Posted by KaraS on January 7, 2005, at 22:30:03
In reply to Some advice needed (hopefully last time), posted by jujube on January 6, 2005, at 14:32:23
> Ok, I am, no doubt, beginning to seem like a pain in the butt with my indecision and insecurities about my meds, but I am in need of some advice and guidance again. I'll try to keep this brief.
Don't be ridiculous! That's what we're here for. And you of all people, who is always there for everyone else, should not think twice about asking for some advice.
> Since last Friday, I have not been able to take anything. This is really because of how my body reacts to aneastetic (had unplanned surgery on Friday) which results in, among other things, my already low blood pressure really dropping, my temperature remaining low, my skin feeling like a block of ice, and it taking days and days for things to get back to normal. Then there is the effect that pain killers, which I had to take, have on me after a few days of use.
>
> Anyways, I had been taking Anafranil for the past 7 weeks, and had managed to go up to 75 mg for a few days before my accident by taking salt tablets to increase my blood pressure so that I could tolerate the higher dose. However, after 7 weeks (mostly at 50 mg), there has only been a modest improvement in mood, general and social anxiety relief and motivation. I was to have continued taking Celexa with the Anafranil, but kept forgetting to take it. I was happy to have experienced some increased energy and motivation and what I thought (hoped) was the beginnings of a return to my old self prior to Christmas after adding some natural supplements (Vitex, NADH and DMAE), but, since the surgery, those are not helping as much and I am feeling empty, scared and anxious. I feel like such a hopeless loser, and have been on the verge of tears all day.You are not a hopeless loser. You're just going through a really difficult time. You were making some progress (albeit incomplete) and then you suffered a terrible setback. No wonder you're upset. This can all turn around again soon when you get on something you can tolerate that will work for you better. Once all of the pain medication is out of your system you will probably respond better to your supplements as well.
> Anyways, it has become increasingly obvious to me that I will not be able to tolerate a high dose of Anafranil. So, I was hoping to get some suggestions on what to try next. I could restart the Celexa at a low dose (for anxiety relief) and ask my pdoc for Provigil if that sounds like it may be effective. Or perhaps I could see if the pdoc is willing to prescribe Nortriptyline to combine with the Celexa. Or . . . I just don't know anymore.Unfortunately this usually comes down to trial and error. You discuss with your doctor. You make educated guesses and then you try them out. Fortunately your guesses are very educated. You do your research and you come to the right places for advice. You can't do much more. I wish I could tell you whether you should go with Celexa or nortriptyline. I don't know whether they can be combined, but if so, that might be an option to consider. You may find that nortriptyline is more easily tolerated than Anafranil. I couldn't say that with any scientific certainty but I do know of several people who were on it for years and tolerated it very well. Provigil is also a good choice as an augmenting medication if your doctor will prescribe it.
> I also have a prescription for Xanax, which I use as needed. I am wondering if Klonopin might be better for social and anticipatory anxiety.
Supposedly Klonopin is the best of the benzos for social anxiety. The only problem is that it tends to cause depression with regular usage. For that reason you might want to wait until you're on an antidepressant that is working well for you before trying it. Then again, once you're on something that works well for you, you might not need it - or at least not very often.
> Well thanks all for reading and sorry for the long-winded message. Any advice would be greatly appreciated.
>
> Tamara
Remember - this is a temporary setback based on an unfortunate occurence. This too shall pass!!Luv ya,
Kara
poster:KaraS
thread:438552
URL: http://www.dr-bob.org/babble/20050103/msgs/439222.html