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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by bleep on July 4, 2008, at 23:33:53
Hi. I recently had to stop Celexa after almost 2 years of success because it caused me to stop urinating. I tried Prozac and it causes it too now. I am told that all SSRIs will cause this in my case now. My doc wanted to try tricyclics so he gave me desipramine and it caused tachycardia and hypotension, which I read a lot of the tricyclics can cause. I am scared to try anything else but I am miserable. My current meds are Topamax 50 mg 2x day (the dose is so low because after 2 years I think it has almost destroyed my memory) and Ativan .5mg up to 3x day but I rarely ever take it because I don't want to be dependent on it. My dx is bipolar, panic/anxiety, but my old doc thought I was borderline personality disorder not bipolar. Also I don't take antipsychotics because they say "may cause sudden unexpained death" in the patient information leaflet and that freaks me out.
Posted by Racer on July 5, 2008, at 1:59:41
In reply to Please Help! Are there any meds left?, posted by bleep on July 4, 2008, at 23:33:53
There are plenty of medications left. After reading your post, the medications that came to my mind are BuSpar -- my favorite anxiolytic, although I'm not taking it currently -- Lamictal, which can be quite helpful for depression; Remeron, which is a very effective antidepressant for many people; Wellbutrin, which may increase anxiety in some; and if it wasn't past my bedtime, I could probably come up with more.
Also, I am a bit suspicious of the doctor saying that all SSRIs will now cause urinary problems for you. Again -- late at night, I'm tired (just finished watching a movie, so stayed up too late), and I don't want to try to form coherent thoughts (beyond the part about Maximilian Schell being a dang fine looking young man!), but to say that without offering any options for mitigating it sounds a bit -- well, I'd revisit that topic, if the Celexa worked for you.
Best luck.
Posted by bleep on July 5, 2008, at 2:25:17
In reply to Re: Please Help! Are there any meds left?, posted by Racer on July 5, 2008, at 1:59:41
Thanks for your help. Let me say that after just over a decade of meds I have tried Buspar (ineffective) and Lamictal (restless legs and I honestly thought the world was ending and too many things to list on that one). Wellbutrin made me VERY agitated. I haven't tried Remeron though I have heard it causes tremendous weight gain. The alternative he gave me was Desipramine, which caused the hypotension and tachycardia. He says all SSRIs will cause urinary retention b/c the Prozac caused it also when we tried it after stopping Celexa and there is research that says they can all cause it. We are going to discuss what to do now on Wednesday. That's why I was asking on here. I know y'all will have more real experience with what these meds do to you than the doctor will. Thanks again!
Posted by Phillipa on July 5, 2008, at 12:46:37
In reply to Re: Please Help! Are there any meds left?, posted by bleep on July 5, 2008, at 2:25:17
Did your pdoc say why they cause urinary retention is it just something that happens to you or is it a bonafide side effect of SSRI's. Reason I ask is I also have it but also cystocele which was almost operated on to fix till urinary flow tests said not necessary. Thanks Phillipa
Posted by bleep on July 5, 2008, at 15:06:32
In reply to Re: Please Help! Are there any meds left? » bleep, posted by Phillipa on July 5, 2008, at 12:46:37
It is a bonafide, though rare, side effect.
Posted by Phillipa on July 5, 2008, at 15:24:09
In reply to Re: Please Help! Are there any meds?))Phillippa, posted by bleep on July 5, 2008, at 15:06:32
Well that explains why I can't get the flow of urine to start and it takes hours after drinking water or anything. And I'm only on 50mg of luvox. Thanks got to google that one know of any sites? Love Phillipa
Posted by bleep on July 5, 2008, at 15:36:14
In reply to Re: Please Help! Are there any meds?))Phillippa » bleep, posted by Phillipa on July 5, 2008, at 15:24:09
http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=2495§ionId=15#
Posted by bleauberry on July 5, 2008, at 19:15:58
In reply to Please Help! Are there any meds left?, posted by bleep on July 4, 2008, at 23:33:53
Why doesn't he just treat the urinary hesitancy? Duhh. I know none of us want to take another drug, but there are meds that correct that symptom, ya know? They are given for the actual condition (not drug induced) as well as for drug induced side effects.
By the way, how does he know you don't have an actual condition that needs to be treated? Sounds to me like it is already there, perhaps borderline or mild, and that the drugs just aggravate it but don't cause it. I also don't know how he can predict all ssris would do that. I mean, if there is one thing in this world you cannot predict, it is psych meds. Because 2 ssris affected you does not mean they all would. Maybe, maybe not. Don't know.
Anyway, if your antidepressant was working for you, that was a huge plus. To be taken out of that safe place into dangerous waters of trying something else, when all that was needed was to examine and treat a side effect, well, that just seems not cool to me.
But back to your question, are there any meds left? Yeah, a bunch. Some have already been mentioned in this thread. A certain portion of pbabblers give up on USA meds out of longterm disappointment and failure with them, despite devoted effort, and turn to unique meds of other countries that are equal or better but way different. Or herbs. If you wanted to throw the whole med thing out the window you could always try Kira brand St Johns Wort, the German formula used in clinical studies.
But I again, due to a peeing problem, I question the judgement of pulling you off a powerful psych med that was working?
Posted by Phillipa on July 5, 2008, at 20:22:49
In reply to Re: Please Help! Are there any meds? Phillipa, posted by bleep on July 5, 2008, at 15:36:14
Bleep thanks mine is just hesitancy bet it's from that though. Phillipa
Posted by nfc on July 7, 2008, at 8:36:31
In reply to Please Help! Are there any meds left?, posted by bleep on July 4, 2008, at 23:33:53
hi there,
just wondering, do u have any psychotic symptoms?
It's important to treat them if you do. I take an AP - abilify and its the risk i'm taking as well I guess. It's suppose to be low risk for unexplained death but nothing's a guarantee so anything can happen. I need to b on an AP cuz w/o it I'd go crazy and would probably be jailed or do something delusional and get myself hurt so its what i gotta do. but yeah hope the best for ya and take care,nfc
Posted by bleep on July 7, 2008, at 17:48:44
In reply to Re: Please Help! Are there any meds left? » bleep, posted by nfc on July 7, 2008, at 8:36:31
Thanks! About the psychotic symptoms, I'm Not sure if I do really...sometimes I def think so, but my pdoc says I describe too many things at once and we need to focus on one thing at a time. Again, I am too freaked out by APs so the instant I put it in my mouth I am obsessing about death or NMS...I already have a strange preoccupation/terrifying fear of death. Years of panic attacks (ESP. around that time of the month) did not help this as I walk around utterly convinced I am going to die. I seem to be developing into a hypochondriac here lately. Maybe I won't die but I have this or that illness. I have felt disconnected and unreal lately, like maybe I don't even exist. I've read that meds can worsen that feeling. So for now I take maybe one .5 mg Ativan a day if even that (though I am prescribed 3 a day if needed (because I am scared of being a drug addict I rarely take them) and am cutting my topamax down to 25 mg 2 x day because lately I cannot remember anything and I feel like a total moron/can't think straight. I see my doc Wednesday. He will offer little if any solace. I have no idea what to even say to him really.
Posted by nfc on July 7, 2008, at 18:12:15
In reply to Re: Please Help! Are there any meds left? » nfc, posted by bleep on July 7, 2008, at 17:48:44
gosh, that's a tough situation you're in.
when my anxiety was shooting up a few weeks ago I was also prescribed ativan but never took it. Pdoc said its not suppose to be addictive but I didn't want to take another med that would give me side effects and would take a long time to get outta my system. thankfully my anxiety kinda just died down over the following days and past weeks.For you I'd recommend really focusing on your anxiety. again speak w/ the pdoc again( or try another?) and let the other meds get outta your system. I guess you don't have any psychotic symptoms to be warranting a AP so no need to worry about that for now. I recommend therapy for you at this time too though. Since you mentioned the hypochondriac thing. Having someone knowledgeable to speak w/ about symptoms or things that bother you and can help you sort out your concerns and bring them back to your doctor. Or ask if you can spend extra time on your pdoc visits answering all your questions. So write them down before the appt.
but yeah take care and we're here for ya,
nfc
Posted by yxibow on July 7, 2008, at 18:37:28
In reply to Re: Please Help! Are there any meds left? » nfc, posted by bleep on July 7, 2008, at 17:48:44
> Thanks! About the psychotic symptoms, I'm Not sure if I do really...sometimes I def think so, but my pdoc says I describe too many things at once and we need to focus on one thing at a time. Again, I am too freaked out by APs so the instant I put it in my mouth I am obsessing about death or NMS...
------------
NMS is incredibly rare, rarer than serotonin syndrome. Its so rare that if you had NMS you wouldn't know it for a while. It generally manifests itself in delirium and extremely high temperatures. I realize this could possibly increase your fear, but again I'm saying it is a rare condition.
And with atypicals like Seroquel and the like, it is way way down in the list of things.
Torsades de pointes is more common (1/4000 or less) with one atypical AP -- Geodon (even though it has been pointed out with new studies that, that syndrome is also rare.) Mellaril, which is still out there, has a greater risk (its a typical AP)
I'm not saying to advocate Seroquel but a low dose of it added to other medications can be very helpful for anxiety and the risk of TD is literally around .1% for most people, accepted now.
Most atypicals range around 5% per year or in a given year for TD to yes, an unknown value but very small, with Risperdal being the only proven one that has had TD records, because its probably closer to the 5% than Seroquel or Zyprexa (about 0.5%).
Its not to say it can't happen, but I guess the point is, somewhere along the line one has to make a decision with any medication -- do the benefits outweigh the risks, and can I accept the side effects or can I just live with a condition. Its a completely personal choice, with informed consent as it is known.-------------------
I already have a strange preoccupation/terrifying fear of death. Years of panic attacks (ESP. around that time of the month) did not help this as I walk around utterly convinced I am going to die. I seem to be developing into a hypochondriac here lately.
------------I have a fear of death that has never gone away, but you know --- most people do. It's part our life cycle though, nobody made the rules, its just there. The longer you live, something is going to get you. It's just something that eventually one learns to, if not accept, to put aside and focus on life affirming things.
But from what I've learned at least, its really a fear of living. Living independently and enjoying life.
I'm an agnostic, so religion while I'm connected to my roots (Jewish), I'm not particularly religious. Some people find consolation in their religion, some in meditation, however you do, there are ways of mitigating this fear.
-----------Maybe I won't die but I have this or that illness. I have felt disconnected and unreal lately, like maybe I don't even exist. I've read that meds can worsen that feeling.
---------------
Its a catch-22, some medications, benzodiazepines for example, can create discontinuity and possibly dissociation eventually if used long enough, but there are also a fair number of psychological reasons too why this happens as well. I don't know, its just a personal experience, so just take it as a case report.------------------
So for now I take maybe one .5 mg Ativan a day if even that (though I am prescribed 3 a day if needed (because I am scared of being a drug addict I rarely take them) and am cutting my topamax down to 25 mg 2 x day because lately I cannot remember anything and I feel like a total moron/can't think straight. I see my doc Wednesday. He will offer little if any solace. I have no idea what to even say to him really.------------------
Its important to stick up to how you feel. And projecting that there will be no solace ends up making a foregone conclusion. Why not turn that around with just a little skeptical optimism.
With medication loads, memory loss can occur -- as hard as it is, it isn't helpful to label yourself as a "moron". I have a lot of memory issues and I tend to label myself things.Yes, I'm not being Pollyanna about it -- there are adjustments in polypharmacy that can change this for the better, but I think a good goal would be to write all you want to say down in a journal or a pad or anything and take that in to your doctor and be honest about your feelings under what you're currently taking.
And yes, there are other medications. You can seek a second opinion (not a second doctor) which may bring some additional light on things.
-- best of wishes-- tidings
Jay
Posted by aaaaalex on July 10, 2008, at 3:37:26
In reply to Re: Please Help! Are there any meds left?, posted by bleep on July 5, 2008, at 2:25:17
"I haven't tried Remeron though I have heard it causes tremendous weight gain."
This is somewhat exaggerated. Chances are you'll gain a few pounds on it, but unless you're really prone to overeating, it's worth a try. It does give you the munchies, but it's controllable - at least, it was for me. Eat right, keep healthy snacks around, and exercise.
This is the end of the thread.
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