Posted by bonnie_ann on April 11, 2001, at 10:38:00
In reply to Re: Paxil and motivation, posted by Pari on April 10, 2001, at 23:05:03
>
> > The phenomenon of becoming emotionally numb is not uncommon with serotonin medicines like Paxil.
> >
> > If someone has a depression that is being caused by low serotonin, then increasing serotonin will lift the depression and restore motivation. However, if the depression is not caused by low serotonin, then increasing serotonin can just make things numb. No lows, but no highs either. Not depressed, but not motivated either. No crying, but not much laughing either. Blahness.
> >
> > In the clinical world this type of response is considered success, since it usually means the patient has improved at least 50%. In my thinking though anything less than total recovery is not acceptable. I actually think a lot of people who have been numbed by serotonin meds have been told they are now well, simply because they aren't depressed any more. I don't buy it.
> >
> > What can be added to an antidepressant to correct the blah numbness? In my personal experience small doses of the antipsychotics Zyprexa, Risperdal, or Amisulpride work the best. They interact with serotonin, dopamine, and NE systems in ways that can enhance antidepressant efficacy. Other common choices include WellbutrinI am currently taking 20mg celexa and 75mg 2x a day- I'm wondering what dose of Wellbutrin you need to take to combat the flatness.
, Ritalin, or Adderall. But those are probably not good choices if anxiety has been a problem. Mood stabilizers could be tried as well, but I've just noticed a lot more success stories with the small dose antipsychotic approach. Zyprexa by the way is not only good for depression and blahness, but it is approved for treating bipolar. In the first week sedation can be bothersome. After that it goes away. Appetite is increased and weight gain is common. But the joy of feeling alive is well worth gaining a few pounds, as I see it.
> >
> > I'm just rambling but I hope there is something here that might be helpful. At this point in your therapy I would look no further than Zyprexa, Risperdal, or Amisulpride. Each could be sampled for a couple weeks each to discover which might be a favorite.
> > John
>
> I have been feeling emotional numbness. When I laugh or smile, which is rare these days, it feels odd. Sometimes my eyes feel sunken and my face feels long most of the time. I have noticed that when I take a couple Trazadone (leftovers)my appetite increases (along with lethargy). My suicidal thoughts are less frequent but there is no joy in my life either. I have found myself watching television 4 to 8 hours a day. My doc just upped my dose of paxil to 30mg/day. What could the paxil be combined with to alleviate these symptoms?
poster:bonnie_ann
thread:58600
URL: http://www.dr-bob.org/babble/20010411/msgs/59418.html