![[dr. bob]](/dr-bob-sm.gif)
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 venus mcmars on October 27, 2003, at 12:47:39
My husband has a cranky, irritable, moody affect. Prozac and paxil made him anxious and hyper. Lamital made him lose weight. Lexapro made him lose his appetite and he had no sex drive. He has also been on Neurontin and Trazadone. He takes Klonapin and Ambien. His doc says Lithium or Depokate is the next step but he refused.
My question is..has anybody failed with all these and found WB (or effexor) to work? Or should he just go to Lithium?
thanks
Posted by recumbent on October 27, 2003, at 13:27:38
In reply to These SSRIs failed..WB or Lithium next?, posted by venus mcmars on October 27, 2003, at 12:47:39
> My husband has a cranky, irritable, moody affect. Prozac and paxil made him anxious and hyper. Lamital made him lose weight. Lexapro made him lose his appetite and he had no sex drive. He has also been on Neurontin and Trazadone. He takes Klonapin and Ambien. His doc says Lithium or Depokate is the next step but he refused.
>
> My question is..has anybody failed with all these and found WB (or effexor) to work? Or should he just go to Lithium?
>
> thanksI too have "cranky, irritable, moody affect". I am on Lexapro. I did not lose my drive, but did have some SE's early on. Everything is fine now. How many weeks did your husband use Lexapro? Does he drink coffee or alchol? Both create irritability for me.
Best!
Posted by sadmom on October 27, 2003, at 15:55:15
In reply to Re: These SSRIs failed..WB or Lithium next?, posted by recumbent on October 27, 2003, at 13:27:38
I tried all the SSRI's and Effexor and Wellbutrin. Now I'm taking Remeron and Strattera together, it seems to be working better than anything else I've tried so far.
Posted by venus mcmars on October 27, 2003, at 16:00:32
In reply to Re: These SSRIs failed..WB or Lithium next?, posted by recumbent on October 27, 2003, at 13:27:38
He drinks coffee and way too much beer, which is another problem. he was on Lexapro for about 4 weeks.
Posted by cybercafe on October 27, 2003, at 16:25:42
In reply to Re: These SSRIs failed..WB or Lithium next?, posted by venus mcmars on October 27, 2003, at 16:00:32
> He drinks coffee and way too much beer, which is another problem. he was on Lexapro for about 4 weeks.
if you drink beer your body won't properly metabolise your meds so you can't really ask any med to work properly (except maybe lorazepam??)
Posted by cybercafe on October 27, 2003, at 16:28:24
In reply to These SSRIs failed..WB or Lithium next?, posted by venus mcmars on October 27, 2003, at 12:47:39
> My husband has a cranky, irritable, moody affect. Prozac and paxil made him anxious and hyper. Lamital made him lose weight. Lexapro made him lose his appetite and he had no sex drive. He has also been on Neurontin and Trazadone. He takes Klonapin and Ambien. His doc says Lithium or Depokate is the next step but he refused.
>
> My question is..has anybody failed with all these and found WB (or effexor) to work? Or should he just go to Lithium?wait... are you saying that lamictal and lexapro worked but had bad side effects, or they didn't work ???
Posted by venus mcmars on October 27, 2003, at 19:30:08
In reply to Re: These SSRIs failed..WB or Lithium next?, posted by cybercafe on October 27, 2003, at 16:28:24
I don't know if Lamictal or Lexapro worked or not because all he talked about was the side effects. I think Lamictal probably did help, but he doesn't think he needs meds so IMHO he looks for side effects as an excuse and I doubt he would admit that anything helped. The Lexapro side effects, however, were definitely real.
Good point about the beer.
Posted by loolot on October 27, 2003, at 20:44:11
In reply to These SSRIs failed..WB or Lithium next?, posted by venus mcmars on October 27, 2003, at 12:47:39
Wellbutrin worked great for me for a few years, while I never did well on SSRIs. My vote is for WB!
Posted by awatts on October 27, 2003, at 22:09:16
In reply to These SSRIs failed..WB or Lithium next?, posted by venus mcmars on October 27, 2003, at 12:47:39
> My question is..has anybody failed with all these and found WB (or effexor) to work? Or should he just go to Lithium.
I tried all the SSRI's with no luck. Then I tried Effexor XR. 150 mg worked and 225 mg worked even better. Start with 37.5 mg and slowly titrate up. I do have side effects with Effexor, but it is great for my depression and OCD.
Read up on the permanent physical damage that Lithium can cause.
Posted by Bob on October 28, 2003, at 2:25:10
In reply to Re: These SSRIs failed..WB or Lithium next?, posted by sadmom on October 27, 2003, at 15:55:15
> I tried all the SSRI's and Effexor and Wellbutrin. Now I'm taking Remeron and Strattera together, it seems to be working better than anything else I've tried so far.
Now that's a combo I haven't come across yet. Interesting.
Posted by Bob on October 28, 2003, at 2:25:59
In reply to Re: These SSRIs failed..WB or Lithium next?, posted by awatts on October 27, 2003, at 22:09:16
> Read up on the permanent physical damage that Lithium can cause.
>
>Like what? The liver problems?
Posted by venus mcmars on October 28, 2003, at 7:08:11
In reply to Re: These SSRIs failed..WB or Lithium next?, posted by loolot on October 27, 2003, at 20:44:11
Calling Dr. Bob..any opinion re: WB or Effexor v. Lithium?
Posted by venus mcmars on October 28, 2003, at 7:37:00
In reply to Re: These SSRIs failed..WB or Lithium next?, posted by venus mcmars on October 28, 2003, at 7:08:11
I should mention that his doctor suspects cyclothymia..although I see more depression and less mania.
Posted by ramsea on October 28, 2003, at 10:20:57
In reply to Re: These SSRIs failed..WB or Lithium next?, posted by venus mcmars on October 28, 2003, at 7:37:00
First of all, sorry you are both having such a hard time. At least you are half way there.
To me the big question is "what is the root of this irritability?"If it's drink, that really doesn't need any med. Less is more. If it's not drink on its own, the drink still needs looking at because of the aforementioned reasons, and also any underlying psychological problems that the beer might be helping to push out of view. So no one is calling him an alcoholic. ANYONE could be in those shoes.
2)You've no doubt had thorough medical checks to rule out other medical problems that can cause these negative mental states?
3)If he is cyclothymic, he wouldn't be subject to much on the manic side of things anyway--it would be mildly depressive/ mildly overexcited mental states. Theoretically any antidepressant can cause certain folks to be irritable and agitated. If he is also subject to a lot of anxiety, WB could increase that. Though it is said that WB may be better for bipolar depressives, leading to less mania, it is also well-documented that anxious types can get even more anxious/agitated and irritable on it. Well, it sure did happen to me.
4)I have been on Lexapro, Celexa, Prozac, and etc., and I believe your husband if he said they caused intolerable SEs. These meds are miracle drugs for some people, and I know that is a fact. But SSRIs cause others of us to NEED a miracle after we take them, they shot me into several lifethreatening mixed (manic and depressive at same time) episodes requiring lengthy hospital stays. But really there were many ways I couldn't tolerate them---huge weight gain, terrible carbohydrate cravings even in my sleep, nightmares, no sexual desire or feeling, feeling like a zombie in a sleep walk, no motivation, and so on.
5) Lastly, I do think everyone should look into side effects of any drug we take. Not just for lithium, which has been used for 50 years and so reems is known about what it can do to the body, but for all the new drugs too, bearing in mind that much less is known about the long-term effects of SSRIs, etc.When they come out with a drug they often seem to say, Hey, this has hardly any side effects, it's benign, doesn't cause weight gain, etc. etc. That's only because the drug is new and the testing isn't finished (did you know the final phase of testing a new drug is to use it on the population at large? Then those side effects start coming in--and sometimes they have to take a drug off the market because it's worse then they thought.)
Personally, I don't have a mild enough illness profile to debate the issue--I take lithium. I guess if I had seizures a lot I'd take something to stop the seizures, whether it made me chubby or sleepy or whatever. So if your husband can get away with it, maybe he doesn't need medicine at all. One last thought--has he been tested for ADD? Because some people with ADD are misdiagnosed as mild bipolars.
Posted by venus mcmars on October 28, 2003, at 12:37:36
In reply to Re: These SSRIs failed..WB or Lithium next?, posted by ramsea on October 28, 2003, at 10:20:57
In response to the above post, thanks for taking the time to provide such a long response. You raise many good questions and I wish I knew the answers. Alcoholism runs in his family. ADD is also a possibility. His mother, aunt and sister all have the same bossy, know-it-all, "my way is the only way" personality, so it could be nuture as well as nature. he has temper tantrums and rages..last night he went ballistic because our two sons took apart his electric razor. I should also add that we have 4 children between the ages of 7 and 11 and he says that KIDS are his problem.
But I have the same 4 kids and also work F/T and I seem to be OK.
Too bad he is so unreceptive to therapy.
AAARRRGGGHH!!
Posted by cybercafe on October 28, 2003, at 17:14:56
In reply to Re: These SSRIs failed..WB or Lithium next?, posted by venus mcmars on October 28, 2003, at 12:37:36
> In response to the above post, thanks for taking the time to provide such a long response. You raise many good questions and I wish I knew the answers. Alcoholism runs in his family. ADD is also a possibility. His mother, aunt and sister all have the same bossy, know-it-all, "my way is the only way" personality, so it could be nuture as well as nature. he has temper tantrums and rages..last night he went ballistic because our two sons took apart his electric razor. I should also add that we have 4 children between the ages of 7 and 11 and he says that KIDS are his problem.
>
> But I have the same 4 kids and also work F/T and I seem to be OK.
>
> Too bad he is so unreceptive to therapy.
>
> AAARRRGGGHH!!
i also thought ADD might be a factor here, but was afraid attempts at diagnosing might not come across too well....... but since you seem pretty open minded .... yeah, ADD can make you really hard to get along with and can cause anger, hyperactivity etc ... irritability for sure .... i could be completely off base here, but you might want to just make sure it's not a factor..... take an online test or something
Posted by ramsea on October 29, 2003, at 4:26:01
In reply to Re: These SSRIs failed..WB or Lithium next?, posted by venus mcmars on October 28, 2003, at 12:37:36
Thanks for reply. Have you thought about Al-Anon for yourself? You don't have to have an alcoholic who's close to you to go there, but anyway you would qualify to go with all those in-laws being alcoholic. Even if you just worked with someone alcoholic you can qualify--and also mentally ill partners/family/associates who influence us can bring us to Al-Anon. I don't go myself but know many people find the approach useful even if they don't become involved. Just a thought for some support for yourself. Take care.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.