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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Janelle on October 8, 2001, at 23:10:18
Hi all,
Well, I got a hold of my pdoc, told her how after about three weeks off an SSRI a-d, I have been spiraling downhill (my symptoms are all over the map), and she agreed with my assessment that I need to AUGMENT the Lamictal by going back on Paxil.
I'm going to start taking 20mg (while maintaining my other meds) tomorrow and I can't wait. I have an appointment to see the pdoc at the end of the week and we can assess from there.
It has been my "gut" feeling all along, although I did not want it to become a *self-fulfilling prophecy,* that Lamictal would not fully address my depression, anxiety and social phobia (the extent to which I've NEVER had before) and ruminating, obssesive-compulsive type thoughts and instead of suggesting that I was *obsessing* about my meds and continuing to just increase the Lamictal, my pdoc agreed with me that I probably do need whatever an SSRI does for serotonin that Lamictal doesn't quite do.
If Chloe reads this - I have the SAME basic experience as you do - the BP2 diagnosis is fuzzy, and I've thought that a small amount of an effective AD can be helpful.
Since Paxil was very effective for me before, I am hoping it will be again, and that any hypomania it MIGHT start to induce (we don't even know if Paxil was the culprit that one time) should be counter-acted by the Lamictal.
Chloe, it is very encouraging to hear that your taking just 1 mg of Celexa (how on earth do you get it down to 1mg?!!) is putting the SPARK back in you (I know the starting Celexa dose is usually 20mgs, since I was on Celexa - up to 40mgs for awhile!)
I truly believe that at least 20mgs of Paxil will alleviate a lot of my horrible symptoms that have resurfaced and will give me my lost spark back. Just like you, without Paxil, I drag (big time) and have no VERVE (perfect word!) for life.
Lamictal *is* having somewhat of an A-D and in my case a good *anti-mania* effect, but the A-D effect is definitely NOT like an SSRI. Comments, feedback welcomed!
Posted by jay on October 9, 2001, at 0:54:20
In reply to YAY! I'm going back on Paxil (Chloe - pls. read) !, posted by Janelle on October 8, 2001, at 23:10:18
Janelle:
Great to hear your doc is responsive. I am really *all over the map*, like you, and it is so scarry not knowing what to expect day-to-day.
An interesting coincidence also...I have been considering Paxil over the past month, as I still have a months supply of samples from a few months ago. I have been on Effexor and Depakote, and the Effexor really irritates me like it did you. I had a good response to low-dose (10mg) of Paxil in the past, so we will see!
The bottom line is...all's we can do is keep trying, and keep that faith of hope. You have had positive experience in the past with Paxil, so there is an excellent chance that, especially augmented with other meds, will work out great.
Best of luck...keep posting :-)
Jay
> Hi all,
>
> Well, I got a hold of my pdoc, told her how after about three weeks off an SSRI a-d, I have been spiraling downhill (my symptoms are all over the map), and she agreed with my assessment that I need to AUGMENT the Lamictal by going back on Paxil.
>
> I'm going to start taking 20mg (while maintaining my other meds) tomorrow and I can't wait. I have an appointment to see the pdoc at the end of the week and we can assess from there.
>
> It has been my "gut" feeling all along, although I did not want it to become a *self-fulfilling prophecy,* that Lamictal would not fully address my depression, anxiety and social phobia (the extent to which I've NEVER had before) and ruminating, obssesive-compulsive type thoughts and instead of suggesting that I was *obsessing* about my meds and continuing to just increase the Lamictal, my pdoc agreed with me that I probably do need whatever an SSRI does for serotonin that Lamictal doesn't quite do.
>
> If Chloe reads this - I have the SAME basic experience as you do - the BP2 diagnosis is fuzzy, and I've thought that a small amount of an effective AD can be helpful.
>
> Since Paxil was very effective for me before, I am hoping it will be again, and that any hypomania it MIGHT start to induce (we don't even know if Paxil was the culprit that one time) should be counter-acted by the Lamictal.
>
> Chloe, it is very encouraging to hear that your taking just 1 mg of Celexa (how on earth do you get it down to 1mg?!!) is putting the SPARK back in you (I know the starting Celexa dose is usually 20mgs, since I was on Celexa - up to 40mgs for awhile!)
>
> I truly believe that at least 20mgs of Paxil will alleviate a lot of my horrible symptoms that have resurfaced and will give me my lost spark back. Just like you, without Paxil, I drag (big time) and have no VERVE (perfect word!) for life.
>
> Lamictal *is* having somewhat of an A-D and in my case a good *anti-mania* effect, but the A-D effect is definitely NOT like an SSRI. Comments, feedback welcomed!
Posted by Collete on October 9, 2001, at 5:21:13
In reply to YAY! I'm going back on Paxil (Chloe - pls. read) !, posted by Janelle on October 8, 2001, at 23:10:18
> Hi all,
>
> Well, I got a hold of my pdoc, told her how after about three weeks off an SSRI a-d, I have been spiraling downhill (my symptoms are all over the map), and she agreed with my assessment that I need to AUGMENT the Lamictal by going back on Paxil.
>
> I'm going to start taking 20mg (while maintaining my other meds) tomorrow and I can't wait. I have an appointment to see the pdoc at the end of the week and we can assess from there.
>
> It has been my "gut" feeling all along, although I did not want it to become a *self-fulfilling prophecy,* that Lamictal would not fully address my depression, anxiety and social phobia (the extent to which I've NEVER had before) and ruminating, obssesive-compulsive type thoughts and instead of suggesting that I was *obsessing* about my meds and continuing to just increase the Lamictal, my pdoc agreed with me that I probably do need whatever an SSRI does for serotonin that Lamictal doesn't quite do.
>
> If Chloe reads this - I have the SAME basic experience as you do - the BP2 diagnosis is fuzzy, and I've thought that a small amount of an effective AD can be helpful.
>
> Since Paxil was very effective for me before, I am hoping it will be again, and that any hypomania it MIGHT start to induce (we don't even know if Paxil was the culprit that one time) should be counter-acted by the Lamictal.
>
> Chloe, it is very encouraging to hear that your taking just 1 mg of Celexa (how on earth do you get it down to 1mg?!!) is putting the SPARK back in you (I know the starting Celexa dose is usually 20mgs, since I was on Celexa - up to 40mgs for awhile!)
>
> I truly believe that at least 20mgs of Paxil will alleviate a lot of my horrible symptoms that have resurfaced and will give me my lost spark back. Just like you, without Paxil, I drag (big time) and have no VERVE (perfect word!) for life.
>
> Lamictal *is* having somewhat of an A-D and in my case a good *anti-mania* effect, but the A-D effect is definitely NOT like an SSRI. Comments, feedback welcomed!Janelle, I have been following your posts but haven't responded because I didn't feel that I had enough knowledge to contribute constructively. All that I read indicated to me too that you should revisit your Paxil and I am glad to hear your pdoc is responsive. We worry so much about placebo and halo effects that sometimes it is hard to believe that our own instincts are right on! Good luck to you and I hope to be reading about good improvement for you soon. Collette
Posted by Janelle on October 9, 2001, at 13:41:56
In reply to Re: YAY! I'm going back on Paxil (Chloe - pls. read) ! » Janelle, posted by Collete on October 9, 2001, at 5:21:13
Posted by Chloe on October 9, 2001, at 17:34:08
In reply to YAY! I'm going back on Paxil (Chloe - pls. read) !, posted by Janelle on October 8, 2001, at 23:10:18
> Well, I got a hold of my pdoc, told her how after about three weeks off an SSRI a-d, I have been spiraling downhill (my symptoms are all over the map), and she agreed with my assessment that I need to AUGMENT the Lamictal by going back on Paxil.
Janelle,
This is great news. I hope that going back on Paxil with your other meds, it the "magic bullet" for you. I know when I went of my Celexa for a week, I was just feeling awful. When I restarted it, I had an almost immediate remission of my depression! I felt a little racy, infact, but it only lasted a day. Now I am fine and basically stabile on Lithium, Neurontin and a splash of Celexa. One thing though, I was on two milligrams of the Celexa pre-Lithium, so you may find you don't need as much Paxil to get the same effect.>how on earth do you get it down to 1mg?!!
I can get the dose so low, because Celexa comes in a liquid form. And from what Mitch has told me, so does Paxil. So if you need to tinker around with micro doses like I have to, you can get the liquid Paxil.
I hope this goes well, and I am so glad you have a good working relationship with you pdoc. He/She seems very willing to work with you, and that is so important.
Keep up posted :)
Chloe
Posted by Janelle on October 9, 2001, at 23:13:14
In reply to Re: YAY! I'm going back on Paxil (Chloe - pls. read) ! » Janelle, posted by Chloe on October 9, 2001, at 17:34:08
Chloe - thanks for your response here - I'm so glad you mentioned that that Celexa and Paxil come in liquid form - I had no idea that they do!
My pdoc is having me go back on Paxil using 20 mg tablets, but if this proves too much, I'll go down to the 10's and if that's still too much, I'll ask for the liquid. I imagine there is a way to measure out the liquid in order to get a micro dose?
I am hoping to get the same reaction you did after you re-started the Celexa; in fact, my pdoc anticipates that since I've already been on Paxil in the past and it worked so well for me, that I should have an almost immediate positive reaction to it, hopefully a remission of my depression and of other troublesome symptoms that have returned since she took me off any SSRI a-d.
Coincidentally, since it happened when I first started taking Paxil, I also expect to feel a little racy, especially because the Paxil will be taken in addition to Lamictal which is activating! Hopefully the initial raciness will not last more than a day or two, if it even happens!
I was pleasantly surprised that my pdoc was so willing to go along with me on my request for the Paxil (I told her I was not above *begging* for it and she said that was not necessary!), because in the past when I've called her with med issues, she has said she thought I was *obsessing* about them. I told her that I had given this Paxil re-start some serious thought and was not ruminating over it, and she said she could tell this time that I sound like I do indeed need it again! Time will tell if it lifts me out of the funk and helps clear the anxiety ...!
-Janelle
Posted by Chloe on October 10, 2001, at 9:16:34
In reply to CHLOE: liquid forms of a-d's, more ... » Chloe, posted by Janelle on October 9, 2001, at 23:13:14
>
> I was pleasantly surprised that my pdoc was so willing to go along with me on my request for the Paxil (I told her I was not above *begging* for it and she said that was not necessary!), because in the past when I've called her with med issues, she has said she thought I was *obsessing* about them. I told her that I had given this Paxil re-start some serious thought and was not ruminating over it, and she said she could tell this time that I sound like I do indeed need it again! Time will tell if it lifts me out of the funk and helps clear the anxiety ...!
Two things Janelle,
Paxil is one of the more sedating SSRI's, so hopefully you won't have a *racy* reaction upon start up. But if you do, I imagine the lamictal will quickly put a lid on it. As I remember Lamictal, I was able to feel quite *up* without getting hypomanic. Lamictal is a very interesting drug in that way.The other thing is that the SSRI's are very good for obsession. So even if you were, (and it sounds like you were NOT!), the Paxil will probably help you will the obsessing and ruminating. The anti obsession part of SSRi's is very unique, and is not found in other AD's like serzone or remeron for example. And I find them quite useless as my primary AD, just for this reason. They don't do anything for the ruminating, annoying thoughts.
Hope the Paxil helps!
Chloe
Posted by Jackster on October 11, 2001, at 20:16:10
In reply to YAY! I'm going back on Paxil (Chloe - pls. read) !, posted by Janelle on October 8, 2001, at 23:10:18
Janelle - please keep us posted on how you're going. I too have been on Paxil, then went off it and it pooped out when I went back on. I'm now back on it in combination with Clomipramine after trying a raft of meds - none of which worked to the extent of Paxil. I would love to hear a happy story of it working again!
Jackie
PS Do you take it in the morning or night? I'm have sedation probs and my PDoc has recommended taking the Paxil at night as well as the Clomipramine. I always thought that Paxil was stimulating not sedating.
This is the end of the thread.
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