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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Francesco on August 29, 2003, at 21:54:32
Some says that SSRIs can make people crave for alcohol and some thinks that alcoholics should take Prozac.
Some says that SSRIs make people aggressive and some says that makes them dominant and assertive.
Some says that SSRIs promote apathy but some says apathy is dued to depression.
Some says that SSRIs make you eat more but some says they’re used for bulimia.
Some says that SSRIs can impair concentration and memory but some says lack of memory and concentration are a sign of depression.
I have read all this stuff and more and I don’t know who I should have to believe in. Everyone has his own opinion and I have no means to discover which is the right one.
Sometimes I think I would like to be diabetics. Everyone would say I should take insuline.
Posted by DSCH on August 30, 2003, at 11:09:20
In reply to SSRIs, what's your opinion ? , posted by Francesco on August 29, 2003, at 21:54:32
Posted by Francesco on August 30, 2003, at 13:57:21
In reply to Re: SSRIs, what's your opinion ? » Francesco , posted by DSCH on August 30, 2003, at 11:09:20
Hi again and sorry for having been so sarcastic. What I'm complaining about is the total lack of an impartial information. The pro-psychiatry books and articles usually forget to talk about people who went crazy on meds. And the anty-psychiatry ones says anything about people who had benefits from drugs. Reading things like "Prozac changed my life, now I'm a wonderful a person and I love everyone" and "My son wanted to kill me when he was on Prozac" I become very confused and I lose the hope to be able to approach my problems in a rational way. Maybe the article you posted explains something (people react in different ways because are different) but it doesn't explain to me why there must be so many "supporters" (for or against) and so few unpassionate observers. The first time I went to a pdoc he told me that I need ADs and so on, three days I went to another one who told me I was just a bit pessimistic and that meds were "crap". Maybe my doubts are a sign of DOC but maybe most of them don't know what they're talkin'about. Sorry again for my complains but some time I really don't know if I am taking care of myself or I am damaging me.
Posted by DSCH on August 30, 2003, at 15:01:30
In reply to Re: SSRIs, what's your opinion ? » DSCH, posted by Francesco on August 30, 2003, at 13:57:21
>Maybe the article you posted explains something (people react in different ways because are different) but it doesn't explain to me why there must be so many "supporters" (for or against) and so few unpassionate observers.
The objective observers are not flooding the media with diatribes. They are out there, publishing research that usually doesn't attract much public notice. Thus the objective ones are lost from the signal-to-noise ratio of public discourse being so low.
>The first time I went to a pdoc he told me that I need ADs and so on, three days I went to another one who told me I was just a bit pessimistic and that meds were "crap". Maybe my doubts are a sign of DOC but maybe most of them don't know what they're talkin'about. Sorry again for my complains but some time I really don't know if I am taking care of myself or I am damaging me.
Psychiatry is in a primitive state relative to the rest of medicine because it rarely images or undertakes chemical diagnostics of brain function [these capabilities are either here yet new and rare and expensive (SPECT, fMRI, PET, SQUID-MEG, QEEG, etc.) or out on the horizon (nanobot monitors)]. Also the brain is whole lot more complex than all the other organs of the body and is not as well understood. Practioners without neuroscientific knowledge and the support of brain imaging and diagnostics are in the position of having to rely on "pharmocologic dissection" by having patient response to medications define what was "really" wrong with them. This has been the theme of mainstream psychiatry since Cade and lithium. Basically it means as a patient that you are on what I think of as the "drug roulette wheel". Some people get good outcomes, others get bad outcomes.
Posted by francesco on August 30, 2003, at 15:40:08
In reply to Re: SSRIs, what's your opinion ? » Francesco , posted by DSCH on August 30, 2003, at 15:01:30
I agree with everything you said. I'm just a little tired and depressed. This is my fourth day on Prozac and I don't feel fine at the moment. You suggested Effexor for me in the past. I told my doc but he didn't seem convinced. I know my sense of well-being will improve but I'm scared and worried about the way the med will affect my whole personality (and I'm not a dummy in the subject). I've just red an article in which a phsychiatrist says that all the SSRIs lessen empathy and sensations in general. I'm not sure if I wanna be that way. I'm afraid that when Prozac will kick in I will forget what my self me was. Do you have any insight that could help me ?
Thanks
Posted by DSCH on August 30, 2003, at 16:16:15
In reply to Re: SSRIs, what's your opinion ? » DSCH, posted by francesco on August 30, 2003, at 15:40:08
> I agree with everything you said. I'm just a little tired and depressed. This is my fourth day on Prozac and I don't feel fine at the moment. You suggested Effexor for me in the past. I told my doc but he didn't seem convinced.
Did you mention Dr. Amen's satisfaction with Effexor in cases that are similar to yours in terms of spectrum profile (some OCD and some ADHD)? You could gently remind him that *you* are not necessarily equivalent to his other patients who got anxious on Effexor. Not that this will probably change much, as psychiatrists are rightly leerly of trusting what is annecodatal and second hand. Perhaps you could find some scholarly articles that Amen has published on "Overfocused ADD" and its treatment that would be good fodder for his rumination and discussion with you (that is if he has published in scholarly journals rather than just in his books and on the web).
>I know my sense of well-being will improve but I'm scared and worried about the way the med will affect my whole personality (and I'm not a dummy in the subject). I've just red an article in which a phsychiatrist says that all the SSRIs lessen empathy and sensations in general.
And it does this to whom? There again you run up against the rather Newtonian notion of same input into the same system results in the same outcome. People are all unique, and peoples' reactions to drugs are all unique.
>I'm not sure if I wanna be that way. I'm afraid that when Prozac will kick in I will forget what my self me was. Do you have any insight that could help me ?
ThanksYou can make choices. You still can have a measure of control over your own health and destiny.
As I see it here are some things you could do...
1) stick it out on Prozac for a month and find out what condition you settle down into and then work from there
2) request that you try out Effexor, stay on it for a month, and go from there
3) request that you go back to Anafranil, stay on it for a month, and go from there
Your pdoc will probably respect what you have to say about your treatment more if you show the willingness to follow his course of treatment for a while, so I'd recommend (1) before going to (2) or (3). You might find yourself improving some in the meantime and if not, it's just a month. To put some perspective on it, I've pretty much lost years in mucking about without much point to it.
Posted by DSCH on August 30, 2003, at 16:56:34
In reply to Re: SSRIs, what's your opinion ? » DSCH, posted by francesco on August 30, 2003, at 15:40:08
A few more non-med things I think might help...
Alcohol and caffiene: basically quit them for the time being.
Sugar and carbohydrates: cut back and substitute more complex for the simple.
Protein and good fats (omega-3): have some in every meal, including breakfast, fish is best.
Keep up physical activity. Walking is fine.
Take a good multivitamin/mineral complex with each meal. I take Atkin's Basic #1 and #3 as decent baselines for a thrice-a-day formula (I take a Solaray Twice-Daily Fe-free with each meal).
Posted by francesco on August 30, 2003, at 17:17:45
In reply to Re: SSRIs, what's your opinion ?, posted by DSCH on August 30, 2003, at 16:56:34
Thanks for the suggestions. I'm going to follow them as much as possible
Posted by DSCH on August 30, 2003, at 17:25:58
In reply to Re: SSRIs, what's your opinion ?, posted by francesco on August 30, 2003, at 17:17:45
Feel free to question the validity of what I recommend/suggest. ;-)
How's your graduate study coming along? You're in bio-ethics, yes? I am considering giving it all another go, but not in the same field as before.
Posted by Viridis on August 30, 2003, at 18:32:02
In reply to SSRIs, what's your opinion ? , posted by Francesco on August 29, 2003, at 21:54:32
I've known quite a few people who have experienced dramatic improvements with SSRIs. For me, they increase anxiety and either cause drastic mood swings (Zoloft) or a state of "wired apathy" (Prozac). My pdoc says I'm not a good candidate for SSRI therapy and recommends that I avoid them.
Really, though, you need to give them a decent try (a few weeks) to see if they help. It's frustrating, but they really are good for some people. The downside is that the incidence of side effects is very high -- for example, my pdoc estimates that sexual side effects occur in at least 60% of patients (he says this is a conservative estimate in his experience). But you could be one of the lucky ones. If not, insist on a shift to something else.
Posted by francesco on August 30, 2003, at 18:42:04
In reply to Re: SSRIs, what's your opinion ? » francesco, posted by DSCH on August 30, 2003, at 17:25:58
I have nothing to question at the moment : )
(I have to remember to tell mama to cook less pasta ;-)
I'm not studying very much (let's say I'm not studying at all) ... but I hope "to begin to start" tomorrow (I find very hironic that I chose academic career while when I'm not on meds I can barely read two lines of newspaper !) ... This is my first PHD year so I have no forthcoming deadlines and that's one of the reasons why I tried to stayed without meds in the last year (other reasons were being more sociable and attractive to ... uhm .... girls) ... What did you study and what are you planning to study ? You said that you're not on meds at the moment. what did you take in the past and how did they work ? (how many questions ! is prozac kickin'in ? ;-) I take Prozac in the morning and maybe it's not a good idea. All day long I have been fatigued and now that it's sleeping time I'm in the mood for a party ! (ok, I know, reading my post it seems I'm bipolar ;-)
Posted by Francesco on August 30, 2003, at 19:05:59
In reply to Re: SSRIs, what's your opinion ? » Francesco , posted by Viridis on August 30, 2003, at 18:32:02
Hi Viridis thank for the support. I've tried Prozac in the past and it did help my ADHD/OCD symtoms but, for what I can remember, made me a bit too aggressive (the mood isn't my main problem: if I got relief from ADHD/OCD syntoms I consequently become less depressed). Can't remember a lot about sexual dysfunctions while on it but my experience with Paxil was delayed orgasm (very stressful) while on Celexa no particular problems. Yesterday I experienced by myself how it's going Prozac from that particular point of view and I can say that the effect is quite paradoxical (But maybe it's too early). Ok, sorry for having told you my whole story life ;-)
Posted by DSCH on August 30, 2003, at 20:32:10
In reply to Re: SSRIs, what's your opinion ? » DSCH, posted by francesco on August 30, 2003, at 18:42:04
http://www.pharmacynetworkgroup.com/c/prozac-pharmacology.htm
Don't read too much into what is happening from moment to moment right now, fluoxetine takes 4-6 days to reach steady-state plasma concentration with daily dosing, and the main metabolite, norfluoxetine, takes 4-16 days. Then there is the up/down regulation of receptors that really makes the difference (and if someone could provide a good reference of just what that is all supposed to be about I would be grateful).
I was on Paxil in 2001. In 2002 I went from Wellbutrin to Provigil to Provigil plus Prozac. Provigil helped me with alertness to a mild extent. Wellbutrin did virtually nothing that I noticed. I think the SSRIs made me apathetic as I just went off them after a few months both times and didn't follow up with the doc. This year I was started on Cylert but then I had lots of wierd and interesting things happen when I experimented with vitamins, amino acids, and other supplements. At the moment I'm down to just taking the Solaray complex, walking daily, and doing the Atkins induction phase diet. I think I will add fish oil after the Labor Day weekend and that'll be it until my appointment with an orthomolecular clinic happens.
Why does the case of the first letter of your forum name keep changing from lower to capital?
Posted by francesco on August 30, 2003, at 21:11:28
In reply to Re: SSRIs, what's your opinion ? » francesco, posted by DSCH on August 30, 2003, at 20:32:10
I was wondering the same : )
Posted by DSCH on August 31, 2003, at 14:48:21
In reply to Re: SSRIs, what's your opinion ? » DSCH, posted by francesco on August 30, 2003, at 21:11:28
I was wondering if it was a manifestation of the bipolarity of your nature. ;-)
Is the inattentive optimistic party guy (F) and the productive but pessimistic social phobic (f)? ;-)
Posted by Francesco on September 3, 2003, at 10:05:20
In reply to (F/f)rancesco, posted by DSCH on August 31, 2003, at 14:48:21
Hi again : ) You're probably right about the capital letter's issue ;-) This is my 8th day on Prozac and I'm not having very much fun. The side effects so far are: tiredness, fatigue, total apathy, nothing to say to anyone, cognitive impairment, slowness, and so on (don't want to bother you but if you like I can continue ;-) ...
Re-reading your posts I can see you didn't have success with SSRIs.I red yesterday that SSRIs are not considered useful for ADHD (with the controversial exception of fluoxetine) while TCAs in low doses seem to be useful but they're considered second choise treatment (after stimulants).
The good news are that I found a doc in a city not so far from Rome who wrote an article on adult ADHD. I wrote him a e-mail and he seems disposable to visit me. (sorry for my awful English but my Italian is awful too at the moment ;-) I've discovered also that even if many stimulants are not available here (Ritalin, Adderall, etc.) there is some available (Provigil). So maybe I'm going to be treated properly for the first time. What about your experience with stims ? (I have nothing against supplements and so on but I seriously doubt to find someone expert in "orthomolecular psychiatry" here ...)
The other option is trying Parnate which seem to have stimulant properties (and that has been suggested by the doctor to whom I asked Wellbutrin). I red some very enthusiastic post recently about it (no emotional blunting, etc.).
My doubts concern the fact that this med is here available only linked to an antypsychotic (the brand name is Parmodalin) and I'm not sure I want to take an antypsychotic because it could have side-effects that Parnate in itself doesn't have. Anyway, since I'm taking Prozac I think I'd have to wait 5 weeks.
Sorry fot the long post but I know you're very well informed about meds and you helped me a lot in the past. Bye !
Posted by DSCH on September 3, 2003, at 12:44:15
In reply to Re: (F/f)rancesco » DSCH, posted by Francesco on September 3, 2003, at 10:05:20
Heh heh, I just responded to your post in the other thread and now I find this here... we really just need to maintain our own thread or switch over to e-mail or something. :-)
Don't be afraid about being detailed.
This is the end of the thread.
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