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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by Amelia_in_StPaul on June 15, 2009, at 21:22:36
Hello all,
This merry-go-round...arggghh. I've been told by new doc to lower fluoxetine over a week's time so that I can start pristiq. My OCD, racing thoughts, and anxiety are through the roof. I am also having paranoid thoughts, I think. I keep telling myself bad things (is this the intrusive thoughts of OCD?), like "you're crazy," or "she's crazy," (about myself--now I'm having intrusive thoughts in the third person) or "slut"--it's like tourette's but internal. I have internal tourette's. I'm imagining all these paranoid scenarios that are so crazy and so irrational I'm afraid to actually say what I'm thinking. Am I having a dopamine surge from coming off fluoxetine?God almighty, is Pristiq a bad idea? Fluoxetine worked imperfectly but at least I could tolerate it--and it worked. I am not hearing great things about Pristiq.
I have MDD, OCD, ADHD, PTSD, BP and maybe some other fricking thing.
I'm just not sure SNRIs are the right path. I took one dose of Effexor 10 years ago and felt like I was dying (flu, chills, eye dilation, etc.).
Thanks,
Amelia
Posted by Phillipa on June 15, 2009, at 23:35:12
In reply to Some encouragement? Pristiq, posted by Amelia_in_StPaul on June 15, 2009, at 21:22:36
Amelia why are you going off the med if it's working or did it stop? Prozac has a long life and takes a few weeks to be completely out of your system. What I don't understand is if your had bad side effects with effexor why pristiq? Love Phillipa
Posted by Justherself54 on June 16, 2009, at 0:30:11
In reply to Re: Some encouragement? Pristiq » Amelia_in_StPaul, posted by Phillipa on June 15, 2009, at 23:35:12
Yes..I would question pristiq also if you couldn't tolerate Effexor. What other AD's have you been on?
Posted by Zana on June 16, 2009, at 8:56:12
In reply to Re: Some encouragement? Pristiq, posted by Justherself54 on June 16, 2009, at 0:30:11
I could not tolerate Effexor. It made me agitated. So far, that has not happened on the Pristiq. I had about 6 weeks- emonths of welling really good at 50mgs. That faded so we are pushing the dose to 100mg. So far, so good. So the point is, even if you have not had success with Effexor, Pristiq may be worth a look.
Zana
Posted by Zana on June 16, 2009, at 8:58:57
In reply to Re: Some encouragement? Pristiq, posted by Zana on June 16, 2009, at 8:56:12
I just read your message through again. What are you taking? Have you tried any of the Atypical Antipsychotics? I hate that name but some of your symptoms make it sound like you might benefit. I have a simple Major Depression but take not one but two APs. Not sure what your med history is like but that kind of jumped out at me when you mentioned intrusive throughts.
Zana
Posted by Amelia_in_StPaul on June 16, 2009, at 10:34:57
In reply to Re: Some encouragement? Pristiq » Amelia_in_StPaul, posted by Phillipa on June 15, 2009, at 23:35:12
Hi Phillipa,
I shouldn't have said it was working. It was working relative to how I feel now, but I was still experiencing some OCD and also a lot of apathy.I'm not sure why she prescribed Pristiq. She seemed to perk up when I described how I did on Remeron, so maybe she thought that if I could tolerate an SNRI, I'd do well on it. I'm kind of not happy about this, though.
Thanks, Amelia
> Amelia why are you going off the med if it's working or did it stop? Prozac has a long life and takes a few weeks to be completely out of your system. What I don't understand is if your had bad side effects with effexor why pristiq? Love Phillipa
Posted by Amelia_in_StPaul on June 16, 2009, at 10:36:47
In reply to Re: Some encouragement? Pristiq, posted by Justherself54 on June 16, 2009, at 0:30:11
Mostly Wellbutrin. I have had problems tolerating medications. I haven't given them proper trials, probably, and probably I've always been put on too high of doses to start. I don't metabolize meds that use the P450 2D6 enzymes very well. Pristiq doesn't use that enzyme much, so maybe that's why she tried it. I'd rather try Cymbalta or Luvox. Amelia.
> Yes..I would question pristiq also if you couldn't tolerate Effexor. What other AD's have you been on?
>
>
Posted by Amelia_in_StPaul on June 16, 2009, at 10:37:58
In reply to Re: Some encouragement? Pristiq, posted by Amelia_in_StPaul on June 16, 2009, at 10:36:47
Posted by Amelia_in_StPaul on June 16, 2009, at 10:44:32
In reply to Re: Some encouragement? Pristiq, posted by Zana on June 16, 2009, at 8:58:57
Thanks for the message from experience, Zana. I don't know, I'm resistant to APs, and my pdocs have always said that my symptoms are due to OCD (experts say APs don't help with OCD) and BPD, which itself can have quasi-psychotic symptoms in periods of stress. But I still worry that I am becoming schizophrenic, which is a symptom of my OCD, but doesn't mean it isn't happening. They keep telling me I'm too old to have it, but I do know that there is a second peak of incidence for women around 45 (I'm 39--maybe experiencing the prodrome?), having to do with hormones (they speculate). So--I don't know. Maybe I should try one. I have such problems tolerating ADs that I can't imagine what life would be like on an AP. Most of them use the enzyme P450 2D6 to metabolize, and I'm one of those that have a genetic mutation so that I don't metabolize drugs that use that pathway very well. This is TMI.
If I remember correctly, you are taking seroquel? I tried one dose of that and felt like I was tripping. That was at ~12 mg (yes, just 12)!!!!! What else do you take, if I may ask?
> I just read your message through again. What are you taking? Have you tried any of the Atypical Antipsychotics? I hate that name but some of your symptoms make it sound like you might benefit. I have a simple Major Depression but take not one but two APs. Not sure what your med history is like but that kind of jumped out at me when you mentioned intrusive throughts.
>
> Zana
Posted by Bob12 on June 16, 2009, at 11:27:12
In reply to Re: Some encouragement? Pristiq, posted by Amelia_in_StPaul on June 16, 2009, at 10:44:32
Amelia,
I know what you mean by internal tourette's. I have the same thing. I have to constantly battle against intrusive negative thoughts as well as OCD. I take zyprexa and valium that is it. Does anyone know of any other medications that might help the paranioa and intrusive negative thinking?
Bob
Posted by Amelia_in_StPaul on June 16, 2009, at 11:54:29
In reply to Re: Some encouragement? Pristiq, posted by Bob12 on June 16, 2009, at 11:27:12
Hello Bob, you don't take an SSRI or SNRI for OCD? That's the treatment protocol for it. As a rule, APs and benzos aren't prescribed for it.
> Amelia,
>
> I know what you mean by internal tourette's. I have the same thing. I have to constantly battle against intrusive negative thoughts as well as OCD. I take zyprexa and valium that is it. Does anyone know of any other medications that might help the paranioa and intrusive negative thinking?
>
> Bob
Posted by Amelia_in_StPaul on June 16, 2009, at 12:04:06
In reply to Some encouragement? Pristiq, posted by Amelia_in_StPaul on June 15, 2009, at 21:22:36
Took the plunge. Took the first pristiq dose two hours ago. Well, this is familiar to starting prozac. I'm feeling wired and tired (well, exhausted) at the same time. Actually, would like to go back to bed, but I doubt I could sleep. This is crazy. Anyone else experience this exhaustion and wiredness at once? does it go away?
> Hello all,
> This merry-go-round...arggghh. I've been told by new doc to lower fluoxetine over a week's time so that I can start pristiq. My OCD, racing thoughts, and anxiety are through the roof. I am also having paranoid thoughts, I think. I keep telling myself bad things (is this the intrusive thoughts of OCD?), like "you're crazy," or "she's crazy," (about myself--now I'm having intrusive thoughts in the third person) or "slut"--it's like tourette's but internal. I have internal tourette's. I'm imagining all these paranoid scenarios that are so crazy and so irrational I'm afraid to actually say what I'm thinking. Am I having a dopamine surge from coming off fluoxetine?
>
> God almighty, is Pristiq a bad idea? Fluoxetine worked imperfectly but at least I could tolerate it--and it worked. I am not hearing great things about Pristiq.
>
> I have MDD, OCD, ADHD, PTSD, BP and maybe some other fricking thing.
>
> I'm just not sure SNRIs are the right path. I took one dose of Effexor 10 years ago and felt like I was dying (flu, chills, eye dilation, etc.).
>
> Thanks,
> Amelia
Posted by Bob12 on June 16, 2009, at 12:36:02
In reply to Re: Some encouragement? Pristiq » Bob12, posted by Amelia_in_StPaul on June 16, 2009, at 11:54:29
Amelia,
I do not take a SSRI or SNRI. I had bad experiences with them in the early 90's. I am waiting for agomelatine to come out and hope this will help my OCD, anxiety, and intrusive negative thoughts.Bob
> Hello Bob, you don't take an SSRI or SNRI for OCD? That's the treatment protocol for it. As a rule, APs and benzos aren't prescribed for it.
>
> > Amelia,
> >
> > I know what you mean by internal tourette's. I have the same thing. I have to constantly battle against intrusive negative thoughts as well as OCD. I take zyprexa and valium that is it. Does anyone know of any other medications that might help the paranioa and intrusive negative thinking?
> >
> > Bob
>
>
Posted by Amelia_in_StPaul on June 16, 2009, at 12:49:22
In reply to Re: Some encouragement? Pristiq, posted by Bob12 on June 16, 2009, at 12:36:02
Bob, wow, it looks like agomelatine might be a wonderful answer for you and me. When does it expect to come out? Is there any progress yet in the application process?
> Amelia,
> I do not take a SSRI or SNRI. I had bad experiences with them in the early 90's. I am waiting for agomelatine to come out and hope this will help my OCD, anxiety, and intrusive negative thoughts.
>
> Bob
>
> > Hello Bob, you don't take an SSRI or SNRI for OCD? That's the treatment protocol for it. As a rule, APs and benzos aren't prescribed for it.
> >
> > > Amelia,
> > >
> > > I know what you mean by internal tourette's. I have the same thing. I have to constantly battle against intrusive negative thoughts as well as OCD. I take zyprexa and valium that is it. Does anyone know of any other medications that might help the paranioa and intrusive negative thinking?
> > >
> > > Bob
> >
> >
>
>
Posted by Amelia_in_StPaul on June 16, 2009, at 12:51:17
In reply to Re: Some encouragement? Pristiq, posted by Zana on June 16, 2009, at 8:58:57
sorry, Zana, I keep fogetting to add people's names to the subject line.
> Thanks for the message from experience, Zana. I don't know, I'm resistant to APs, and my pdocs have always said that my symptoms are due to OCD (experts say APs don't help with OCD) and BPD, which itself can have quasi-psychotic symptoms in periods of stress. But I still worry that I am becoming schizophrenic, which is a symptom of my OCD, but doesn't mean it isn't happening. They keep telling me I'm too old to have it, but I do know that there is a second peak of incidence for women around 45 (I'm 39--maybe experiencing the prodrome?), having to do with hormones (they speculate). So--I don't know. Maybe I should try one. I have such problems tolerating ADs that I can't imagine what life would be like on an AP. Most of them use the enzyme P450 2D6 to metabolize, and I'm one of those that have a genetic mutation so that I don't metabolize drugs that use that pathway very well. This is TMI.
>
> If I remember correctly, you are taking seroquel? I tried one dose of that and felt like I was tripping. That was at ~12 mg (yes, just 12)!!!!! What else do you take, if I may ask?
> I just read your message through again. What are you taking? Have you tried any of the Atypical Antipsychotics? I hate that name but some of your symptoms make it sound like you might benefit. I have a simple Major Depression but take not one but two APs. Not sure what your med history is like but that kind of jumped out at me when you mentioned intrusive throughts.
>
> Zana
Posted by Zana on June 16, 2009, at 14:05:00
In reply to Re: Some encouragement? Pristiq » Zana, posted by Amelia_in_StPaul on June 16, 2009, at 12:51:17
I am taking remeron, seroquel, pristiq, provigil, klonopin, gabapentin and resperal. I have tried all the other APs except zyprexa and found some of them, I think actually maybe only abilify to be of some help but only for a short time. This is all for treatment of major depression.
The experience you describe of being wired and exhausted at the same time is very typical of SSRI's ,less so with SNRIs. As you know, pristiq is a mixture, an SSRI/SNRI. That is usually an early side effect and should lessen. But yeh, I've certainly had the feeling that I was both exhausted and wanted to go to bed but sure I couldn't sleep and also the feeling of not sleeping at all when in fact I was getting some sleep. I've never done OK on an SSRI without a sleep med. That's what the remeron was originally tried for. Then my pdoc ramped it up hoping to get some AD effect which never emerged, then we added seroquel which had a modest AD effect, then the pristiq and my pdoc was then reluctant to reduce the remeron since there is some literature about the combination of remeron and pristiq being effective.
I doubt very much that you are becoming schitzophrenic. Is there any family history? It sounds like you are right that what you are experiencing is part of your OCD. My pdoc put mr on reparidal because she thinks all depression is a kind of yhought disorder. I don't know if shes right or not and I don'y know wht seroqul wouldn't cover that bot, oh well, that's how I am taking 25 meds - just feels like 25.Zana
Posted by Amelia_in_StPaul on June 16, 2009, at 15:15:23
In reply to Re: Some encouragement? Pristiq, posted by Zana on June 16, 2009, at 14:05:00
Thanks for the reassurance about wired/tired lessening. I'm glad to hear it. Some nausea kicked in, and my eyes feeling sort of dilated, I'm not sure that's the correct way to describe it, but I'm tolerating all this better than I thought I would. Suppose we'll see tonight, though. I do take Trazodone, so I hope it will see me through.
There is a family history of schizophrenia--my sister. My OCD started as an obsession that I would become schizophrenic. I think these thoughts are probably part of that, but one never can tell. It wouldn't bother me so much, except that she has had this condition for 20 years and has not much improved, even on medication. So it's hard to see and I have a huge fear of it.
Have you tried Trazodone before? I'm sure you have, but I was just curious. I know lots of people take Seroquel for sleeping, and anxiety, but I couldn't tolerate even that tiny dose. I am considering Abilify. I guess I worry that my dopamine receptors will get supersensitive, and that I will never be able to be off an AP. Actually, my depression was not that bad when I first went on an AD. Now I cannot live without ADs.
I don't know, I think your doc may be right. I've learned in the last two years just how much my depression and anxiety are caused by my thoughts. I just wish that I wasn't so d@mn sensitive to meds. On the other hand, I am tolerating Pristiq better than I thought. But this is day 1. I've taken meds where the side effects got worse after the first day. Well, we'll see...
thanks for your encouragement, Zana
> I am taking remeron, seroquel, pristiq, provigil, klonopin, gabapentin and resperal. I have tried all the other APs except zyprexa and found some of them, I think actually maybe only abilify to be of some help but only for a short time. This is all for treatment of major depression.
> The experience you describe of being wired and exhausted at the same time is very typical of SSRI's ,less so with SNRIs. As you know, pristiq is a mixture, an SSRI/SNRI. That is usually an early side effect and should lessen. But yeh, I've certainly had the feeling that I was both exhausted and wanted to go to bed but sure I couldn't sleep and also the feeling of not sleeping at all when in fact I was getting some sleep. I've never done OK on an SSRI without a sleep med. That's what the remeron was originally tried for. Then my pdoc ramped it up hoping to get some AD effect which never emerged, then we added seroquel which had a modest AD effect, then the pristiq and my pdoc was then reluctant to reduce the remeron since there is some literature about the combination of remeron and pristiq being effective.
> I doubt very much that you are becoming schitzophrenic. Is there any family history? It sounds like you are right that what you are experiencing is part of your OCD. My pdoc put mr on reparidal because she thinks all depression is a kind of yhought disorder. I don't know if shes right or not and I don'y know wht seroqul wouldn't cover that bot, oh well, that's how I am taking 25 meds - just feels like 25.
>
> Zana
Posted by floatingbridge on June 16, 2009, at 16:22:07
In reply to Re: Some encouragement? Pristiq » Zana, posted by Amelia_in_StPaul on June 16, 2009, at 15:15:23
Hi Amelia,
Why Abilify? For sleep?
Candace
Posted by Amelia_in_StPaul on June 16, 2009, at 17:16:51
In reply to Re: Some encouragement? Pristiq, posted by floatingbridge on June 16, 2009, at 16:22:07
Hi Candace, b/c I was thinking it could help clear out my thoughts, perhaps help balance out dopamine, if that's an issue. I don't think abilify is ever used for sleep, is it?
> Hi Amelia,
>
> Why Abilify? For sleep?
>
> Candace
Posted by floatingbridge on June 16, 2009, at 17:32:56
In reply to Re: Some encouragement? Pristiq » floatingbridge, posted by Amelia_in_StPaul on June 16, 2009, at 17:16:51
Hi Amelia,
I didn't think it was used for sleep either--I think it was just the way I read it in context of your post. I've read here that Abilify has worked well for some here. It didn't work for me, but then again, I had no trouble withdawing from it either after 10 months.
Pristiq is working well for me at 50. Effexor worked well enough to keep me afloat years ago, but was anxiety producing--but I was in grad school and needed to get stuff done, so....
Why do pdocs perk up at the mention of certain meds? I, too was wondering about cymbalta, but when I mentioned pristiq, a little light went off above my pdoc's head.
Good luck to you on pristiq.
Candace
Posted by desolationrower on June 19, 2009, at 18:39:02
In reply to Re: Some encouragement? Pristiq, posted by Bob12 on June 16, 2009, at 12:36:02
have you taken an AP while taking an sri?
-d/r
This is the end of the thread.
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