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Dr. Bob is Robert Hsiung, MD,
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Posted by AlexCanada on September 16, 2012, at 16:10:34
Zoloft Sept Experience: Day 3- duller emotions, cognitive impairment in some manner too. Apathy. Lack of empathy. Day 4- really hard to think. emotions flat. insomnia issues. bit of head burning on day 3 during insomnia. Libido been extremely low. Day 6- zoloft induced insomnia seems gone. still very lousy overall. even gabapentin didn't help much today and yesterday. possibly worse as zoloft keeps building up. no more headaches though. likely was due to parnate withdrawal. difficult to think, emotionally numb. sometimes anxiety. Day 10- Emotionally very numb. Very poor cognition. Difficult to think. Mind feels blank often. Libido dead. Apathy. Feel very dumb. So far I am definitely worse on zoloft. Mood has less fluctuation. Mood is more consistent... consistently dull dumb unmotivated uninterested and tired. Very anti-social. Cannot relate to others. Difficult to care about anything.
That was a basic summary. I am not optimistic about results. I am hoping some kind of response comes soon but these days are really empty dull lousy. So hard to think. I usually end up pushing myself to do things. I rarely smile and am very emotionally unresponsive. This SSRI numbing garbage is frustrating me.
Is it worth it to keep taking it for another week?
The reason I had hope in zoloft was because paxil helped me many years ago, and gabapentin continues to help to some degree sometimes. Other meds which worked best for me include Parnate, Ritalin/Dexedrine, and Emsam. Parnate and Paxil have pooped out on me. Ritalin has built much tolerance. Gabapentin usually builds quick tolerance whereas I used to be able to take it daily with some decent results.
My dose is 25mg. For paxil the magic number was about 9.5mg. I am very sensitive to meds. What might be an equivilent dose for Zoloft? Since I'm suppossed to move up to 50mg soon.
I have strong melancholic depression and anxiety (anxiety is mostly taken care of via Valium). Generally very poor cognition, low energy, very poor memory, antero grade memory loss, low drive, low motivation, much anhedonia, very low interest, very poor ability to enjoy anything, low emotions, often very non reactive mood, etc.
I been considering other options such as Savella (not available in Canada), Latuda (not available), Emsam (again), Miraprex/Requip, Rolipram, Desipramine, Focalin, Aricept among few possible others. It frustrates me that it's difficult to order anything in Canada due to customs seizing things but not much I can do about that.
Some of these meds are indicated for memory because my memory issues are very very severe.
Please let me know your thoughts and any advice.
My past meds and other general information are shown below:
-----------------
Biggest Issues: Severely poor long term memory and ability to retain new knowledge, Antero Grade Memory Loss, Poor Cognition, Lack of emotions, Anhedonia, Dysphoria, Mind feeling blocked/cloudy, Severe lack of enjoyment, Lack of drive/motivation/desire/sense of reward, Difficulty relating to others and feel bit like a zombie, Severe difficulty being social (also partially due to inability to relate), Anxiety (usually handled if I keep taking valium), Low energy
Effects of Memory and Cognitive Issues: Loss of current thought process and forgetfulness of what I was about to do, Forget what happened a day ago, people's names, difficulty imagining what people's faces look like, unable to recall events from tv shows/movies/media, slow speech usually, takes time to process thoughts and information,
Best Medications tried: Ritalin/Dex (especially first time), Parnate (first few months especially), Paxil (some resemblence of normalicy and integration into society). Valium/Ativan (some mood improvement + anti-anxiety), Gabapentin (Improvement of almost all symptoms including emotions and cognition, but tolerance builds quickly)Treatments Tried:
Benzo- Valium, Ativan, Klonopin, Xanax
SSRI- Celexa, Paxil, Zoloft,
SNRI/Other/Alternative- Wellbutrin, Effexor, Stablon, Remeron, Lithium, Adrafinil, Gabapentin, Narproxen, Vivarint, Buspar, Trivistal LA, ECT, rTMS, Reboxetine, Mirapex,
NRI- Reboxetine,
MAOI- Parnate, Nardil
Stimulant- Ritalin, Dexedrine, Provigil
Anti-Psychotics- Zyprexa, Risperidal, Abilify (as a low dose add-on), Seroquel,
Natural/Herbal- Rhodiola Rosea, Omega 3, Omega Complex, Korean Ginseng, Magnesium Glycinate, Royal Jelly, Niacin, Gingko Biloba, Bee Pollen, L-Arginine, Resveratrol, D3, Maca Root,Sensitivities: Vitamin A, Sunlight,
----Treatment Results:
Worse: Celexa (gradual worsening of depression and burning pain), Effexor (rapid worsening of depression and burning pain), Abilify (rapid worsening of depression when taken w Parnate), Cymbalta (gradual worsening of depression), Seroquel, ECT (Severely damaged my long term memory and overall cognition perminently), Nortriptyline, Lithium,Better: Risperidal (some ability to enjoy things but overall would still be largely lacking), Parnate, Ritalin (first time this or Dexedrine was taken I was able to feel a bit like my old self, ability to experience pleasure, positive outlook, return of old hobbies, Was able to appreciate being alive), Dexedrine (similar to ritalin), Valium (some mood improvement, some anxiety improvement, most benzos have had similar effect), Ativan (was more social on this than other benzos while also on Paxil), Rhodiola Rosea (herbal similar to an MAOI) (A small miracle for mood, energy, cognition, general well being, would still be lacking pleasure. Has lost much effect over time), Gabapentin (tremendous cognitive improvement, imagination, more emotions, less cloudy thought process, feeling of greater intellectual capacity. Some improvement to mood, ability to be social. Although rapid tolerance onset, inconsistent, ironically sometimes cognitive impairment.), Vivarint (some mood improvement, massive improvement to sex drive),
Mixed Results: Remeron (sluggish on low doses, more active on higher doses, very mild mood improvement, impulsive spending), Zyprexa (some mood improvement, lot of lethargy, cognitive slowness, food tasted wonderful), Stablon, Modafinil (increased Cognition, Energy, Motivation but may compound dysphoria)
Negligible or Unsure: Nardil, Adrafinil, Narproxen, Buspar, rTMS (could not access any tangible improvement), Reboxetine, Mirapex, Piribedil, Klonopin, Wellbutrin,
Needs confirmation (not sure if taken): Prozac,
Posted by jono_in_adelaide on September 16, 2012, at 17:42:06
In reply to Day 10 Zoloft. Lousy so far., posted by AlexCanada on September 16, 2012, at 16:10:34
Try taking Zoloft (50mg) along with Welbutrin (300mg) - discuss with your doctor.
Try and not to hyperfocus on every bodily sensation, you have a serious ilness requiring strong medicine, some side effects are inevitable. If you arnt willing to tolorate any side effects, stick to bach flower remedies and homeopatic nux vomica
Posted by schleprock on September 16, 2012, at 21:28:26
In reply to Day 10 Zoloft. Lousy so far., posted by AlexCanada on September 16, 2012, at 16:10:34
Though i'm sure it's been mentioned to you many times, you should try a TCA with a mild side effect profile, such as nortriptyline or imipramine. I had positive results the very first day on nortriptyline.
Posted by AlexCanada on September 17, 2012, at 0:13:49
In reply to Re: Day 10 Zoloft. Lousy so far. » AlexCanada, posted by schleprock on September 16, 2012, at 21:28:26
> Though i'm sure it's been mentioned to you many times, you should try a TCA with a mild side effect profile, such as nortriptyline or imipramine. I had positive results the very first day on nortriptyline.
I've tried nortriptyline before. i don't recall the details but it didn't work out for me.
Desipramine is a possibility as is imipramine.
It's not so much the side effects. I have endured various physical side effects from parnate for instance which involved hypotension which led me to pass out briefly and hit my head against the wall. Also my left hand and arm on a seperate occassion would be numb and unusable for a few weeks. The feeling to my arm and hand came back but it seems my fingers cannot move as quickly as they used to on my left hand. Despite these and other side effects I continued on Parnate because it helped me more than most medications ever did.
Zoloft makes me feel inhuman though.
I think I may need something stimulating rather than sedating, and something which isn't numbing.
I'm quite sure that i've taken nortriptiline before but I'll try to confirm it since I know many people mention it.
Posted by AlexCanada on September 17, 2012, at 0:23:10
In reply to Re: Day 10 Zoloft. Lousy so far., posted by jono_in_adelaide on September 16, 2012, at 17:42:06
Zoloft makes me feel inhuman so far. Apathy Apathy Apathy. Being a zombie is not a sensation I dealt with while on Parnate and other medications. It feels very troubling and grim. I am normally an emotional type of person despite my impairment but this is a strong numbing.
My other reply speaks of which kind of side effects I dealt with on Parnate and I would rather take those than feeling as if I am the walking dead. I feel as if everyone could die and I wouldn't shed a tear. Cognitively I feel very shut down as well. Are these SSRi type side effects usually transcient? At least on some level?
Wellbutrin didn't work for me unfortunately. I don't recall if it was tried with an SSRi though.
Regarding the Bach Flower and nux Vomica are these generally fine to take regardless of what medication I am on?
> Try taking Zoloft (50mg) along with Welbutrin (300mg) - discuss with your doctor.
>
> Try and not to hyperfocus on every bodily sensation, you have a serious ilness requiring strong medicine, some side effects are inevitable. If you arnt willing to tolorate any side effects, stick to bach flower remedies and homeopatic nux vomica
Posted by Zyprexa on September 17, 2012, at 0:45:06
In reply to Day 10 Zoloft. Lousy so far., posted by AlexCanada on September 16, 2012, at 16:10:34
zoloft and celexa are very similar. I would give up on zoloft and go back to paxil at a higher dose. If you have good results with ritalin (a stimulant), maybe welbutrin would work.
Posted by jono_in_adelaide on September 17, 2012, at 1:14:01
In reply to Re: Day 10 Zoloft. Lousy so far., posted by Zyprexa on September 17, 2012, at 0:45:06
Agree with Zyprexia - if you have found a particular SSRI that you can tolorate, go back to it, they are all fairly equal in terms of efficiency, so if one is easier to tolorate take that.
Taking Welbutrin with an SSRI hits all three neurotransmitters at once to good effect, seretonin, dopamine and noradrenalin, it can be very effective, and would be well worth considering.
Simple things like bach flowers and valarian should be fine if you want a mild tranquilising effect with no side effects - just follow the directions on the pack.
Posted by jono_in_adelaide on September 17, 2012, at 1:20:41
In reply to Re: Day 10 Zoloft. Lousy so far., posted by jono_in_adelaide on September 17, 2012, at 1:14:01
also, the welbutrin knocks some of the ssri side effects on the head (emotional flattening, loss of sex drive) while the ssri can reduce any anxiety caused by the welbutrin.
Lexapro or Celexa plus desipramine could also be considered, though this only hits seretonin and noradrenalin, not dopamine
Posted by Raisinb on September 17, 2012, at 22:22:09
In reply to Day 10 Zoloft. Lousy so far., posted by AlexCanada on September 16, 2012, at 16:10:34
25 mg is a very low dose of Zoloft. However, if you keep upping the dose, you're likely to experience the emotional numbing more.
My advice would be to follow your doctors directions about titrating up and give it a few weeks. Unfortunately you really don't know how an SSRI trial will turn out until you give it some time.
Zoloft has helped me a lot in the past and it does help a lot of people so it's worth giving it a shot.
Posted by AlexCanada on September 19, 2012, at 21:10:00
In reply to Re: Day 10 Zoloft. Lousy so far. » AlexCanada, posted by Raisinb on September 17, 2012, at 22:22:09
I'm up to 50mg now for few days. So far I am slightly better but still very emotionally numb (slightly less though), cognition still very poor but slight improvement. Feel bit less negative.
Is the dopamine related action of zoloft related to dose? Or is there always some dopamine action regardless? Does Zoloft function any differently at higher doses or is it simply just more potent?
I have also eliminated Omega 3 500 DHA and 70 EPA supplements 3000 units a day from my diet. I do feel this played some vital role. Some people don't respond well to Omega even if it's DHA and I usually felt as if my mood was a bit ''darker'' whenever I took 2000-5000 a day. Why this might be, I have no clue.
Magnesium Glycinate 100-200mg supplement also I removed from my diet. Sometimes it would cause me a bit of anxiety and normally my anxiety is very low. Magnesium is said to likely potentiate ritalin (which I take along with valium) so perhaps some interaction was there.
I find myself sleeping a lot. My schedule is bit upside down. After taking my Zoloft 3pm doses I feel usually a bit tired and feel like laying down after an hour, and sometimes even fall asleep and nap for a bit, some strange dreams manifest. Naps never last longer than an hour or two.
DHEA 100mg (with calium 120mg in the tablet unfortunately) has some positive impact. Had some benefit to energy and empathy.
Still difficult to enjoy things or be interested to begin with but I am pushing myself to try and keep myself busy. Today unfortunately feels worse than yesterday but overall had been some improvement past few days. Still struggling a lot w/ cognition and it's really difficult to talk to people. Memory extremely poor. My head feels really warm at times.
Does anyone have experience with Rhodiola Rosea + SSRIs?
Posted by jono_in_adelaide on September 19, 2012, at 22:57:53
In reply to Day 13 Zoloft. Slightly better., posted by AlexCanada on September 19, 2012, at 21:10:00
Alex, could you detail your diagnosis and all the emds that you're currently taking.
I didnt realise that you were already on Ritalin when i suggested a tricyclic or Welbutrin
Posted by AlexCanada on September 19, 2012, at 23:49:21
In reply to Re: Day 13 Zoloft. Slightly better., posted by jono_in_adelaide on September 19, 2012, at 22:57:53
> Alex, could you detail your diagnosis and all the emds that you're currently taking.
>
> I didnt realise that you were already on Ritalin when i suggested a tricyclic or WelbutrinZoloft 50mg, ritalin 2.5mg 4+ times daily, valium 2.5 3+ times daily, Rhodiola Rosea Mind Body Spirit brand 600mg, DHEA 100mg (w/ 120mg calcium). Once in a while I take gabapentin 100-200mg for a bit of a boost to drive motivation emotion and ability to enjoy things but it's inconsistent. Most days I do not take gabapentin. I been considering taking L-Tyrosine. Also I plan to start taking Royal Jelly again since finally my shipment arrived.
Treatment Resistant Melancholic Depression. Some generalized anxiety but usually it's taken care of. Have never had any psychotic features. Have never felt hypomanic except possibly once in my life something which may resemble it. When i took parnate + valium + ritalin + high dose Korean Ginseng I had a period of 5 days where I didn't necessarily have much interest in anything but I did feel highly sexual. Huge libido and I took advantage of it of constantly ahem... chatting online. Alcohol helped me be social in that regard but impaired my already lousy cognition. Upon further research korean ginseng + parnate can cause such manic like behaviour.
Biggest Issues: Severely poor long term memory and ability to retain new knowledge, Antero Grade Memory Loss, Poor Cognition, Lack of emotions, Anhedonia, Dysphoria, Mind feeling blocked/cloudy, Severe lack of enjoyment, Lack of drive/motivation/desire/sense of reward, Difficulty relating to others and feel bit like a zombie, Severe difficulty being social (also partially due to inability to relate), Anxiety (usually handled if I keep taking valium), Low energy,
Effects of Memory and Cognitive Issues: Loss of current thought process and forgetfulness of what I was about to do, Forget what happened a day ago, people's names, difficulty imagining what people's faces look like, unable to recall events from tv shows/movies/media, slow speech usually, takes time to process thoughts and information,
Best Medications tried: Ritalin/Dex (especially first time), Parnate (first few months especially), Paxil (some resemblence of normalicy and integration into society). Valium/Ativan (some mood improvement + anti-anxiety), Gabapentin (Improvement of almost all symptoms including emotions and cognition, but tolerance builds quickly)Treatments Tried:
Benzo- Valium, Ativan, Klonopin, Xanax
SSRI- Celexa, Paxil, Zoloft,
SNRI/Other/Alternative- Wellbutrin, Effexor, Stablon, Remeron, Lithium, Adrafinil, Gabapentin, Narproxen, Vivarint, Buspar, Trivistal LA, ECT, rTMS, Mirapex,
NRI- Reboxetine,
MAOI- Parnate, Nardil
Stimulant- Ritalin, Dexedrine, Provigil
Anti-Psychotics- Zyprexa, Risperidal, Abilify (as a low dose add-on), Seroquel,
Natural/Herbal- Rhodiola Rosea, Omega 3, Omega Complex, Korean Ginseng, Magnesium Glycinate, Royal Jelly, Niacin, Gingko Biloba, Bee Pollen, L-Arginine, Resveratrol, D3, Maca Root,Sensitivities: Vitamin A, Sunlight,
----Treatment Results:
Worse: Celexa (gradual worsening of depression and burning pain), Effexor (rapid worsening of depression and burning pain), Abilify (rapid worsening of depression/anx when taken w Parnate), Cymbalta (gradual worsening of depression), Seroquel, ECT (Severely damaged my long term memory and overall cognition perminently), Nortriptyline, Lithium,Better: Risperidal (some ability to enjoy things but overall would still be largely lacking), Parnate, Ritalin (first time this or Dexedrine was taken I was able to feel a bit like my old self, ability to experience pleasure, positive outlook, return of old hobbies, Was able to appreciate being alive), Dexedrine (similar to ritalin), Valium (some mood improvement, some anxiety improvement, most benzos have had similar effect), Ativan (was more social on this than other benzos while also on Paxil), Rhodiola Rosea (herbal similar to an MAOI) (A small miracle for mood, energy, cognition, general well being, would still be lacking pleasure. Has lost much effect over time), Gabapentin (tremendous cognitive improvement, imagination, more emotions, less cloudy thought process, feeling of greater intellectual capacity. Some improvement to mood, ability to be social. Although rapid tolerance onset, inconsistent, ironically sometimes cognitive impairment.), Vivarint (some mood improvement, massive improvement to sex drive),
Mixed Results: Remeron (sluggish on low doses, more active on higher doses, very mild mood improvement, impulsive spending), Zyprexa (some mood improvement, lot of lethargy, cognitive slowness, food tasted wonderful), Stablon, Modafinil (increased Cognition, Energy, Motivation but may compound dysphoria)
Negligible or Unsure: Nardil, Adrafinil, Narproxen, Buspar, rTMS (could not access any tangible improvement), Reboxetine, Mirapex, Piribedil, Klonopin, Wellbutrin,
This is the end of the thread.
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