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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by kribensis on March 26, 2014, at 14:57:27
Hi all.
I have been reading this site for quite some time now (amazing, helpful posts!). This might be long and I appreciate all of you who manage to read this whole thing.My history: I am a 44 year old woman. History of anxiety/depression in my family. I have a background in natural health/healing and I eat well, exercise and do everything I can to manage my depression but natural things haven't been enough. I get lethargic, gain weight, turn to food for comfort, avoid people, lack confidence, etc.
I recall talking to our family dr about how I felt in my late teens, early 20's. She basically did not want to put me on meds but gave me no other suggestions either. I suffered for a long time before going to a walk in clinic one day and having a dr give me a prescription for an anti-depressant when I was about 24 years old. I had to try a few before I found one that works. It seems like the SSRI's do nothing or make me worse. The one that worked was Effexor. It seriously changed my life and that is not an exaggeration. I felt like I was normal for the first time EVER. I think I ever knew something was wrong with me during childhood but it wasn't until my teens that thing really went sideways.
Anyway, I was on Effexor for a few years and did really well with it. Very few side effects for me, my sex drive and ability to orgasm weren't affected. I had more trouble sleeping but as I sleep too much or just lie in bed when depressed, that was manageable.
It started to poop out and I would need higher and higher doses. I then got pregnant, stopped it during pregnancy and while breastfeeding. I was so afraid of the meds affecting my child that I struggled through it (in hindsight perhaps not the best choice but the one I made at that time). I nursed my child for 2.5 years (hard to get her to stop) but finally stopped because I knew I was really struggling and needed to get back on Effexor.
Again it worked well for me. I was on it for a few years, increasing the dosage as needed. It was starting to poop out on me, my dr tried adding in wellbutrin, had a negative reaction (more depressed). Went and saw a traditional chinese medicine dr who gave me a supplement for "energy", that was used with people with CFS. According to the label, it was a few herbs, nothing that seemed out of the ordinary. The herbal supplement was amazing. I actually weaned off Effexor and was just on the herbal supplement. I felt better on it than I did on effexor. I was on it for a couple of years before it was pulled by Health Canada because it was found to have traces of sibutramine and sildenafil.
I felt terrible after stopping, think I went through withdrawals. At that point though I still didn't know those ingredients were in the supplements, just knew that I couldn't get it anymore. Went through a couple of years of trying everything natural again and just sunk deeper into the depression.
That takes me to where I am now. Dr wanted me to try just wellbutrin on it's own again as he felt there would be less side effects. Didn't work for me. Weird nerve stuff happens to me, I felt about 30 minutes per day of a perk up, then just feel more irritable and have trouble sleeping.
Went back to good old Effexor, just for a week as when I was in getting the rx, dr mentioned Manerix to me. Had never heard about it but said he used to use it a lot with good success.
I started on Effexor regardless (said I would look into Maxerix) as I was really struggling and felt desperate. Effexor works really fast for me but this time I lost the ability to orgasm. Ugh. So I read about Manxerix and am going to try that instead and if that doesn't work, will go back to Effexor. Not being able to orgasm totally sucks but feeling depressed is even worse for me.
I have been off Effexor (that I only took for 5 days, 3 days at 37.5, 2 days 75) for 4 days now. My dr says it is okay right now to start Manerix based on the short time I was on effexor but from reading online, I think I need to wait longer.
Questions: Do I need to wait longer to start? Am struggling and would like to start the Manerix asap.
-From my story above and how well that herbal combo worked for me that had sibutramine and sildenafil, is there a different anti-depressant med that might work for me if Manerix doesn't?
I appreciate any feedback. I wish something natural would but have tried most things out there and nothing seems to help much or for very long. I also think I need a med that acts on norepinephrine as anything that just acts on serotonin (even effexor at lower doses) doesn't seem to do much. I tend to need something that is a bit more activating.
Posted by b2chica on March 26, 2014, at 16:27:07
In reply to helps with meds/Manerix, etc, posted by kribensis on March 26, 2014, at 14:57:27
first Welcome.
second. want to say congrats for being able to nurse for so long. i think its beautiful.only suggestion i have is pristiq it is a metabolite of effexor.
i had horrible results with effexor but pristq worked well.
i am up to 100mg, normally start with 50. that was fine first couple years. stopped for my second child. when started again, needed to go up to 100.best wishes.
b2c
Posted by Beckett on March 26, 2014, at 23:51:10
In reply to helps with meds/Manerix, etc, posted by kribensis on March 26, 2014, at 14:57:27
Hi,
I don't think any reversible MAOI inhibitors are available here (US).
I am not currently on an AD but responded well to Emsam at the lowest dose (6mg). It was energizing for awhile. At this dose I think that Emsam is a reversible MAOI inhibitor as is manerix.. It was gentler on me than other ADs. Not sure if my experience would carry over to manerix.
I reslate to much of what you have written--trying to use Chinese medicine, the struggles and achievements you mention parenting, the incredible sensation of feeling normal after long periods combating symptoms. Has anyone mentioned dysthymia or cyclothymia? Both are distinct but can overlap.
It's tough working against genetics. I experience the cycle of lethargy, increased social avoidance....
Trail and error can be a grueling process but finding something that works is amazing!
Posted by phidippus on March 27, 2014, at 13:51:07
In reply to helps with meds/Manerix, etc, posted by kribensis on March 26, 2014, at 14:57:27
>Do I need to wait longer to start?
Typically you want a two week washout period before starting an MAOI (monoamine oxidase inhibitor-the Manerix) even then you won't get immediate relief. It takes 4 to 6 weeks before the full effects of an
antidepressant really become apparent.Are you aware of the dietary restrictions of Manerix?
I'm curious why your doctor hasn't tried you on Cymbalta or Fetzima. Both drugs are in the same class as Effexor and could yield the same results for you.
Another option is Mirtazapine, which increases levels of dopamine, norepenephrine and serotonin.
>Am struggling and would like to start the Manerix asap.
Remember, it takes 4 to 6 weeks for an antidepressant to take full effect.
>that herbal combo worked for me that had sibutramine and sildenafil
Sibutramine is a centrally-acting serotonin-norepinephrine reuptake inhibitor structurally related to amphetamines,
As an SNRI, it shares a similar mechanism of action with Effexor, Cymbalta and Fetzima.
Sildenafil citrate is also sold as Viagra. What role it had in treating your mood is questionable.
Eric
Posted by kribensis on March 27, 2014, at 22:34:00
In reply to Re: helps with meds/Manerix, etc » kribensis, posted by phidippus on March 27, 2014, at 13:51:07
Thanks to all for the responses.
Eric: I agree about the sildenafil. When I'm not depressed have always had a health sex drive and been fortunate enough to orgasm quite easily and I didn't notice a difference when taking the "herbal" combination in that regard... perhaps it countered the sexual side effects of the sibutramine if there is any with that one, but didn't notice anything different even in regards to sex/orgasm.
I know there is normally a two week wash out period before starting Manerix but I looked it up and actually for effexor it said 7 days. My GP said that I didn't even need to wait that long as I had only been taking effexor for 5 days. I have no idea if that is true or not but have been off effexor for 4 days and took my first Manerix today (5th day). Thought it was okay based on what the GP said and now after reading your post, I am feeling a huge amount of anxiety about it! I will have to read up on serotonin syndrome after finishing this post. Am freaked out now.
My dr also did not tell me about dietary restrictions and I had googled that and found that only people who have high blood pressure (mine is low) need to worry about that- is that not the case?
Today I feel off. I know that is normal for starting a new med but after reading your post, I feel like I don't want to continue with it. I was actually more lethargic and sleepy than usual, really weird feeling in my head, cloudy. Many people have said they found Manerix stimulating but it has been the opposite for me (know this is not a good indication as it has only been 1 day!).
What I am thinking is that I am not going to continue with Manerix, am now too anxious about the whole thing, and go back to effexor as I know that works. Will wait two days. Effexor works extremely fast for me, I am not kidding when I say that within 5 days of starting effexor I already start to feel like a non-depressed "normal" person.
Is Fetzima available in Canada? I haven't read much about that one, will have to look into it. I know Cymbalta tends to be similar to effexor but I *think* there is a greater risk of liver damage, etc., than effexor so why not use effexor if that works? I know it will help me for at least a year, just not sure what I'm going to do if it causes me not to be able to orgasm- not fun.
Will also look into Mirtazapine. Thank you!
Posted by kribensis on March 27, 2014, at 22:49:09
In reply to Re: helps with meds/Manerix, etc, posted by b2chica on March 26, 2014, at 16:27:07
> first Welcome.
> second. want to say congrats for being able to nurse for so long. i think its beautiful.
>
> only suggestion i have is pristiq it is a metabolite of effexor.
>
> i had horrible results with effexor but pristq worked well.
> i am up to 100mg, normally start with 50. that was fine first couple years. stopped for my second child. when started again, needed to go up to 100.
>
> best wishes.
> b2cThank you for your response! I think part of the reason I nursed so long was that it was easy.... and I was tired and going through a divorce.
I've read a lot about Pristiq and was interested in it but it comes in a hard extended release shell. I think my digestive system has trouble with those.... I had that issue with the wellbutrin hard shell and when doing research about Pristiq read about people having that issue with it and were actually getting some withdrawal symptoms on and off because they felt like they sometimes didn't break down the shell. With effexor I can open the capsule and just swallow the little time release beads.
Posted by phidippus on March 28, 2014, at 1:26:22
In reply to Re: helps with meds/Manerix, etc, posted by kribensis on March 27, 2014, at 22:34:00
>I am feeling a huge amount of anxiety about it!
I was wrong-Manerix does not have the same dietary restrictions as other MAOIs
Now that you mention you had been on Effexor for only a few days, I think a 4 day wash out period is sufficient.
>Am freaked out now.
No need to freak out! I think you're safe taking the Manerix now. I don't know that it will work as quickly as Effexor works for you, however.
> Today I feel off. I know that is normal for starting a new med but after reading your post, I feel like I don't want to continue with it.
I feel you have other options that make more sense. Cymbalta or Mirtazapine are good alternatives with less side effects than Manerix.
>I was actually more lethargic and sleepy than usual, really weird feeling in my head, cloudy.
What was your dose?
>go back to effexor as I know that works.
I thought it had not been as effective as it used to be. If that's the case, I strongly recommend you try another SNRI or Mirtazapine.
>I am not kidding when I say that within 5 days of starting effexor I already start to feel like a non-depressed "normal" person.
I respond to it quickly as well, but in a negative way.
> Is Fetzima available in Canada?
It should be.
>I know Cymbalta tends to be similar to effexor but I *think* there is a greater risk of liver damage
Comparatively speaking Cymbalta has no greater risk of causing liver damage than effexor.
>why not use effexor if that works?
Again, if it has become less effective and is causing you unwanted side effects, look into a medication with a similar mode of action, ie Cymbalta, Pristiq or Fetzima.
Also keep in mind that Mirtazapine has low incidence of sexual side effects. In fact it is often prescribed to patients having sexual side effects from antidepressants to help reverse those side effects.
Sorry I freaked you out on the Manerix!
Eric
Posted by kribensis on March 28, 2014, at 10:28:25
In reply to Re: helps with meds/Manerix, etc » kribensis, posted by phidippus on March 28, 2014, at 1:26:22
Hi Eric,
Don't worry. I am on the anxious side about starting any new meds due to a severe reaction I had to a drug at one time. It seems to come out at night more than during the day which is when I read your post.
From what I have read about Manerix, it actually has a much lower incidence of side effects including no negative effects on cognitive function (actually says it can improve this) or liver or cardiovascular system. Also often enhances sex drive and orgasm.
Just to recap, I have actually been off all antidepressants for 3 years now. After that "herbal" stuff (with sibutramine) was taken off the market, I went hard on doing a natural healing program. To make a long story short, I know my overall health improved, I still have issues that I now think were passed down through my mom's side that no matter what I do, is not going to make my life all that tolerable without meds.
I first tried wellbutrin a few weeks ago, we don't get along well at all.
Then went back to effexor. It worked great in the past but only lasts for about 1-2 years but maybe that is enough.
When I went in to my dr to ask for it, he mentioned Manerix. Said he used to use it a lot and some responded really well, less side, effects, etc.
As I felt desperate started effexor while reading whatever I could find on Manerix (which isn't much b/c it is not available in US). During just that 5 days on low dose effexor, totally lost my ability to orgasm! (Didn't happen to me previously when I was on it.) I wouldn't care at all except I'm dating someone right now and that just sucks and is frustrating. It also makes sex not as good for my partner as he takes a lot of pleasure in making me orgasm.
I know I was only on the effexor for 5 days so a short period of time but that is not a good sign.
From what I've read I'll run into the sexual side effects with cymbalta and some of the others. I guess people can add in slidenfil? But that is an additional med which is a pain.
Yesterday I took a single 150 dose of the Manerix and then am supposed to go up to 300 after a few days or a week. Yesterday felt crappy but after just one day on it was back to having a great (normal for me) orgasm this morning which made me realize that I can't just live with not being able to.
Mirtazapine I *think* causes weight gain. I am not overweight at all but, as a woman, am also paranoid about weight gain as I tend to gain weight/eat more when depressed. Anything that causes weight gain is a no-go for me. Effexor is weight neutral for me or will cause a bit of weight loss because I'm happier.
Perhaps I should start with effexor and when it poops out then move to some of the others you mentioned that are similar. I just need to think about what I'm going to do about the orgasm issue if that stays while I'm on the effexor.
Posted by phidippus on March 28, 2014, at 17:33:53
In reply to Re: helps with meds/Manerix, etc, posted by kribensis on March 28, 2014, at 10:28:25
Stick with the Manerix since you've already started it.
Eric
Posted by kribensis on March 30, 2014, at 10:24:17
In reply to Re: helps with meds/Manerix, etc » kribensis, posted by phidippus on March 28, 2014, at 17:33:53
Manerix for 3 days and did not go well. Really weird front lobe pressure as well as eye pressure which made my eyes look weird. Also very tired, no energy, forgetful. I feel like I'm hanging by a string right now and really need to get out of this gross head space I am in.
I guess it is back to effexor, at least for now. I'll have to deal with the anorgasmia. Getting out of this awful depression state is more important right now as it is affecting my ability to work, get things done, and my relationship with my son.
I am looking into milnacipran however, which, in theory, seems like it may be an even better fit than effexor. I need to check if it is available here in Canada. Thanks
Posted by phidippus on March 30, 2014, at 14:41:49
In reply to Re: helps with meds/Manerix, etc, posted by kribensis on March 30, 2014, at 10:24:17
If you want no sexual side effects, try Mirtazapine.
Eric
This is the end of the thread.
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