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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Hordak on February 4, 2018, at 10:04:04
Hello Comrades,
I've been taking Sertraline (50mg daily) for 9 months now.
Reason for taking Sertraline: Depression & SAD. Maybe some GAD.So Sertraline treats my baseline anxiety quite well, also got rid of digestion problems, but I am struggling with side effects:
# Motor restlessness, agitation. I've always been quite "hyperactive", but Sertraline has worsened it by a good amount. I cannot sit still, I feel I have to walk, to pace. I move my fingers and toes to "release" some of the energy. Also lots of fidgeting, rocking back and forth. I have the urge to crawl out of my skin.
# Indifference, amotivation, apathy, lethargy. I get less things done on Sertraline than before Sertraline. Just want to sit around and do nothing. It is really disconcerting, because things would happen like a major car malfunction or someone f*ck*ng me over and I'd be thinking "this SHOULD piss me off, but, meh.. whatever.."! I've been doing some reading & research and there is the hypothesis that SSRI-induced-stimulation of 5HT2C & 5HT2A receptors dampens the dopaminergic transmission in the prefrontal cortex thus causing these specific SSRI side effects. Antagonism / Inverse Agonism of these receptors should theoretically resolve the problem. What medications do antagonize / inverse agonize these receptors? Are there any other reliable theories on what is causing this? And what could help?
# Sleep disturbances, f*ck*d up sleep cycle, crappy sleep. Falling asleep is difficult, shallow sleep, waking up a lot in the night => daytime fatigue. (This week I've been sleeping a lot, maybe because the body wants to compensate for last months's bad sleep?)
# Heat intolerance + hot flashes. My entire life I've been loving warmth and heat. I was the guy who could sit at the top row in the sauna for 20min @ 100°C (212 °F), but right now I cannot even stand a mild summer. And I have been getting hot flashes lasting between 10-15 mins several times a day (I am a 29 year old male, so pretty sure it is not menopause related)
# I also lost quite a bit of weight, partially due to loss of appetite, but also due to increased metabolic rate. My appetite is back to normal, but I am still not gaining any weight. BMI 20 right now.
# Palpitations (BUM BUM BUM BUM. BUM . . . BUM . . . BUM)
# mild headaches and "pressure" in my neck. Nothing bad, but very annoying in the mid and long term.
Now I don't know what to do. I need some meds with "less" side effects. I haven't tried any combination of medications yet. To my dismay my doc prefers the SSRI merry go around aka SSRI carousel. I found a new psychiatrist and I will have a first appointment in about a month, but I don't know what to suggest to him. Has anybody some experience with a similar situation? Which antidepressant would be suitable for me? If there is someone who had the same problem and found some solution: please write me. Thank you. Greetings from Germany!
Posted by Hugh on February 5, 2018, at 22:08:11
In reply to Sertraline side effects, posted by Hordak on February 4, 2018, at 10:04:04
I've tried about a dozen antidepressants, and most of them have caused me to experience unpleasant side effects. Two exceptions were agomelatine and selegiline. I took a low dosage of selegiline (5 mg). At this dosage, it's an MAO-B inhibitor, and only affects dopamine, so there were no dietary restrictions. At higher dosages, it also inhibits MAO-A, and then there are dietary restrictions.
The treatment I've benefited from the most, long-term, is neurofeedback. (This is widely available in Germany.)
A treatment that isn't available here in the US but is available in Germany is Whole Body Hyperthermia. In Germany, it's usually used to treat cancer and Lyme Disease. A recent study conducted by the University of Wisconsin and the University of Arizona found that sixty percent of people with major depression who received a single treatment of Whole Body Hyperthermia improved. Forty percent met the criteria for remission of depression. Their improvement lasted for six weeks. (It's possible that it lasted much longer, but there was no follow-up after six weeks.)
https://medicalxpress.com/news/2016-05-body-temperature-relieves-depression-symptoms.html
Posted by Hordak on February 6, 2018, at 8:58:18
In reply to Re: Sertraline side effects, posted by Hugh on February 5, 2018, at 22:08:11
Agomelatine might be worth a try. We have it in Germany. We also have Selegiline, but they don't prescribe it for depression/SAD.
Neurofeedback... never heard of this before, but it sounds & reads quite interesting. I will look into it. Whole Body Hyperthermia... would Sauna (100°C, 20min) do the trick or has it to be a special "whole-body hyperthermia device"? Maye an infrared sauna? The whole-body hyperthermia device also uses infrared.
Posted by Hugh on February 6, 2018, at 11:23:18
In reply to Re: Sertraline side effects, posted by Hordak on February 6, 2018, at 8:58:18
Agomelatine didn't help my depression or anxiety, but it did help my insomnia. It would knock me out for about four hours every night. I was able to quit taking it cold turkey, without any withdrawal symptoms. Most antidepressants should be tapered over a period of weeks.
I doubt that an infrared sauna could raise your body temperature as high as Whole Body Hyperthermia does. And with WBH, they keep your temperature elevated for 90 minutes or longer.
Have you tried light therapy for your SAD? I've read that bright and blue light therapy can cause damage to the eyes.
http://www.sunnexbiotech.com/therapist/main.htm
It's believed that green light therapy is safer. The Re-Timer is a green light device.
This is an informative newsletter about neurofeedback:
I recommend the book A Symphony in the Brain by Jim Robbins.
There are several different neurofeedback protocols. The one that interests me the most is called Whole-Brain Training Circuit. It was recently developed by a neurofeedback clinician and trainer named Peter Van Deusen. It's described here:
https://brain-trainer.com/about/whole-brain-training-plan/
I see that there are three neurofeedback clinicians in Germany who were trained by Van Deusen. If none of them are near you, they might be able to recommend a clinician in your area.
This is the end of the thread.
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