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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by afatchic on May 8, 2000, at 20:01:11
I've been so impressed with the intellect and knowledge displayed on this board. I need your recommendations. I've suffered from dysthimia all my life with lapses into major depression. I inherited the condition from my dad who self-medicated with alcohol until it killed him. I finally got up the courage and talked to a doctor I trusted. It really does help working in the medical field when you can get to know the doctors as people first. Here's my history: I started on trazadone in 1989, it took about 3 weeks but the results were wonderful. I felt "normal". I was able to experience happiness. After 4 years on trazadone, I had gained about 40 pounds even though I was a "health freak". I thought the weight gain was worth the emotional well-being but, being in the Air Force, the weight gain was ruining my career. I reluctantly switched to prozac, which worked just as well for me. I stopped having orgasms and stopped wanting to have sex but I didn't learn that it was caused by the Prozac until I'd taken it for 5 years (great for a marriage). That brings me up to the present. I've been on wellbutrin now for about a month and it doesn't seem to be working. I have noticed that I don't have much of desire to drink alcohol but that's the only positive change. Otherwise, I am so irritable! People in stores make me angry for petty things and I've been snapping at my husband and son. Does anyone have any advice for me? I'm looking for a drug that allows me to be happy, doesn't make me fat, doesn't make me frigid, and doesn't make me a witch. Anybody?
Posted by tina on May 8, 2000, at 20:09:51
In reply to EVERYONE! I need anew drug, posted by afatchic on May 8, 2000, at 20:01:11
People in stores usually deserve it.
Men need a good snapping every once in a while.
What's wrong with being fat, frigid and witchy??Only my opinion.
> I've been so impressed with the intellect and knowledge displayed on this board. I need your recommendations. I've suffered from dysthimia all my life with lapses into major depression. I inherited the condition from my dad who self-medicated with alcohol until it killed him. I finally got up the courage and talked to a doctor I trusted. It really does help working in the medical field when you can get to know the doctors as people first. Here's my history: I started on trazadone in 1989, it took about 3 weeks but the results were wonderful. I felt "normal". I was able to experience happiness. After 4 years on trazadone, I had gained about 40 pounds even though I was a "health freak". I thought the weight gain was worth the emotional well-being but, being in the Air Force, the weight gain was ruining my career. I reluctantly switched to prozac, which worked just as well for me. I stopped having orgasms and stopped wanting to have sex but I didn't learn that it was caused by the Prozac until I'd taken it for 5 years (great for a marriage). That brings me up to the present. I've been on wellbutrin now for about a month and it doesn't seem to be working. I have noticed that I don't have much of desire to drink alcohol but that's the only positive change. Otherwise, I am so irritable! People in stores make me angry for petty things and I've been snapping at my husband and son. Does anyone have any advice for me? I'm looking for a drug that allows me to be happy, doesn't make me fat, doesn't make me frigid, and doesn't make me a witch. Anybody?
Posted by Mark H. on May 8, 2000, at 23:42:16
In reply to Re: EVERYONE! I need anew drug, posted by tina on May 8, 2000, at 20:09:51
Wellbutrin was one of the worst drugs I tried -- creating confabulations of memory that were quite embarrassing. Also just came THIS CLOSE to costing a buddy of mine his job; he quit Wellbutrin and his productivity resumed within about 5 days. It treats some people well, but make no mistake that it is completely wrong for some of us.
Your list cannot be filled at this time, my friend. You'll have to pick and choose. Effexor works really well for me, but I eat like a vacuum cleaner. I estimate that up to 75 percent of the people on this list are looking for an effective AD that doesn't destroy memory, mood, sexuality and the old waistline.
Dump the Wellbutrin and try something else. If you find anything legal and healthy for appetite, be sure to let us all know!
Much love,
Mark H.
Posted by AndrewB on May 9, 2000, at 3:30:31
In reply to EVERYONE! I need anew drug, posted by afatchic on May 8, 2000, at 20:01:11
For ideas go to the Tips section of this site and search for SSRI Sexual Dysfunction.
Posted by JohnL on May 9, 2000, at 4:57:34
In reply to EVERYONE! I need anew drug, posted by afatchic on May 8, 2000, at 20:01:11
It seems you have responded best so far to serotonin drugs, indicating that some serotonin chemistry is involved. That's probably why Wellbutrin hasn't worked out very well, since it is not a serotonin med.
With that in mind, I think it makes sense to explore all the serotonin options in search of your best match. I think you should only settle for long term commitment to any one of them after having compared all of them first. Normally I would suggest short comparison trials of 2 weeks each or so, but the sexual side effect issue kind of makes that unrealistic. That's because, in my experience anyway, a sexual side effect can take several weeks to disappear after discontinuing the drug. With me, for example, my total lack of sexual desire did not resolve until after being completely off Zoloft for 3 weeks. Only then did my sexual desire return to normal.
So I think you should try Celexa, Paxil, Zoloft, Effexor, and Luvox. Perhaps you could look at the year 2000 as the year you dedicated to comparing all the options for your best match. Six weeks each should give you a pretty good handle on each one of them. And again, I'm focusing on the serotonin meds because that's what has worked for you in the past.
After all is said and done, it might turn out that Prozac was the best all along. That wouldn't surprise me at all. Zoloft and Paxil in particular seem notorious for causing sexual side effects, while Prozac seems to do so the least. But you never would have known for sure without comparing.
If Prozac turned out to be the best match, then you could explore ways of treating the side effects. In short, to avoid the witchy and frigid syndrome, stick with meds in a class that has worked before for you...serotonin meds. To avoid the weight gain and sexual side effects, hopefully a best match in the class will be discovered. If not, then treat the side effects.
I wish there was an easier way! But hopefully adding some structure to the process will help.
JohnL
Posted by SLS on May 9, 2000, at 7:45:49
In reply to EVERYONE! I need anew drug, posted by afatchic on May 8, 2000, at 20:01:11
> I've been so impressed with the intellect and knowledge displayed on this board. I need your recommendations. I've suffered from dysthimia all my life with lapses into major depression. I inherited the condition from my dad who self-medicated with alcohol until it killed him. I finally got up the courage and talked to a doctor I trusted. It really does help working in the medical field when you can get to know the doctors as people first. Here's my history: I started on trazadone in 1989, it took about 3 weeks but the results were wonderful. I felt "normal". I was able to experience happiness. After 4 years on trazadone, I had gained about 40 pounds even though I was a "health freak". I thought the weight gain was worth the emotional well-being but, being in the Air Force, the weight gain was ruining my career. I reluctantly switched to prozac, which worked just as well for me. I stopped having orgasms and stopped wanting to have sex but I didn't learn that it was caused by the Prozac until I'd taken it for 5 years (great for a marriage). That brings me up to the present. I've been on wellbutrin now for about a month and it doesn't seem to be working. I have noticed that I don't have much of desire to drink alcohol but that's the only positive change. Otherwise, I am so irritable! People in stores make me angry for petty things and I've been snapping at my husband and son. Does anyone have any advice for me? I'm looking for a drug that allows me to be happy, doesn't make me fat, doesn't make me frigid, and doesn't make me a witch. Anybody?
Was the Prozac still working when you discontinued it?Does Wellbutrin do anything at all, positive or negative? Does it give you more energy? How much are you taking?
JohnL has given you a set of good suggestions. I would also check out the information described by AndrewB.
It seems that continuing to work with an SSRI or Effexor is indicated. Zoloft or Effexor are reasonable alternatives to Prozac.
Wellbutrin has actually been used to counteract the sexual dysfunction caused by these drugs, and can make for a good augmenting agent to boost the antidepressant effects of both Zoloft and Effexor. If Wellbutrin is not hurting you at all, and especially if it is helping with energy, you may want first try adding back an SSRI or Effexor.
I think I also read some posts suggesting that Viagra works well on an as-needed basis. Periactin or yohimbine are also possibilities, but I haven't seen anyone post anything about them.
Fix the depression.
Good luck.
- Scott
Posted by Noa on May 9, 2000, at 9:12:42
In reply to Re: EVERYONE! I need anew drug, posted by SLS on May 9, 2000, at 7:45:49
You may have already addressed this in an earlier thread, but have you had your thyroid checked? Also, sometimes it works to use two meds (or more) so that you do not have to take so much of an SSRI that causes sexual dysfunction. Ritalin has helped me (I also have double depression) as would other stimulants, I suppose.
Unfortunately, this is still very much a trial and error process, but at least you have a lot of options open to you.
Posted by stephanie l. on May 9, 2000, at 11:18:11
In reply to Re: EVERYONE! I need anew drug, posted by Noa on May 9, 2000, at 9:12:42
> You may have already addressed this in an earlier thread, but have you had your thyroid checked? Also, sometimes it works to use two meds (or more) so that you do not have to take so much of an SSRI that causes sexual dysfunction. Ritalin has helped me (I also have double depression) as would other stimulants, I suppose.
>
> Unfortunately, this is still very much a trial and error process, but at least you have a lot of options open to you.I have tried yohimbe for med-induced sexual pro blems. The good news is -- it worked -- right away. The bad news was that I had to take it at a dose that gave me side effects (dizziness, etc.) The dose that gave me side effects was quite small -- I am sensitive to "drugs." But the dose I was on might not be bad for other people.
Also --- it turned out that the yohimbe helps with my depression -- at a small dose --it's a stimulant. So -- it's been a good experiment (I am now going to try ginkgo for the sex problems.)stephanie l.
Posted by Andre Allard on May 10, 2000, at 3:37:22
In reply to EVERYONE! I need anew drug, posted by afatchic on May 8, 2000, at 20:01:11
> I've been so impressed with the intellect and knowledge displayed on this board. I need your recommendations. I've suffered from dysthimia all my life with lapses into major depression. I inherited the condition from my dad who self-medicated with alcohol until it killed him. I finally got up the courage and talked to a doctor I trusted. It really does help working in the medical field when you can get to know the doctors as people first. Here's my history: I started on trazadone in 1989, it took about 3 weeks but the results were wonderful. I felt "normal". I was able to experience happiness. After 4 years on trazadone, I had gained about 40 pounds even though I was a "health freak". I thought the weight gain was worth the emotional well-being but, being in the Air Force, the weight gain was ruining my career. I reluctantly switched to prozac, which worked just as well for me. I stopped having orgasms and stopped wanting to have sex but I didn't learn that it was caused by the Prozac until I'd taken it for 5 years (great for a marriage). That brings me up to the present. I've been on wellbutrin now for about a month and it doesn't seem to be working. I have noticed that I don't have much of desire to drink alcohol but that's the only positive change. Otherwise, I am so irritable! People in stores make me angry for petty things and I've been snapping at my husband and son. Does anyone have any advice for me? I'm looking for a drug that allows me to be happy, doesn't make me fat, doesn't make me frigid, and doesn't make me a witch. Anybody?
So you are looking for something that makes you happy, but doesn't make you fat, frigid or a witch. It seems you might have a bit of a problem. The thing is that AD's that do not cause weight gain tend to make you frigid and a witch (prozac, zoloft, effexor, wellbutrin). The AD's that do not make you frigid and a witch, at times, cause weight gain (serzone, remeron, paxil). This means you are looking for something in the middle. You might want to try a new class of meds called RIMA's (reversable inhibitor of manoamine oxidase). This class is similiar to the older MAOI's in its ability to alter the function of manoamine oxidase which in turn effects seritonin, norepinephrine and dopamine. The difference with the newer RIMA's is they do not interact with tyramine which means there is no restricted diet. The drug is called manerix. It is only available in Canada at this time (I do not know where you live). Something else you might want to try is Celexa, Luvox or even Zoloft. If one of these SSRI's makes you frigid, you can try adding trazadone at bedtime. I am on effexor which makes me frigid and a witch. When I take trazadone, as I have suggested, I am not frigid but am still a witch. Better than nothing I suppose. You can discuss these suggestions with the doc. Let us know how things turn out. Good luck!
Posted by Sherry on May 10, 2000, at 4:41:12
In reply to Re: EVERYONE! I need anew drug, posted by Andre Allard on May 10, 2000, at 3:37:22
Wellbutrin turned me into a witch from hell, but it did wonders for my libido. You may want to consider Serzone. I didn't gain one ounce on it, but it did not work for me either. As always, YMMV.
Posted by KarenB on May 10, 2000, at 12:34:45
In reply to EVERYONE! I need anew drug, posted by afatchic on May 8, 2000, at 20:01:11
I have read that Celexa does not reportedly have the sexual side effects of the other SSRIs. Since Trazadone and Prozac did work for your depression, you may want to give Celexa a try, it being in the same class.
There are many, many posts written over the past several weeks by the users of Celexa, if you want to check it out.
Good luck.
Hey, if you lose that 40 lbs, does that mean you'll be changing your handle?:)Maybe skinnychic?
Karen
Posted by harry b. on May 10, 2000, at 13:43:34
In reply to Re: EVERYONE! I need a new drug, posted by KarenB on May 10, 2000, at 12:34:45
> I have read that Celexa does not reportedly have the sexual side effects of the other SSRIs.
KarenB, afatchic, and anyone else-I can only speak of my own experience. Celexa has
made it impossible for me to reach orgasm. The doc
at the hospital who prescribed it told me that
Celexa was unlikely to cause sexual dysfunction.
I'm not alone, there have been several posts here
about Celexa and sexual side effects.FWIW, my therapist tells me it's a minor complaint
but I can't always view it from his perspective.
Posted by harry b. on May 10, 2000, at 14:04:18
In reply to Re: EVERYONE! I need anew drug, posted by stephanie l. on May 9, 2000, at 11:18:11
> I have tried yohimbe for med-induced sexual pro blems. The good news is -- it worked -- right away. The bad news was that I had to take it at a dose that gave me side effects (dizziness, etc.)
>
> stephanie l.stephanie- Can you tell me more about the yohimbe?
What dose did you take, and how often did you
take it?What 'brand' were you taking?
How soon did the desired effects occur?
Thanks
Posted by harry b. on May 10, 2000, at 15:42:25
In reply to Re: EVERYONE! I need anew drug-stephanie l., posted by harry b. on May 10, 2000, at 14:04:18
>
> > I have tried yohimbe for med-induced sexual pro blems. The good news is -- it worked -- right away. The bad news was that I had to take it at a dose that gave me side effects (dizziness, etc.)
> >
> > stephanie l.
>
> stephanie- Can you tell me more about the yohimbe?
>
> What dose did you take, and how often did you
> take it?
>
> What 'brand' were you taking?
>
> How soon did the desired effects occur?
>
> ThanksPS: hate to be a bother, but...
What med (AD?) was causing the problem?
Did you ask your doc about using yohimbe?
Thanks again
Posted by KarenB on May 10, 2000, at 18:08:15
In reply to Re: EVERYONE! I need a new drug, posted by harry b. on May 10, 2000, at 13:43:34
> > I have read that Celexa does not reportedly have the sexual side effects of the other SSRIs.
>
>
> KarenB, afatchic, and anyone else-
>
> I can only speak of my own experience. Celexa has
> made it impossible for me to reach orgasm. The doc
> at the hospital who prescribed it told me that
> Celexa was unlikely to cause sexual dysfunction.
> I'm not alone, there have been several posts here
> about Celexa and sexual side effects.
>
> FWIW, my therapist tells me it's a minor complaint
> but I can't always view it from his perspective.
>
>Harry: Inability to reach orgasm MINOR? I thinketh not.
afatchic: Please disregard the suggestion of Celexa - I have read at least three posts about weight gain from Celexa today and now Harry's post here about this "minor" side effect.
You may want to try one or more of the tricyclics, like Nortriptyline. It has different action altogether than what you have been on but it may be worth a try, nonetheless, as the side effects for you with SSRIs seem to be unacceptable. They would be for me.
Karen
Posted by SLS on May 11, 2000, at 7:19:01
In reply to Re: EVERYONE! I need anew drug, posted by stephanie l. on May 9, 2000, at 11:18:11
> I have tried yohimbe for med-induced sexual pro blems. The good news is -- it worked -- right away. The bad news was that I had to take it at a dose that gave me side effects (dizziness, etc.) The dose that gave me side effects was quite small -- I am sensitive to "drugs." But the dose I was on might not be bad for other people.
> Also --- it turned out that the yohimbe helps with my depression -- at a small dose --it's a stimulant. So -- it's been a good experiment (I am now going to try ginkgo for the sex problems.)
>
> stephanie l.
Hi Sephanie.
I had once considered using yohimbine as an adjunct for treating my depression. What other drugs were you taking at the time? How would you described how yohimbine affected you?Thanks.
Have you tried Ritalin?
If all else fails, you may want to look into Periactin (cyproheptadine).
Good luck.
- Scott
Posted by afatchic on May 11, 2000, at 7:40:07
In reply to Re: EVERYONE! I need anew drug, posted by Noa on May 9, 2000, at 9:12:42
Noa,
Yes, I've had my thyroid checked MANY times. Doctors always want to check it but they order a TSH and say it's in the normal range and that's the end of it. My last TSH was about 2 years ago, and it was 4.6. I do remember having a "panel" thyroid done many years ago and the T3 was abnormally low. The doctor said my T4 was normal, so it didn't matter. Could you direct me to a web site that could give me more complete information? Most of what I've read is the conservative medical "wisdom" that insists that as long as TSH falls in the normal range, there is nothing wrong with your thyroid. Please enlighten me. Thanks for listening.
> You may have already addressed this in an earlier thread, but have you had your thyroid checked? Also, sometimes it works to use two meds (or more) so that you do not have to take so much of an SSRI that causes sexual dysfunction. Ritalin has helped me (I also have double depression) as would other stimulants, I suppose.
>
> Unfortunately, this is still very much a trial and error process, but at least you have a lot of options open to you.
Posted by Noa on May 11, 2000, at 9:48:26
In reply to Re: EVERYONE! I need a new drug/thyroid?, posted by afatchic on May 11, 2000, at 7:40:07
Try this site:
www.thyroid-info.com
It is the site of Mary Shomon, author of Living Well with Hypothyroidism: What your doctor doesn't tell you that you need to know. I found both the book and the website helpful. I located my endocrinologist from her site, because she has a page where people can recommend endocrinologists who are up on the latest approaches to hypothyroidism.
A TSH of 4.6 sounds high to me. And if your T3 was low, even if your T4 was ok, that might also be a problem. Some people are missing an enzyme or protein (I am sorry, I don't remember which) that converts T4 to T3.
In any event, for many people, especially those of us with psychiatric issues, a TSH of 4.6 is way too high.
Also, look into the book, The Thyroid Solution by Ridha Arem. Both of these books are on Dr. Bob's Read page, which you can get to from the link at the top of this page.
This is the end of the thread.
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