Posted by Racer on September 22, 2007, at 1:34:21
In reply to Good idea, but here are some other concerns... » olysi79, posted by sometimesblue on September 21, 2007, at 15:20:37
This are just off the point at the top of my head:
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> 1. How long should i wait to see if these symtoms will go away?Depends on the specific side effect, and on its severity. My guess is that the mood swings are considered "severe," because they may indicate bipolar, and WB is not a great drug for bipolar.
If the side effects are tolerable, I'd say give it about four to eight weeks at a therapeutic dose. Just as it can take that long for an antidepressant to kick in, it can also take that long for the adjustment phase side effects to level out.
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> 2. And, if they don't, what's the next best alternative?That's always hard to say. Your doctor suggested Cymbalta, which I think is well worth trying. My guess is that you'll likely have to work out a way to address some side effects -- as Olysi wisely noted, asking how to mitigate side effects can limit the horror stories. Here are my suggestions:
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> My biggest concerns:
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> 1. anorgasmThere are medications which can mitigate the anorgasmia from serotinergic medications. I used cyproheptidine successfully when I was on Effexor and on Cymbalta. Worked fine for me -- kinda like Viagra, you take a pill half an hour before you want to be able to roll around and scream, then you can do that successfully for about four to six hours. It doesn't work for everyone, but it's an anti-histimine, so the worst that happens if it doesn't work is -- it doesn't work. Also, it's an old drug -- dirt cheap.
Other options include WB to go with an SRI-type drug. There are others, but I forget.
> 2. energy
It might be that you want to try something like Provigil to augment whatever you take.
> 3. focus
See note above.
> 4. motivation
> 5. depressionThese are likely to go together. At least for me, if I am depressed, I am unmotivated. (Unfortunately, the only times I'm really motivated are those times I'm in a state of semi-starvation. I suppose that could be an option -- but it's not a good one...)
> 6. anxiety
Cymbalta is very good for this. I'm told EMSAM is good for all these things, but I haven't tried it.
I hope that helps.
poster:Racer
thread:784322
URL: http://www.dr-bob.org/babble/20070919/msgs/784436.html