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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 francesrose on August 7, 2008, at 22:05:27
I had my first bout of depression/anxiety when I was 21 (I'm 38 now). I suffered a major loss and then moved away from all of my support systems and subsequently had a major depressive episode complete with full-blown panic attacks. I landed in the hospital for a nice ten-day stay. At that time, the hospital pdoc told me that I had a problem with being too dependent on people and that I needed therapy. And I had severe abandonment anxiety. He sent me on my merry way with a prescription to get therapy and learn how to be more independent. I went back to my hometown and started intense therapy (three times per week) and also gave up drugs and alcohol (I couldnt drink/drug my pain away anymore). It took me a year to get to a point where I was somewhat functional, though I still had low-level anxiety and depression. My GP during that time didn't want to prescribe any medication because he didnt believe in it (I think that was kind of the norm in the early 90s?) he concurred with the pdoc that all I needed intense therapy and I would be fine. Looking back on it, I see that I would have had a much easier time if I had been on medication, but cest le vie.
Anyway, since then I have gone up and down with anxiety and depression. I have done extensive therapy with and without medication. My medication history consists of Zoloft, a very brief stint with Effexor, and Prozac/ Wellbutrin combo. The Zoloft worked great at first, but then I gained 50+ lbs and got sluggish and zombie-like. Effexor was awful. I was prescribed Prozac & Wellbutrin after being officially diagnosed with ADHD, depression and anxiety and it worked well for a while until I had major life-stress happen, then I turned into a nervous wreck.
I havent been on any medication for over a year and life has been absolutely miserable for the past seven months. I finally made an appointment with my GP to discuss medication again.
Lately, I have come to realize a few things: 1)I am a very anxious, nervous person and am more prone to an anxious-type of depression, rather than melancholy depression. I am a very edgy and irritable and I stress-out too easily. I think I am seeing, for the first time ever, that what I have is not temporary or situational. 2) I have a pattern of blaming my job for my depression/anxiety. I have quit so many jobs in past ten years because I stress-out and freak-out. I want to stop that pattern.
So, to get to the point, I need some input. I guess I am concerned about where to go from here. If I am more prone to an anxious type of depression, should I take Wellbutrin and Prozac? Wellbutrin makes grouchiness worse, but that side-effect seems to subside after a few months and I love the focus it gives me - it slows my brain down - plus no weight gain. Prozac got a little wierd for me - border manic episode when dosage was increased to 40mg? I don't know, but didn't like it. I liked Zoloft because it took the edge off, but didnt like the weight gain and zombie-ness. I just worked my butt off to lose 55lbs this past year, so I really don't want to pack the pounds on again.
I want to be able to relax and enjoy my kids/husband/life again. I want to be able to stay at a job for longer than two years. I want to stop freaking out.
Advice is appreciated and thanks for reading this far.
Posted by Phillipa on August 7, 2008, at 23:50:22
In reply to Advice Needed - Meds for Anxiety/Depression?, posted by francesrose on August 7, 2008, at 22:05:27
Wow wellbutrin slowed your brain down it sped mine up. Been on the same luvox and valium forever and now tired all the time and synthroid. Phillipa
Posted by francesrose on August 8, 2008, at 5:05:05
In reply to Re: Advice Needed - Meds for Anxiety/Depression? » francesrose, posted by Phillipa on August 7, 2008, at 23:50:22
Yeah, that's the ol' ADHD, stimulants slow me down. Loved cocaine back in the 80s for that very reason. :)
> Wow wellbutrin slowed your brain down it sped mine up. Been on the same luvox and valium forever and now tired all the time and synthroid. Phillipa
Posted by bleauberry on August 8, 2008, at 5:31:25
In reply to Advice Needed - Meds for Anxiety/Depression?, posted by francesrose on August 7, 2008, at 22:05:27
Maybe Lexapro or Cymbalta? Either one could go along with Wellbutrin. Of the two, Cymbalta is least likely to cause weight gain. Though the margin is small, Lexapro actually has an edge in superiority over other ADs according to metastudies. If weight gain is an issue, that can be countered with lifestyle modifications that go along with medication modifications. Stuff like high proteins, low carbs, low sugars, emphasis on raw veggies and fruits, lots of water...all stuff good for weight control as well as overall body/mind healing and health.
I mentioned the above two ADs because you've already been to the others. I think it makes sense to start fresh instead of going back in time. Your old meds would probably feel a lot different than they did back then anyway. Your body isn't the same as it was then.
For your symptoms actually the first idea that popped into my head was Paxil. But, serious sexual side effects as well as high risk of significant weight gain.
Posted by francesrose on August 8, 2008, at 12:19:27
In reply to Re: Advice Needed - Meds for Anxiety/Depression?, posted by bleauberry on August 8, 2008, at 5:31:25
> Maybe Lexapro or Cymbalta? Either one could go along with Wellbutrin. Of the two, Cymbalta is least likely to cause weight gain. Though the margin is small, Lexapro actually has an edge in superiority over other ADs according to metastudies. If weight gain is an issue, that can be countered with lifestyle modifications that go along with medication modifications. Stuff like high proteins, low carbs, low sugars, emphasis on raw veggies and fruits, lots of water...all stuff good for weight control as well as overall body/mind healing and health.
>
> I mentioned the above two ADs because you've already been to the others. I think it makes sense to start fresh instead of going back in time. Your old meds would probably feel a lot different than they did back then anyway. Your body isn't the same as it was then.
>
> For your symptoms actually the first idea that popped into my head was Paxil. But, serious sexual side effects as well as high risk of significant weight gain.Thank you, I am going to talk with my GP about Lexapro today. I'm scared of Paxil because of the horror stories I've heard about trying to get off of it and the weight gain issues. If an AD has weight gain as a side-effect, it will happen to me just thinking about it. I absolutely cannot control my appetite on an AD with that side-effect. Thank you though, for the input, it is very helpful.
Posted by francesrose on August 8, 2008, at 15:13:25
In reply to Re: Advice Needed - Meds for Anxiety/Depression? » bleauberry, posted by francesrose on August 8, 2008, at 12:19:27
Well I saw my GP and she gave me some samples of Cymbalta to try. So, I'll give that a go and see what happens. If anyone has any input about Cymbalta, good or bad, I'd be glad to read about it.
Posted by Phillipa on August 8, 2008, at 19:21:33
In reply to Cymbalta it is..., posted by francesrose on August 8, 2008, at 15:13:25
What dose are you starting at? Keep us posted. Phillipa
Posted by francesrose on August 8, 2008, at 19:59:30
In reply to Re: Cymbalta it is... » francesrose, posted by Phillipa on August 8, 2008, at 19:21:33
> What dose are you starting at? Keep us posted. Phillipa
She gave me 30 mg samples. We'll see how it goes!! :)
Posted by francesrose on August 10, 2008, at 6:34:25
In reply to Cymbalta it is..., posted by francesrose on August 8, 2008, at 15:13:25
Yesterday was my first day on the Cymbalta and I just had the usual side effects from starting a medication - dry mouth, stomachache, insomnia. Maybe a minuscule reduction in anxiety? For about five minutes yesterday my brain seemed to stop long enough for me to take a look around and realize that things have gotten really bad, really out-of-control, despite my best efforts to keep it together.
The one thing I'm asking myself a lot lately is why do I keep going off medication? I tell myself that I won't EVER go off of them again, then things get better and I go off of them. And things get worse. Then I go on them, etc. etc. etc. Sigh.
Anyway, I have to address my anxiety issues and I hope this medication will help!
Posted by West on August 10, 2008, at 9:24:57
In reply to Re: Cymbalta it is..., posted by francesrose on August 10, 2008, at 6:34:25
i'm taking it at the moment and it isn't helping my depression. Escitalopram statistically gets more people better. Going over to effexor.
Posted by West on August 14, 2008, at 8:27:56
In reply to Re: Cymbalta it is..., posted by West on August 10, 2008, at 9:24:57
Sorry for that grim message which was TOTALLY premature, it was very irresponsible to post that. I am a week in and doing MUCH better. The worst side effects of nausea and dizziness went after day 2, I just have some insomnia now which isn't really too bad. I hope i ididn't scare you off it, i am quite hopeful for cymbalta- i was in such bad shape before i took this.
Posted by manic666 on August 18, 2008, at 3:44:31
In reply to Re: Advice Needed - Meds for Anxiety/Depression? » francesrose, posted by Phillipa on August 7, 2008, at 23:50:22
hello im on cymbalta 60mg i seem stable, but i use the herb valerian i tell people again it may sound dull but it sedates me .any way cymbalta didnt really help anxiety, an when they put me to 120mg made it worse. was going to come off but got back down to 60 in a week with help from calcium tabs an valerian so my doc said keep the 60 for a time longer seems cool.
Posted by francesrose on August 18, 2008, at 4:57:34
In reply to Re: Cymbalta it is..., posted by West on August 14, 2008, at 8:27:56
Hi West,
No need to apologize, I know starting a med is hard. Side effects suck. I ended up stopping the Cymbalta because it made me REALLY spaced out. I felt really good, but just wanted to sit on the couch and zone. Almost like being high on an illegal substance...
Anyway, I'm glad you are feeling better. :)
> Sorry for that grim message which was TOTALLY premature, it was very irresponsible to post that. I am a week in and doing MUCH better. The worst side effects of nausea and dizziness went after day 2, I just have some insomnia now which isn't really too bad. I hope i ididn't scare you off it, i am quite hopeful for cymbalta- i was in such bad shape before i took this.
Posted by francesrose on August 18, 2008, at 5:00:46
In reply to Re: Advice Needed - Meds for Anxiety/Depression?, posted by manic666 on August 18, 2008, at 3:44:31
Thanks for your input, Manic. I like Valerian, too, haven't used it in a long while, but have used Calcium.
It's good to get some positive feedback on Cymbalta, thanks.
hello im on cymbalta 60mg i seem stable, but i use the herb valerian i tell people again it may sound dull but it sedates me .any way cymbalta didnt really help anxiety, an when they put me to 120mg made it worse. was going to come off but got back down to 60 in a week with help from calcium tabs an valerian so my doc said keep the 60 for a time longer seems cool.
This is the end of the thread.
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