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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Zillhouse on April 23, 2009, at 4:00:24
Hi all. First let me just say, I've been reading these posts for a quite some time and it never ceases to amaze me what a great bunch of people you are. Everyone that contributes to this site is doing a huge service for people out in the world. I for one haven't posted here once (until now), but I have garnered so much from all of your experiences and insight. Each and every one of you. So thank you.
The reason I'm posting now is because I've run into a fairly large snag.
Here's the back story. Skip to the question at the end if you don't feel like reading. In 2001 I was diagnosed with anxiety disorder, for which I was prescribed Paxil. It made a world of difference, it literally pulled me out of the depths of hell. But of course, as many of you can attest, I got tired of the side effects (specifically sexual/tiredness) and decided to come off. Thus beginning my yo-yo trip through AD land.
So on and off of Paxil for 2 years, couldn't seem to stick with it. Then a try at Effexor, not a good experience...then paxil again...Then the switch to Lexapro...then the addition of Wellbutrin. Lex and Well was the combo that lasted the longest about 3 years or up until 2008. Still the side effects made it hard to stay on the drugs (terrible sexual side effects, mental slowing, overall lameness and the such).
So April of last year I went to a new Pdoc, and was almost immediately prescribed Lithium. He said he thought there was a slight mood disorder. It didn't seem to do much, but make me really thirsty, tired, and queasy. After about 3 months of that, I went to the Amen Clinic, where I was put through a series of tests, which basically said I had Depression, Anxiety, possible PTSD and possible OCD (not in that order). I was put on Lamictal, which I tried for about 3 weeks and then junked due to my pdoc's request (nausea, itching, fogginess). this led me to the decision to say screw you to all medications.
Dropped the Lithium,
Then dropped the Lexapro,
Was only on 300mg of Wellbutrin xl, then finally in Feb of this year stopped all meds. I felt great for a while, then the decent into hell began.
On 3/20/09 went back on 150mg Wellbutrin xl with as needed 0.5mg Ativan. Finally I Broke down, had to take a leave from my job and found a new pdoc. On 4/6 we talked, and we decided I should go back to Paxil.
Here's where I need your help, I took the first dose 10mg Paxil at 10pm on 4/6. By 12am I felt like I was on ecstasy, Everything was amazing, I couldn't sleep so I put on some headphones and flew to the moon. I just kept having the most incredible thoughts. I wanted to get out of my bed in the dark and start dancing. The next day, I didn't feel so well, but sure enough at 10pm I took my next 10mg pill and rocked again. Because I couldn't sleep, I decided it would be best to take the paxil in the morning. So sure enough, I skipped the next dose, and waited until the following morning. That's when things turned bad. From that day forward my new paxil experience has become horrible. I've been extremely anxious, can't leave the house, my eyes have been so dilated it looks like I have black irises. I would even go as far as to say I've had suicidal thoughts (will not act on them, not to worry). On 4/15 I increased the dose to 20mg, but this seemed to make things worse. I litterally couldn't get out of my bed in the morning. Head was spinning the worst thoughts, and I'm absolutely terrified of the world. So on 4/18 I bumped the med back down to 10mg, still way too much. Finally on 4/21 I split the pill in half and tried 5mg. This seemed to easy the tension a bit, this evening I did the same thing, and I'm feeling a bit better.
For those that read, should I keep trying the med, or should I get on something different? I'm pretty lost here.
For those that didn't read (I understand, I hate reading too) Is there anything out there that just deals with anxiety and doesn't effect sexuality at all?
Sorry this was so long.
Thanks
Zill
Posted by Zana on April 23, 2009, at 8:48:46
In reply to New here..., posted by Zillhouse on April 23, 2009, at 4:00:24
Hi and welcome. What a long, hard story. I would definitely let your pdoc know what is going on see what they recommend. It sounds early to tell how the med is really going to effect you but you might need something calming to counteract the activating aspects of the AD.
I too have been on the AD merrygoround for a long time. I'm actually trying a new AD, Pristiq right now with mixed results. Most have been too agitating for me. I'm trying to keep the agitation this is causing under control with klonopin and gabapentin. I have a new pdoc who is sort of flighty and who I'm not sure I trust. I recently lost my old one, she booted me after 15 yrs, so am hunting for a new one who seems really good and steady.
I have been on a lot of combinations of Atypical Antipsycotics (hate the name) and mood stabilizers. That might be an area to explore with your pdoc.
No magic bullet. But it sounds like there is lots of room for you to try new things. I can give you more details on the names of the meds if you like.
You might also try a post with the name of the meds you are wondering about. That might get you more helpful responses.
Look forward to hearing about how things go.
Posted by Zyprexa on April 23, 2009, at 10:02:58
In reply to New here..., posted by Zillhouse on April 23, 2009, at 4:00:24
Xanax, for anxiety and no sex problems. Or klonopin, same thing only longer lasting.
Posted by Phillipa on April 23, 2009, at 11:00:10
In reply to Re: New here... » Zillhouse, posted by Zyprexa on April 23, 2009, at 10:02:58
Agree with above but also ativan or valium all benzos. Phillipa and welcome to babble.
Posted by manic666 on April 23, 2009, at 13:48:20
In reply to New here..., posted by Zillhouse on April 23, 2009, at 4:00:24
there are more wrong ad,s than right ones for you, it just finding the golden egg, you sure have had your share of wrong meds ,we are all the same win some loose a lot , good look my friend
Posted by Zillhouse on April 23, 2009, at 15:42:38
In reply to Re: New here..., posted by Zana on April 23, 2009, at 8:48:46
thank you all for your responses :)
A further inquiry
All the other times I started Paxil I don't remember it being this much of a roller coaster, and it definitely didn't exacerbate the anxiety. If anything it calmed me down rather quickly. Granted I wasn't taking the Wellbutrin along side it before.
Is is possible for a medication to react so differently when tried again at a later time?
Is there anything to worry about if such a "high" is induced by the first dose of an ssri?
Am I being premature by wanting to get the hell off of this drug and try something else?
My main issues are social anxiety, general anxiety, and a depression that I believe is a result of the anxiety. I've also been in therapy for about 2 1/2 years, my therapist thinks there is a PTSD.
My current meds are:
Wellbutrin 150xl
Paxil 5mg
Ativan 0.5mg (as needed, I don't take this very often for fear of addiction)
Propranolol 10mg (as needed, doesn't seem to do anything)Fun Times ;)
Zill
Posted by Zyprexa on April 23, 2009, at 15:46:59
In reply to Re: New here..., posted by Zillhouse on April 23, 2009, at 15:42:38
Its possible that the wellbutrin is interacting with the paxil. And if you stop the wellbutrin the paxil will work again.
Posted by sowhysosad on April 23, 2009, at 16:12:12
In reply to Re: New here..., posted by Zyprexa on April 23, 2009, at 15:46:59
I can't see how it would, as wellbutrin doesn't have a strong enough effect on dopamine to counteract the serotonergic effect of the paxil.
Could be some other mechanism though I guess. Wellbutrin has as a bad rep for causing anxiety for some people, but not necessarily by interacting with other meds.
> Its possible that the wellbutrin is interacting with the paxil. And if you stop the wellbutrin the paxil will work again.
Posted by Phillipa on April 23, 2009, at 20:14:01
In reply to Re: New here..., posted by sowhysosad on April 23, 2009, at 16:12:12
Wellbutrin at 150mg put me in the hospital even with benzos it was much too stimulating think that's your answer. Love Phillipa
Posted by sowhysosad on April 23, 2009, at 21:07:34
In reply to Re: New here... » sowhysosad, posted by Phillipa on April 23, 2009, at 20:14:01
> Wellbutrin at 150mg put me in the hospital even with benzos it was much too stimulating think that's your answer. Love Phillipa
Ouch! It has a pretty powerful effect on norepinephrine which I'd guess is what some people react to. Norepinephrine makes me kinda tense, edgy and withdrawn in the absence of dopamine and serotonin, but thankfully nothing that extreme! I suppose some of us just can't tolerate it.
Posted by sam K on April 24, 2009, at 0:31:25
In reply to New here..., posted by Zillhouse on April 23, 2009, at 4:00:24
it can help anxiety. AND it really increased my sex drive.
Posted by manic666 on April 24, 2009, at 12:50:45
In reply to Re: New here..., posted by Zillhouse on April 23, 2009, at 15:42:38
just an answer to a med reacting different a second time, prozac worked great for me once , tried again some years later an was, nearly wipped out with a reation i got the second time
Posted by Amelia_in_StPaul on April 24, 2009, at 17:49:16
In reply to New here..., posted by Zillhouse on April 23, 2009, at 4:00:24
Hi there, zillhouse! Welcome! My god, what an awful experience you've had on Paxil. I myself have not heard a lot of great stories about Paxil. Have you tried anything besides it, Wellbutrin, Lithium, and Lamictal (I think you mentioned Wellbutrin; forgive me if not!)?
It sounds like you experienced a day of med-induced mania. I have to say that according to some in the psychiatric community, that can equal a bipolar disorder. (Bipolar II, if you didn't lose contact with reality.) I know you've tried two mood stabilizers, though Lamictal isn't much of an actual stabilizer. That you've had incredible amounts of anxiety signals BPII as well.
I am not as well versed as others in the chemistry of all of this, but I do wonder if a mood stabilizer isn't what you need. Let's see what others say.
Welcome! Amelia
Posted by desolationrower on April 24, 2009, at 20:48:32
In reply to Re: New here..., posted by Amelia_in_StPaul on April 24, 2009, at 17:49:16
one thing that makes it hard is you haven't tried many types of medications. maybe try buspirone, it can reduce sexual effects of ssris and also help anxiety, try a high dose if low dose doesn't do much
-d/r
Posted by Zillhouse on April 25, 2009, at 15:13:28
In reply to Re: New here..., posted by desolationrower on April 24, 2009, at 20:48:32
I forgot to mention that I did try buspar in the past, I took it with my original prescription of paxil (but only for a few weeks if I remember correctly), then I tried it again a few years later, it didn't seem to have much of an effect if any at all. Has anyone here had any luck with it?
Both Paxil and Lexapro have caused me serious sexual side effects, frequent anorgasmia and ED. That is with and without the addition of Wellbutrin. Is it safe to say that all ssri's are going to cause this problem?
I have an appointment with my pdoc on monday, he says if paxil doesn't work then he wants to try luvox citing that it has lesser incidence of sexual side effects. In your experience is this accurate or am I better off trying a different class of med altogether? My main issues are Anxiety, social anxiety, depression (lack of self confidence, mainly due to the anxiety). I basically want to hide under my covers all day.
I really hate the sexual side effects of paxil and lexapro they are the main reason I stopped both medications in the past.
Again thank you for all of your responses. :)
Posted by desolationrower on April 27, 2009, at 0:21:50
In reply to Re: New here..., posted by Zillhouse on April 23, 2009, at 15:42:38
yeah, ssris all will give sexual side effects, unless you get lucky. have you tried mirtazipine and/or alprazolam.
-d/r
This is the end of the thread.
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