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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by socialdeviantjeff on December 22, 2003, at 2:47:28
Ok, here's my situation. For the past several months I've been on and off several drugs. The side-effects with all have been horrendous. It's like having a chronic illness. Right now, I take 150 mg Effexor, 300 mg Tegretol and 2 mg Perphenezine. I can only work part time. For two months I feel like I've had the flu. Cognitive problems, IBS, twitches, asomnia (circadian rhythm sleep disorder - delayed phase type), fatigue with a capital F, lightheaedness, complete and total lack of pleasure, irritability, dysphoria, you name it. I feel like the walking dead.
Despite this, there has been some benefit. Less suicidal ideation, less generalized anxiety, less anger in traffic, less guilt. But really on a scale of 1 to ten , these improvements are a 1 or 2, 3 on a good day.
My dx's are refractory psychotic depression, dysthemia, paranoid personality, Generalized anxiety Disorder, OCD.
I've bee on and reasons for discontinuing:
Ritalin (from 6 until 14)
Paxil-did nothing
Zoloft-did nothing
Amitryptaline & Desimpramine-made me psychotic
Wellbutrin-Allergic reaction
Prozac-Allergic Reaction
Neurontin-Allergic reaction
Lexapro-Side Effects
Lithium-Side EffectsMany of these tried in various combos.
I'm really beginning to wonder if this "walking dead" state is worth the minimal benefit I'm receiving. It has been this way with almost every med. It seems to be a trade-off. I could be miserable and dysfunctional one way or the other. If I keep meds, I'll lose a lot on the way of being active, having pleasure, etc. If I dump meds, I could very well wind up suicidal and the overal emotional situation would be quite bad.
FYI, Ive spent many a year with psychologists since age 6 to no avail.
Opinions welcome. TIA
Posted by linkadge on December 22, 2003, at 7:07:33
In reply to Quality of life on AD's Vs. off - opinions, please, posted by socialdeviantjeff on December 22, 2003, at 2:47:28
Perhaps changin the perphenazine with a newer antispychotic (risperdal, zyprexa) would clear up some of the sleep issues) (both are 5ht2a antagonisists and can block insomnia caused by many antidepressants).
You may as well want to reduce the tegrotol. In my experience anticonvulsant-antidepressant combinations do not work very well. (I could of course be wrong in your case).
Posted by Bill LL on December 22, 2003, at 8:40:21
In reply to Quality of life on AD's Vs. off - opinions, please, posted by socialdeviantjeff on December 22, 2003, at 2:47:28
I'm no expert on Effexor, but isn't 150mg a day a low dose? Maybe your dose should be increased.
Posted by KarmaFairy on December 22, 2003, at 9:59:36
In reply to Re: Quality of life on AD's Vs. off - opinions, please, posted by Bill LL on December 22, 2003, at 8:40:21
I take 75mg Effexor...that is the minimum therapeutic dose. I don't think that increasing the Effexor would at all resolve the side-effect issues. I would hope that tweaking combinations could be able to yeild better results and fewer side-effects...the *most* perfect combination can be like searching for a needle in a hay stack, but it's better to try than to just accept terrible side-effects. Good luck...
Posted by socialdeviantjeff on December 22, 2003, at 21:27:44
In reply to Re: Quality of life on AD's Vs. off - opinions, please, posted by KarmaFairy on December 22, 2003, at 9:59:36
Thanks for the replies. As the Effexor goes, it took two months to get to 150. For the Tegretol, it took 3 months to get to 400, then I backed down to 300 on the advice of my pdoc. The Perphenezine is used for budget reasons (it's cheap) and it also helps with the nausea. This is also my first antipsychotic.
As far as neuroleptics and AD's go, it's true that they are not very high doses. I want to discontinue Tegretol and try Depakote. Is there a generic for it? As far as AD's, my pdoc wants to try a couple more things then go to MAOI's. Probably Parnate to start. We've been trying to keep with meds that have a lower side effect profile. Any ideas? Any TCA or SSRI is out.
I'm Trying to keep faith that there is a med or combo of that will work without causing such huge problems. At this point, I'm wondering what's worse-being disabled by meds, or by my issues alone.
Posted by brussell on December 22, 2003, at 21:29:40
In reply to Quality of life on AD's Vs. off - opinions, please, posted by socialdeviantjeff on December 22, 2003, at 2:47:28
Because of the wide range of drugs you have tried without success, and your problem with feeling like the "walking dead" on them, I would strongly suggest trying a MAOI. You would need to discontinue the Effexor and Tegretol, so this is definitely something you should discuss with a good psychiatrist.
Good Luck
This is the end of the thread.
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