Posted by LostBoyinNC1 on July 27, 2002, at 20:51:11
In reply to Re: How psychiatry wrecked my life. » cybercafe, posted by rjk on July 26, 2002, at 5:51:48
> > >This is probably due to genetic polymorphisms of the liver enzymes that metabolize these medications. Some people can become deathly ill on medication combos that don't bother others, and unfortunately, there are still many doctors out there that are unaware of the importance of learning about the potential dangers of drug interactions.
> >
> > is there anything a doctor can do to test a patient or know ahead of time?
> >
> I don't know, but I don't think that was my problem. The problem was that I was not treatment resistant and I am convinced that it is simply a case of that combination of drugs being too strong for my brain to cope with and something had to give, which it did.
> RichardIt could have been anything. There is no way for anyone on this group to diagnose you or give you specifics about what wrong. Only guidance. I can tell you that if you were not on any anti-psychotic drug at the time you can eliminate EPS or movement disorder symptoms, which can sometimes mimic as drug interaction when combined with antidepressants. The liver enzyme thing, thats iffy no way to tell for sure.
Id suggest you get a second opinion from a decent psychiatrist, probably a "psychopharmacologist" who lives at least 100 miles away from your former psychiatrist's office. Get someone who listens, dont get a know it all Pdoc. And who does not personally know the guy who rx'ed you the combo you say gave you a hard time. If you get a second opinion, dont go to a guy who is in the same town your first psychiatrist lives in, cause all these guys know each other at the local level, and psychiatry isnt competitive in say, the way sports medicine is competitive. In other words, psychiatrists as a group are kind of like cops...they tend to cover for each other and sometimes wont admit what really happened in order to cover their buddy. Psychiatry is not very competitive, most Pdocs dont try to outdo each other very often.
Where your problems might have come from is a total misdiagnosis. You might be bipolar and simply not able to tolerate a heavy duty antidepressant combination like Remeron plus Effexor. A second opinion might be helpful. Or you could have been experiencing severe antidepressant activation and akathisia that was driving you up the wall. Maybe some benadryl to relieve initial antidepressant akathisia (agitation) or a benzo like klonopin would have helped you.
BTW, for unipolar treatment resistant depressives the Remeron plus high dose Effexor combo is well established. Read some of Stephen Stahl's psychopharmacology books under "unipolar treatment resistant depression" to see for yourself.
I myself found I had severe trouble doing polypharmacy starting when I tried combining a low dose atypical anti-psychotic with the antidepressant Remeron. For years after I tried combining various psych meds, unsuccessfully. I would just get agitated feeling after a week and feel more depressed. Finally after four years I discovered anti-EPS meds and discovered I could EASILY do polypharmacy if I took a parkinsons med like Cogentin or Amantadine, even though these meds have pain in the ass side effects which are hard to tolerate.
If I do the polypharmacy thing now, if I just combine a bunch of psych meds I feel better for a few days, then soon I "numb up" and start feeling like crap. I develop akathisia and worsened depression and feel like I want to climb the walls due to this physical agitation feeling I get. But throw in some Amantadine or Cogentin into the combo, and suddenly with a day Im fine.
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poster:LostBoyinNC1
thread:113521
URL: http://www.dr-bob.org/babble/20020725/msgs/113960.html