Posted by JPHR on December 30, 2008, at 16:22:24
In reply to Re: Long-Term Users of SSRI's--Need Your Help » JPHR, posted by Bob on December 30, 2008, at 15:50:18
> Uhhh... so what was done to alleviate the apathy?
As I stated, other respondents already provided some useful advice, so I wasn't focusing on that issue in my post, especially since any actions taken to reduce/eliminate the symptoms successfully will vary over individuals (as the previous posts demonstrate).
But since you asked so politely, this is what I did: First, after speaking with my psychiatrist, I gradually reduced the dose of paroxetine (Paxil), which was at 60 mg; and he added 200 mg of buproprion (Welbutrin), which some studies (open-label and case studies, unfortunately) suggest may help. Because paroxetine has such a long half-life, it tskes several weeks (at least) to determine if dosage changes help.
In my case, even 10 mg caused too much fatigue: I still had an extremely difficult time getting up in the morning and was tired throughout the day. As for the apathy/avolition, I think there was some improvement, but it was difficult to be sure because I was so tired.
Thus, I stopped taking even the 10 mg dose a few weeks ago. I'm still withdrawing from the paroxetine, but I'm feeling well enough to contribute to this thread!! In other words, I'm less fatigued and apathetic, and feel much more motivated to tackle work-related and everyday chores (even with the fragmented sleep I'm getting, which probably is a result of the withdrawal).
However, I would not necessarily recommend this to anyone else: each person's physiology and psychological issues differ. I decided to go this route because my ability to function on paroxetine was so minimal. In other words, even if I develop problems because I'm no longer taking paroxetine (especially anxiety & depression), my functioning probably can't get any worse than if I had stayed on it.
If I'm wrong about this, then I'll try one of the non-SSRI medications that some research suggests do not lead to the apathy syndrome. Again, however, I know of no research on this issue that is well-controlled; and there also is a lot of variation among individuals. Thus, in the end, a trial-&-error approach (informed by whatever research is out there) must be used for each person.
poster:JPHR
thread:857586
URL: http://www.dr-bob.org/babble/20081223/msgs/871451.html