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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by jeffrey on October 27, 2003, at 11:42:44
Hi everyone,
I have been reading the postings regularly since my current episode of anxiety. I have found great info from this community and would appreciate any advice. I have had ruminating thoughts and obsessive worry about low risk health issues for my pregnant wife. ie. she had an x-ray while pregnant and I cant get it out of my head that the baby will develop cancer. I worry daily that I will not be able to enjoy the baby and child as it grows and will worry forever about the xray. I was ready and excited for my wife to get pregnant.
I have had previous success on Zoloft 150 mg and Effexor XR at 75 mg for health related worrying and obsessing over HIV tests. I used xanax, ativan and klonopin as needed during these episodes. After finding out I was not HIV positive, I would ween of the SSRIs and other drugs and experience life very normally drug free. I have been in remission from any mood disorder without medication for 2 years until this pregancy/x-ray thing. I thought my problems were over.
Anyway, I am currently on 225XR Effexor and .5 klonopin 2x daily and have had some improvement but I still have excessive worry and feel the physical symptoms of anxiety (shallow breathing, heart racing) and have developed depression as the medication is not working well enough. I have been on the meds for 2.5 months and a month at Effexor 225xr. I am about 40-50% better. I can function but am nowhere near feeling like "myself" and every free moment I worry about this unborn baby/x-ray/cancer. I do not enjoy the things I normally enjoy and feel uneasy at all times. My sleep had been pretty good but feel tired alot and have trouble waking up. I still work but can take a leave from work for a month sometime soon for medical reasons.
I would appreciate any advice related to whether I should contiue with these meds or whether a change is in order. This has been particulraily frustrating because I responded so well to effexor xr before at a much lower dose 75 mg.
I am in Canada and understand that we do not have lexapro yet? Any confirmation/thoughts on when it will be available would also be appreciated.
Sould I consider augmenting the Effexor with Wellbutrin or neurontin or switch SSRI's (maybe Celexa?). I am seeing a new PDoc this week. I would like to discuss a strategy with him. Previously I have only seen my GP.
Any help, advice or thoughts would be greatly appreciate. Best wishes to everone struggling with overwhelming anxiety and depression.
Posted by Sooshi on October 27, 2003, at 12:40:16
In reply to My Story and Effexor - Suggestions please , posted by jeffrey on October 27, 2003, at 11:42:44
Hi Jeffrey,
I'm so sorry to hear that you are going through such a hard time. I struggled terribly with anxiety/panic for years, and know exactly where you are coming from. I currently take 300mg Effexor XR, so I do have experience with that. You could definately ask your doc to up the dosage, and give it a little more time. It doesn't sound like you've been on the 225mg for very long. I've also heard that augmenting with Wellbutrin works wonders for some people, so do mention it to the doc.The main reason I'm replying to your post is to let you know that my son was born a premie, and his lungs would not expand to let him breathe. He had MANY, MANY x-rays, not just one, and it terrified me to think what damage might be done to his little body. But I had no choice...it was a life or death decision. BUT, today he is 9 years old, healthy as a horse, no signs of cancer AT ALL!!! I know that with an anxiety disorder it's hard to get those negative thoughts out of your head even when hearing a positive story such as this one, but TRY to keep it in mind!
I hope all goes well, and let me know if you need to talk further,
Sooshi
Posted by jeffrey on October 27, 2003, at 13:40:49
In reply to Re: My Story and Effexor - Suggestions please » jeffrey, posted by Sooshi on October 27, 2003, at 12:40:16
> Hi Jeffrey,
> I'm so sorry to hear that you are going through such a hard time. I struggled terribly with anxiety/panic for years, and know exactly where you are coming from. I currently take 300mg Effexor XR, so I do have experience with that. You could definately ask your doc to up the dosage, and give it a little more time. It doesn't sound like you've been on the 225mg for very long. I've also heard that augmenting with Wellbutrin works wonders for some people, so do mention it to the doc.
>
> The main reason I'm replying to your post is to let you know that my son was born a premie, and his lungs would not expand to let him breathe. He had MANY, MANY x-rays, not just one, and it terrified me to think what damage might be done to his little body. But I had no choice...it was a life or death decision. BUT, today he is 9 years old, healthy as a horse, no signs of cancer AT ALL!!! I know that with an anxiety disorder it's hard to get those negative thoughts out of your head even when hearing a positive story such as this one, but TRY to keep it in mind!
>
> I hope all goes well, and let me know if you need to talk further,
> Sooshi
Thanks Sooshi for your thoughtful reply!
I am happy your son is doing well. I will try to keep your good story in mind. Perhaps its my anxiety disorder or that I am a lawyer but I have a bad habit of distinguishing good stories from my own situiation. In your case, immediately after reading your post, I said to myself "those xrays were after delivery when the body is formed not during pregancny when the cells of the baby are rapidly dividing".Regarding the effexor was it not working well at 225xr but effextive at 300 xr? Is it worth a move up? I have come off effexor before and its a fairly tough couple of weeks and I suspect will be made tougher if from a higher does.
Anyway, thanks again and best wishes!
Posted by Sooshi on October 27, 2003, at 15:59:57
In reply to Re: My Story and Effexor - Suggestions please, posted by jeffrey on October 27, 2003, at 13:40:49
ARGH! I knew those negative thoughts would figure out a way around my positive story!!:) Well, let me see....I guess you could say that he was a Premie and therefore not fully formed when he got xrayed, or how about the fact that even now at 9 years old he is still growing with rapidly dividing cells....!!! (You see, I've had a lot of Cognitive Therapy [which cured me of my anxiety attacks, btw] and I'll do just about anything to prove untrue those invasive, negative thoughts of mine.)
As for the higher dose of Effexor, in my case anyway, I definately did not get a therapeutic response until I got to 300mg. I have actually gone higher than this too (350), until I started a mood stabilizer, which has been a real life saver for me. I will most likely stay at 300mg for now, as it is providing the right amount of ad effects.
Posted by zeugma on October 27, 2003, at 18:32:34
In reply to My Story and Effexor - Suggestions please , posted by jeffrey on October 27, 2003, at 11:42:44
Jeffrey,
Maybe a lower dose of Effexor would be better for you. At 75 mg, Effexor mostly blocks serotonin reuptake, while at higher doses, it also blocks norepinephrine reuptake, which makes some people anxious.
Posted by jeffrey on October 28, 2003, at 9:06:37
In reply to Re: My Story and Effexor - Suggestions please , posted by zeugma on October 27, 2003, at 18:32:34
Thanks Sooshi for your thoughts to my negative response. Maybe its CBT I need and not an increased dose.
Thanks Zeugma for your suggestion. Effexor was helpful during a previous episode of anxiety at 75 mg but after 2 weeks during this current bout I felf little improvement so I rapidly moved up. I feel somewhat better but I have been relying on the clonazapam twice a day and combind they only provide what I would estimate as 40-50% relief and I dont feel "myself". ie I am uneasy and when I have a spare second I turn my thoughts to negative things.
Anyway, thanks for your advice. Any thoughts from you or anyone else are greatly appreciated.
Posted by T_R_D on October 28, 2003, at 9:55:47
In reply to My Story and Effexor - Suggestions please , posted by jeffrey on October 27, 2003, at 11:42:44
Hi jeffrey, when I was using Effexor at peak effectiveness I was on 375mg plus augmentation with Wellbutrin and a thyroid drug called Cytomel. There have been discussion on this board about not using Cytomel as it can screw up your Thyroid? Anyway, that was a really good combination for me for quite a while. I ended up going off the Effexor due to a rapid increase in some fairly rare side effects, even at a low dose (75mg.) So, buh-bye Effexor. I'm taking Wellby and Celexa now and feeling good.
It's always worht it to keep trying and adjusting. the generaly rule of thumb is that if there is any beneficial effect from taking a certain drug, you stick with it and play around until you can get the right dosage. Conversely, if a drug doesn't work you'll know right away. Maybe it just takes some experience with trying a fair amount of meds!
Good luck and keep sticking with it!
PS - I'm from Canada too (Toronto!) :)
Posted by oeps7 on October 28, 2003, at 11:42:52
In reply to Re: My Story and Effexor - Suggestions please , posted by T_R_D on October 28, 2003, at 9:55:47
Hi Jeffrey,
I can relate to your obsessive worries. I go through them myself - one thing you can do when this happens is try to realize it's your ocd - and that the thought is greatly distorted there is also a very good book you could read in addition to your meds called "Mind Over Mood" - along the lines of cognitive behaviorial therapy - if you work through the exercizes in the book they do help - unfortunately I get lazy and don't always go back to it when my ocd kicks in. But these can be helpful in addition to your meds - also Lucinda Basset "Attacking Anxiety" - supplement some of these things. I think another book "Brain Lock" ??? is good. Add these things and I think they will be helpful.
Your baby will be fine- just realize it is your ocd flaring up.
All the best,
Mary
Posted by jeffrey on October 28, 2003, at 14:23:48
In reply to Re: My Story and Effexor - Suggestions please , posted by T_R_D on October 28, 2003, at 9:55:47
Mary,
Thank you for your suggestions for controlling my worrying thoughts. I will check out those books as well. As well, thanks for the positive thought about my baby. It is very difficult... whenever I think about the baby to be I associate it with the xray and the small chance of getting cancer. I worry that I will not be able to get this thought out of my head to enjoy the child my wife and I have wanted so badly. Anyway, it sounds like you understand my situation exactly. Thanks again for your good wishes.TRD-
Thanks for your thoughts. Are you on the Celexa-Wellbutrin combo for anxiety/ depression. My depression is a secondary and is a result of the anxiety and my inability to control it. So are you saying that even though I am experienceing some benefit from the effexor and clonazapam combo but not a complete benefit, I should stick it out with these two. I have had a complete remission of symptoms in the past from effexor- but not this time. What will the Wellbutrin hopefully add to my mix if it is effective? By the way, I am in Toronto as well, and looking out its another crappy day. I have had trouble finding a good pdoc in Toronto. So far I have been seeeing my GP who I dont completely trust with aggressive drug augmenting strategies and perhaps some therapy would help me too. I dont know the rules of this group but if you have any ideas of a good pdoc with meds in Toronto, that would be appreciated too. I dont want to give my personal email because it is my complete name. Thanks very much and best wishes for a mild winter in Toronto.
Posted by T_R_D on October 29, 2003, at 12:14:29
In reply to Re: My Story and Effexor - Suggestions please , posted by jeffrey on October 28, 2003, at 14:23:48
Hey J, yeah, another crappy day indeed. I'm really tired today too...I'd really rather be at home snuggling up in bed with my cats :)
It's hard to say whether the Wellbutrin would help or not. It might. I have a friend who takes it and he sounds more like you anxiety primary, depression secondary. I'm kind of the other way around. Unfortunately, I think it's just trial and error.
I actually see a GP for my meds not a pdoc. He's pretty good--better than some pdocs I've had! I just sort of lucked out. He's got a psych. as well as a medical background so it's kind of like one stop shopping...very handy. I'm currently getting some therapy as well...not sure if it's really doing much but I managed to get it for free so I'm not taking it for granted.
If you'd like, maybe we could take this off board for some more discussion about local resources etc... Feel free to email me at kdorrin@thestar.ca
Hope to hear from you soon,
Karen
Posted by Clayton on October 30, 2003, at 12:27:31
In reply to Re: My Story and Effexor - Suggestions please , posted by T_R_D on October 29, 2003, at 12:14:29
I have ben treated for depression and anxiety (SAD/insomnia) with Prozac. Very limited help.
Next came Paxil. Not eficacious for mood but reduced the SAD about 50%
Enter the new pdoc. He added Remaron to Paxil. Says they work synergistically. The improvement in every area of my life, with every psychological problem, is remarkable. The keys to the kingdom! As Effexor is a SSNRI, I thought you might be interested as Remaron also brings both neurotransmitters into plat albeit via a different mechanism. Also works in about a week.
See my post on "substances" - Antidepresants: What worked for me.
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