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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Pari on April 3, 2001, at 23:31:29
I am a diagnosed BP and have recently switched from Welbutrin to Paxil. My doc switched me to Paxil due to intense anxiety and loss of appetite I was having, and we thought some of it might be from the Welbutrin. I am now on my 6th or 7th week on Paxil 20mg and the anxiety has lessened. The problem is that I still can't seem to motivate myself on a consistent basis to do even basic life things (like eat and go to work) and have been resorting to trying to stay in bed to sleep it off. Of course I know this is irrational, and I want to change. Does the Paxil lower motivations along with anxiety?
Posted by Dubya on April 4, 2001, at 0:00:41
In reply to Paxil and motivation, posted by Pari on April 3, 2001, at 23:31:29
Well, I am taking a tricyclic (Anafranil/Clomipramine) for OCD, an anxiety disorder and mild depression. So far, some progress has been achieved. Anxiety is 20-35% less but, I am at a point where my motivation has driven down again. In fact, today, I was praying that I could get my motivation in check and not fear that I am going crazy. I had a choice btwn Clomipramine and PAxil, no Paxil though b/c, at the time, I was on an anti-histamine (for most of my life) so major side effects were possible. However, now that I quit my Claritin in FEb, I would really consider PAxil b/c I just want to feel good/like me. I feel a sense of 'laziness' like you are explaining. I hope mine goes away by switching drugs or, in a couple of days.
Posted by SalArmy4me on April 4, 2001, at 2:43:50
In reply to Paxil and motivation, posted by Pari on April 3, 2001, at 23:31:29
You gotta get up to at least 40 mg of Paxil in order to make a difference. 60 is possible, and I'm insane so I went on 80--but that really didn't make a difference from 60.
> I am a diagnosed BP and have recently switched from Welbutrin to Paxil. My doc switched me to Paxil due to intense anxiety and loss of appetite I was having, and we thought some of it might be from the Welbutrin. I am now on my 6th or 7th week on Paxil 20mg and the anxiety has lessened. The problem is that I still can't seem to motivate myself on a consistent basis to do even basic life things (like eat and go to work) and have been resorting to trying to stay in bed to sleep it off. Of course I know this is irrational, and I want to change. Does the Paxil lower motivations along with anxiety?
Posted by JohnL on April 5, 2001, at 16:05:31
In reply to Paxil and motivation, posted by Pari on April 3, 2001, at 23:31:29
> I am a diagnosed BP and have recently switched from Welbutrin to Paxil. My doc switched me to Paxil due to intense anxiety and loss of appetite I was having, and we thought some of it might be from the Welbutrin. I am now on my 6th or 7th week on Paxil 20mg and the anxiety has lessened. The problem is that I still can't seem to motivate myself on a consistent basis to do even basic life things (like eat and go to work) and have been resorting to trying to stay in bed to sleep it off. Of course I know this is irrational, and I want to change. Does the Paxil lower motivations along with anxiety?
The phenomenon of becoming emotionally numb is not uncommon with serotonin medicines like Paxil.
If someone has a depression that is being caused by low serotonin, then increasing serotonin will lift the depression and restore motivation. However, if the depression is not caused by low serotonin, then increasing serotonin can just make things numb. No lows, but no highs either. Not depressed, but not motivated either. No crying, but not much laughing either. Blahness.
In the clinical world this type of response is considered success, since it usually means the patient has improved at least 50%. In my thinking though anything less than total recovery is not acceptable. I actually think a lot of people who have been numbed by serotonin meds have been told they are now well, simply because they aren't depressed any more. I don't buy it.
What can be added to an antidepressant to correct the blah numbness? In my personal experience small doses of the antipsychotics Zyprexa, Risperdal, or Amisulpride work the best. They interact with serotonin, dopamine, and NE systems in ways that can enhance antidepressant efficacy. Other common choices include Wellbutrin, Ritalin, or Adderall. But those are probably not good choices if anxiety has been a problem. Mood stabilizers could be tried as well, but I've just noticed a lot more success stories with the small dose antipsychotic approach. Zyprexa by the way is not only good for depression and blahness, but it is approved for treating bipolar. In the first week sedation can be bothersome. After that it goes away. Appetite is increased and weight gain is common. But the joy of feeling alive is well worth gaining a few pounds, as I see it.
I'm just rambling but I hope there is something here that might be helpful. At this point in your therapy I would look no further than Zyprexa, Risperdal, or Amisulpride. Each could be sampled for a couple weeks each to discover which might be a favorite.
John
Posted by Pari on April 10, 2001, at 23:05:03
In reply to Re: Paxil and motivation, posted by JohnL on April 5, 2001, at 16:05:31
> The phenomenon of becoming emotionally numb is not uncommon with serotonin medicines like Paxil.
>
> If someone has a depression that is being caused by low serotonin, then increasing serotonin will lift the depression and restore motivation. However, if the depression is not caused by low serotonin, then increasing serotonin can just make things numb. No lows, but no highs either. Not depressed, but not motivated either. No crying, but not much laughing either. Blahness.
>
> In the clinical world this type of response is considered success, since it usually means the patient has improved at least 50%. In my thinking though anything less than total recovery is not acceptable. I actually think a lot of people who have been numbed by serotonin meds have been told they are now well, simply because they aren't depressed any more. I don't buy it.
>
> What can be added to an antidepressant to correct the blah numbness? In my personal experience small doses of the antipsychotics Zyprexa, Risperdal, or Amisulpride work the best. They interact with serotonin, dopamine, and NE systems in ways that can enhance antidepressant efficacy. Other common choices include Wellbutrin, Ritalin, or Adderall. But those are probably not good choices if anxiety has been a problem. Mood stabilizers could be tried as well, but I've just noticed a lot more success stories with the small dose antipsychotic approach. Zyprexa by the way is not only good for depression and blahness, but it is approved for treating bipolar. In the first week sedation can be bothersome. After that it goes away. Appetite is increased and weight gain is common. But the joy of feeling alive is well worth gaining a few pounds, as I see it.
>
> I'm just rambling but I hope there is something here that might be helpful. At this point in your therapy I would look no further than Zyprexa, Risperdal, or Amisulpride. Each could be sampled for a couple weeks each to discover which might be a favorite.
> JohnI have been feeling emotional numbness. When I laugh or smile, which is rare these days, it feels odd. Sometimes my eyes feel sunken and my face feels long most of the time. I have noticed that when I take a couple Trazadone (leftovers)my appetite increases (along with lethargy). My suicidal thoughts are less frequent but there is no joy in my life either. I have found myself watching television 4 to 8 hours a day. My doc just upped my dose of paxil to 30mg/day. What could the paxil be combined with to alleviate these symptoms?
Posted by bonnie_ann on April 11, 2001, at 10:38:00
In reply to Re: Paxil and motivation, posted by Pari on April 10, 2001, at 23:05:03
>
> > The phenomenon of becoming emotionally numb is not uncommon with serotonin medicines like Paxil.
> >
> > If someone has a depression that is being caused by low serotonin, then increasing serotonin will lift the depression and restore motivation. However, if the depression is not caused by low serotonin, then increasing serotonin can just make things numb. No lows, but no highs either. Not depressed, but not motivated either. No crying, but not much laughing either. Blahness.
> >
> > In the clinical world this type of response is considered success, since it usually means the patient has improved at least 50%. In my thinking though anything less than total recovery is not acceptable. I actually think a lot of people who have been numbed by serotonin meds have been told they are now well, simply because they aren't depressed any more. I don't buy it.
> >
> > What can be added to an antidepressant to correct the blah numbness? In my personal experience small doses of the antipsychotics Zyprexa, Risperdal, or Amisulpride work the best. They interact with serotonin, dopamine, and NE systems in ways that can enhance antidepressant efficacy. Other common choices include WellbutrinI am currently taking 20mg celexa and 75mg 2x a day- I'm wondering what dose of Wellbutrin you need to take to combat the flatness.
, Ritalin, or Adderall. But those are probably not good choices if anxiety has been a problem. Mood stabilizers could be tried as well, but I've just noticed a lot more success stories with the small dose antipsychotic approach. Zyprexa by the way is not only good for depression and blahness, but it is approved for treating bipolar. In the first week sedation can be bothersome. After that it goes away. Appetite is increased and weight gain is common. But the joy of feeling alive is well worth gaining a few pounds, as I see it.
> >
> > I'm just rambling but I hope there is something here that might be helpful. At this point in your therapy I would look no further than Zyprexa, Risperdal, or Amisulpride. Each could be sampled for a couple weeks each to discover which might be a favorite.
> > John
>
> I have been feeling emotional numbness. When I laugh or smile, which is rare these days, it feels odd. Sometimes my eyes feel sunken and my face feels long most of the time. I have noticed that when I take a couple Trazadone (leftovers)my appetite increases (along with lethargy). My suicidal thoughts are less frequent but there is no joy in my life either. I have found myself watching television 4 to 8 hours a day. My doc just upped my dose of paxil to 30mg/day. What could the paxil be combined with to alleviate these symptoms?
Posted by Kathy99 on April 14, 2001, at 11:35:45
In reply to Re: Paxil and motivation, posted by bonnie_ann on April 11, 2001, at 10:38:00
I never had emotional numbness on Paxil, but I found I did on other meds, like Buspar, and most recently, Celexa. I never felt as low as it sounds you are, however. I wonder is Paxil is the right med for you.... I thought it was mainly for slight depression, but suicidal depression?
I never had trouble with motivation on Paxil, either (although I did on Celexa). I have tons of energy to do all kinds of things, get my work done on time, and it's all accompanied with a feeling of "pleasure". Unlike the other stuff I've tried.
I just had the most horrible experience with Celexa, so I know what it feels like to be on the "right" med, and it was fairly obvious early on. The Paxil allowed me to do things I never thought I'd be able to do... I wonder why there are so few threads here about Paxil?
This is the end of the thread.
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