![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by nmk on January 5, 2003, at 11:28:54
I am going to see my pdoc tomorrow and I am hoping any of you can help with suggestions, treatment options etc.. I am currently one year postpartum and dove into a severe depression five months after the baby was born (this also happened with my first pregnancy). I have tried zoloft (no effect), effexor (made me too dizzy), Lexapro (cured the anxiety and depression but left me extremely nauseous), and am currently back on 125 mg of zoloft with 300 mg x 2 per day of Trileptal with no success. I have never been diagnosed as bipolar but my doc wanted to see if the Trileptal would help. I have been on the current cocktail for the past month.
I don't know what to do at this point and am wondering if I have given the AD's a fair shot. I feel normal when I get my period each month but then the anxiety and depression emerge afterward. I have tried oral contraceptives but the progesterone sent me into a severe depression so I discontinued immediately.
I awake with severe anxiety, take 1 mg of ativan, and feel a bit better afterward but still depressed. The depression is more tolerable than the anxiety for me. I don't want to continue taking the ativan but it is the only source of relief for me.
I just don't know what to do at this point and am hoping anyone can offer some suggestions? Thanks in advance.
Nicole
Posted by Jumpy on January 5, 2003, at 13:33:58
In reply to Mitch and others, I am at my wits end., posted by nmk on January 5, 2003, at 11:28:54
> I just don't know what to do at this point and am hoping anyone can offer some suggestions? Thanks in advance.
>
> NicoleHey Nicole,
First, anyone in your family suffer from mental illness? If so, do they take medication? What has been the most effective medication for them? (Response often runs in families)
Second, have you maximized you dose of zoloft ... tapered up to 200 to 250 mg?
Third, have you every tried a tricyclic AD such as Pamelor? It is great for depression, anxiety to some degree, and can help with insomnia.
Fourth, if you got your anxiety under control, maybe with a small dose of a long acting benzo like klonopin or tranxene, you could simply add wellbutrin to the zoloft. This would allow you to avoid tapering off zoloft and tapering up on a new AD.
Fifth, have you had a routine medical exam and blood work to rule out medical cause of depression and anxiety?
When someone has not responded to 2 meds at full dose from different classes, some may call this treatment resistant depression. No one really knows what the next best step is for these people (switch, augment, allow current trial to persist longer). STAR*D study is going to answer the question to what to do with treatment resistant depression. Until then, it is just guess work.
Hope this helps.
Jumpy
Posted by polarbear206 on January 5, 2003, at 14:33:13
In reply to Mitch and others, I am at my wits end., posted by nmk on January 5, 2003, at 11:28:54
> I am going to see my pdoc tomorrow and I am hoping any of you can help with suggestions, treatment options etc.. I am currently one year postpartum and dove into a severe depression five months after the baby was born (this also happened with my first pregnancy). I have tried zoloft (no effect), effexor (made me too dizzy), Lexapro (cured the anxiety and depression but left me extremely nauseous), and am currently back on 125 mg of zoloft with 300 mg x 2 per day of Trileptal with no success. I have never been diagnosed as bipolar but my doc wanted to see if the Trileptal would help. I have been on the current cocktail for the past month.
>
> I don't know what to do at this point and am wondering if I have given the AD's a fair shot. I feel normal when I get my period each month but then the anxiety and depression emerge afterward. I have tried oral contraceptives but the progesterone sent me into a severe depression so I discontinued immediately.
>
> I awake with severe anxiety, take 1 mg of ativan, and feel a bit better afterward but still depressed. The depression is more tolerable than the anxiety for me. I don't want to continue taking the ativan but it is the only source of relief for me.
>
> I just don't know what to do at this point and am hoping anyone can offer some suggestions? Thanks in advance.
>
> NicoleNicole,
Where you aware that many women who suffer from postpartum depression are later diagnosed with an underlying bipolar disorder? I suffered from postpartum depression after my son was born and I really never got back to normal after different trials of antidepressants over the years. I had the same cyclic depression and anxiety after my period as you did. I would just bottom out and slip into depression and anxiety attacks. All of this got worse over the years. My pdoc suspected I had a mild bipolar disorder. It was hard for me to accept this. I did alot of research over the years and finally came to the conclusion that this is what I had. I have been on lamictal since last march. I feel so much better taking a tiny dose of an antidepressant with the lamictal.I also tried birth control pills, but the mental depression was very bad. There is a broad spectrum to mood disorders. You don't have to be manic to be diagnosed with bipolar. Manic depression is at the other end of the spectrum. A good book I suggest you read is "Why Your Depression Isn't Getting Better" It's about the epidemic of undiagnosed bipolar disorders. My bipolar is depression dominated. I would cycle with oversleeping, low energy, confusion and concentration problems. This would escalte to anxiety. Antidepressants used alone and in higher doses without a mood stablizer would just exacerbate everything. You may need to back of the a/d and increase the trileptal or try another mood stablizer. I finally found the right mood stablizer after trying lithium and depakote. I didn't like the side effects with them and just didn't feel right. Lamictal has no side effects. No weight gain either. Many who post here are having alot of success with this drug.
Laura.
Posted by Ritch on January 5, 2003, at 14:35:20
In reply to Mitch and others, I am at my wits end., posted by nmk on January 5, 2003, at 11:28:54
> I am going to see my pdoc tomorrow and I am hoping any of you can help with suggestions, treatment options etc.. I am currently one year postpartum and dove into a severe depression five months after the baby was born (this also happened with my first pregnancy). I have tried zoloft (no effect), effexor (made me too dizzy), Lexapro (cured the anxiety and depression but left me extremely nauseous), and am currently back on 125 mg of zoloft with 300 mg x 2 per day of Trileptal with no success. I have never been diagnosed as bipolar but my doc wanted to see if the Trileptal would help. I have been on the current cocktail for the past month.
>
> I don't know what to do at this point and am wondering if I have given the AD's a fair shot. I feel normal when I get my period each month but then the anxiety and depression emerge afterward. I have tried oral contraceptives but the progesterone sent me into a severe depression so I discontinued immediately.
>
> I awake with severe anxiety, take 1 mg of ativan, and feel a bit better afterward but still depressed. The depression is more tolerable than the anxiety for me. I don't want to continue taking the ativan but it is the only source of relief for me.
>
> I just don't know what to do at this point and am hoping anyone can offer some suggestions? Thanks in advance.
>
> Nicole
Nicole, one important clue you mentioned was that Lexapro worked for your anxiety/depression but it made you too nauseous. Trileptal can provoke considerable nausea in some people as well. I can't take more than 225mg/day because of that reason. Also, I am finding Trileptal to be very little help for hypomania or anxiety, only the depressive symptoms seem to be helped. In fact, I get a "wirey" nauseous feeling from it. I would suggest to your pdoc the idea of going back to what worked for you (in this case Lexapro), and find some means to get the nausea under control. Try to find out if the Trileptal is aggravating it-maybe a dose reduction would do the trick. A nausea reducing antihistamine such as Meclizine or Periactin or Atarax might be helpful. Clearly your depressions are connected to hormone changes. What about getting a complete hormone level blood workup done? While you are there it might be a good idea to get a serum sodium level done to make sure the Trileptal isn't lowering it excessively. Hope this of some help---Mitch
Posted by nmk on January 5, 2003, at 15:00:23
In reply to Re: Mitch and others, I am at my wits end. NICOLE, posted by polarbear206 on January 5, 2003, at 14:33:13
> >
>
>
>
> Where you aware that many women who suffer from postpartum depression are later diagnosed with an underlying bipolar disorder? I suffered from postpartum depression after my son was born and I really never got back to normal after different trials of antidepressants over the years. I had the same cyclic depression and anxiety after my period as you did. I would just bottom out and slip into depression and anxiety attacks. All of this got worse over the years. My pdoc suspected I had a mild bipolar disorder. It was hard for me to accept this. I did alot of research over the years and finally came to the conclusion that this is what I had. I have been on lamictal since last march. I feel so much better taking a tiny dose of an antidepressant with the lamictal.I also tried birth control pills, but the mental depression was very bad. There is a broad spectrum to mood disorders. You don't have to be manic to be diagnosed with bipolar. Manic depression is at the other end of the spectrum. A good book I suggest you read is "Why Your Depression Isn't Getting Better" It's about the epidemic of undiagnosed bipolar disorders. My bipolar is depression dominated. I would cycle with oversleeping, low energy, confusion and concentration problems. This would escalte to anxiety. Antidepressants used alone and in higher doses without a mood stablizer would just exacerbate everything. You may need to back of the a/d and increase the trileptal or try another mood stablizer. I finally found the right mood stablizer after trying lithium and depakote. I didn't like the side effects with them and just didn't feel right. Lamictal has no side effects. No weight gain either. Many who post here are having alot of success with this drug.
>
> Laura.
Laura,Your situation sounds so similar to mine and I am
grateful for your advice. Could you please tell me what dose of Lamictal you are on and the type and dose of antidepressant you take with it? Do you feel that you are feeling back to where you were before having children or is it a daily struggle?Also, what about estrogen therapy? Since I feel "normal" during menses, couldn't there be some way to replicate the hormonal activity going on during that time? Have you ever tried taking any hormonal supplements and if so, did it improve your mood? I hope I can keep in touch with you and pick your brain some more. I will also check out the book you suggested.
Many thanks,
Nicole
Posted by nmk on January 5, 2003, at 15:02:12
In reply to Mitch and others, I am at my wits end., posted by nmk on January 5, 2003, at 11:28:54
I truly appreciate your responses and will discuss these options with the doc tomorrow. I will keep you posted.
Thanks,
Nicole
Posted by Noa on January 5, 2003, at 15:29:11
In reply to Thank you Jumpy, Mitch, and Laura, posted by nmk on January 5, 2003, at 15:02:12
Just to add to the mix, have you had your thyroid functions checked? Apparently, many women become hypothyroid, or develop unstable thyroid, with both hyper and hypo- after pregnancy, and this can cause anxiety and depression.
HEre are some resources:
Posted by Jumpy on January 5, 2003, at 16:03:30
In reply to Re: Mitch and others, I am at my wits end. NICOLE, posted by polarbear206 on January 5, 2003, at 14:33:13
> Where you aware that many women who suffer from postpartum depression are later diagnosed with an underlying bipolar disorder?
Dear Laura,
I have heard of this theory as well. I wasn't quite sure if it was just another physician taking something unknown in psychiatry and lumping into the "bipolar spectrum disorders". Do you know if this has been substantiated in a study or has been accepted into mainstream psychiatry? Thanks.
Jumpy
PS the reason I am skeptical of BPII is I received that diagnosis and subsequently had trials of lithium, lamictal and depakote only to have my depression deepen. Those were very difficult months.
Posted by nmk on January 5, 2003, at 18:29:44
In reply to Re: Thank you Jumpy, Mitch, and Laura » nmk, posted by Noa on January 5, 2003, at 15:29:11
> Just to add to the mix, have you had your thyroid functions checked? Apparently, many women become hypothyroid, or develop unstable thyroid, with both hyper and hypo- after pregnancy, and this can cause anxiety and depression.
>
> HEre are some resources:
>
> http://thyroid.about.com/gi/dynamic/offsite.htm?site=http://www.thyroid%2Dinfo.com/topdrs/districtofcolumbia.htm
>
> http://thyroid.about.com/gi/dynamic/offsite.htm?site=http://www.thyroid%2Dinfo.com/topdrs/districtofcolumbia.htm
Yep, I had my doctor do a complete hormone profile and I do have hypothyroidism. I am currently taking a low dose of synthroid. What bothers me is that my pdoc (who used to be an ob/gyn) never suggested the blood work until I brought it up.
Posted by nmk on January 5, 2003, at 18:38:24
In reply to Re: Mitch and others, I am at my wits end. NICOLE » polarbear206, posted by Jumpy on January 5, 2003, at 16:03:30
> > Where you aware that many women who suffer from postpartum depression are later diagnosed with an underlying bipolar disorder?
>
> Dear Laura,
>
> I have heard of this theory as well. I wasn't quite sure if it was just another physician taking something unknown in psychiatry and lumping into the "bipolar spectrum disorders". Do you know if this has been substantiated in a study or has been accepted into mainstream psychiatry? Thanks.
>
> Jumpy
>
> PS the reason I am skeptical of BPII is I received that diagnosis and subsequently had trials of lithium, lamictal and depakote only to have my depression deepen. Those were very difficult months.Jumpy,
You raise an interesting question and I would like to know if the literature supports that claim.
How much time did you give the mood stabilizers before going off of them? I am confused on what these meds do if one is not bipolar. With me, the depression and anxiety are the same on or off the Trileptal. Am I better off trying another mood stabilizer or trying a new antidepressant? I am so confused. What finally worked for you?
Thanks,
Nicole
Posted by Jumpy on January 5, 2003, at 19:26:25
In reply to Jumpy:questions, posted by nmk on January 5, 2003, at 18:38:24
> How much time did you give the mood stabilizers before going off of them?
Lamictal-12 weeks at dose up to 300mg per day
Lithium-6 weeks at doses up to 1200mg per day (was getting vomiting and diarrhea above that)
Depakote-4 days at doses up to 500mg per day (made me severely depressed and almost catatonic)>I am confused on what these meds do if one is not bipolar. With me, the depression and anxiety are the same on or off the Trileptal. Am I better off trying another mood stabilizer or trying a new antidepressant?
Have you ever taken a bipolar questionaire like
http://www.psycheducation.org/depression/MDQ.htmThis might help you and your doc decide the likehood of you being bipolar. Also reading the website www.psycheducation.org can be helpful. No matter what the results of the test, lithium augmentation has been proven in studies to be helpful to a signficant amount of non responders. 600 to 900 mg can bring dramatic relief to patients sometime within 48 hours.
If you had a family history of bipolar illness or scored high on the test, maximizing the trileptal or adding a different mood stablizer would be sensible. Also reducing the zoloft may help. If you scored low on the test or have no family history of bipolar disorder or did not get hypomanic with zoloft, augmenting zoloft with wellbutrin or pamelor would be a reasonable decision.
>I am so confused. What finally worked for you?
Nardil and klonopin.
> Thanks,
>
> Nicole
>Hang in there, it is a bumpy road, but eventually most people find relief with some medication combination, exercise, good sleep, therapy ... and if necessary ECT.
Jumpy
PS I would get routine blood work like CBC, liver function tests, chem-7, RPR, B12, Folate levels, full thyroid panel (make sure your TSH is between 2 and 0.5 ... even though up to 4 is normal, but for depressed individuals the TSH should be maximally low)
Posted by Noa on January 5, 2003, at 19:40:30
In reply to Re: Thank you Jumpy, Mitch, and Laura-Noa, posted by nmk on January 5, 2003, at 18:29:44
I also, at one point, went the route of lithium because my pdoc thought maybe I had a bipolar type of depression. I got better for about a month, and then start getting worse and worse and really depressed. It turned out that the lithium made my hypothyroidism worse. Now, I could have stayed on the lithium, and just upped the thyroid doses, but I decided to look into the thyroid thing more thoroughly.
I had already been on synthroid and cytomel, but acc. to the endocrinologist I subsequently met with, my hypothyroidism had been way Under-treated. Some doctors are not up to date on recent research about undertreated hypothyroidism, and how to treat it. They go simply by the "normal range" of TSH, but for many of us, being at the high end of "normal" TSH is way too high.
The other thought to explore is that some people need both T4 like in synthroid, as well as T3, like in cytomel (there are other brands, too, but these are what I know personally).
Geez, I feel like we're having a battle of competing hypotheses here. I hope I am not adding to your stress.
Posted by Jumpy on January 5, 2003, at 20:08:27
In reply to Re: Thank you Jumpy, Mitch, and Laura-Noa, posted by Noa on January 5, 2003, at 19:40:30
> I had already been on synthroid and cytomel, but acc. to the endocrinologist I subsequently met with, my hypothyroidism had been way Under-treated. Some doctors are not up to date on recent research about undertreated hypothyroidism, and how to treat it. They go simply by the "normal range" of TSH, but for many of us, being at the high end of "normal" TSH is way too high.
>
> The other thought to explore is that some people need both T4 like in synthroid, as well as T3, like in cytomel (there are other brands, too, but these are what I know personally).
>I totally concur. The TSH muct be very low for many patients with depression. Levels around 3 or 4 are too high. And many studies show T4 is not helpful as an augmenting agent. One needs a combo of T3 and T4.
Jumpy
Posted by polarbear206 on January 5, 2003, at 20:50:25
In reply to Re: Mitch and others, I am at my wits end. NICOLE, posted by nmk on January 5, 2003, at 15:00:23
> > >
> >
> >
> >
> > Where you aware that many women who suffer from postpartum depression are later diagnosed with an underlying bipolar disorder? I suffered from postpartum depression after my son was born and I really never got back to normal after different trials of antidepressants over the years. I had the same cyclic depression and anxiety after my period as you did. I would just bottom out and slip into depression and anxiety attacks. All of this got worse over the years. My pdoc suspected I had a mild bipolar disorder. It was hard for me to accept this. I did alot of research over the years and finally came to the conclusion that this is what I had. I have been on lamictal since last march. I feel so much better taking a tiny dose of an antidepressant with the lamictal.I also tried birth control pills, but the mental depression was very bad. There is a broad spectrum to mood disorders. You don't have to be manic to be diagnosed with bipolar. Manic depression is at the other end of the spectrum. A good book I suggest you read is "Why Your Depression Isn't Getting Better" It's about the epidemic of undiagnosed bipolar disorders. My bipolar is depression dominated. I would cycle with oversleeping, low energy, confusion and concentration problems. This would escalte to anxiety. Antidepressants used alone and in higher doses without a mood stablizer would just exacerbate everything. You may need to back of the a/d and increase the trileptal or try another mood stablizer. I finally found the right mood stablizer after trying lithium and depakote. I didn't like the side effects with them and just didn't feel right. Lamictal has no side effects. No weight gain either. Many who post here are having alot of success with this drug.
> >
> > Laura.
>
>
> Laura,
>
> Your situation sounds so similar to mine and I am
> grateful for your advice. Could you please tell me what dose of Lamictal you are on and the type and dose of antidepressant you take with it? Do you feel that you are feeling back to where you were before having children or is it a daily struggle?
>
> Also, what about estrogen therapy? Since I feel "normal" during menses, couldn't there be some way to replicate the hormonal activity going on during that time? Have you ever tried taking any hormonal supplements and if so, did it improve your mood? I hope I can keep in touch with you and pick your brain some more. I will also check out the book you suggested.
>
> Many thanks,
>
> Nicole
>
Nicole,I am taking 200mg of lamictal. I divide the dose in the morning and evening. Before lamictal was added, I was on 100mg of imipramine and 15mg of paxil. This combo kept the depression most of the time at bay, but I would have mixed states where I
was very irritable and tired. When I took paxil alone, it made me really happy with all this energy 2 weeks before my period and after it I would crash and feel sluggish, lethargic confused and had carbohydrate cravings. I also have some SAD with this which is very common with bipolars. I am now down to 25mg of imipramine and down to 7.5mg of paxil. I'm going to stop the paxil in the future. I have never been able to get down to this low of a dose on antidepressants. I feel 100% better with the low dose of a/d with the lamictal. It's been 14 long years to get to this point.I tried some of my mother's premerin years ago. It does have some very good antidepressant properties. I took a 1/2 of a .625mg tablet. When I did this I was able to lower the paxil to 10mg. I felt wonderful. My pdoc wasn't to thrilled about it because he thought the estrogen would eventually make me hypomanic. I have read some literature about the use of estrogen patches to prevent reoccurances of post partum depression.
One of the others who posted suggested pscheducation.org. This is one of the best sites I have found. There is a very interesting page on thyroid and bipolar. I'm going to send some pages I want you to check out.
Laura.
Posted by polarbear206 on January 5, 2003, at 21:05:46
In reply to Re: Mitch and others, I am at my wits end. NICOLE » polarbear206, posted by Jumpy on January 5, 2003, at 16:03:30
> > Where you aware that many women who suffer from postpartum depression are later diagnosed with an underlying bipolar disorder?
>
> Dear Laura,
>
> I have heard of this theory as well. I wasn't quite sure if it was just another physician taking something unknown in psychiatry and lumping into the "bipolar spectrum disorders". Do you know if this has been substantiated in a study or has been accepted into mainstream psychiatry? Thanks.Jumpy,
Yes, there have been studies to back this up. I have read various articles about bipolar diagnosis following PPD. It is also mentioned in the book I suggested.Laura.
>
>
> PS the reason I am skeptical of BPII is I received that diagnosis and subsequently had trials of lithium, lamictal and depakote only to have my depression deepen. Those were very difficult months.
Jumpy,Where you taking an a/d with the mood stablizers that you tried? Most with bipolar 2 need to be on an antidepressant with a mood stablizer. If not, maybe thats why your depression deepened.
Posted by polarbear206 on January 5, 2003, at 21:11:36
In reply to Re: Thank you Jumpy, Mitch, and Laura » nmk, posted by Noa on January 5, 2003, at 15:29:11
> Just to add to the mix, have you had your thyroid functions checked? Apparently, many women become hypothyroid, or develop unstable thyroid, with both hyper and hypo- after pregnancy, and this can cause anxiety and depression.
>
> HEre are some resources:
>
>http://thyroid.about.com/gi/dynamic/offsite.htm?site=http://www.thyroid%2Dinfo.com/topdrs/districtofcolumbia.htm
>
> http://thyroid.about.com/gi/dynamic/offsite.htm?site=http://www.thyroid%2Dinfo.com/topdrs/districtofcolumbia.htmNoa,
I had my thyroid checked several times. I was convinced at one point that I was hypo, but my levels turned out to be within normal limits. Thyroid and depression do tend to mimmick each other though.
Laura
Posted by disney4 on January 6, 2003, at 13:00:37
In reply to Re: Mitch and others, I am at my wits end. NICOLE, posted by polarbear206 on January 5, 2003, at 20:50:25
Hi Laura,
I am getting ready to try Lamictal, but have read reports of a blistering skin condition that can occur from it. Am I confusing this with another medication, as you report no side effects noted. I am also considering imipramine at a low dose, but am afraid of weight gain. I am a binge eater. I am diagnosed with OCD and Bipolar disorder.
Thanks,
Elsie
Posted by nmk on January 6, 2003, at 13:11:18
In reply to Mitch and others, I am at my wits end., posted by nmk on January 5, 2003, at 11:28:54
You have been so wonderful in responding, I appreciate all of the support and advice I have received, you are all incredible people.
Just got back from my pdoc appt. and he wants me to lower the zoloft to 75mg, lower the trileptal to 150 x 2 per day, and he added a new med called Strattera. I guess it just came out this month and he stated if it is going to work, I will know immediately. Does anyone know anything about it?I know it is used to treat adhd in children and is not an amphetemine. I asked him about the Lexapro again and he advised giving this a shot first.
Many of you brought up hypothyroidism and I do in fact have it and am on a low dose of synthroid. Should I ask my doc to switch me to a T3/T4 med as you suggested? I am very afraid of going in the opposite direction and becoming hyperthyroid. Since extreme anxiety is my biggest problem, that would be a nightmare for me.
Many thanks,
Nicole
Posted by disney4 on January 6, 2003, at 14:13:27
In reply to Update: Today's pdoc appt, posted by nmk on January 6, 2003, at 13:11:18
Hi,
I am also considering giving the Straterra a go. Can you update me before Friday on how it is working for you? I am mainly concerned with side effects.
Thanks, Elsie
Posted by Noa on January 6, 2003, at 14:17:36
In reply to Update: Today's pdoc appt, posted by nmk on January 6, 2003, at 13:11:18
Straterra is brand new--just approved, so you will be our informant! An earlier thread started by Jim is about his just having started Straterra, too. He had given us several installments in a log of his reaction to it.
As for hyperthyroidism--not only the anxiety, but if you become hyperthyroid, you could get quite sick. However, fwiw, here is the approach my endo has taken: First, my pdoc had added a T3 med (cytomel). Later, the endo had me increase the synthroid in tiny increments and certain intervals, and monitor how I feel. He had me keep going with this until I noticed no new benefit. At that point, he had me drop back to the amount at which I last experienced improvement in how I felt.
I also get my TSH and other thyroid tests done every few months to monitor. My endo is comfortable with me being at a TSH of under 1.0, and he told me that with hypothyroid and depression, this can be necessary. He told me he is not worried about me becoming hyperthyroid, as long as I monitor for signs of it, and also get my blood work done regularly (if my TSH is low AND I have overabundant amounts of Thyroid hormone in my system, that would be an indicator). I asked about risk of osteoporosis, and he said it is not the thyroid meds that causes bone loss, it is when one actually has hyperthyroid symptoms that I would be at risk. Most doctors are not comfortable with such an aggressive approach, though.In any event, you should probably stick to one new intervention at a time, to see how the Straterra works. Good luck and keep us posted.
Posted by nmk on January 6, 2003, at 14:28:34
In reply to Re: Update: Today's pdoc appt, posted by disney4 on January 6, 2003, at 14:13:27
> Hi,
>
> I am also considering giving the Straterra a go. Can you update me before Friday on how it is working for you? I am mainly concerned with side effects.
>
> Thanks, ElsieSure Elsie. I start my first dose tomorrow and I will keep you posted. The doc said that typical s/e's were dry mouth and some loss of appetite (but not nausea). I could stand to lose a few Remeron pounds anyway.
Nicole
Posted by polarbear206 on January 6, 2003, at 16:21:50
In reply to Re: Mitch and others, I am at my wits end. NICOLE » polarbear206, posted by disney4 on January 6, 2003, at 13:00:37
> Hi Laura,
>
> I am getting ready to try Lamictal, but have read reports of a blistering skin condition that can occur from it. Am I confusing this with another medication, as you report no side effects noted. I am also considering imipramine at a low dose, but am afraid of weight gain. I am a binge eater. I am diagnosed with OCD and Bipolar disorder.
>
> Thanks,
> ElsieElise,
The chances of getting the severe form of Stevens-Johnson's Snydrome are very slim. Just make sure your doctor starts you out on a low dose and titrates the dose up slow. I got an itchy rash when I initially started the lamictal. I tend to get rashes easily because I'm a fair skin blonde. The rash would come and go while I was increasing the dose. Once I got up to 75mg and thereafter, I no longer got a rash. I am now on 200mg. Good Luck. Let me know how it's going. Many people go through the same as I did and are able to continue with the drug with no further problems. Just keep you pdoc informed if you develop a SEVERE rash.
Laura.
Posted by Ritch on January 7, 2003, at 0:57:16
In reply to Update: Today's pdoc appt, posted by nmk on January 6, 2003, at 13:11:18
> You have been so wonderful in responding, I appreciate all of the support and advice I have received, you are all incredible people.
>
> Just got back from my pdoc appt. and he wants me to lower the zoloft to 75mg, lower the trileptal to 150 x 2 per day, and he added a new med called Strattera. I guess it just came out this month and he stated if it is going to work, I will know immediately. Does anyone know anything about it?I know it is used to treat adhd in children and is not an amphetemine. I asked him about the Lexapro again and he advised giving this a shot first.
>
> Many of you brought up hypothyroidism and I do in fact have it and am on a low dose of synthroid. Should I ask my doc to switch me to a T3/T4 med as you suggested? I am very afraid of going in the opposite direction and becoming hyperthyroid. Since extreme anxiety is my biggest problem, that would be a nightmare for me.
>
> Many thanks,
>
> Nicole
Hi Nicole, that is certainly interesting about the Straterra. I'm curious too, since I will be seeing my pdoc again here in a few weeks and I don't want to be on pstims or TCA's, and it would really be super to have the robust anti-ADHD response I got from desipramine without the orthostatic hypotension, blurred vision, rapid heartrate, that I got from a very low dose of desipramine. Oh one thing, Zoloft will inhibit the metabolism of Straterra so it (Straterra) might have a more pronounced effect on you (at a lower dosage) than it otherwise might have. You didn't say what the dosage was he gave you. good luck--Mitch
Posted by nmk on January 7, 2003, at 9:30:52
In reply to Re: Update: Today's pdoc appt » nmk, posted by Ritch on January 7, 2003, at 0:57:16
>
> Hi Nicole, that is certainly interesting about the Straterra. I'm curious too, since I will be seeing my pdoc again here in a few weeks and I don't want to be on pstims or TCA's, and it would really be super to have the robust anti-ADHD response I got from desipramine without the orthostatic hypotension, blurred vision, rapid heartrate, that I got from a very low dose of desipramine. Oh one thing, Zoloft will inhibit the metabolism of Straterra so it (Straterra) might have a more pronounced effect on you (at a lower dosage) than it otherwise might have. You didn't say what the dosage was he gave you. good luck--Mitch
Hi Mitch,He put me on a low dose, 18 mg, and reduced my zoloft from 125 mg to 75 mg. He also reduced the Trileptal from 300 x 2 per day to 150 mg x2 per day. This is day one of the Straterra and so far, I have noticed an increase in my energy level and improvement in mood. This med is much more tolerable than my trial with Adderall. The Adderall almost made me hyper and seemed to aggravate the anxiety. This feels like I have had a few cups of java without the racing heart, nervousness, etc.. My depression needed a kick in the the pants and I hope this will do it but I know better not get my hopes up. I will keep you and the others posted with this trial and I want to thank you again for all of your advice.
Nicole
Posted by Ritch on January 7, 2003, at 12:28:27
In reply to Re: Update: Today's pdoc appt: MITCH, posted by nmk on January 7, 2003, at 9:30:52
This is the end of the thread.
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