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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 21 to 45 of 45. Go back in thread:
Posted by bleauberry on January 28, 2009, at 17:12:22
In reply to Risk of prolonged use of anti-depressives, posted by indigodaniel on January 27, 2009, at 9:24:11
SLS has a lot of wisdom. Check his posts again. I would emphasize the general notion/opinion that SSRIs are rather limited and not dependable longterm. It does represent a rather conservative and primitive treatment protocol to use just them. Mirtazapine was a reasonable option but didn't work right. That's ok. There is still Nortriptyline, Cymbalta, Desipramine, Nardil, Parnate, Marplan, Abilify, Zyprexa, Ritalin, Lamictal. Not sure if Effexor was one you tried or not. It is unique in its power. Lexapro too, even though it is an ssri, seems to change its personality in a very good way when combined with risperdal or abilify.
More than likely it would be a combination of 2 or 3 of those that you really need to be your best, not a simple limited ssri thing.
I do not think any amount of psychological warfare, regardless of how talented it is, will fix a biochemical problem. You kind of have to instinctively decide whether your symptoms are psychologically based, biologically based, or a mix of both.
Some people who are mercury toxic from amalgams are told to go to psychotherapy for their depression. I tell you what, no amount of talking or EFT or massage or anything is going to get that mercury out of the cells. It is a biological thing that needs a biological treatment. It's kind of the same with biologically caused depression.
Psychological therapy helps in terms of understanding it all and learning coping techniques that make it less overwhelming. It helps make the burden feel lighter, but does not make the burden go away.
Posted by antigua3 on January 29, 2009, at 11:01:01
In reply to Re: Risk of prolonged use of anti-depressives » antigua3, posted by JadeKelly on January 28, 2009, at 14:25:26
Absolutely no need to apologize. You didn't say a thing that offended me.
I understand where you're coming from and wish you the very best. If I can ever be of help, please don't hesitate to let me know.
antigua
Posted by Jadekelly on January 29, 2009, at 13:12:19
In reply to Re: Risk of prolonged use of anti-depressives » JadeKelly, posted by antigua3 on January 29, 2009, at 11:01:01
Posted by Indigodaniel on January 29, 2009, at 15:01:06
In reply to Re: Risk of prolonged use of anti-depressives, posted by Garnet71 on January 28, 2009, at 11:21:26
interesting concept indigo child. I have honestly never come across it before but will certainly look into it.
When it comes to EFT I will continue working with it and hope that it will help me together with changed medication.
id
Posted by Indigodaniel on January 29, 2009, at 15:17:34
In reply to Re: Risk of prolonged use of anti-depressives, posted by SLS on January 28, 2009, at 11:24:13
Scott, thanks for sharing of your experience. It has given me some valuable insights.
Posted by garnet71 on January 29, 2009, at 19:57:55
In reply to Re: Risk of prolonged use of anti-depressives, posted by Indigodaniel on January 29, 2009, at 15:01:06
> interesting concept indigo child. I have honestly never come across it before but will certainly look into it.
>
> When it comes to EFT I will continue working with it and hope that it will help me together with changed medication.
>
> id--------------
okay, well indigo is one of my favorite colors - I wasn't sure if you were referring to a color or a concept. The names we choose for our avatars are interesting. :)
Posted by NewQuestions on February 3, 2009, at 8:39:55
In reply to Risk of prolonged use of anti-depressives, posted by indigodaniel on January 27, 2009, at 9:24:11
Scott--Can you post your drug history, problems and successes?
Posted by SLS on February 3, 2009, at 9:29:14
In reply to Re: Risk of prolonged use of anti-depressives--SLS, posted by NewQuestions on February 3, 2009, at 8:39:55
> Scott--Can you post your drug history, problems and successes?
That's a TALL order. Give me a little time to organize my thoughts.
I guess to start off with, I cannot think of more than a handful of antidepressants and mood stabilizers that I have not tried. These include:
maprotiline
citalopram
doxepin
phenytoinHere is the list of things I have tried, but not the combinations. Some of these drugs are hypnotics or anxiolytics.
--------------------------------------------
adinazolam
alprazolam
amitriptyline
amoxapine
aripiprazole
bromocriptine
bupropion
carbamazepine
chloral hydrate
chlorpromazine
clomipramine
clonazepam
clorgyline
d-amphetamine
desipramine
doxycycline
escitalopram
fluoxetine
fluphenazine
gabapentin
idazoxan
imipramine
indalpine
isocarboxezid
lamotrigine
levitiracetam
lithium
lorazepam
methylphenadate
mifepristone
mirtazapine
moclobemide
modafinil
nomifensine
nortriptyline
olanzapine
paroxetine
pemoline
perphanazine
phenelzine
PKU-8059
pregabalin
protriptyline
quetiapine
reboxetine
risperidone
selegiline
sulpiride
triiodothyronine T3
thyroxine T4
temazepam
thioridazine
topiramate
tranylcypromine
trazodone
triazolam
trimipramine
valproate
venlafaxine
viqualine
ziprasidone-------------------------------------------------
- Scott
Posted by NewQuestions on February 3, 2009, at 13:13:34
In reply to Re: Risk of prolonged use of anti-depressives--SLS » NewQuestions, posted by SLS on February 3, 2009, at 9:29:14
Can you look at my prior posts and comment? Can you relate? Did you find anything that worked for a while, and then stopped working, or have you found difficulty finding the right drug to begin with?
Posted by 49er on February 3, 2009, at 17:18:37
In reply to Risk of prolonged use of anti-depressives, posted by indigodaniel on January 27, 2009, at 9:24:11
Hi,
As one who is slowly tapering off of meds due to horrific side effects, I have a different viewpoint that may not be popular on these boards. But that hasn't stopped me previously:)
I personally feel that long term use of psych meds can cause serious side effects. I am suffering from a hearing loss, tinnitus, and some cognitive issues.
Joseph Glenmullen, a psychiatrist who is not antimeds, has also raised this possibility.
I won't comment on your therapist's theory but let me say this. Withdrawing too fast from meds or cold turkeying can also cause suicidal ideation. I was cold turkeyed off of Prozac many years ago and the suicidal ideation lasted for months.
Also, many psych meds have suicidal ideation as a side effect. I know, everyone says the risk is miniscule. But keep in mind that side effects are greatly underreported. It is estimate that only 1 to 10% of adverse affects are reported to the FDA in the US.
If you do decide to taper, I would do it very slowly. Ten percent of the current dose every 3 to 6 weeks. This is not very popular with psychiatrists and when I have mentioned this on boards, a certain psychiatrist tells me it won't work. Well, many people are proving otherwise and tapering slowly is alot safer.
By the way, I have suffered insomnia as a withdrawal symptom from Remeron. But if I had tapered at the rate my psychiatrist wanted me taper at, I would have been in alot worse shape.
I have been able to taper in spite of dealing with a family death and job instability. It hasn't been easy but feeling like a human being again is all the motivation I need.
Also, while my hearing hasn't returned to normal, it certainly has improved.
If you're interesting in tapering slowly send me a private message. This goes for anybody. I have nothing to sell.
Good luck with your decision.
49er
> Hi,
>
> I have taken SSRI-drugs for more than 10 years. During this time I have also worked with several different therapists as well as courses in personal development and meditations. (I have also tried quit using the medication twice with no success)
>
> Last fall I fell into one of my deepest depressions ever. I have been given a combination of SSRI-drug (Seroxat) and one named Mirtazapine.
>
> I don't get any better (have had severe suicidal thoughts for several months) and I have started to believe that the drugs might block my recovery.
>
> The therapist that I am currently working with (specializes in EFT - Emotional Freedom Tecnique) have put forward a hypothesis that my long use of anti-depressive might in fact block any progress and being contra-productive.
>
> My question is therefore - do you know about other cases where anti-depressives is known to have had a negative effect if taken over such a long time that I have taken them?
>
>
> //Indigodaniel
>
Posted by garnet71 on February 4, 2009, at 22:49:25
In reply to Re: Risk of prolonged use of anti-depressives--SLS » NewQuestions, posted by SLS on February 3, 2009, at 9:29:14
That list is daunting.
I've never even heard of hypnotics. Sometimes I wonder, Scott, if your medical problems are a result of taking all of these medications, in addition to the ECT you spoke of in another post?
Posted by SLS on February 5, 2009, at 2:05:32
In reply to Re: Risk of prolonged use of anti-depressives--SLS » SLS, posted by garnet71 on February 4, 2009, at 22:49:25
> That list is daunting.
>
> I've never even heard of hypnotics. Sometimes I wonder, Scott, if your medical problems are a result of taking all of these medications, in addition to the ECT you spoke of in another post?Which medical problems?
- Scott
Posted by garnet71 on February 5, 2009, at 23:19:49
In reply to Re: Risk of prolonged use of anti-depressives--SLS » garnet71, posted by SLS on February 5, 2009, at 2:05:32
> > That list is daunting.
> >
> > I've never even heard of hypnotics. Sometimes I wonder, Scott, if your medical problems are a result of taking all of these medications, in addition to the ECT you spoke of in another post?
>
> Which medical problems?
>
>
> - Scott*****************
The one that prevents you from functioning to your full capacity.
Posted by SLS on February 6, 2009, at 5:10:21
In reply to Re: Risk of prolonged use of anti-depressives--SLS » SLS, posted by garnet71 on February 5, 2009, at 23:19:49
> > > That list is daunting.
> > >
> > > I've never even heard of hypnotics. Sometimes I wonder, Scott, if your medical problems are a result of taking all of these medications, in addition to the ECT you spoke of in another post?
> >
> > Which medical problems?
> >
> >
> > - Scott
>
> *****************
>
> The one that prevents you from functioning to your full capacity.
I think I understand your logic here. I had a medical problem only AFTER I took drugs.It was my life's ambition as a child to take antidepressants, although I was perfectly healthy. I was obsessed with wanting to experience the side effects of these drugs that we have all come to know and love. I proceeded to fool the entire diagnostic team at Columbia University by feigning ultra-rapid-cycling bipolar disorder just to get my hands on some. Thank God I got what I wanted from these professionals. I couldn't have gotten sick without them.
Don't wonder too much about me. I'm not worth it.
- Scott
Posted by 49er on February 6, 2009, at 6:11:26
In reply to Re: Risk of prolonged use of anti-depressives--SLS, posted by SLS on February 6, 2009, at 5:10:21
Scott,Why the sarcasm as Garnett raised perfectly legitimate points and wasn't disrespectful to you?
So are you saying that psych meds are completely side effect free and cause no problems? I don't think you are but that is the way you are coming across.
By the way, when I thought that psych meds were wonderful, anybody who wrote posts like the ones I write on these board would incur my wrath. I wouldn't respond unless I was respectful but silently, I seethed. I just didn't want to believe that my beloved psych meds could be the source of my problems.
Even when I connected the use of Remeron to my hearing loss, I still didn't taper right away as that is how spellbound these meds had me. It was only when I started tapering that I realized how wrong I was.
Anyway, as one who always respected your points of view even though I vehemently disagree with you, I am disappointed in this type of post.
> > The one that prevents you from functioning to your full capacity.
>
>
> I think I understand your logic here. I had a medical problem only AFTER I took drugs.
>
> It was my life's ambition as a child to take antidepressants, although I was perfectly healthy. I was obsessed with wanting to experience the side effects of these drugs that we have all come to know and love. I proceeded to fool the entire diagnostic team at Columbia University by feigning ultra-rapid-cycling bipolar disorder just to get my hands on some. Thank God I got what I wanted from these professionals. I couldn't have gotten sick without them.
>
> Don't wonder too much about me. I'm not worth it.
>
>
> - Scott
>
>
Posted by SLS on February 6, 2009, at 6:43:49
In reply to Re: Risk of prolonged use of anti-depressives--SLS, posted by 49er on February 6, 2009, at 6:11:26
>
> Scott,
>
> Why the sarcasm as Garnett raised perfectly legitimate points and wasn't disrespectful to you?Yes, you are right. I get defensive when people say things like that to me, as I have heard it for decades. I will apologize.
Thanks for keeping me in line. I appreciate it.
I hope I don't come across as saying that psychiatric medications are without side effects and other undesirable traits. Unfortunately, for some conditions, they are the best we have to work with.
Thanks again.
- Scott
Posted by SLS on February 6, 2009, at 6:47:13
In reply to Re: Risk of prolonged use of anti-depressives--SLS » SLS, posted by garnet71 on February 4, 2009, at 22:49:25
I apologize, Garnet, for being sarcastic.
As I said to 49er, I get defensive when people say things like that to me, as I have heard it all for decades. That's all.
- Scott
Posted by SLS on February 6, 2009, at 6:58:04
In reply to Re: Risk of prolonged use of anti-depressives--SLS, posted by 49er on February 6, 2009, at 6:11:26
> ...even though I vehemently disagree with you.
Damn. I thought I was more persuasive than that. Charm alone should be worth something (yeah, right).
:-)
- Scott
Posted by Neal on February 7, 2009, at 1:24:16
In reply to Re: Risk of prolonged use of anti-depressives--SLS, posted by SLS on February 6, 2009, at 6:58:04
We get a post similar to "risk of long term use of ADs" every 3 months for the last 5 years. Just my 2 cents for the recent readers who may think that idea is new.
Posted by 49er on February 7, 2009, at 10:43:07
In reply to Re: Risk of prolonged use of anti-depressives--SLS » 49er, posted by SLS on February 6, 2009, at 6:43:49
> >
> > Scott,
> >
> > Why the sarcasm as Garnett raised perfectly legitimate points and wasn't disrespectful to you?
>
> Yes, you are right. I get defensive when people say things like that to me, as I have heard it for decades. I will apologize.
>
> Thanks for keeping me in line. I appreciate it.
>
> I hope I don't come across as saying that psychiatric medications are without side effects and other undesirable traits. Unfortunately, for some conditions, they are the best we have to work with.
>
> Thanks again.
>
>
> - ScottThanks Scott, I really appreciate your post and your apology. It takes a big person to do what you did.
49er
Posted by garnet71 on February 7, 2009, at 12:13:58
In reply to Apology » garnet71, posted by SLS on February 6, 2009, at 6:47:13
"As I said to 49er, I get defensive when people say things like that to me, as I have heard it all for decades. That's all."
Scott, I'm sorry if my words had negative connoctations. My thoughts were certainly not intended to be devaluing in any way; I was thinking in terms of helpfullness.
I was not implying you are not bipolar, and after seeing that daunting list, I had wondered what the implications of taking so many medications would be after time.
Thoughts of my mother's friend crossed my mind when I saw your list. My mother's friend, who I became very fond of and was close with since I was 13 (even introduced her to Mom), was taking no less than 16 medications for bipolar treatment and developed many Parksinson-like symptoms recently. When visiting my mother, one time she curled up on the bathroom floor drooling and in a catatonic state. Couldn't drive any longer. Serious cognitive decline. She is an ivy-league graduate. Hasn't been able to work for many years and has been treated within the Medicaid system. She has bipolar.
She found a new doctor recently who took her off all of the medications (was shocked at all she was taking), eventually leaving 2, if I recall correctly. She is much better now. Maybe she'll never fully recover, but the change was very hopeful.
You are much younger than my mother's friend, and I mistakenly thought it was worth pointing out that perhaps you should at least consider the possbility. I do realize you have a handle on your meds, and it seems as though you are not taking 16, but just wondered if you thought about this. Sometimes others have mentioned things that led me to thinking of other possibilities, which led to other thoughts and possibilities that I had not previously considered.
Sorry if what I said wasn't helpful.
Posted by garnet71 on February 7, 2009, at 12:17:15
In reply to Apology » garnet71, posted by SLS on February 6, 2009, at 6:47:13
Just an afterthought - I didn't think it was necessary to apologize from your comment to mine (but I understand where 49er was coming from) after I saw how it made you feel. Your response was not out of place in that context, and I thought it was quite creative.
It did not upset me, thus no need to apologize.
Posted by Sigismund on February 8, 2009, at 14:43:14
In reply to Re: Apology » SLS, posted by garnet71 on February 7, 2009, at 12:13:58
It is fair to wonder what the negative effects of med trials might be. They are drugs, they are not placebos, and an effect is to be expected.
(This is not to imply that anyone here is not really suffering, of course, before starting them.)
I know I simply would not be up to a heap of med trials.....working my way through the SSRIs and moving on from there.
Posted by linkadge on February 8, 2009, at 17:14:42
In reply to Re: Apology, posted by Sigismund on February 8, 2009, at 14:43:14
I do agree that psychiatric medications may infact prolong the disease state for some individuals. I also think they can lead to comorbid conditions which require more medications.
My mother was a very healthy individual. After 20 years of psychiatric medications she has gained about 120 pounds, got diabeties, kidney problems, liver problems, thyroid problems and more.
The medications can sure take a toll on you. I do belive that.
Linkadge
Posted by JadeKelly on February 8, 2009, at 17:38:05
In reply to Re: Apology, posted by Sigismund on February 8, 2009, at 14:43:14
To those waiting for relief,
When I became depressed (finally did get an accurate dx, MDD) I tried a couple ssri's: Prozac for 30 days and Lexapro for a few days. SSRI's are not for me. I saw SO MANY people trying med after med, just to be disappointed again. I imagine we see a disproportionate of non-responders here. Somehow, I had it in my head that I would be in that group. I think because of how deeply depressed I was. I felt it would take a sledge hammer to get me out of it. And I was out of time. Meaning, I have to work, and take care of my home.
I made the decision to start an MAOI (EMSAM) before I even joined the sight. But it was because of an old poster's experience that I did it. I switched to Parnate and it was and act of faith that I stayed on that for almost 3 months before I responded, even with all the side effects. Frankly, I don't know how I did it. I had people telling me to stay on it, and people telling me to get off. Looking back it was a very rough ride for me. Some had a much easier time of it, some had to abort MAOI's.
I'm now so far from that original depression that I want to get down and kiss the ground for releasing me from that dark hole I was in. I continue to get better every day. And I'm grateful that I didn't have to trial many other meds first.
What this means for me or anyone else I don't really know. When I found the fantastic PDoc I have now, he was surprized that I hadn't tried many other meds. He said since I was so far into my treatment we would continue with Parnate and a augment. He tweaked things a bit. My investment paid off. Should I have tried others first? Would they be easier on my system? If it "poops"out, will it be harder to find one that works? I don't know. My Doc did say he thought I may have ended up on an maoi anyaway. I don't know what he bases that on, all I know is that I had a gut feeling about Parnate and it worked for me in the end.
The message here I geuss is to use your intuition throughout the process. If you are here you are probably on meds or want to be. Is my PDoc the best I can get? Don't stay with a PDoc who will not talk carefully about your feelings, history, past s/e's etc. It is CRITICAL that you get a good diagnostician-sp?. I don't care what people say about switching docs. I'd still be in that hole if not for my new PDoc. If they aren't interested in coming up with a comprehensive plan for you-cut em loose. You need to have hope and you'll only have that with a competent PDoc who cares. Then trust him/her.
If you instinctively know a med is not for you, talk to PDoc about it. If you see a little improvement but your sick of waiting and PDoc has ideas to build on that stay with it! I waited 3 months for mine. It was worth every day. Make a plan as to how you will get thru 2-3 months if need be, so you are not freaking out everyday. If that means a loan, help from your church whatever. "But I can't afford it" Can you afford NOT to?
Good luck,
~Jade
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