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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by babak on January 12, 2004, at 12:04:12
Hi,
I am trapped by Paroxetine. I have been taking 30mg a day for 10 months now and although it has been helpful with my anxiety, it has turned me into a vegetable. I have no drive, no libido, my mind is foggy and the lethargy which has taken over me is so deafening that I it is driving me crazy.
I have tried to come off it or at least reduce the dosage. Even at 5mg reduction, within 10 days I start to feel irritated, even more lethargic, more depressed and hopeless.
So I added a 45mg of Ritalin which helps me get out of be at least but nowhere near enough to make me anything like functional.
I want to try Selegiline at 15mg a day but I am scared of Serotonin Syndrome but I have also heard that at lower doses it is safe.
Can anyone help?
Will it help with coming off Paroxetine?
Thanks
Babak
P.S Generally I have quite a high tolerance. I was taking 60mg of Mirtazapine & 375mg of Venelafaxine plus Lithium at one point
Posted by hawkeye on January 12, 2004, at 16:37:24
In reply to Selegiline, Paroxetine, Ritalin, posted by babak on January 12, 2004, at 12:04:12
At low levels (<15mgs/day) Selegine is a highly selective MAIO B Inhibitor so it won't effect seretonin. However, it will increase the levels of dopamine floating around your system, so you may want to try it without the Ritalin first.
Posted by babak on January 12, 2004, at 19:24:31
In reply to Re: Selegiline, Paroxetine, Ritalin, posted by hawkeye on January 12, 2004, at 16:37:24
Thanks for the response,
What about Sodium Valproate, does that make things worse?
Will I be able to reduce paroxetine then?
Posted by Ame Sans Vie on January 13, 2004, at 7:12:30
In reply to Re: Selegiline, Paroxetine, Ritalin » hawkeye, posted by babak on January 12, 2004, at 19:24:31
The tried and true method for paroxetine discontinuation is switching to an equivalent dose of Prozac. The Prozac is quite similar to Paxil in some regards and so it prevents withdrawal. And due to Prozac's ultra-long half-life, it's quite easy to discontinue it as it is eliminated from your system over a period of weeks, rather than hours as with Paxil. I used this method to discontinue Ultram (whose withdrawal syndrome was akin to Paxil's but many times worse). I thought I'd never get off the stuff, but with Prozac it was no problem.
Posted by SLS on January 13, 2004, at 9:21:50
In reply to Re: Selegiline, Paroxetine, Ritalin, posted by Ame Sans Vie on January 13, 2004, at 7:12:30
Hi Michael.
> I used this method to discontinue Ultram (whose withdrawal syndrome was akin to Paxil's but many times worse). I thought I'd never get off the stuff, but with Prozac it was no problem.
What was your reason for taking Ultram, how well did it work, and what were your reasons for stopping it?
I'm sure you've already explained, but I don't seem to remember.
Thanks.
- Scott
Posted by babak on January 14, 2004, at 9:42:33
In reply to Re: Selegiline, Paroxetine, Ritalin, posted by Ame Sans Vie on January 13, 2004, at 7:12:30
Ame Sans Vie, what are you on and is it working?
Posted by Ame Sans Vie on January 14, 2004, at 15:52:06
In reply to Re: Selegiline, Paroxetine, Ritalin » Ame Sans Vie, posted by SLS on January 13, 2004, at 9:21:50
I was prescribed Ultram at 100mg four times daily for depression and mild OCD symptoms. It worked absolutely wonderfully, and posed no problems for several months. But then my fibromyalgia pain began to worsen and I noticed that when I missed a dose or two, my pain subsided considerably. Go figure. <shrug>
Posted by Ame Sans Vie on January 14, 2004, at 15:55:36
In reply to Re: Selegiline, Paroxetine, Ritalin » Ame Sans Vie, posted by babak on January 14, 2004, at 9:42:33
I think I'm finally settled on the perfect med combo for me:
Klonopin -- 3mg at 6:00AM, 2mg at noon, and 3mg at 6:00PM
Adderall XR -- 60mg each morning
Prozac -- 20mg each morning
Chloral hydrate -- 1,000mg as needed for sleep
Tuinal -- 200mg as needed for sleepIt's working better than anything I've been on before, and has been working beyond my expectations for months now. I'm diagnosed with primary social anxiety, agoraphobia, panic disorder, depression, and mild OCD and ADD.
Posted by SLS on January 14, 2004, at 16:45:23
In reply to Re: Selegiline, Paroxetine, Ritalin » babak, posted by Ame Sans Vie on January 14, 2004, at 15:55:36
> I think I'm finally settled on the perfect med combo for me:
>
> Klonopin -- 3mg at 6:00AM, 2mg at noon, and 3mg at 6:00PM
> Adderall XR -- 60mg each morning
> Prozac -- 20mg each morning
> Chloral hydrate -- 1,000mg as needed for sleep
> Tuinal -- 200mg as needed for sleep
>
> It's working better than anything I've been on before, and has been working beyond my expectations for months now.Way cool.
> I'm diagnosed with primary social anxiety, agoraphobia, panic disorder, depression, and mild OCD and ADD.
Do you feel that the Adderall is contributing at all to your antidepressant response?
- Scott
Posted by Ame Sans Vie on January 15, 2004, at 7:03:01
In reply to Re: Selegiline, Paroxetine, Ritalin » Ame Sans Vie, posted by SLS on January 14, 2004, at 16:45:23
> Do you feel that the Adderall is contributing at all to your antidepressant response?
Absolutely! The Adderall is certainly my mainstay antidepressant -- the Prozac is just there for backup, and I don't really know whether it's doing much for me. I originally began taking it only as a means to withdraw from Ultram (for which it worked flawlessly) and just never dropped it. The way I see it, everything is going great now -- no need to rock the boat.
I'm not concerned with development of tolerance as I've been able to maintain a constant effect from amphetamines for months now without raising dose. In all fairness, I do take 60mg Delsym (dextromethorphan polystirex) twice daily, which is quite likely preventing tolerance. My pdoc endorses the use of DXM to all his stimulant-treated patients now, ever since I brought it to his attention months ago. He's seeing many patients finally stabilized on doses of amphetamines whereas they used to escalate monthly or even weekly. It doesn't seem to be working as well for his patients taking methylphenidate.
Posted by SLS on January 15, 2004, at 7:59:29
In reply to Re: Selegiline, Paroxetine, Ritalin » SLS, posted by Ame Sans Vie on January 15, 2004, at 7:03:01
> > Do you feel that the Adderall is contributing at all to your antidepressant response?
> Absolutely! The Adderall is certainly my mainstay antidepressant -- the Prozac is just there for backup, and I don't really know whether it's doing much for me. I originally began taking it only as a means to withdraw from Ultram (for which it worked flawlessly) and just never dropped it. The way I see it, everything is going great now -- no need to rock the boat.<smiles>
I'm glad things are going so well for you. Be sure that I'll be exploiting your improved and sharpened intellect from time to time.
Sincerely,
Scott
Posted by babak on January 15, 2004, at 10:53:36
In reply to Re: Selegiline, Paroxetine, Ritalin » SLS, posted by Ame Sans Vie on January 15, 2004, at 7:03:01
The question is are you now well enough to drop your nick name?
Because a soul without life is exactly how I feel.
Posted by jerrympls on January 17, 2004, at 23:31:17
In reply to Re: Selegiline, Paroxetine, Ritalin » SLS, posted by Ame Sans Vie on January 15, 2004, at 7:03:01
> > Do you feel that the Adderall is contributing at all to your antidepressant response?
>
> Absolutely! The Adderall is certainly my mainstay antidepressant -- the Prozac is just there for backup, and I don't really know whether it's doing much for me. I originally began taking it only as a means to withdraw from Ultram (for which it worked flawlessly) and just never dropped it. The way I see it, everything is going great now -- no need to rock the boat.
>
> I'm not concerned with development of tolerance as I've been able to maintain a constant effect from amphetamines for months now without raising dose. In all fairness, I do take 60mg Delsym (dextromethorphan polystirex) twice daily, which is quite likely preventing tolerance. My pdoc endorses the use of DXM to all his stimulant-treated patients now, ever since I brought it to his attention months ago. He's seeing many patients finally stabilized on doses of amphetamines whereas they used to escalate monthly or even weekly. It doesn't seem to be working as well for his patients taking methylphenidate.
>
>Dextromethorphan helps prevent tolerance to stimulants?? I've never heard of this. Very interesting! Also - I've recently read about the use of Ultram as an antidepressant for TRD that apparently works very fast - is this true?? Did your doc present this option to you or did you supply yoru doc with research info in order to try Ultram? Can you point me to anymore info??
Thanks in advance!
Jerry
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