Posted by Conundrum on November 29, 2010, at 20:15:52
In reply to Need help approaching pdoc, posted by merpmerp on November 29, 2010, at 17:18:07
Frankly it sounds like SSRIs are not for you. Feeling thoughts of self harm are classic SSRI side effects. SO classic that Eli Lilly had to cover them up in the clinical trials before prozac was on the market and give ppl valium to calm them down. Apathy is common with lexapro as well. It really sounds like SSRIs are not for you and you need to let your doctor know that you don't like the way you feel on them. Fortunately there are other drugs that work via different mechanisms and might have positive effect for you.
All your side effects scream of too much serotonin. You should make your pdoc aware of this. I'm not sure what you are being treated for, but if its lethargic type of depression you should consider perhaps wellbutrin, remeron, tricyclics, or maybe even stimulants. If its anxiety, wellbutrin might help, but don't forget about benzos, also St. John's Wort might help if its a good brand, it probably won't push serotonin as hard as the SSRIs.
> As I expected, my doc does not want to let me decrease to 2.5 mg Lexapro. However, I would really, really like to give it a try. (Currently at 5 mg, have been on 10 mg in the past.) The doc says 2.5 mg is subtheraputic.
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> At 10 mg, I have experienced very frequent, violent, intrusive OCD-ish thoughts, images of self-harm etc. I had that at 20 mg Prozac too. I had never had anything like that in my life prior to the meds. The doc says it's from the meds. These thoughts diminish but don't entirely disappear on 5 mg. Both Lex and Prozac also give me dose-dependent diarrhea. This never goes away unless I reduce the dose, and can be quite severe. I have been medically checked for any other cause; there seems to be none. 5 mg also gives me extreme apathy, lethargy, and extremely fuzzy brain which is not good for a grad student. I was on 5 mg for 4 months and this never went away.
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> So I'm about ready to kick Lex to the curb and try something else, but before I do that, it seems that a trial of 2.5 mg is the less drastic thing to do. (I am all for making small changes and waiting a long time to see how that goes, I would rather do that than try something riskier.)
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> How can I talk to her about this? Should I bring in any medical literature I can find on the subject of lower doses, or should I just repeatedly tell her what *I* feel and my symptoms? (I have, repeatedly and in writing, given her my list of symptoms along with a corresponding med chronology.)
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> What I do not want to do is just do a 2.5 mg trial without her consent, but I will consider this if I can't convince her.
Complaints: post-SSRI problems: anhedonia, memory and concentration problems, sexual dysfunction. )
Country:USA
Currently taking mirtazapine, tianeptine, and SAM-e
poster:Conundrum
thread:971808
URL: http://www.dr-bob.org/babble/20101117/msgs/971835.html