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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Kathleen6674 on August 29, 2001, at 22:46:02
I've been on Celexa 20mgs a day, for just over two weeks.
I feel a little better - greater sense of well-being,
not as zombieish as I was prior to this, when I was on
Serzone (don't get me started on sleeping 14-16 hours a
night, leg cramps, and constantly being on the verge of
tears - that med was a colossal failure for me).I still feel "numbed out" (and not just sexually. What IS
it with SSRIs?) - I don't feel *as* depressed, although
I'm still waiting for the full effects to kick in - I know
it takes up to 8 weeks for that to happen. But anyway,
I still have little focus or motivation, have a very hard
time getting things started, which is a problem since
I'm trying to find a job. It's an enormous effort to start
anything, and then I never seem to get any momentum to
carry on through and finish things.I've had probs w/each of the anti-d's I've been on:
-Prozac, made me hypomanic, gained 30 pounds, sexual probs,
then numbed me out and stopped working as an anti-d-Wellbutrin, worked a *little* but gave me panic attacks,
jitters, GAD. Did help me shed 14 of the Prozac pounds before
side effects bothered me too much.Serzone - total zombie, *worse* than before; claustrophobia
after one beer, chronic leg cramps, muscle weakness
(could NOT exercise at all, hence gained some weight back).I've been told that Wellbutrin and Serzone are the only
ones that don't cause weight gain and sexual dysfunction
(or worse problems).Right now, I'm hoping the Celexa will work, but I'm wondering
what people have done to counteract the no motivation thing
and/or the weight thing and the sex thing.I'm starting to think I'll NEVER have a fully functioning
life - I can be suidical, but thin and orgasmic, motivated
but manic and fat and unable to cry, or a weak, hypersominiac
lump who sobs continuously.Someone tell me things can work, please!
Posted by Janelle on August 29, 2001, at 22:54:04
In reply to Motivation problems on Celexa, posted by Kathleen6674 on August 29, 2001, at 22:46:02
Things CAN work; please hang in there.
I was on Celexa for awhile, and went up to 40 mg on it. Unfortunately, it was sedating and gave me headaches, but I wonder if you up the dose if that would help? I think you're not even at the minimal therapeutic dose for Celexa. If I'm not mistaken, I think 40 mg is the "average". Maybe just increasing it would help lift you further?
You mentioned quite a few meds that you've tried, but not Paxil, Zoloft or Effexor ... if upping the Celexa does not work (and you'd have to give it some time at 40 mg/day), you may then want to consider one of those. Just suggestions.
Posted by Duda on August 30, 2001, at 15:56:13
In reply to Re: Motivation problems on Celexa » Kathleen6674, posted by Janelle on August 29, 2001, at 22:54:04
> If motivation continues to be lacking at 40 mgs of Celexa (50 mgs was my perfect doseage), ask your doctor about provigil, a cousin to the popular Amisulpride available overseas.
Posted by Duda on August 30, 2001, at 16:11:52
In reply to Re: Motivation problems on Celexa, posted by Duda on August 30, 2001, at 15:56:13
> > If motivation continues to be lacking at 40 mgs of Celexa (50 mgs was my perfect doseage), ask your doctor about provigil, a cousin to the popular Amisulpride available overseas.
I'm sorry, I meant Adrafinil, not Amisulpride.
Duda
Posted by JohnL on August 30, 2001, at 16:20:05
In reply to Motivation problems on Celexa, posted by Kathleen6674 on August 29, 2001, at 22:46:02
>
> I still feel "numbed out" (and not just sexually. What IS
> it with SSRIs?) - I don't feel *as* depressed, although
> I'm still waiting for the full effects to kick in - I know
> it takes up to 8 weeks for that to happen...
>Hi Kathleen,
Numbness from SSRIs isn't unusual. I think it happens more often than people like to admit. The least likely to do that is Prozac. Unfortunately I do understand you had some problems with Prozac.That emotional numbness can be dealt with though. Usually the addition of a norepinephrine drug or a dopamine drug will do the trick. The problem though is sifting through the vast array of choices to discover which of those drugs will work for you. Choosing ones with the easiest side effects might be a good way to narrow down the list.
The most anti-numbness drug I've ever tried is Adrafinil. Ritalin and Adderall did Ok for a few days before they pooped out and tolerance started to set in. The second most anti-numbness drug I've tried is Zyprexa at a low dose. But since weight gain is an issue you are concerned about, another choice that could be better for you than Zyprexa is Risperdal. Usually only a small dose, like 1mg or less, is enough to do the trick.
There are other drugs too, such as dopamine agonists, Amisulpride, or Sulpiride which can work marvelously for symptoms of numbness. They are not easy to get though, so I think Adrafinil and Risperdal are good candidates to try, in addition to your ongoing Celexa. If you find benefit with another drug, then you may well be able to reduce your dosage of Celexa as well.
I wish there was an easier way. But I did want to assure you that what you are experiencing is not unusual, and that it can be treated successfully. I experienced the same emotional numbness for way too many years. My current medication completely elminated that numbness. So believe me, I know where you're coming from.
John
Posted by Darby on August 30, 2001, at 21:49:51
In reply to Motivation problems on Celexa, posted by Kathleen6674 on August 29, 2001, at 22:46:02
Some recent studies have identified this phenomenon with long-term use of serotonin enhancing meds. There's a very interesting piece covering this subject with detailed case reports in the Vol 11/no.2/ 2001 issue of JOURNAL OF CHILD AND ADOLESCENT PSYCHOPHARMACOLOGY. For most of the subjects, reducing (not increasing) the dosage helped greatly. In the case of Celexa, halving dose to 10mg daily might help with motivation while preserving some of the antidepressant effects. There's a fine line between feeling "good" and wanting to be involved in the world on the one hand and feeling "nonchalant" and being unconcerned with and unconnected to the rest of the world.
Or, adding a small dose of a dopaminergic agent like bromocriptine, amantadine, pramipexole, or a stimulant might improve your situation.
Good luck.
Darby
Posted by SalArmy4me on August 30, 2001, at 21:59:36
In reply to Some Call It Frontal Lobe/Amotivational Syndrome, posted by Darby on August 30, 2001, at 21:49:51
I highly recommend Bromocriptine because of the nice feelings it gives me (in combo with moclobemide, though). It restores my drive and appetite.
Posted by Mitch on August 30, 2001, at 23:28:14
In reply to Some Call It Frontal Lobe/Amotivational Syndrome, posted by Darby on August 30, 2001, at 21:49:51
> Some recent studies have identified this phenomenon with long-term use of serotonin enhancing meds. There's a very interesting piece covering this subject with detailed case reports in the Vol 11/no.2/ 2001 issue of JOURNAL OF CHILD AND ADOLESCENT PSYCHOPHARMACOLOGY. For most of the subjects, reducing (not increasing) the dosage helped greatly. In the case of Celexa, halving dose to 10mg daily might help with motivation while preserving some of the antidepressant effects. There's a fine line between feeling "good" and wanting to be involved in the world on the one hand and feeling "nonchalant" and being unconcerned with and unconnected to the rest of the world.
>
> Or, adding a small dose of a dopaminergic agent like bromocriptine, amantadine, pramipexole, or a stimulant might improve your situation.
>
> Good luck.
>
> DarbyI was wondering when someone was going to find the words to describe the paradox I go through with SSri's. If I don't take them I feel bored to death, though with lessened cycling, but just a chronic blah dysthymia ensues, although I *can* be very reactive and emotional given the stimulus. If I do take them my mood cycling is aggravated, but I "get things done" and I am less anxious with more energy, although I can feel satisfied with doing nothing and just not care, and that doesn't feel right *either*.
Posted by Phil on August 31, 2001, at 7:10:38
In reply to Motivation problems on Celexa, posted by Kathleen6674 on August 29, 2001, at 22:46:02
Kathleen, What has finally worked for me after about 3 years of frustration is a combo of Celexa, Klonopin, Ritalin and Wellbutrin.
I'd give the Celexa some time and if you're still numbed out, talk to your doctor about possibly adding Ritalin.
I was on Paxil and Ritalin for a few years and while it worked, I still had a healthy case of apathy but the Ritalin did help in other ways.
It is very frustrating but something will do the trick.
I've also found that group therapy has helped tremendously. I had isolated so long that my thinking was getting weird. Group will straighten that out!!Push on,
Phil
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