
> wht don't you just go on the lexapro for the 3 weeks and see how you feel?
> it got me through a few tough times
>
> ssri's are best thought of as a temporary solution for many of us
>
> lexapro lifted the fog and the fear for me
>
> good luckthanks for your reply. are you still on lexapro currently? or were you just on it til you felt you could cope again and then came off?
Posted by Justherself54 on March 8, 2008, at 7:41:52
In reply to Re: So confused about where to go next :(, posted by g_g_g_unit on March 8, 2008, at 0:12:46
Lexapro was a great AD for me, but it pooped out on me (they all do)..I couldn't even take a child's dose of prozac..the two best AD's I've been on were Lexapro and Zoloft..I couldn't tolerate any of the others..I'd give it a try..especially if you're feeling suicidal, are having memory problems, and lost motivation..all signs of depression..
One other thing..I have fibromyalgia..when I'm having a flare I get what we call it "brain fog" almost like your head is full of cotton and I have difficulty remembering names and functioning period..I don't know your circumstances but if you have body pain for no reason, morning stiffness and fatigue..this just popped into my head when you described the fogginess..fibro and depression also go hand in hand..
Just a thought and I'm probably way off mark, but thought I'd mention it..
I hope you get an answer soon..keep posting..there's nothing worse than having a whole bunch of questions rolling around in your head and nobody to share them with..
Posted by 4WD on March 8, 2008, at 16:42:37
In reply to Re: So confused about where to go next :(, posted by g_g_g_unit on March 8, 2008, at 0:10:23
Hi,
I had the exact same problem with Prozac. It lifted my depression but it caused me terrible insomnia. I was so naive then (this was in the late 80's) that I didn't connect the insomnia with the Prozac. I had had problems with insomnia my whole life anyway.
When the Prozac pooped out on me after about 8 years, I switched to Effexor. The insomnia got much much less. I stayed on Effexor for about 4-5 years then it pooped out too. Then I switched to Cymbalta. Pffft! Insomnia gone. Almost overnight. I could even nap in the afternoons or fall into a doze on the couch in the evenings. I took Cymbalta for about 4-5 months then stopped it. (I have treatment resistant depression and it wasn't doing enough to help).
But here's the weird thing. Even after I stopped the Cymbalta, the insomnia stayed gone. It's been three years now and no more insomnia. You might ask your doctor about a trial of Effexor or Cymbalta. Effexor helped me more but Cymbalta really took care of the insomnia problem.
You could also stay on the Prozac if it really works well for you and ask your pdoc to treat you with something for sleep.
Marsha
>
> i already tried prozac @ 10mg but i couldn't sleep either. it's like i wasn't energized by it per se - i felt totally flat, but at the same time just awake at night. i even tried switching the time i took it, but no diff.
Posted by bleauberry on March 8, 2008, at 18:40:12
In reply to So confused about where to go next :(, posted by g_g_g_unit on March 7, 2008, at 19:37:29
There are so many causes of brain fog. Geez, where to start. Hey, if prozac helped but insomnia was a problem, why not take something for the insomnia instead of stopping the prozac? I guess you could try the lexapro and see. Either way, nothing is perfect. Almost everyone has side effects. It might be helpful to think of managing side effects rather than enduring them. Except in extreme cases insomnia is a pretty easy one to treat.
Candida, parasites, hidden bacterial infection, food intolerances that have not been suspected or diagnosed (gluten being a common one), too many heavy metals in the body, cortisol too low, temporary or borderline or outright hypoglycemia, a diet with too much omega 6 oils and not enough omega 3 oils...all these things will cause serious brain fog.
The candida, parasites, and bacteria are hard to diagnose because lab test are often negative or contradictory even when the person is heavily infected. These critters can hide real well but still spill massive doses of toxins in your bloodstream. Best bet is to treat them blindly and just assume you have them. Cortisol can be tested with a 24 hour 4 sample saliva test. Skip all foods with gluten (wheat, barley, oats, rye) for a week and see how you feel. Then eat them again and see if there is any difference. Some cortisol lab tests also include gluten intolerance as part of the package. Food intolerances are more common than suspected in my opinion. Other common ones are cassein (protein in dairy), corn, soy, nuts, shellfish. Brain fog is the primary symptom. A lab test can pinpoint everything you are sensitive to, but they are expensive at about $300. Get a cheap diabetic meter at the pharmacy and prick your finger a few times a day to see what your blood sugar is doing. Avoid hydrogenated oils (read the ingredients), and instead use olive oil and also supplement with flax oil and borage oil.
Look at your teeth to see if you have any silver fillings. If yes, the mercury vapor rising off of them 24/7 is notorious for causing brain fog and messing with brain neurotransmitters too, in addition to screwing up just about everything in the body.When someone complains of brain fog and they are only looking to fix it with some psych drug, I personally think they are ignoring the body's cry to fix something that is wrong.
Posted by g_g_g_unit on March 9, 2008, at 1:08:46
In reply to Re: So confused about where to go next :(, posted by Justherself54 on March 8, 2008, at 7:41:52
> Lexapro was a great AD for me, but it pooped out on me (they all do)..I couldn't even take a child's dose of prozac..the two best AD's I've been on were Lexapro and Zoloft..I couldn't tolerate any of the others..I'd give it a try..especially if you're feeling suicidal, are having memory problems, and lost motivation..all signs of depression..
>
> One other thing..I have fibromyalgia..when I'm having a flare I get what we call it "brain fog" almost like your head is full of cotton and I have difficulty remembering names and functioning period..I don't know your circumstances but if you have body pain for no reason, morning stiffness and fatigue..this just popped into my head when you described the fogginess..fibro and depression also go hand in hand..
>
> Just a thought and I'm probably way off mark, but thought I'd mention it..
>
> I hope you get an answer soon..keep posting..there's nothing worse than having a whole bunch of questions rolling around in your head and nobody to share them with..
>
>thanks so much for your support. since i don't really suffer from body pain, i doubt it's fibromyalgia. i think i'll give the lexapro a trial .. i dont have anything to lose
Posted by g_g_g_unit on March 9, 2008, at 1:14:19
In reply to Re: So confused about where to go next :(, posted by bleauberry on March 8, 2008, at 18:40:12
> There are so many causes of brain fog. Geez, where to start. Hey, if prozac helped but insomnia was a problem, why not take something for the insomnia instead of stopping the prozac? I guess you could try the lexapro and see. Either way, nothing is perfect. Almost everyone has side effects. It might be helpful to think of managing side effects rather than enduring them. Except in extreme cases insomnia is a pretty easy one to treat.
>
> Candida, parasites, hidden bacterial infection, food intolerances that have not been suspected or diagnosed (gluten being a common one), too many heavy metals in the body, cortisol too low, temporary or borderline or outright hypoglycemia, a diet with too much omega 6 oils and not enough omega 3 oils...all these things will cause serious brain fog.
>
> The candida, parasites, and bacteria are hard to diagnose because lab test are often negative or contradictory even when the person is heavily infected. These critters can hide real well but still spill massive doses of toxins in your bloodstream. Best bet is to treat them blindly and just assume you have them. Cortisol can be tested with a 24 hour 4 sample saliva test. Skip all foods with gluten (wheat, barley, oats, rye) for a week and see how you feel. Then eat them again and see if there is any difference. Some cortisol lab tests also include gluten intolerance as part of the package. Food intolerances are more common than suspected in my opinion. Other common ones are cassein (protein in dairy), corn, soy, nuts, shellfish. Brain fog is the primary symptom. A lab test can pinpoint everything you are sensitive to, but they are expensive at about $300. Get a cheap diabetic meter at the pharmacy and prick your finger a few times a day to see what your blood sugar is doing. Avoid hydrogenated oils (read the ingredients), and instead use olive oil and also supplement with flax oil and borage oil.
> Look at your teeth to see if you have any silver fillings. If yes, the mercury vapor rising off of them 24/7 is notorious for causing brain fog and messing with brain neurotransmitters too, in addition to screwing up just about everything in the body.
>
> When someone complains of brain fog and they are only looking to fix it with some psych drug, I personally think they are ignoring the body's cry to fix something that is wrong.
>
>thanks for your comprehensive post. assuming i did assume i had problems w/ candida, parasites, and bacteria, how would i treat them?
it's like sometimes i would think about my breathing and get scared and walk around hyperventilating. i was convinced i had a breathing disorder but when i tried to 'treat' it w/ breathing exercises etc. it just got worse because i was just feeding it further by paying attention to it. once i became indifferent or distracted by something else, the problem vanished. so part of me thinks this might be, as my doctor suggested, a self-fulfilling prophecy. like if i'm doing something like reading i will just suddenly became hyper-aware of what i'm doing which will derail the task at hand. so maybe if i just stopped trying to 'treat' it it would be okay. likewise i'm sure the anxiety of my memory getting worse will obvious make recall more difficult. i dont know. its such a fine line ...
Posted by g_g_g_unit on March 9, 2008, at 4:20:04
In reply to Re: So confused about where to go next :(, posted by g_g_g_unit on March 9, 2008, at 1:14:19
if its any help the first post in this thread perfectly describes how i feel . http://www.dr-bob.org/cgi-bin/pb/mget.pl?post=/babble/20030708/msgs/240216.html
the symptoms first started appearing after i came off remeron. i know this is just like total uneducated speculation but like my pdoc doesnt make me wean off stuff - i was at a low dose (15mg) for about a month but he just made me stop abruptly. same with the prozac now. could it be like just trying stuff for short bursts (i.e. month or two) and then ceasing be messing with my seretonin levels and giving me a fuzzy feeling? sorry if theres no pharmacological logic behind that lol . i guess i should try lexapro and give it a decent shot to try and stabilize, or have a total clear out and just go clean for a while. i guess its moments like these that make me worrya bout the accumulative effect putting all these pills into me might be having ...
Posted by 49er on March 9, 2008, at 7:06:07
In reply to Re: So confused about where to go next :(, posted by g_g_g_unit on March 9, 2008, at 4:20:04
> if its any help the first post in this thread perfectly describes how i feel . http://www.dr-bob.org/cgi-bin/pb/mget.pl?post=/babble/20030708/msgs/240216.html
>
> the symptoms first started appearing after i came off remeron. i know this is just like total uneducated speculation but like my pdoc doesnt make me wean off stuff - i was at a low dose (15mg) for about a month but he just made me stop abruptly. same with the prozac now. could it be like just trying stuff for short bursts (i.e. month or two) and then ceasing be messing with my seretonin levels and giving me a fuzzy feeling? sorry if theres no pharmacological logic behind that lol . i guess i should try lexapro and give it a decent shot to try and stabilize, or have a total clear out and just go clean for a while. i guess its moments like these that make me worrya bout the accumulative effect putting all these pills into me might be having ...Hi,
Because of the board rules, I can't really tell you what I think of your doctor's practice in not tapering you off of Remeron. Let's just say I don't think it is a good idea. That is an extreme understatement.
The recommendation on the Paxil Progress Boards, which is run by an RN, is 10% of the current dose every 3 to 6 weeks. I have been tapering at this rate on Remeron that last few weeks and have had minimal problems. When I tried to taper more quickly, I paid dearly. I will not make that mistake again.
When you taper a psych med too quickly or cold turkey it, it is like putting the car in reverse at 60 miles an hour. Your brain needs time to adjust as these drugs make alot of neurochemical changes to your body.
Also, when you taper too quickly or cold turkey a med, you will get symptoms that seem like a return of the illness but are not.
That sounds like what happened in your case.
By the way, it has been my experience that many doctors are not familiar with a slow tapering rate that the Paxil Progress Boards recommend. When I initially proposed it to my psychiatrist, he was quite resistant. To his credit, he was still willing to do what I want but it was rough sailing at first.
Anyway, I hope this helps.
49er
Posted by g_g_g_unit on March 9, 2008, at 18:39:08
In reply to Re: So confused about where to go next :(, posted by 49er on March 9, 2008, at 7:06:07
> > if its any help the first post in this thread perfectly describes how i feel . http://www.dr-bob.org/cgi-bin/pb/mget.pl?post=/babble/20030708/msgs/240216.html
> >
> > the symptoms first started appearing after i came off remeron. i know this is just like total uneducated speculation but like my pdoc doesnt make me wean off stuff - i was at a low dose (15mg) for about a month but he just made me stop abruptly. same with the prozac now. could it be like just trying stuff for short bursts (i.e. month or two) and then ceasing be messing with my seretonin levels and giving me a fuzzy feeling? sorry if theres no pharmacological logic behind that lol . i guess i should try lexapro and give it a decent shot to try and stabilize, or have a total clear out and just go clean for a while. i guess its moments like these that make me worrya bout the accumulative effect putting all these pills into me might be having ...
>
> Hi,
>
> Because of the board rules, I can't really tell you what I think of your doctor's practice in not tapering you off of Remeron. Let's just say I don't think it is a good idea. That is an extreme understatement.
>
> The recommendation on the Paxil Progress Boards, which is run by an RN, is 10% of the current dose every 3 to 6 weeks. I have been tapering at this rate on Remeron that last few weeks and have had minimal problems. When I tried to taper more quickly, I paid dearly. I will not make that mistake again.
>
> When you taper a psych med too quickly or cold turkey it, it is like putting the car in reverse at 60 miles an hour. Your brain needs time to adjust as these drugs make alot of neurochemical changes to your body.
>
> Also, when you taper too quickly or cold turkey a med, you will get symptoms that seem like a return of the illness but are not.
>
> That sounds like what happened in your case.
>
> By the way, it has been my experience that many doctors are not familiar with a slow tapering rate that the Paxil Progress Boards recommend. When I initially proposed it to my psychiatrist, he was quite resistant. To his credit, he was still willing to do what I want but it was rough sailing at first.
>
> Anyway, I hope this helps.
>
> 49er
>
>retrospectively, i guess i should've mentioned the remeron/prozac cold-turkey-quits first, since they're teh most drastic changes that have occured in the past 2 months. it's just that i so instrincally trust my pdoc that it didn't seem to warrant attention.
Posted by Bob on March 10, 2008, at 17:08:16
In reply to Re: So confused about where to go next :(, posted by elanor roosevelt on March 7, 2008, at 20:37:41
> wht don't you just go on the lexapro for the 3 weeks and see how you feel?
> it got me through a few tough times
>
> ssri's are best thought of as a temporary solution for many of us
>
> lexapro lifted the fog and the fear for me
>
> good luck
Just curious... if you consider SSRIs to be just temporary solutions, what do you think a longer term solution is? Possibly tricyclics, or MAOIs?
Posted by bleauberry on March 10, 2008, at 22:01:27
In reply to Re: So confused about where to go next :(, posted by g_g_g_unit on March 9, 2008, at 4:20:04
> the symptoms first started appearing after i came off remeron. i know this is just like total uneducated speculation but like my pdoc doesnt make me wean off stuff - i was at a low dose (15mg) for about a month but he just made me stop abruptly. same with the prozac now. could it be like just trying stuff for short bursts (i.e. month or two) and then ceasing be messing with my seretonin levels and giving me a fuzzy feeling? sorry if theres no pharmacological logic behind that lol . i guess i should try lexapro and give it a decent shot to try and stabilize, or have a total clear out and just go clean for a while. i guess its moments like these that make me worrya bout the accumulative effect putting all these pills into me might be having ...Definitely stopping meds cold turkey will mess you up. Even if you were only on them a week, not to mention a month or more. I guess it probably varies from person to person, but for me I have noticed that after stopping a med even after weaning off it carefully, it really takes a solid 3 weeks to 3 months to stabilize at some new baseline. But that baseline is never the same as the one before taking the drugs. The drugs, in my opinion, do change the game, even long after they are gone.
Posted by Bob on March 11, 2008, at 13:32:55
In reply to Re: So confused about where to go next :(, posted by bleauberry on March 10, 2008, at 22:01:27
> Definitely stopping meds cold turkey will mess you up. Even if you were only on them a week, not to mention a month or more. I guess it probably varies from person to person, but for me I have noticed that after stopping a med even after weaning off it carefully, it really takes a solid 3 weeks to 3 months to stabilize at some new baseline. But that baseline is never the same as the one before taking the drugs. The drugs, in my opinion, do change the game, even long after they are gone.
>
>
I'm going to have to agree with the theory that drugs "change the game", but I'm going to include ECT also. I can look back at the many, many drugs I took, and the ECT trials I had and can say that every drug changed things significantly at least for the short term, and some profoundly changed things for the long term, even after discontinuation. That's my experience anyway.
Posted by g_g_g_unit on March 13, 2008, at 4:24:58
In reply to Re: So confused about where to go next :(, posted by bleauberry on March 10, 2008, at 22:01:27
>
> Definitely stopping meds cold turkey will mess you up. Even if you were only on them a week, not to mention a month or more. I guess it probably varies from person to person, but for me I have noticed that after stopping a med even after weaning off it carefully, it really takes a solid 3 weeks to 3 months to stabilize at some new baseline. But that baseline is never the same as the one before taking the drugs. The drugs, in my opinion, do change the game, even long after they are gone.
>
>sure, it's reasonable to expect that the drugs will change the game, but i just worry about how drastically. i also feel at this point that i need to start taking more responsibility for myself. prior to this incident, i - in accordance with doctor guidance, of course - believed that i could just go on a pill for a while and if it didn't work out, okay then, let's just cut it out my system and move onto the next. i pray that this foggy disassociation doesn't count as a permanent part of what you refer to as an alterted baseline, though i suspect not since there's probably countless incidents of people going onto ssri's for short periods and ceasing them abruptly, considering that all the doctors/pdocs i've encountered have advised that (at least where a long half-life was involved). so i now have three boxes of lexapro sitting on my desk beside me. i am scared. considering i began to feel normal again w/ the prozac i am very tempted to just begin lexapro, now knowing of course that a taper would be essential in the off-chance that things didn't work out. then again, i also don't want to act out of impatience, i.e. trying to cancel out what might be part of a discontinuation syndrome by just going on another pill. but i can't really live the way i feel now. i'm seeing a naturopath tomorrow just to cover diet bases etc. nevertheless, the lexapro is calling out to me lol. pending i give it a safe trial, bleauberry (in your esteemed opinion of course - and by the way thank you for your considerate & thoughtful responses to my threads) is there no real reason to believe that it could cause permanent 'brain damage' thru compounding with the effects i'm already feeling? :/
Posted by g_g_g_unit on March 13, 2008, at 4:47:10
In reply to Re: So confused about where to go next :(, posted by g_g_g_unit on March 13, 2008, at 4:24:58
oh and FYI the last ssri dose i took was 20mg of prozac 10 days ago (geez hard to believe it's only been 10 days, feels like this has all lasted an eternity). pdoc suggested that 5 days after stopping the prozac cold turkey should be a good tiem frame to start the lexapro
This is the end of the thread.
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