Posted by Iden on October 23, 2011, at 12:15:41
In reply to Can't tolerate meds,TIRED all the time, + Deplin, posted by zatar on October 19, 2011, at 9:03:21
> I have been diagnosed with Fibromyalgia and CFS......
> I can't tolerate any SSRIs due to mild serotonin
> syndrome; tried various SSRIs in low doses - all worsen
> insomnia, increase anxiety and cause agitation, increased
> muscle tension (which exacerbates FMS pain).
>
> Amitriptyline 5mg caused too much fatigue.......> Was on Desyrel years ago without many side
> effects, but did not get deep sleep ......> I could tolerate usual doses of amitriptyline and
> Remeron. Recent trials showed that I can't tolerate
> even 1/10th the dose. So I'm thinking it's not drug
> metabolism related, but the receptors have changed
> somehow......
> - Could Deplin be revving up my system too much and
> causing increased anxiety and fatigue?From a subsequent post:
> I've "sucked it up" quite a bit. Prozac was the worst 2
> months of my life. I give all my med trials at least 2-3
> months, but because of Prozac's long half life, I had
> serotonin syndrome for a LONG time. We're talking
> about 1/8-1/4 the usual dose. I actually wake up with
> jaw and neck muscle fasciculations when taking SSRIs.
Based on my personal experience with a number
of psychiatric drugs and not tolerating them well,
drug metabolism did come to mind.Your comment about Remeron is curious though.
You mention Prozac. The usual starting dose of
20 mg / day caused me considerable side effects
so I quit. Experiencing considerable depression,
I would begin again, same result. It eventually
occurred to me to try a partial dose. Prozac can be
dissolved in a given amount of water and portioned
out using a graduated cylinder. It keeps fine in the
refrigerator. Over time, I learned that if I was
going to re-start Prozac, I needed to start at 2 mg/ day
and over weeks work up to my max of 5 to 6 mg /day.
This is just one drug as an example.I eventually had an idea and made a list of all the
psychiatric drugs I had a problem with and then
sought to see how they were metabolized and see
what they might have in common.It turns out that liver enzymes P450 2D6 and/or
P450 2C19 can be the culprits if enzyme activity
is low or very low. Such people are called "poor
metabolizers."To explore this, if you haven't, try Googling
P450 poor metabolizer
P450 2D6 poor metabolizer
P450 2C19 poor metabolizerRegarding Deplin, it made me feel sick and I quit.
I tried again, same.
I tried 1/4 of a tablet / day. Made me feel bad.
I tried 1/4 of a tablet every other day and it
made me feel bad. The pdoc I see strongly
encouraged me to keep trying. It is hard to
keep taking something that makes me feel worse.Iden
poster:Iden
thread:1000203
URL: http://www.dr-bob.org/babble/20111016/msgs/1000601.html