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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 meltingpot on July 28, 2018, at 12:24:48
Why is it that in my 20s I took 20mg of Seroxat or a small dose of Prothiaden and it worked amazingly well.
However, I came off meds when I was 35 when the Seroxat was still working was fine for 3 years and the depression and anxiety came back only this time with strong suicidal thoughts. That time I took 20mg of Seroxat again and it just make me feel like I had a lump in my chest, totally apathetic yet anxious, unable to concentrate and still suicidal. It gets me when people advise on coming off antidepressants, they say reduce the dose slowly and wean off them. If I do that I feel ten times worse?
Why didn't ECT work for me? My psychiatrist at the time (a very good one) said it might not because it doesn't tend to work for my kind of depression. Not sure what my kind of depression is any more.
Why is it that some people have episodes of depression which they eventually come out of. Why haven't I come out of it? Why am I still taking medication after 15 years and every time I come off it I feel exactly as I did 15 years ago regardless of my circumstances?
I went to see a therapist who seems to think my childhood is at the root of my problems. I did have some bad things happen as a child but I never felt depressed or anxious then. I got upset yes but never felt like there was no way out or dispairing. The thing is I don't ever remember feeling depressed or anxious until I hit the age of 17. Also, I can't see how talking about my childhood every week is going to change anything. It would be lovely if it did but don't see how.
Denise
Posted by linkadge on July 30, 2018, at 19:20:13
In reply to A Number of questions, posted by meltingpot on July 28, 2018, at 12:24:48
Hi Denise,
I wish I had the answers. Have you tried other TCAs?
Nobody really has a clear answer on why meds can stop working, or why / when ECT works.
Therapists always believe that childhood is the root cause of all problems.
Have you tried ketamine? Scopolamine?
Linkadge
Posted by SLS on July 30, 2018, at 21:58:51
In reply to A Number of questions, posted by meltingpot on July 28, 2018, at 12:24:48
The psychosocial stresses or chronic traumas of childhood can help to set up the psychobiology of depression. However, once kindled, depression can become driven by biology exclusive of situation and psyche. It can only help to resolve psychological issues. However, this doesn't necessarily change the trajectory of mood illness once it is established. It can, though, especially when psychotherapy is administered early in the disease process. With each successive depressive episode, it takes less and less psychosocial stress to trigger them.
Perhaps ketamine would be worth a try, as Linkadge suggested. Intranasal ketamine is becoming more widely accepted as an alternative to intravenous administration. A friend of mine is doing quite well with intranasal ketamine. She had failed numerous drug treatments for depression. She was only partially responsive to a combination of Abilify, Lamictal, and Wellbutrin. Ketamine is the only drug she takes now. She takes one dose every 5 days.
- Scott
Posted by meltingpot on July 31, 2018, at 7:37:57
In reply to Re: A Number of questions, posted by linkadge on July 30, 2018, at 19:20:13
Hi Linkadge,
Thanks for getting back to me. I know you have probably have your own personal questions on why you suffer from mental illness as we all must do. I just don't get it. I want to know why I feel so lousy on a small amount of Seroxat and why taking meds seems to be such a crap shoot. Afterall, with pain, majority of people respond in the same way to a pain killer, it reduces the pain. You wouldn't give somebody a pain killer for a migraine and expect it to make the migraine ten times worse.
I did go to New York to try Ketamine. I was on Seroxat at the time so wasn't feeling too bad anyway, at least I was well enough to actually think something might work. When I'm not on anything I wouldn't have even gone. I found the Ketamine infusion to be a very pleasant experience. I have to say I enjoyed sitting there with it infused into my blood stream but I don't remember there being any noticeable affect afterwards.
Having said that, I have a friend in the States who has been on the Jensen esketamine trial, she has pretty much failed to respond to anything and initially she didn't feel any benefit from the esketamine but after about a month she is feeling great. Well last time she emailed me she was.
I've tried finding esketamine trials in the UK but they have stopped recruiting people. You can go to Oxford and pay to have them but I'm loathe to pay for 8 treatments. I've been told it might go to market in 2021 so maybe I will just wait until then. Luckily I have my current medication to keep me going.
Denise
Posted by meltingpot on July 31, 2018, at 7:40:22
In reply to Re: A Number of questions » meltingpot, posted by SLS on July 30, 2018, at 21:58:51
Hi Scott,
As I just said to Linkadge
I did go to New York to try Ketamine. I was on Seroxat at the time so wasn't feeling too bad anyway, at least I was well enough to actually think something might work. When I'm not on anything I wouldn't have even gone. I found the Ketamine infusion to be a very pleasant experience. I have to say I enjoyed sitting there with it infused into my blood stream but I don't remember there being any noticeable affect afterwards.
Having said that, I have a friend in the States who has been on the Jensen esketamine trial, she has pretty much failed to respond to anything and initially she didn't feel any benefit from the esketamine but after about a month she is feeling great. Well last time she emailed me she was.
I've tried finding esketamine trials in the UK but they have stopped recruiting people. You can go to Oxford and pay to have them but I'm loathe to pay for 8 treatments. I've been told it might go to market in 2021 so maybe I will just wait until then. Luckily I have my current medication to keep me going.
How long did it take your friend to get a response from Ketamine?
Denise
Posted by linkadge on July 31, 2018, at 9:11:51
In reply to To Linkadge, posted by meltingpot on July 31, 2018, at 7:37:57
If paroxetine is providing some benefit then stay on it. If you are feeling very apathetic, then perhaps lower the dose a bit.
Have you ever tried augmenting it with TCA? TCA / SSRI combinations can work quite well. For example, desipramine, nortriptyline or, if anxiety is more the problem, amitriptyline.
I know the availability of TCAs is different in the UK.
Have you tried wellbutrin + paroxetine?
Linakdge
Posted by SLS on July 31, 2018, at 9:29:37
In reply to To Scott, posted by meltingpot on July 31, 2018, at 7:40:22
> How long did it take your friend to get a response from Ketamine?
3 days.
- Scott
Posted by meltingpot on July 31, 2018, at 11:17:31
In reply to Re: To Scott » meltingpot, posted by SLS on July 31, 2018, at 9:29:37
Hi Scott,
I think it took her around a month but I will double check with her. The second time round she had to add Lexapro. But also she actually said she tripped when she had it which suprised me because I didn't when I had the infusion. I felt out of it and I was reading some magazines and started to believe the articles in the magazines were sending messages specifcally to me but I didn't actually trip.
My friend has very resistant depression. She briefly responded to DBS but lost the response and she also initially responded to VNS. So she has tried just about everything.
I will find out from her and let you know.
Denise
Posted by meltingpot on July 31, 2018, at 11:47:47
In reply to Re: To Linkadge, posted by linkadge on July 31, 2018, at 9:11:51
Hi Linkadge,
No, I don't feel apathetic on the 40. It's when I reduce the dose that I feel awful.
If I remember correctly your real name is Ian isn't it?
Denise
Posted by meltingpot on July 31, 2018, at 12:06:56
In reply to Re: A Number of questions » meltingpot, posted by SLS on July 30, 2018, at 21:58:51
Hi Scott,
Do you think that if I saw a therapist every week and talked about my childhood it might cure me? The thing is he said in some cases it can take years! I could be dead by then anyway.
I know you suffer from Biopolar with more the depressive symptoms but how old were you when it started and can you pin point it to anything?
Denise
Posted by ed_uk2010 on July 31, 2018, at 14:19:17
In reply to To Linkadge, posted by meltingpot on July 31, 2018, at 7:37:57
>Afterall, with pain, majority of people respond in the same way to a pain killer, it reduces the pain.
Ah now that's a whole new can of worms! :) Chronic pain disorders are equally problematic to treat as depressive illness, with very variable treatment response.
This is the end of the thread.
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