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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by tampagirl70 on November 16, 2004, at 9:27:51
At the beginning of this month I was depressed and obsessing and my pdoc raised my dose of Celexa from 40 to 60mg. Last week things were much better and I thought I was on the road to normalcy. This past Saturday I crashed and am again depressed and obsessing. Now my doc is thinking of raising me to 80mg Celexa. I was fine for over 3 years on anywhere from 20-40mg; why now all of a sudden am I having these problems and need to take a higher dose? This worries me. Is the Celexa pooping out on me? What do I do if it stops working? Help!!
Posted by Ted Brosnan on November 16, 2004, at 11:02:55
In reply to SCARED Pdoc wants to raise meds again, posted by tampagirl70 on November 16, 2004, at 9:27:51
You have to accept that the low mood might just come back out of the blue.
Antidepressants will not make you feel good all day around. Normals, not depressed, also experience ups and downs and it's completely normal.
I think if you fuss about it you make it worse. When you feel sad just ignore it and tell yourself that by next morning it will be away.
Believe me, medications are strong but human will is much stronger! Before couple of weeks I was down, I decided not to raise any medicince but rather to stop them all. I knew it will go away by time, and it really did after 3-4 days.
Using antidepressants in depressed patients can be counterproductive. The drugs might increase the patients sense of lack of control and helplessness.
Don't forget the will power you have and practice it :)
I am not suggesting stoping the medicine augment it with mind power!
Posted by linkadge on November 16, 2004, at 11:46:42
In reply to Re: SCARED Pdoc wants to raise meds again, posted by Ted Brosnan on November 16, 2004, at 11:02:55
I as well am not saying for you to stop taking your meds. However, there will always be those breakthough times. Antidepressants are just one of the tools in the box.
Make a list of some of the other tools that are available to you.
In the end you make the decisions. What do you think is best. I can understand that this board gives a lot of mixed messages!
Linkadge
Posted by King Vultan on November 16, 2004, at 12:05:44
In reply to SCARED Pdoc wants to raise meds again, posted by tampagirl70 on November 16, 2004, at 9:27:51
> At the beginning of this month I was depressed and obsessing and my pdoc raised my dose of Celexa from 40 to 60mg. Last week things were much better and I thought I was on the road to normalcy. This past Saturday I crashed and am again depressed and obsessing. Now my doc is thinking of raising me to 80mg Celexa. I was fine for over 3 years on anywhere from 20-40mg; why now all of a sudden am I having these problems and need to take a higher dose? This worries me. Is the Celexa pooping out on me? What do I do if it stops working? Help!!
I think it might be better in a case like this to switch to a drug with more of a dual action, such as Effexor or Cymbalta, rather than just raising the dosage of your SSRI. Drugs that work on both serotonin and norepinephrine seem to work better in the long term than plain SSRIs do.Todd
Posted by tampagirl70 on November 16, 2004, at 12:41:10
In reply to Re: SCARED Pdoc wants to raise meds again, posted by King Vultan on November 16, 2004, at 12:05:44
OCD is my biggest issue. The depression comes along for the ride when I start obsessing. I was on Effexor for a while a long time ago and I don't think it helped. I was also taking Norpramin and it gave me terrible dry mouth and made me sweat a lot. ARen't most SSRIs are good for OCD if taken in higher doses?
Posted by banga on November 16, 2004, at 14:38:24
In reply to Re: SCARED Pdoc wants to raise meds again, posted by tampagirl70 on November 16, 2004, at 12:41:10
What about clomipramine? Ever tried it? I loved it, aside from some weight gain.
Posted by King Vultan on November 16, 2004, at 16:12:29
In reply to Re: SCARED Pdoc wants to raise meds again, posted by tampagirl70 on November 16, 2004, at 12:41:10
> OCD is my biggest issue. The depression comes along for the ride when I start obsessing. I was on Effexor for a while a long time ago and I don't think it helped. I was also taking Norpramin and it gave me terrible dry mouth and made me sweat a lot. ARen't most SSRIs are good for OCD if taken in higher doses?
SSRIs are indicated for OCD, and I did find Zoloft helpful for mine, but I felt Effexor was just about as effective. I never took more than 150 mg/day of Effexor, though, and mostly less than that because it gave me such bad insomnia. The Norpramin (desipramine) problems do indicate that other drugs that significantly affect norepinephrine reuptake may tend to cause the same kinds of side effects in your particular case.One thing I've heard of being used for refractory OCD is adding a low dose of an atypical antipsychotic, such as Risperdal or maybe Zyprexa. Some of these drugs are relatively selective for blockading the serotonin-2A receptor at low dosages, and this can be helpful in augmenting SSRIs in treating OCD. The problem that can happen sometimes just trying to deal with the problem using high doses of an SSRI is that they can result in this receptor becoming overly stimulated, which can actually make OCD worse, as well as cause other side effects.
Todd
Posted by tampagirl70 on November 16, 2004, at 16:14:04
In reply to Re: SCARED Pdoc wants to raise meds again, posted by banga on November 16, 2004, at 14:38:24
Never tried it. I've tried Zoloft (killed sex drive which is already very low, and possibly made me gain weight), Luvox (not for very long) and Effexor (not for very long). Zoloft helped a great deal, but I couldn't stand the side effects so I begged my doctor to put me on Celexa, which has been very good to me. Until now, that is. And it could very well be the meds are still doing what they're supposed to be doing, I just had a set back.
Posted by tampagirl70 on November 16, 2004, at 16:30:11
In reply to Re: SCARED Pdoc wants to raise meds again » tampagirl70, posted by King Vultan on November 16, 2004, at 16:12:29
I was actually wondering if maybe the 60mg is too high and that's what caused the setback this past weekend. I haven't noticed any other side effects. I'm also taking 300mg Wellbutrin XL or XR (I forget which) to help counteract any sexual side effects caused by the Celexa. I noticed a change when I switched to Celexa from Zoloft, but that was about 3 years ago and I don't think my sex drive has gotten any better since then.
I'm seeing my pdoc on Friday and I'll ask him about the Risperdal or Zyprexa. Thanks for the info.
Posted by Bill LL on November 16, 2004, at 16:33:20
In reply to SCARED Pdoc wants to raise meds again, posted by tampagirl70 on November 16, 2004, at 9:27:51
Don't hesitate to try the 80 mg. If I were you, I would definitely go up to about 120 mg of Celexa before considering a medication change.
If 120 mg doesn't work well, I would then either increase it more, or augment, or switch to a different drug such as Duloxetine (Cymbalta).
I personally take 30 mg Lexapro and 120 mg (60 mg morning and 60 mg evening) of Strattera. Lexapro hits serotonin and although Strattera is not an "antidepressant", it hits norepinephrine which helps me feel more calm and attentive.
My 30 mg Lexapro is the equivalent of probably about 90 to 120 mg of Celexa.
Posted by Ted Brosnan on November 16, 2004, at 16:41:41
In reply to Re: SCARED Pdoc wants to raise meds again, posted by Bill LL on November 16, 2004, at 16:33:20
Doesn't the Strattera make you way too anxious at that dose? what about sleep problems?
Thanks
> Don't hesitate to try the 80 mg. If I were you, I would definitely go up to about 120 mg of Celexa before considering a medication change.
>
> If 120 mg doesn't work well, I would then either increase it more, or augment, or switch to a different drug such as Duloxetine (Cymbalta).
>
> I personally take 30 mg Lexapro and 120 mg (60 mg morning and 60 mg evening) of Strattera. Lexapro hits serotonin and although Strattera is not an "antidepressant", it hits norepinephrine which helps me feel more calm and attentive.
>
> My 30 mg Lexapro is the equivalent of probably about 90 to 120 mg of Celexa.
Posted by banga on November 16, 2004, at 16:49:45
In reply to Re: SCARED Pdoc wants to raise meds again » Bill LL, posted by Ted Brosnan on November 16, 2004, at 16:41:41
Anafranil, clomipramine, is specifically indicated for OCD. It acts on serotonin and norepinephrine, plus a few other things. For me, I found it a great drug, seemed to kick anxiety and rumination(I dont have OCD, but GAD) a bit, and my world was more vibrant and colorful than on plain SSRIs.
The only minus was some weight gain, though not as horrid in that sense as Paxil was for me.
The weight gain is why I'm not on it, I have a bad back and gaining weight means my back goes out. But I am comforted that Anafranil is there for me if all else fails.
I would say it has less icky side effects than neuroleptics, I think it's worth keeping in mind. But of course each of our chemistries are different.....
Posted by linkadge on November 16, 2004, at 21:01:35
In reply to Re: SCARED Pdoc wants to raise meds again, posted by banga on November 16, 2004, at 16:49:45
Anafranil can be a better med for anxiety, and depression than celexa is. Sometimes when the anxiety/depression is adressed, the OCD goes along with it.
Linkadge
Posted by Bill LL on November 17, 2004, at 8:46:39
In reply to Re: SCARED Pdoc wants to raise meds again » Bill LL, posted by Ted Brosnan on November 16, 2004, at 16:41:41
Up until 5 weeks a go, I was taking both 60 mg pills in the morning. That did make me too anxious. Then I switched to 1 in the morning and 1 at about 6 pm. I feel more relaxed.
I read a couple of abstracts of clinical studies and the average dose was 100 mg per day. So I'm just a little over the average. The dose is considered to be weight related. I weigh 180 lbs.
I really have never noticed an effect on my sleep onw way or the other.
> Doesn't the Strattera make you way too anxious at that dose? what about sleep problems?
>
> Thanks
>
> > Don't hesitate to try the 80 mg. If I were you, I would definitely go up to about 120 mg of Celexa before considering a medication change.
> >
> > If 120 mg doesn't work well, I would then either increase it more, or augment, or switch to a different drug such as Duloxetine (Cymbalta).
> >
> > I personally take 30 mg Lexapro and 120 mg (60 mg morning and 60 mg evening) of Strattera. Lexapro hits serotonin and although Strattera is not an "antidepressant", it hits norepinephrine which helps me feel more calm and attentive.
> >
> > My 30 mg Lexapro is the equivalent of probably about 90 to 120 mg of Celexa.
>
>
This is the end of the thread.
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