![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by Cindylou on September 6, 2001, at 14:41:14
Hi,
I've tried Prozac on three different occasions, and every time I "hit a wall" after about two months. It just happened again.Out of desperation, I started Prozac again in June (nothing else was working -- all had horrible side effects. Tried Effexor, Paxil, Zoloft; combined with Wellbutrin to help the fatigue. I also tried adding Provigil for a day and felt like I had the worst hangover ever.) I thought maybe this time would be different.
I started out the Prozac really low -- 2.5 mg. -- since I am very med sensitive. This seemed to work well -- eventually I increased up to 10 mg.
I felt pretty good for a couple months, had energy, didn't need to nap, etc. I was even a bit agitated. But about a week ago -- WHAM. I hit that old familiar wall. I feel sick, exhausted, heavy-headed, can't focus, etc. It feels like there's a lead balloon in my head. This is the all-too-familiar feeling I get from SSRIs. I tried increasing the Prozac to see if that would work, but it only made it worse.
I am taking Wellbutrin, and tried increasing that a bit, but it didn't help. Tried some Adderall. Didn't help. NOTHING WILL CUT THROUGH THIS FOG.
I am so discouraged. Does anyone have suggestions for me???? Any good ideas for treatment of depression for people who feel this way on SSRIs???
Any MAOIs that don't cause horrible fatigue?? I've tried the tri-cyclics, and all had horrible side effects I couldn't tolerate.
I feel like I've tried everything but the MAOIs. Am a bit afraid of those.
Please, please help. Any suggestions are greatly appreciated. Feel like giving up.
cindy.
P.S. My diagnosis is depression and anxiety; not bipolar.
Posted by Zo on September 6, 2001, at 15:26:53
In reply to Prozac CRASH again -- Please help me., posted by Cindylou on September 6, 2001, at 14:41:14
Hi Cindylou, Didn't I post to you a while back the unhappy suggestion that you may have CFS? Anyway, that's the
vibe I get, reading you. Not that I would wish that dx on a living soul. Well, maybe my ex, but aside from him . ..Coincidentially, it kinda looks like ALL the symptoms of that wretched illness just got plucked out of my life. Disappeared, in 6 days on buprenorphine. After several decades sick, this is requiring a bit of an ADJUSTMENT, you can bet.
I'm really concerned, and would very much like to help. Let me know if you'd like to offlist.
Best,
Zo
Posted by fluffykitty on September 6, 2001, at 16:23:49
In reply to Re: Prozac CRASH again -- Please help me. » Cindylou, posted by Zo on September 6, 2001, at 15:26:53
> Hi Cindylou, Didn't I post to you a while back the unhappy suggestion that you may have CFS?
I found this very good web site about CFS and other things:
http://web.tampabay.rr.com/lymecfs/
Posted by Cindylou on September 6, 2001, at 18:56:00
In reply to Re: Prozac CRASH again -- Please help me. » Cindylou, posted by Zo on September 6, 2001, at 15:26:53
Hi Zo,
You never mentioned to me that I might have CFS -- however, I have suspected for years that I might have it. Can you get a blood test for it? I asked a doctor test me for it about 5 years ago, and the results came back negative. However, I'm not sure what kind of blood test he did to determine this. He was an ob/gyn, so may not have known exactly what to look for.It makes a lot of sense to me that I may have something like CFS since I react differently to every AD med out there than most people. They all seem to make me more tired.
I would love to hear from you, and appreciate your concern -- I'm at dmflaig@bignet.net (Sorry, I don't know how to make that a link.)
And by the way, CONGRATULATIONS on finding the med that works for you! It must be a strange, but welcome, feeling not being exhausted all of a sudden. I am truly happy for you.
-cindy
> Hi Cindylou, Didn't I post to you a while back the unhappy suggestion that you may have CFS? Anyway, that's the
> vibe I get, reading you. Not that I would wish that dx on a living soul. Well, maybe my ex, but aside from him . ..
>
> Coincidentially, it kinda looks like ALL the symptoms of that wretched illness just got plucked out of my life. Disappeared, in 6 days on buprenorphine. After several decades sick, this is requiring a bit of an ADJUSTMENT, you can bet.
>
> I'm really concerned, and would very much like to help. Let me know if you'd like to offlist.
>
> Best,
> Zo
Posted by ChrisK on September 7, 2001, at 3:00:52
In reply to Prozac CRASH again -- Please help me., posted by Cindylou on September 6, 2001, at 14:41:14
OK, here's my humble suggestion. Since the Prozac worked at one time augment it with either Zyprexa or possiblly Naltrexone. You can continue the Prozac while trying the other two. There is a lot of anecdotal evedence on the site that supports both of these as good augmentors.
Best of luck,
Chris
> Hi,
> I've tried Prozac on three different occasions, and every time I "hit a wall" after about two months. It just happened again.
>
> Out of desperation, I started Prozac again in June (nothing else was working -- all had horrible side effects. Tried Effexor, Paxil, Zoloft; combined with Wellbutrin to help the fatigue. I also tried adding Provigil for a day and felt like I had the worst hangover ever.) I thought maybe this time would be different.
>
> I started out the Prozac really low -- 2.5 mg. -- since I am very med sensitive. This seemed to work well -- eventually I increased up to 10 mg.
>
> I felt pretty good for a couple months, had energy, didn't need to nap, etc. I was even a bit agitated. But about a week ago -- WHAM. I hit that old familiar wall. I feel sick, exhausted, heavy-headed, can't focus, etc. It feels like there's a lead balloon in my head. This is the all-too-familiar feeling I get from SSRIs. I tried increasing the Prozac to see if that would work, but it only made it worse.
>
> I am taking Wellbutrin, and tried increasing that a bit, but it didn't help. Tried some Adderall. Didn't help. NOTHING WILL CUT THROUGH THIS FOG.
>
> I am so discouraged. Does anyone have suggestions for me???? Any good ideas for treatment of depression for people who feel this way on SSRIs???
>
> Any MAOIs that don't cause horrible fatigue?? I've tried the tri-cyclics, and all had horrible side effects I couldn't tolerate.
>
> I feel like I've tried everything but the MAOIs. Am a bit afraid of those.
>
> Please, please help. Any suggestions are greatly appreciated. Feel like giving up.
>
> cindy.
>
> P.S. My diagnosis is depression and anxiety; not bipolar.
Posted by JohnL on September 7, 2001, at 4:40:27
In reply to Prozac CRASH again -- Please help me., posted by Cindylou on September 6, 2001, at 14:41:14
You asked for suggestions. Here's a good one. Zyprexa. Believe me, Zyprexa and Prozac together can be wonderful, as shown in both anecdotal evidence and in clinical evidence. The two together are far better than either alone, kind of like the sum is greater than the parts added together, if that makes any sense. All of the symptoms you have described are symptoms that generally respond very well to Zyprexa. Because it is called an antipsychotic, don't let that scare you. It has a wide range of good benefits spanning the entire psychiatric symptom scale, and it is great for all kinds of things besides just schizophrenia. So don't let the name get in the way. It is a wonderful drug, as most people who have tried it will confirm. The only drawback seems to be likely weight gain, which can be controlled with careful eating habits.
Just my opinion, but do not stop the Prozac and do not try anything else. Simply add 2.5mg Zyprexa at dinner time, and after a week or so go up to 5mg. Don't waste your time doing anything else until this has been tried first. If in the unlikely situation it does not prove good to you, then my second choice would be Risperdal in addition to the Prozac.
Of course, mileage varies. But that is exactly why I am suggesting Zyprexa. Zyprexa tends to provide excellent mileage. In this hit and miss game, I think it makes sense to go with something that has the highest odds for success. Zyprexa fits that description.
Sure there are plenty of other choices. I mean, such as Remeron, tricyclics, MAOIs, on and on and on. Forget them all for now. Go straight to Zyprexa. It has the highest performance and the highest mileage, in my opinion based on casual observation, anecdotal evidence, clinical evidence, and personal experience.
John> Hi,
> I've tried Prozac on three different occasions, and every time I "hit a wall" after about two months. It just happened again.
>
> Out of desperation, I started Prozac again in June (nothing else was working -- all had horrible side effects. Tried Effexor, Paxil, Zoloft; combined with Wellbutrin to help the fatigue. I also tried adding Provigil for a day and felt like I had the worst hangover ever.) I thought maybe this time would be different.
>
> I started out the Prozac really low -- 2.5 mg. -- since I am very med sensitive. This seemed to work well -- eventually I increased up to 10 mg.
>
> I felt pretty good for a couple months, had energy, didn't need to nap, etc. I was even a bit agitated. But about a week ago -- WHAM. I hit that old familiar wall. I feel sick, exhausted, heavy-headed, can't focus, etc. It feels like there's a lead balloon in my head. This is the all-too-familiar feeling I get from SSRIs. I tried increasing the Prozac to see if that would work, but it only made it worse.
>
> I am taking Wellbutrin, and tried increasing that a bit, but it didn't help. Tried some Adderall. Didn't help. NOTHING WILL CUT THROUGH THIS FOG.
>
> I am so discouraged. Does anyone have suggestions for me???? Any good ideas for treatment of depression for people who feel this way on SSRIs???
>
> Any MAOIs that don't cause horrible fatigue?? I've tried the tri-cyclics, and all had horrible side effects I couldn't tolerate.
>
> I feel like I've tried everything but the MAOIs. Am a bit afraid of those.
>
> Please, please help. Any suggestions are greatly appreciated. Feel like giving up.
>
> cindy.
>
> P.S. My diagnosis is depression and anxiety; not bipolar.
Posted by jay on September 7, 2001, at 9:08:51
In reply to Re: Prozac CRASH again -- Please help me., posted by JohnL on September 7, 2001, at 4:40:27
In his excellent book 'Noonday Demon', Andrew Solomon (sp?) talks of some amazing success with Zyprexa for agitated depression. (I would say agitation is a massive part of depression, and is linked to anxiety, although doctors and people seem to seperate the two. I see agitation as amplified anxiety, then amplified to psychosis. So, in this chain, since Zyprexa is a atypical antipsychotic, it can bring down the agitation, and hence bring down the anxiety.) In N. America, I agree Zyprexa, and Risperdal (which I am on, and has worked wonders, compared to where I was, for many months) are the two best atypical antipsychotics. There are some new ones I am not familiar with (Zisperdone sp??), and even though I found Seroquel to work somewhat, it seemed to need at least 3x a day dosing, and with the fluctuating blood level, I think makes it less effective. Plus, there are still unanswered concerns about cataracts and low thyroid, which have not been a problem with the others. In fact, I think Seroquel, in small doses, might be good for PRN 'breakthroughs'. I still have a small stash, and find it more effective then benzos to put me to sleep if needed.Anyhow, just my opinion. YMMV...etc. Keep the faith..it CAN get better, and with some trials with the mentioned meds, you likely will be on the road to recovery much quicker then imagined.
Jay
> You asked for suggestions. Here's a good one. Zyprexa. Believe me, Zyprexa and Prozac together can be wonderful, as shown in both anecdotal evidence and in clinical evidence. The two together are far better than either alone, kind of like the sum is greater than the parts added together, if that makes any sense. All of the symptoms you have described are symptoms that generally respond very well to Zyprexa. Because it is called an antipsychotic, don't let that scare you. It has a wide range of good benefits spanning the entire psychiatric symptom scale, and it is great for all kinds of things besides just schizophrenia. So don't let the name get in the way. It is a wonderful drug, as most people who have tried it will confirm. The only drawback seems to be likely weight gain, which can be controlled with careful eating habits.
>
> Just my opinion, but do not stop the Prozac and do not try anything else. Simply add 2.5mg Zyprexa at dinner time, and after a week or so go up to 5mg. Don't waste your time doing anything else until this has been tried first. If in the unlikely situation it does not prove good to you, then my second choice would be Risperdal in addition to the Prozac.
>
> Of course, mileage varies. But that is exactly why I am suggesting Zyprexa. Zyprexa tends to provide excellent mileage. In this hit and miss game, I think it makes sense to go with something that has the highest odds for success. Zyprexa fits that description.
>
> Sure there are plenty of other choices. I mean, such as Remeron, tricyclics, MAOIs, on and on and on. Forget them all for now. Go straight to Zyprexa. It has the highest performance and the highest mileage, in my opinion based on casual observation, anecdotal evidence, clinical evidence, and personal experience.
>
> John
>
> > Hi,
> > I've tried Prozac on three different occasions, and every time I "hit a wall" after about two months. It just happened again.
> >
> > Out of desperation, I started Prozac again in June (nothing else was working -- all had horrible side effects. Tried Effexor, Paxil, Zoloft; combined with Wellbutrin to help the fatigue. I also tried adding Provigil for a day and felt like I had the worst hangover ever.) I thought maybe this time would be different.
> >
> > I started out the Prozac really low -- 2.5 mg. -- since I am very med sensitive. This seemed to work well -- eventually I increased up to 10 mg.
> >
> > I felt pretty good for a couple months, had energy, didn't need to nap, etc. I was even a bit agitated. But about a week ago -- WHAM. I hit that old familiar wall. I feel sick, exhausted, heavy-headed, can't focus, etc. It feels like there's a lead balloon in my head. This is the all-too-familiar feeling I get from SSRIs. I tried increasing the Prozac to see if that would work, but it only made it worse.
> >
> > I am taking Wellbutrin, and tried increasing that a bit, but it didn't help. Tried some Adderall. Didn't help. NOTHING WILL CUT THROUGH THIS FOG.
> >
> > I am so discouraged. Does anyone have suggestions for me???? Any good ideas for treatment of depression for people who feel this way on SSRIs???
> >
> > Any MAOIs that don't cause horrible fatigue?? I've tried the tri-cyclics, and all had horrible side effects I couldn't tolerate.
> >
> > I feel like I've tried everything but the MAOIs. Am a bit afraid of those.
> >
> > Please, please help. Any suggestions are greatly appreciated. Feel like giving up.
> >
> > cindy.
> >
> > P.S. My diagnosis is depression and anxiety; not bipolar.
Posted by Cindylou on September 7, 2001, at 13:56:01
In reply to Prozac CRASH again -- Please help me., posted by Cindylou on September 6, 2001, at 14:41:14
Thank you everyone for your feedback, and for giving me hope. I will take all of your suggestions to my pdoc on Wednesday. I cut the Prozac down to 5 mg. for now -- still feel tired and have to nap, but don't feel as disoriented and don't have as much "lead/fog in the head." I'll keep you posted on what I end up doing.
Any more ideas are welcome -- the more the merrier!
Thanks again,
Cindy> Hi,
> I've tried Prozac on three different occasions, and every time I "hit a wall" after about two months. It just happened again.
>
> Out of desperation, I started Prozac again in June (nothing else was working -- all had horrible side effects. Tried Effexor, Paxil, Zoloft; combined with Wellbutrin to help the fatigue. I also tried adding Provigil for a day and felt like I had the worst hangover ever.) I thought maybe this time would be different.
>
> I started out the Prozac really low -- 2.5 mg. -- since I am very med sensitive. This seemed to work well -- eventually I increased up to 10 mg.
>
> I felt pretty good for a couple months, had energy, didn't need to nap, etc. I was even a bit agitated. But about a week ago -- WHAM. I hit that old familiar wall. I feel sick, exhausted, heavy-headed, can't focus, etc. It feels like there's a lead balloon in my head. This is the all-too-familiar feeling I get from SSRIs. I tried increasing the Prozac to see if that would work, but it only made it worse.
>
> I am taking Wellbutrin, and tried increasing that a bit, but it didn't help. Tried some Adderall. Didn't help. NOTHING WILL CUT THROUGH THIS FOG.
>
> I am so discouraged. Does anyone have suggestions for me???? Any good ideas for treatment of depression for people who feel this way on SSRIs???
>
> Any MAOIs that don't cause horrible fatigue?? I've tried the tri-cyclics, and all had horrible side effects I couldn't tolerate.
>
> I feel like I've tried everything but the MAOIs. Am a bit afraid of those.
>
> Please, please help. Any suggestions are greatly appreciated. Feel like giving up.
>
> cindy.
>
> P.S. My diagnosis is depression and anxiety; not bipolar.
Posted by Cindylou on September 12, 2001, at 22:04:40
In reply to Re: Prozac CRASH again -- Thank you., posted by Cindylou on September 7, 2001, at 13:56:01
Well, I saw my pdoc today and shared all of your suggestions with her. She was very responsive to all of them ... and I almost took home a sample of Risperdal to start trying. (Since I get very fatigued on most medications, she thought Risperdal would be a better choice than Zyprexa).
But just before I left, she said that HER first choice for me would be to try a low dose of Lithium! Just the name Lithium scares me -- it sounds like we're pulling out the "big guns" now.
Her reasoning makes sense -- I do have these swings in mood -- but not "highs" or manias. For me, I may feel good (e.g., like a normal person, with normal energy and motivation) for a few days, maybe a week if I'm lucky -- but the feeling never lasts. I always spiral downward again (feeling tired, weary, lethargic, etc.) usually for a few weeks. Then I might feel some relief for a few days again ... and the cycle continues. It often seems related to PMS, but sometimes there is no rhyme or reason to it.
So... I agreed to try it, even though it scares me. My doc has been with me for a year now, and she has been wonderfully open with me, trying out my suggestions and listening to the information I bring her. Best of all, she hasn't given up on me.
I would love to hear from anyone who has tried Lithium, to see if it helped or not. I would only take about 300 mg a day, in addition to my 5 mg. Prozac and 150 mg. Wellbutrin. (I am very med sensitive, that's why the doses are so low).
Thanks for everything,
cindy> Thank you everyone for your feedback, and for giving me hope. I will take all of your suggestions to my pdoc on Wednesday. I cut the Prozac down to 5 mg. for now -- still feel tired and have to nap, but don't feel as disoriented and don't have as much "lead/fog in the head." I'll keep you posted on what I end up doing.
>
> Any more ideas are welcome -- the more the merrier!
> Thanks again,
> Cindy
>
> > Hi,
> > I've tried Prozac on three different occasions, and every time I "hit a wall" after about two months. It just happened again.
> >
> > Out of desperation, I started Prozac again in June (nothing else was working -- all had horrible side effects. Tried Effexor, Paxil, Zoloft; combined with Wellbutrin to help the fatigue. I also tried adding Provigil for a day and felt like I had the worst hangover ever.) I thought maybe this time would be different.
> >
> > I started out the Prozac really low -- 2.5 mg. -- since I am very med sensitive. This seemed to work well -- eventually I increased up to 10 mg.
> >
> > I felt pretty good for a couple months, had energy, didn't need to nap, etc. I was even a bit agitated. But about a week ago -- WHAM. I hit that old familiar wall. I feel sick, exhausted, heavy-headed, can't focus, etc. It feels like there's a lead balloon in my head. This is the all-too-familiar feeling I get from SSRIs. I tried increasing the Prozac to see if that would work, but it only made it worse.
> >
> > I am taking Wellbutrin, and tried increasing that a bit, but it didn't help. Tried some Adderall. Didn't help. NOTHING WILL CUT THROUGH THIS FOG.
> >
> > I am so discouraged. Does anyone have suggestions for me???? Any good ideas for treatment of depression for people who feel this way on SSRIs???
> >
> > Any MAOIs that don't cause horrible fatigue?? I've tried the tri-cyclics, and all had horrible side effects I couldn't tolerate.
> >
> > I feel like I've tried everything but the MAOIs. Am a bit afraid of those.
> >
> > Please, please help. Any suggestions are greatly appreciated. Feel like giving up.
> >
> > cindy.
> >
> > P.S. My diagnosis is depression and anxiety; not bipolar.
Posted by Cindylou on September 13, 2001, at 7:20:48
In reply to Re: Prozac CRASH again -- Thank you., posted by Cindylou on September 7, 2001, at 13:56:01
Hi,
Just a note -- I was reading the above post about generic vs. authentic Prozac. At first I didn't really follow it because I was convinced they were the same. But this "crash" happened about two weeks or so after switching to generic.Hmmmmmmmmm....
cindy> Thank you everyone for your feedback, and for giving me hope. I will take all of your suggestions to my pdoc on Wednesday. I cut the Prozac down to 5 mg. for now -- still feel tired and have to nap, but don't feel as disoriented and don't have as much "lead/fog in the head." I'll keep you posted on what I end up doing.
>
> Any more ideas are welcome -- the more the merrier!
> Thanks again,
> Cindy
>
> > Hi,
> > I've tried Prozac on three different occasions, and every time I "hit a wall" after about two months. It just happened again.
> >
> > Out of desperation, I started Prozac again in June (nothing else was working -- all had horrible side effects. Tried Effexor, Paxil, Zoloft; combined with Wellbutrin to help the fatigue. I also tried adding Provigil for a day and felt like I had the worst hangover ever.) I thought maybe this time would be different.
> >
> > I started out the Prozac really low -- 2.5 mg. -- since I am very med sensitive. This seemed to work well -- eventually I increased up to 10 mg.
> >
> > I felt pretty good for a couple months, had energy, didn't need to nap, etc. I was even a bit agitated. But about a week ago -- WHAM. I hit that old familiar wall. I feel sick, exhausted, heavy-headed, can't focus, etc. It feels like there's a lead balloon in my head. This is the all-too-familiar feeling I get from SSRIs. I tried increasing the Prozac to see if that would work, but it only made it worse.
> >
> > I am taking Wellbutrin, and tried increasing that a bit, but it didn't help. Tried some Adderall. Didn't help. NOTHING WILL CUT THROUGH THIS FOG.
> >
> > I am so discouraged. Does anyone have suggestions for me???? Any good ideas for treatment of depression for people who feel this way on SSRIs???
> >
> > Any MAOIs that don't cause horrible fatigue?? I've tried the tri-cyclics, and all had horrible side effects I couldn't tolerate.
> >
> > I feel like I've tried everything but the MAOIs. Am a bit afraid of those.
> >
> > Please, please help. Any suggestions are greatly appreciated. Feel like giving up.
> >
> > cindy.
> >
> > P.S. My diagnosis is depression and anxiety; not bipolar.
Posted by pellmell on September 13, 2001, at 10:49:27
In reply to Re: Prozac CRASH --pdoc suggests LITHIUM?!, posted by Cindylou on September 12, 2001, at 22:04:40
> I would love to hear from anyone who has tried Lithium, to see if it helped or not. I would only take about 300 mg a day, in addition to my 5 mg. Prozac and 150 mg. Wellbutrin. (I am very med sensitive, that's why the doses are so low).
>When my first diagnosed major depressive episode was uh, diagnosed, my first pdoc (who I only saw once...there's a story there) put me on Zoloft. I worked with my second pdoc after that, working all the way up to 200mg, which as you probably know is the max recommended dose of the stuff. I still wasn't getting a good response. So my pdoc added lithium. I think the dose was one 300mg capsule in the morning and two at night with the Zoloft.
Anyway, three days after I started taking it my depression began to lift, and within a couple of weeks I was feeling whole again.
Those whose job it is to guess about these things hypothesize that lithium works farther down the cascade than the reuptake inhibitors, at the "second messenger" level (the second messenger is the message to the neuron's nucleus resulting from the interaction between a nurotransmitter and its receptor). Which is a good thing: future psychaitric meds will most likely be targeted at that level and below.
Anyway, lithium was just what I needed. I hope it works for you as well. Oh, one tip, which your doc probably already gave you: keep yourself hydrated. Lithium's an inorganic salt, and has a bit of a diuretic affect.
-pm
Posted by Cindylou on September 14, 2001, at 15:21:54
In reply to Re: Prozac CRASH --pdoc suggests LITHIUM?! » Cindylou, posted by pellmell on September 13, 2001, at 10:49:27
Dear PM,
Thanks so much for your response. You gave me the courage to fill the prescription and take my first dose of the Lithium. HOWEVER ...I feel so lousy today I can't continue it :(. I am the worst person when it comes to side effects; very few meds are "kind" to me.
So, on to my next trial -- Risperdal. I'll wait a few days for this Lithium to leave my system.
Thanks again for your support,
- cindy
> > I would love to hear from anyone who has tried Lithium, to see if it helped or not. I would only take about 300 mg a day, in addition to my 5 mg. Prozac and 150 mg. Wellbutrin. (I am very med sensitive, that's why the doses are so low).
> >
>
> When my first diagnosed major depressive episode was uh, diagnosed, my first pdoc (who I only saw once...there's a story there) put me on Zoloft. I worked with my second pdoc after that, working all the way up to 200mg, which as you probably know is the max recommended dose of the stuff. I still wasn't getting a good response. So my pdoc added lithium. I think the dose was one 300mg capsule in the morning and two at night with the Zoloft.
>
> Anyway, three days after I started taking it my depression began to lift, and within a couple of weeks I was feeling whole again.
>
> Those whose job it is to guess about these things hypothesize that lithium works farther down the cascade than the reuptake inhibitors, at the "second messenger" level (the second messenger is the message to the neuron's nucleus resulting from the interaction between a nurotransmitter and its receptor). Which is a good thing: future psychaitric meds will most likely be targeted at that level and below.
>
> Anyway, lithium was just what I needed. I hope it works for you as well. Oh, one tip, which your doc probably already gave you: keep yourself hydrated. Lithium's an inorganic salt, and has a bit of a diuretic affect.
>
> -pm
Posted by Emme on September 16, 2001, at 9:55:32
In reply to Re: Prozac CRASH --pdoc suggests LITHIUM?! » pellmell, posted by Cindylou on September 14, 2001, at 15:21:54
Hi Cindylou,
What dose of Lithium did you try? I too am extremely sensitive to meds. At one point my doctor convinced me to try Li. I lasted four days, a couple of days at 150 mg, then up to 300. At the end of that four days I seemed less depressed. But, I was totally knocked out and missed 2 days of work. So I discontinued the Lithium. My thinking is that at some point I may need to try it again, but I will try a much much smaller dose. A "hamster" dose, as my doctor would say, and see what happens. For those of us that are so sensitive, a crumb of medicine might do the trick, or at least titrating up from a tiny speck. I've gotten good at slicing tablets into wee bits with a pill slicer. :) Good luck.
Emme> Dear PM,
> Thanks so much for your response. You gave me the courage to fill the prescription and take my first dose of the Lithium. HOWEVER ...
>
> I feel so lousy today I can't continue it :(. I am the worst person when it comes to side effects; very few meds are "kind" to me.
>
> So, on to my next trial -- Risperdal. I'll wait a few days for this Lithium to leave my system.
>
> Thanks again for your support,
> - cindy
>
>
> > > I would love to hear from anyone who has tried Lithium, to see if it helped or not. I would only take about 300 mg a day, in addition to my 5 mg. Prozac and 150 mg. Wellbutrin. (I am very med sensitive, that's why the doses are so low).
> > >
> >
> > When my first diagnosed major depressive episode was uh, diagnosed, my first pdoc (who I only saw once...there's a story there) put me on Zoloft. I worked with my second pdoc after that, working all the way up to 200mg, which as you probably know is the max recommended dose of the stuff. I still wasn't getting a good response. So my pdoc added lithium. I think the dose was one 300mg capsule in the morning and two at night with the Zoloft.
> >
> > Anyway, three days after I started taking it my depression began to lift, and within a couple of weeks I was feeling whole again.
> >
> > Those whose job it is to guess about these things hypothesize that lithium works farther down the cascade than the reuptake inhibitors, at the "second messenger" level (the second messenger is the message to the neuron's nucleus resulting from the interaction between a nurotransmitter and its receptor). Which is a good thing: future psychaitric meds will most likely be targeted at that level and below.
> >
> > Anyway, lithium was just what I needed. I hope it works for you as well. Oh, one tip, which your doc probably already gave you: keep yourself hydrated. Lithium's an inorganic salt, and has a bit of a diuretic affect.
> >
> > -pm
Posted by Cindylou on September 16, 2001, at 11:22:32
In reply to Re: Prozac CRASH --pdoc suggests LITHIUM?! » Cindylou, posted by Emme on September 16, 2001, at 9:55:32
Hi Emme,
Thanks so much for your response ... it's good to know there's someone else out there like me who is so med-sensitive. It definitely makes things more difficult.I took 150 mg. of Lithium at night, and was supposed to take another 150 mg. the next morning, but I felt too horrible just from that dose I took the night before. I knew it was no use trying to keep it up, just from past experience -- there have been too many wasted days and weeks, even months, waiting for side effects from various meds to subside (when normally they don't subside for me; at least not much.)
Do you mind me asking what meds you are on now (if any?) I'm very curious to see what has worked for you.
Thanks again,
cindy
> Hi Cindylou,
>
> What dose of Lithium did you try? I too am extremely sensitive to meds. At one point my doctor convinced me to try Li. I lasted four days, a couple of days at 150 mg, then up to 300. At the end of that four days I seemed less depressed. But, I was totally knocked out and missed 2 days of work. So I discontinued the Lithium. My thinking is that at some point I may need to try it again, but I will try a much much smaller dose. A "hamster" dose, as my doctor would say, and see what happens. For those of us that are so sensitive, a crumb of medicine might do the trick, or at least titrating up from a tiny speck. I've gotten good at slicing tablets into wee bits with a pill slicer. :) Good luck.
> Emme
>
>
>
> > Dear PM,
> > Thanks so much for your response. You gave me the courage to fill the prescription and take my first dose of the Lithium. HOWEVER ...
> >
> > I feel so lousy today I can't continue it :(. I am the worst person when it comes to side effects; very few meds are "kind" to me.
> >
> > So, on to my next trial -- Risperdal. I'll wait a few days for this Lithium to leave my system.
> >
> > Thanks again for your support,
> > - cindy
> >
> >
> > > > I would love to hear from anyone who has tried Lithium, to see if it helped or not. I would only take about 300 mg a day, in addition to my 5 mg. Prozac and 150 mg. Wellbutrin. (I am very med sensitive, that's why the doses are so low).
> > > >
> > >
> > > When my first diagnosed major depressive episode was uh, diagnosed, my first pdoc (who I only saw once...there's a story there) put me on Zoloft. I worked with my second pdoc after that, working all the way up to 200mg, which as you probably know is the max recommended dose of the stuff. I still wasn't getting a good response. So my pdoc added lithium. I think the dose was one 300mg capsule in the morning and two at night with the Zoloft.
> > >
> > > Anyway, three days after I started taking it my depression began to lift, and within a couple of weeks I was feeling whole again.
> > >
> > > Those whose job it is to guess about these things hypothesize that lithium works farther down the cascade than the reuptake inhibitors, at the "second messenger" level (the second messenger is the message to the neuron's nucleus resulting from the interaction between a nurotransmitter and its receptor). Which is a good thing: future psychaitric meds will most likely be targeted at that level and below.
> > >
> > > Anyway, lithium was just what I needed. I hope it works for you as well. Oh, one tip, which your doc probably already gave you: keep yourself hydrated. Lithium's an inorganic salt, and has a bit of a diuretic affect.
> > >
> > > -pm
Posted by Emme on September 16, 2001, at 22:54:04
In reply to Re: Prozac CRASH --pdoc suggests LITHIUM?! » Emme, posted by Cindylou on September 16, 2001, at 11:22:32
Hi Cindy,
I can really sympathize about the wasted time. Makes me sad. I suspect many if not most people here feel similarly. The med/drug sensitivity is also hard. I feel as if my doctor and I are trying to walk an impossibly thin tightrope, finding a regimen where I'm calm but not too sedated, have energy but am not jittery.
As for what I'm on now, well, I'm definitely not yet stabilized and not very functional. I had been on Remeron with good success until it lost efficacy. I've been on other ADs. My doctor now believes I'm BPII. I go back and forth on whether I think it's correct or not. But I'm willing to not worry about labels and just try the meds. So now we're marching through the anticonvulsants, trying ones that are supposed to have minimal side effect profiles. Lamictal was definitly helping my depression and I liked it a lot but I got a mild rash. It's still up in the air about whether we try that one again.
At the moment, I'm easing off of Trileptal and Neurontin (I was an unmotivated zombie on that combo) and ramping up on Gabitril. A low dose of Atenolol and some Klonopin really help in keeping some sort of lid on the anxiety. If I have too much trouble sleeping, 25 mg of Seroquel helps, though I only need that occasionally right now. I am sure we'll be playing with things for a while. If the gabitril doesn't help, then maybe I'll try Lithium again. Maybe. At a tiny dose. In combo with something else perhaps. 150 mg of Li was too high. I'm kind of scared of the stuff, though I knkow it helps so many people. With us low-dose folks, it makes sense to start off with a smaller than normal dose, ease it up slowly, and see how it goes. My doctor says she has seen success with patients on extremely tiny doses of drugs. You're trying Risperdal next, right? I'd be interested to hear how that goes for you.
cheers,
Emme
> Hi Emme,
> Thanks so much for your response ... it's good to know there's someone else out there like me who is so med-sensitive. It definitely makes things more difficult.
>
> I took 150 mg. of Lithium at night, and was supposed to take another 150 mg. the next morning, but I felt too horrible just from that dose I took the night before. I knew it was no use trying to keep it up, just from past experience -- there have been too many wasted days and weeks, even months, waiting for side effects from various meds to subside (when normally they don't subside for me; at least not much.)
>
> Do you mind me asking what meds you are on now (if any?) I'm very curious to see what has worked for you.
>
> Thanks again,
> cindy
>
>
> > Hi Cindylou,
> >
> > What dose of Lithium did you try? I too am extremely sensitive to meds. At one point my doctor convinced me to try Li. I lasted four days, a couple of days at 150 mg, then up to 300. At the end of that four days I seemed less depressed. But, I was totally knocked out and missed 2 days of work. So I discontinued the Lithium. My thinking is that at some point I may need to try it again, but I will try a much much smaller dose. A "hamster" dose, as my doctor would say, and see what happens. For those of us that are so sensitive, a crumb of medicine might do the trick, or at least titrating up from a tiny speck. I've gotten good at slicing tablets into wee bits with a pill slicer. :) Good luck.
> > Emme
> >
> >
Posted by Cindylou on September 17, 2001, at 6:31:19
In reply to Re: Prozac CRASH --pdoc suggests LITHIUM?! » Cindylou, posted by Emme on September 16, 2001, at 22:54:04
Hi Emme,
Thanks for the information. My pdoc and I haven't considered Lamactil yet -- did it make you at all fatigued or foggy-headed? That's my most common side effect.I'll most likely start the Risperdal tonight ... I'll let you know how it goes! Right now, I'm only on 5 mg Prozac (which I don't think is doing much at all for me) and 150 mg. Wellbutrin, which is kind of keeping me afloat. Maybe the Risperdal will help boost the effects of those two -- but I'm learning not to get my hopes up. I have heard Risperdal works the best with Paxil ... but we'll see how it goes with the Prozac and Wellbutrin for now.
I'm also going to an alternative medicine chiropractor Wednesday (I know ... ughhh! But I'll try anything at this point). He has a PhD in Clinical Nutrition and treats illnesses with vitamins. I definitely am not considering replacing meds with vitamins, but I'm hoping that, in addition to meds, the vitamins might help with my overall well-being.
Thanks again -- I'll keep you posted,
cindy
> Hi Cindy,
>
> I can really sympathize about the wasted time. Makes me sad. I suspect many if not most people here feel similarly. The med/drug sensitivity is also hard. I feel as if my doctor and I are trying to walk an impossibly thin tightrope, finding a regimen where I'm calm but not too sedated, have energy but am not jittery.
>
> As for what I'm on now, well, I'm definitely not yet stabilized and not very functional. I had been on Remeron with good success until it lost efficacy. I've been on other ADs. My doctor now believes I'm BPII. I go back and forth on whether I think it's correct or not. But I'm willing to not worry about labels and just try the meds. So now we're marching through the anticonvulsants, trying ones that are supposed to have minimal side effect profiles. Lamictal was definitly helping my depression and I liked it a lot but I got a mild rash. It's still up in the air about whether we try that one again.
>
> At the moment, I'm easing off of Trileptal and Neurontin (I was an unmotivated zombie on that combo) and ramping up on Gabitril. A low dose of Atenolol and some Klonopin really help in keeping some sort of lid on the anxiety. If I have too much trouble sleeping, 25 mg of Seroquel helps, though I only need that occasionally right now. I am sure we'll be playing with things for a while. If the gabitril doesn't help, then maybe I'll try Lithium again. Maybe. At a tiny dose. In combo with something else perhaps. 150 mg of Li was too high. I'm kind of scared of the stuff, though I knkow it helps so many people. With us low-dose folks, it makes sense to start off with a smaller than normal dose, ease it up slowly, and see how it goes. My doctor says she has seen success with patients on extremely tiny doses of drugs. You're trying Risperdal next, right? I'd be interested to hear how that goes for you.
>
> cheers,
> Emme
>
>
>
>
> > Hi Emme,
> > Thanks so much for your response ... it's good to know there's someone else out there like me who is so med-sensitive. It definitely makes things more difficult.
> >
> > I took 150 mg. of Lithium at night, and was supposed to take another 150 mg. the next morning, but I felt too horrible just from that dose I took the night before. I knew it was no use trying to keep it up, just from past experience -- there have been too many wasted days and weeks, even months, waiting for side effects from various meds to subside (when normally they don't subside for me; at least not much.)
> >
> > Do you mind me asking what meds you are on now (if any?) I'm very curious to see what has worked for you.
> >
> > Thanks again,
> > cindy
> >
> >
> > > Hi Cindylou,
> > >
> > > What dose of Lithium did you try? I too am extremely sensitive to meds. At one point my doctor convinced me to try Li. I lasted four days, a couple of days at 150 mg, then up to 300. At the end of that four days I seemed less depressed. But, I was totally knocked out and missed 2 days of work. So I discontinued the Lithium. My thinking is that at some point I may need to try it again, but I will try a much much smaller dose. A "hamster" dose, as my doctor would say, and see what happens. For those of us that are so sensitive, a crumb of medicine might do the trick, or at least titrating up from a tiny speck. I've gotten good at slicing tablets into wee bits with a pill slicer. :) Good luck.
> > > Emme
> > >
> > >
Posted by Emme on September 18, 2001, at 22:05:03
In reply to Re: Prozac CRASH --pdoc suggests LITHIUM?! » Emme, posted by Cindylou on September 17, 2001, at 6:31:19
Hi Cindy,
The Lamictal did not make me tired. It seemed to rev me up and I needed to control the jitteriness with Klonopin in order to concentrate and be comfortable. I wasn't foggy-headed, just anxious. Anyway, it was great to have some energy. Some of the anxiousness started to simmer down when I got over 60 mg, which is also when the antidepressant effects started to kick in. How do you find the Wellbutrin? Even with Serzone, I could only tolerate 150 mg before I got too jittery. Good luck with the Risperdal.
Emme> Hi Emme,
> Thanks for the information. My pdoc and I haven't considered Lamactil yet -- did it make you at all fatigued or foggy-headed? That's my most common side effect.
>
> I'll most likely start the Risperdal tonight ... I'll let you know how it goes! Right now, I'm only on 5 mg Prozac (which I don't think is doing much at all for me) and 150 mg. Wellbutrin, which is kind of keeping me afloat. Maybe the Risperdal will help boost the effects of those two -- but I'm learning not to get my hopes up. I have heard Risperdal works the best with Paxil ... but we'll see how it goes with the Prozac and Wellbutrin for now.
>
> I'm also going to an alternative medicine chiropractor Wednesday (I know ... ughhh! But I'll try anything at this point). He has a PhD in Clinical Nutrition and treats illnesses with vitamins. I definitely am not considering replacing meds with vitamins, but I'm hoping that, in addition to meds, the vitamins might help with my overall well-being.
>
> Thanks again -- I'll keep you posted,
> cindy
>
>
Posted by Cindylou on September 20, 2001, at 14:57:01
In reply to Re: Prozac CRASH --pdoc suggests LITHIUM?! » Cindylou, posted by Emme on September 18, 2001, at 22:05:03
Hi Emme,
The Wellbutrin is the only med I've been able to tolerate fairly well ... the only time it causes me agitation is during PMS when I'm on Prozac. For those two weeks out of the month, the agitation can get so bad I feel like I can't function, so I usually have to cut the Wellbutrin dose down by half and add Klonapin. When PMS is over, I can go back up to 150 mg. with no problems.I've taken Wellbutrin with Zoloft and Effexor -- both times I was on 300 mg and had NO agitation whatsoever ... probably because I was such a zombie on both of those SSRIs that nothing could cut through the fog.
I've also taken Wellbutrin alone, and have no side effects from it, but it doesn't do much to help my depression on its own.
A long answer to a simple question! But everything is a bit more complicated with me, it seems :)
I'm waiting for a couple weeks to take the Risperdal ... the chiropractor I saw has me taking a lot of B vitamins and several protein shakes a day ... thought I'd give that a chance to kick in (if it ever does) before adding the Risp.
Hope all's well,
Cindy
> Hi Cindy,
>
> The Lamictal did not make me tired. It seemed to rev me up and I needed to control the jitteriness with Klonopin in order to concentrate and be comfortable. I wasn't foggy-headed, just anxious. Anyway, it was great to have some energy. Some of the anxiousness started to simmer down when I got over 60 mg, which is also when the antidepressant effects started to kick in. How do you find the Wellbutrin? Even with Serzone, I could only tolerate 150 mg before I got too jittery. Good luck with the Risperdal.
> Emme
>
> > Hi Emme,
> > Thanks for the information. My pdoc and I haven't considered Lamactil yet -- did it make you at all fatigued or foggy-headed? That's my most common side effect.
> >
> > I'll most likely start the Risperdal tonight ... I'll let you know how it goes! Right now, I'm only on 5 mg Prozac (which I don't think is doing much at all for me) and 150 mg. Wellbutrin, which is kind of keeping me afloat. Maybe the Risperdal will help boost the effects of those two -- but I'm learning not to get my hopes up. I have heard Risperdal works the best with Paxil ... but we'll see how it goes with the Prozac and Wellbutrin for now.
> >
> > I'm also going to an alternative medicine chiropractor Wednesday (I know ... ughhh! But I'll try anything at this point). He has a PhD in Clinical Nutrition and treats illnesses with vitamins. I definitely am not considering replacing meds with vitamins, but I'm hoping that, in addition to meds, the vitamins might help with my overall well-being.
> >
> > Thanks again -- I'll keep you posted,
> > cindy
> >
> >
Posted by jeanette on November 20, 2003, at 21:24:33
In reply to Prozac CRASH again -- Please help me., posted by Cindylou on September 6, 2001, at 14:41:14
have you tried just wellbutrin alone for the depression? it worked wonders for me, but did nothing for my mood swings(dysthymia and borderline personality disorder) now i'm on 20mg of prozac( which did nothing for my depression) and just added 600mg a day of lithium. it was rough the first week but i'm feeling better now- i still think i'm going to switch back to the wellbutrin though.
> Hi,
> I've tried Prozac on three different occasions, and every time I "hit a wall" after about two months. It just happened again.
>
> Out of desperation, I started Prozac again in June (nothing else was working -- all had horrible side effects. Tried Effexor, Paxil, Zoloft; combined with Wellbutrin to help the fatigue. I also tried adding Provigil for a day and felt like I had the worst hangover ever.) I thought maybe this time would be different.
>
> I started out the Prozac really low -- 2.5 mg. -- since I am very med sensitive. This seemed to work well -- eventually I increased up to 10 mg.
>
> I felt pretty good for a couple months, had energy, didn't need to nap, etc. I was even a bit agitated. But about a week ago -- WHAM. I hit that old familiar wall. I feel sick, exhausted, heavy-headed, can't focus, etc. It feels like there's a lead balloon in my head. This is the all-too-familiar feeling I get from SSRIs. I tried increasing the Prozac to see if that would work, but it only made it worse.
>
> I am taking Wellbutrin, and tried increasing that a bit, but it didn't help. Tried some Adderall. Didn't help. NOTHING WILL CUT THROUGH THIS FOG.
>
> I am so discouraged. Does anyone have suggestions for me???? Any good ideas for treatment of depression for people who feel this way on SSRIs???
>
> Any MAOIs that don't cause horrible fatigue?? I've tried the tri-cyclics, and all had horrible side effects I couldn't tolerate.
>
> I feel like I've tried everything but the MAOIs. Am a bit afraid of those.
>
> Please, please help. Any suggestions are greatly appreciated. Feel like giving up.
>
> cindy.
>
> P.S. My diagnosis is depression and anxiety; not bipolar.
Posted by Flipsactown on November 21, 2003, at 11:46:18
In reply to Prozac CRASH again -- Please help me., posted by Cindylou on September 6, 2001, at 14:41:14
Hello Cindy,
Don't get discouraged. I have been on prozac for the longest time on and off for 12 years. Initially, all I needed was prozac. After about 2 years prozac pooped out and was no longer working. My pdoc suggested zoloft and that worked for about a year but it also pooped out. Then my pdoc added desipramine and that worked because it enhanced the effectiveness of prozac. I alternated prozac and zoloft with desipramine a couple of times until they pooped out. My pdoc added wellbutrin to the prozac and desipramine and that worked for awhile then pooped out. I have tried paxil, celexa, effexor,elavil, etc. They either did not work or I was not able to tolerate the side effects.
Currently, I am on 100mgs of prozac, 60mgs of remeron and 300mgs lamictal. This combo is working just fine. Lamictal was added 2 months ago. I noticed my depression had lessened in my 6th week of taking lamictal. Now in my 8th week, I am feeling even better.
You just have to try different combos and you should finally get the relief from depression. However, what works for one person may not work for another.
Although lamictal is primarily used as an anti-seizure medication, ask your pdoc to prescribe lamictal for your depression because it has been shown to be effective on treatment resistance depression, bipolar and unipolar. I am unipolar. My depression is mainly caused by chronic back pain for which I take oxycontin. I hope this information will give you some encouragement. Hang in there.
Flipsactown
> Hi,
> I've tried Prozac on three different occasions, and every time I "hit a wall" after about two months. It just happened again.
>
> Out of desperation, I started Prozac again in June (nothing else was working -- all had horrible side effects. Tried Effexor, Paxil, Zoloft; combined with Wellbutrin to help the fatigue. I also tried adding Provigil for a day and felt like I had the worst hangover ever.) I thought maybe this time would be different.
>
> I started out the Prozac really low -- 2.5 mg. -- since I am very med sensitive. This seemed to work well -- eventually I increased up to 10 mg.
>
> I felt pretty good for a couple months, had energy, didn't need to nap, etc. I was even a bit agitated. But about a week ago -- WHAM. I hit that old familiar wall. I feel sick, exhausted, heavy-headed, can't focus, etc. It feels like there's a lead balloon in my head. This is the all-too-familiar feeling I get from SSRIs. I tried increasing the Prozac to see if that would work, but it only made it worse.
>
> I am taking Wellbutrin, and tried increasing that a bit, but it didn't help. Tried some Adderall. Didn't help. NOTHING WILL CUT THROUGH THIS FOG.
>
> I am so discouraged. Does anyone have suggestions for me???? Any good ideas for treatment of depression for people who feel this way on SSRIs???
>
> Any MAOIs that don't cause horrible fatigue?? I've tried the tri-cyclics, and all had horrible side effects I couldn't tolerate.
>
> I feel like I've tried everything but the MAOIs. Am a bit afraid of those.
>
> Please, please help. Any suggestions are greatly appreciated. Feel like giving up.
>
> cindy.
>
> P.S. My diagnosis is depression and anxiety; not bipolar.
Posted by KarenRB53 on February 25, 2008, at 9:39:06
In reply to Re: Prozac CRASH again -- Please help me. » Cindylou, posted by Flipsactown on November 21, 2003, at 11:46:18
Posted by henryo on February 28, 2008, at 5:11:46
In reply to Re: Prozac CRASH again -- Please help me. (nm), posted by KarenRB53 on February 25, 2008, at 9:39:06
Try Deplin. Its an augmentation. Takes a scrip but its medical food. Sort of cheap for an AD. good luck.
This is the end of the thread.
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