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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by jbec on November 5, 2003, at 0:49:49
I am at the end of my rope. I have never been as disgusted and disappointed with myself as I feel now. Aside from the fact that my life isn't turning out the way I hoped, I feel like the medical professionals are not only letting me down, but making me feel worse. Here is my story....
I was diagnosed with depression in the late winter of 2001. The reason I was diagnosed at all was because I booked a physical with my doctor. I was afraid I was ill with something because no matter how much I exercised, I was always tired and sad--and I couldn't lose weight. (Exercising is a natural anti-depressant and getting in shape usually supplies you with energy. However, I never had energy and cried by myself while I hid from my family)--so I saw my doctor.
At first, I was given CELEXA. It helped a bit, but was ridiculous with the amount of nausea and after a few months made me sooo lethargic that it was difficult to hold a fart in. I switched GP's (he retired), and my new doctor put me on PROZAC. After a few months on Prozac, the nausea continued and once again, fatigue set in. We then switched to EFFEXOR. My GP said it was more "activating" than the prozac. And should combat the fatigue well. The Effexor was wonderful. For the first few weeks, I felt great. I was exercising, ambitious, and happy. Then once again, after a few weeks extreme fatigue set in. I was sleeping all the time, and when I wasn't sleeping, I felt like a zombie. So then, we switched to WELBUTRIN. The Welbutrin was AWESOME, definitely better than the Effexor and no fatigue at all. After about 2 months, I hit a wall of fatigue and was once again zombified. All I wanted to do was sleep. The counsellor I was seeing noticed my fatigue and took over my medicating. She prescribed REMERON. The remeron destroyed me. Not only could I not get out of bed, but I couldn't even DRIVE! I felt drunk and weak for about six days. After six days, I took MYSELF off the Remeron. I was by far, one of the worst chemicals I have ever put into my body. Adding to the counsellor's "betrayal" (in my eyes), was the fact that she KNEW how much I was struggling with fatigue and lack of weight-loss, yet she NEVER told me of Remeron's side affects.I stopped seeing the counsellor after that.
So Today, I saw a psychiatrist after a referral from my GP. My GP's thinking was to get a "specialist" to come up with a medication mix that would serve me best. My GP wrote up a broad stroke description of my situation and sent it to the shrink. So, after the usual questions and filling out those usual questionaires to "Score" how depressed you are, the psychiatrist asked my drug/drinking habits. Not wanting to lie or hold anything back, I was honest. I have NEVER used drugs or smoked, BUT, I do tend to binge when I drink. (Usually 1-2 times/month). I am working very hard to change that. I also said that I am no longer exercising because I am just too damn tired.
I guess I should have lied.
No sooner had I said that, then the psychiatrist told me that alcohol is a depressant and that's why I am depressed and I'm tired because I am not exercising and I am out of shape. It could all be in your head. Or, it could be other hormones relating to the pituitary or other glands. But, Go back on Welbutrin.
Okay.
She ignored the fact that I told her I have struggled with misery, moodswings and fatigue since puberty. She ignored that fact that I didn't start drinking until I was 19, and she ignored the fact that even though, I am no longer exercising right now, up until 3 months ago I was able to bench 200 lbs and frequently exercised until I vomited (1.5hrs X 3 days/Week cardio and weights). And even though I could bench 200 and puked regularly with working out, I couldn't drop more than 8 pounds and my pants have never been tighter around the waist.
So... please... if you took the time to read this, please take the time just give an opinion.
Is anyone else experiencing things like this?
Is it in my head?
Is it physical?
Is it the medications?
Can you recommend medications?Thank you for your time.
Posted by Elle2021 on November 5, 2003, at 1:14:04
In reply to Someone, please help me. , posted by jbec on November 5, 2003, at 0:49:49
It could very well be the medications that are making you gain weight, BUT don't stop taking them, it may just be taking a while to kick in. Try getting a second opinion. Maybe your binge drinking BECAUSE your depressed and your self-medicating... God bless you.
Elle
Posted by CC67 on November 5, 2003, at 1:29:41
In reply to Someone, please help me. , posted by jbec on November 5, 2003, at 0:49:49
Hi jbec
Sorry to hear your frustration,I know how you feel,but don't give up!!
I think that wellbutrin and prozac together can be activating and if you can work your way up to 450mg well and 80mg prozac,that should be nice combo.
My wife has been on sr 200 wellbutrin x 2 per day/and prozac 60mg for years.will I should clarify,befor the sr 200 well was available it was the sr100 x2 twice a day.I use to take my well with gurana and that activated it.or panax ginseng,orange juice worked good with my well also.
I take adderall and focalin,they work pretty good together for me.I take *multi vit,xtra e800 a day
omega 3,bilberry,lutein,b100,calcium and magnesium also.
also try some hot green tea,that seems to perk me up to. other than that I dont drink any pop or caffeine any more.I have taken 450 a day of well and adderall to,or I have tryed adderall and effexor xr.
maybe try IR well tabs.maybe IR efexxor.
Hang in ,Hope this helps som:) michael
Posted by crazychickuk on November 5, 2003, at 3:39:09
In reply to Re: Someone, please help me. jbec » jbec, posted by CC67 on November 5, 2003, at 1:29:41
jbec... you are not alone i am in the uk too and am having such a hard time with the profession and my meds... but my meds do the opposite to me they make to manic remeron is the only med thats calms me down BUT also maked me depressed.. fancy emailing me? if you are in the uk too? click on my name or email me d1980angel@aol.com or crazychickuk@msn.com hope to hear from you soon.
take care...
and you are not alone. at this moment in t ime i am upset.. i been treated worse than you. email me and i will tell you all. see if we can work together..
Posted by cybercafe on November 5, 2003, at 3:51:31
In reply to Someone, please help me. , posted by jbec on November 5, 2003, at 0:49:49
> I am at the end of my rope. I have never been as disgusted and disappointed with myself as I feel now. Aside from the fact that my life isn't turning out the way I hoped, I feel like the medical professionals are not only letting me down, but making me feel worse. Here is my story....
>
> I was diagnosed with depression in the late winter of 2001. The reason I was diagnosed at all was because I booked a physical with my doctor. I was afraid I was ill with something because no matter how much I exercised, I was always tired and sad--and I couldn't lose weight. (Exercising is a natural anti-depressant and getting in shape usually supplies you with energy. However, I never had energy and cried by myself while I hid from my family)--so I saw my doctor.
>
>
> At first, I was given CELEXA. It helped a bit, but was ridiculous with the amount of nausea and after a few months made me sooo lethargic that it was difficult to hold a fart in. I switched GP's (he retired), and my new doctor put me on PROZAC. After a few months on Prozac, the nausea continued and once again, fatigue set in. We then switched to EFFEXOR. My GP said it was more "activating" than the prozac. And should combat the fatigue well. The Effexor was wonderful. For the first few weeks, I felt great. I was exercising, ambitious, and happy. Then once again, after a few weeks extreme fatigue set in. I was sleeping all the time, and when I wasn't sleeping, I felt like a zombie. So then, we switched to WELBUTRIN. The Welbutrin was AWESOME, definitely better than the Effexor and no fatigue at all. After about 2 months, I hit a wall of fatigue and was once again zombified. All I wanted to do was sleep. The counsellor I was seeing noticed my fatigue and took over my medicating. She prescribed REMERON. The remeron destroyed me. Not only could I not get out of bed, but I couldn't even DRIVE! I felt drunk and weak for about six days. After six days, I took MYSELF off the Remeron. I was by far, one of the worst chemicals I have ever put into my body. Adding to the counsellor's "betrayal" (in my eyes), was the fact that she KNEW how much I was struggling with fatigue and lack of weight-loss, yet she NEVER told me of Remeron's side affects.
>
> I stopped seeing the counsellor after that.
>
> So Today, I saw a psychiatrist after a referral from my GP. My GP's thinking was to get a "specialist" to come up with a medication mix that would serve me best. My GP wrote up a broad stroke description of my situation and sent it to the shrink. So, after the usual questions and filling out those usual questionaires to "Score" how depressed you are, the psychiatrist asked my drug/drinking habits. Not wanting to lie or hold anything back, I was honest. I have NEVER used drugs or smoked, BUT, I do tend to binge when I drink. (Usually 1-2 times/month). I am working very hard to change that. I also said that I am no longer exercising because I am just too damn tired.
>
> I guess I should have lied.
>
> No sooner had I said that, then the psychiatrist told me that alcohol is a depressant and that's why I am depressed and I'm tired because I am not exercising and I am out of shape. It could all be in your head. Or, it could be other hormones relating to the pituitary or other glands. But, Go back on Welbutrin.
>
> Okay.
>
> She ignored the fact that I told her I have struggled with misery, moodswings and fatigue since puberty. She ignored that fact that I didn't start drinking until I was 19, and she ignored the fact that even though, I am no longer exercising right now, up until 3 months ago I was able to bench 200 lbs and frequently exercised until I vomited (1.5hrs X 3 days/Week cardio and weights). And even though I could bench 200 and puked regularly with working out, I couldn't drop more than 8 pounds and my pants have never been tighter around the waist.
>
> So... please... if you took the time to read this, please take the time just give an opinion.
>
> Is anyone else experiencing things like this?
> Is it in my head?
> Is it physical?
> Is it the medications?
> Can you recommend medications?you could always try parnate. i had the same problems, but parnate really energizes me and lets you cut back on sleep. i imagine stimulants might be good in this regard also
>
> Thank you for your time.
>
>
Posted by Robert Fairburn on November 5, 2003, at 5:27:42
In reply to Someone, please help me. , posted by jbec on November 5, 2003, at 0:49:49
Yes I do think its time to try a MAOI drug, you sound atypical to me whcih does respond well to a MAOI. Dont let the docter give you a RMAOI because they are not as effective. So ask for parnate and hang in there, work you dosage up slowly and be prepared to wait a while. These drugs have a very high success rate. However they can give you the odd rough day before they start working to there full effect.
Regards Robert
Posted by DanielJ on November 5, 2003, at 7:22:59
In reply to Someone, please help me. , posted by jbec on November 5, 2003, at 0:49:49
From my brief experience with ADs and Anti-Psys ie Zyprexa, Zoloft, Abilify, Lexapro. I have noticed that there is a period of from 2 weeks to about 2-3 months before the medications take full effect. Sometimes then, profound changes occur like drowsiness nausea etc. It doesn't neccessarily mean that you should try something else. It can mean that it is time to cut back a little on the doseage. A pill cutter will do this and don't overdo it. Clip a little off the end of the pill and see what effect it has. If things improve you may want to clip a little more or less till you find the right amount. Reason? As I stated, the meds build up in your system slowly so you need less each day to maintain the ideal level. This is something that requires careful monitoring but the right number of mg in each dose in a pill has to be fixed as far as the pharmacy and mfg. are concerned but everyone is different and metabolizes differently. It is far better to try this than switch to another med that may not help at all or make things worse. Especially if the one that you are taking is working. Maois require a restrictive diet and deviations from that regimen can be risky. This is important to consider before trying them. See what your P Dr says of course. My Dr agrees with varying dosages to obtain the optimum level. Good luck to you!
Posted by TJO on November 5, 2003, at 8:45:52
In reply to Re: Someone, please help me. OK I'll try, posted by DanielJ on November 5, 2003, at 7:22:59
Hi there,
I get very tired sometimes from my meds and use caffeine to pick myself up. Maybe that would work for you.
Good Luck
Tammy
Posted by cupcake on November 5, 2003, at 10:44:59
In reply to Someone, please help me. , posted by jbec on November 5, 2003, at 0:49:49
hi jbec,
sorry you're going through such a rough time. it's even harder when you feel like you can't get doctors to listen to you. anyway, i have experienced similar problems with the fatigue and difficulty losing weight. about two years ago i was diagnosed with hypothyroid disorder, which can produce a lot of the symptoms you describe, incl fatigue, weight gain (or difficulty losing), mood swings, sadness, etc. i also have chronic depression. i take effexor xr, strattera (for depression and difficulty focusing) and synthroid for the thyroid problem.
has anyone given you a blood test? i would request that, for sure...in the meantime, hang in there and don't give up.
cupcake
Posted by sadmom on November 5, 2003, at 14:09:39
In reply to Re: Someone, please help me. , posted by cupcake on November 5, 2003, at 10:44:59
I have been messing with 4 yrs of a/d combos myself. I was always extremely tired during that time. I started taking 2.5 grams of fish oil a day (equivalent to 8 Walgreens omega-3 capsules) and it really helped my energy. I still need to take anti-depressants etc though.
Also getting a thyroid test is a must, if they never ordered one for you yet.
Posted by Caleb96 on November 8, 2003, at 13:13:28
In reply to Re: Someone, please help me. , posted by Robert Fairburn on November 5, 2003, at 5:27:42
OK jbec, don't give up--several years ago I ran into the same problem you're having. I had tried every SSRI on the market, but continued to have problems (sleepiness, sexual dysfunction, jittery). I was also drinking quite a bit to alleviate my stress. The doctor (internal med) put me on alprazolam (Xanax) to help with the heebie-jeebies, but I still kept drinking, too. That's a bad combination.
Finally, I quit drinking completely and then things started to get better. I went three and a half years without taking a drink, then one night--for some strange reason--I drank a bottle of red wine. It didn't even give me a buzz--just heartburn and a queasy feeling. I swore I'd never touch alcohol again, and I haven't since that night. (Although the German's make some pretty good non-alcoholic beers that are nice on a hot summer day.)
Anyway, back to your problem. After several very successful years on Zoloft, I started to get depressed and lost interest in everything. My internist increased the dose to 100 mg/d and that helped for about six months. Then I hit a brick wall. I was in grad school trying to finish up my PhD, but I couldn't get myself to do anything. One day in desperation, I went to see one of the universities psychologists. He immediately referred me to a psychiatrist who, he said, was an expert with meds. The psychiatrist put me on Remeron (I agreed to try it)even though he warned me about all the side-effects. Whoa! That stuff is horrible! The doctor warned me it's a very strong histamine blocker and it would make me tired. My wife said I was like a zombie. I also gained weight--I went from 170 lbs to 200 lbs (I'm 5' 11")in just a few weeks! My sister-in-law who's a nurse said they give Remeron to elderly patients in nursing homes--they give it to them because elderly people tend to eat like birds and the Remeron makes them eat like starving pigs. That's good if your thin and frail, but I found it useless as an antidepressant. I told the doctor I couldn't take the stuff.
The doctor then put me on Effexor XR. At first I was scared to take the drug because I looked on the internet and read all these horror stories people had posted about Effexor. Also, I looked at the chemical structure and was concerned because Effexor is very similar to opioids because it almost follows the "morphine rule." In fact (I found this out later)it's one carbon bond removed from the opioid analgesic Tramadol. Now if you don't know anything about organic chemistry you might not follow what I'm saying. And I'm not trying to scare anyone, but from what I've read, venlafaxine (Effexor) was originally developed as a treatment for fibromyalgia. Anyway, I started taking the Effexor XR and within a few days I felt great. As time went by I had to have the dose adjusted, but I've been on 300 mg/d of Effexor for 2 1/2 years now. The doctor later added 300 mg/d Wellbutrin to try and counteract the sexual disfunction caused by the elevated serotonin levels.
I'm not sure what dose of Effexor you were taking, but my psychiatrist told me the literature says you can go up to 450 mg/d. He says some doctors prescribe even higher. Also, unlike the SSRIs Effexor is dual acting--it elevates both serotonin and norepinephrine in the post synaptic juction. This combined effect is supposed to be more resistant to losing its activity. Also the Wellbutrin is very stimulating so it helps with any sleepiness (if you look at its chemical structure it looks a lot like speed, but you can't read too much into a chemical's structure since a minor change may result in a totally inactive compound). Also, I've switched from Xanax to Klonopin. Xanax has a very short half-life and leaves you feeling worse when it wears off. Klonopin has a relatively long half-life, so it doesn't make you feel like you're falling off the edge as it wears off. I don't know why doctors don't prescribe the longer-acting benzodiazepines instead of drugs like Xanax. Personally, I think it's easier to get addicted to the short-acting benzos, and it's easier to wean yourself off the long-acting benzos.
Anyway, the bottom line is I would recommend you talk to your doctor about trying a combination of drugs. The Effexor and Wellbutrin combination has worked for me. Effexor has a really short half-life, so if you want to have "normal" sex, I've found I can cut out the Effexor for a few days. You have to plan ahead, that kills the spontaneous passion, but it works for me. You'll have a great orgasm. Another problem I have with cutting out Effexor for a few days is on the second day, I get a hellatious, splitting headache. It usually can be brought under control by taking about six ibuprofen.
Also, try to cut out or cut way down on your alcohol intake. Alcohol is a depressant and it's also hard on your internal organs. Consider the volume of alcohol one has to consume to get a calming buzz: if you drink three beers, that's roughly 84 GRAMS of alcohol, or about 84,000 times one 1 mg Xanax tablet! In order for your body to metabolize alcohol, it has to remove electrons from the molecule, which results in the generation of free radicals. Free radicals damage cells and ultimately damage tissues and organs. From a biochemical point of view, I think it's really bad stuff, but that's my opinion.
Well, I've really gotten carried away, so I'll stop here. Below I've posted the latest from the scientific literature--I notice they don't metion withdrawal....
Clinical Therapeutics
Volume 25, Issue 8 , August 2003 , Pages 2138-2154
Venlafaxine (Effexor): A 2003 update
Mary A. Gutierrez BCPPa, , , Glen L. Stimmel BCPPb, a and Janet Y. Aiso MBAc
a School of Pharmacy, University of Southern California, Los Angeles, USA
b School of Medicine, University of Southern California, Los Angeles, USA
c JANEN Clinical Pharmacy Consultants, South Pasadena, California, USA
Accepted 29 May 2003. ; Available online 18 September 2003.
Abstract
Background: venlafaxine has been available for use as an antidepressant in the United States for a decade.
Objective: Comprehensive reviews of venlafaxine have been published elsewhere; thus, this update focuses on newer issues of treatment remission in depression, treatment-resistant depression, and extended-release venlafaxine for generalized anxiety disorder (GAD).
Methods: Relevant clinical literature from 1993 through 2003 was identified from database searches of MEDLINE and International Pharmaceutical Abstracts, and from manual searches of reference lists of the identified papers. Search terms included venlafaxine extended-release, venlafaxine XR, treatment-resistant depression, depressive disorders, anxiety disorders, generalized anxiety disorder, and antidepressive agents second generation.
Results: With its dual action of serotonin and noradrenergic reuptake inhibition, venlafaxine has been shown to be superior in efficacy to selective serotonin reuptake inhibitors for severe major depressive disorder, treatment-resistant depression, and depressive symptom remission. Its demonstrated efficacy for both short- and long-term treatment of GAD has led to its use for obsessive-compulsive disorder and chronic pain syndromes, although inadequate clinical literature currently exists to support these latter 2 uses. In the past decade, no new or unexpected adverse events have been identified with venlafaxine therapy, except a possibly greater risk of fatal overdose compared with other serotonergic drugs, suggesting the need for caution in patients with suicidal ideation. Because venlafaxine is a potent serotonin agonist, caution must also be exercised to prevent the possibility of serotonin syndrome when used with other serotonin agonists, and its dose should be tapered very gradually to minimize the risk of a serotonin withdrawal reaction.
Conclusion: Venlafaxine has emerged as a successful post-SSRI-era antidepressant with an expanded range of uses since it was first marketed.
Posted by ace on November 9, 2003, at 22:44:36
In reply to Re: Someone, please help me. , posted by Robert Fairburn on November 5, 2003, at 5:27:42
> Yes I do think its time to try a MAOI drug, you sound atypical to me whcih does respond well to a MAOI. Dont let the docter give you a RMAOI because they are not as effective.
Very true.
So ask for parnate and hang in there, work you dosage up slowly and be prepared to wait a while. These drugs have a very high success rate.True again.
However they can give you the odd rough day before they start working to there full effect.
>True too. But not as much spoken about...MAOIs can initially cause a little anhedonia, maybe make depression and anxiety before they fully work. Keep this in mind MAOI users...
> Regards Robert
>
>
This is the end of the thread.
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