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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 39. This is the beginning of the thread.
Posted by flmm on January 7, 2006, at 11:36:11
I am getting the feeling a lot of people on this board are always changing drugs to battle depression. I think what a lot of people are doing is chasing the euphoric high that comes with starting a new drug, and improperly thinking they are in remission, or the antidepressant is better than another.It seems to be a losing and frustating battle. I say if a drug does a reasonable job of keeping you from being horribly depressed it is probably as good as it gets.These drugs are not intended to make you high, or even happy, just not depressed! Lets keep it in perspective..........
Posted by tepiaca on January 7, 2006, at 12:53:10
In reply to Constant drug changes? and Depression, posted by flmm on January 7, 2006, at 11:36:11
In my case, I only has responsed well to the
MAOI Nardil . In the last months I have been
trying others drugs like Tolvon , Risperdal ,
Abilify , Paxil , I am now on Remeron, but
nothing seem to give me relief. I have
a serious problem and my doctor dont know
exactly what is it. In this moment Im tired of
tried so much drugs,sometimes I want to return
to Nardil, but I also think that this is the
moment to try new ones.
Posted by cache-monkey on January 7, 2006, at 13:43:18
In reply to Constant drug changes? and Depression, posted by flmm on January 7, 2006, at 11:36:11
I definitely think that some, including me for a while, are "chasing the dragon" as it were.
But at the same time (and this is where I now fall) there is a process in finding the right medication or med combo that works. I'm just looking for balance, peace even, right now. I do think I need meds to get there until I can do some serious work in therapy.
But, in my recent round of drug trials, I've been getting very little positive effect from the meds that I've tried and pretty bad side effects. I'm not talking about sexual dysfunction or weight gain, but a worsening of the psychological symptoms I'm trying to treat in the first place. Or a worsening in another psychological domain, e.g. massively increased anxiety from a drug taken to treat depression.
These are trade-offs that basically just suck to make. And I for one don't think they have to be made.
~cache-monkey
> I am getting the feeling a lot of people on this board are always changing drugs to battle depression. I think what a lot of people are doing is chasing the euphoric high that comes with starting a new drug, and improperly thinking they are in remission, or the antidepressant is better than another.It seems to be a losing and frustating battle. I say if a drug does a reasonable job of keeping you from being horribly depressed it is probably as good as it gets.These drugs are not intended to make you high, or even happy, just not depressed! Lets keep it in perspective..........
Posted by linkadge on January 7, 2006, at 13:53:07
In reply to Re: Constant drug changes? and Depression » flmm, posted by cache-monkey on January 7, 2006, at 13:43:18
Thats why I just got off them. I've taken so many different antidepressants, and it was basically the same deal. It gave me an effect for a while, but then I would pretty much settle into the same position I was before I took them (plus all the side effects remained).
That first effect sticks with you though. You can remember it so well. Its those fleeting moments you remember that make you think that all of life should be that way.
Linkadge
Posted by linkadge on January 7, 2006, at 13:56:11
In reply to Re: Constant drug changes? and Depression, posted by linkadge on January 7, 2006, at 13:53:07
The only lesson that seems to be most recurrant in my life is.
"There is nothing beyond stability"
If you want more now, you'll have to expect less later.
Linkadge
Posted by Declan on January 7, 2006, at 16:41:15
In reply to Re: Constant drug changes? and Depression, posted by linkadge on January 7, 2006, at 13:56:11
Yeah Link, I was struck by something you said a while back: "There is no edge, only balance"
Declan
Posted by linkadge on January 7, 2006, at 17:46:03
In reply to Re: Constant drug changes? and Depression » linkadge, posted by Declan on January 7, 2006, at 16:41:15
I certainly have a tendancy in my life, to make poor decisions about meds for the wrong reaons.
I have found that not medicating every little problem is probably better for you in the long run.
For a while, by brain seemed to immediately think about my medication whenever something wrong happened in my life.
I was underestimating, and probably hampering my brain's own ability to heal itself with time, by taking too many pills.
I'm not saying that medications can't help, but it was a tendancy for me (coupled with the internet) to think that I knew better than my brain.
But, the brain always knows better.
Linkadge
Posted by flmm on January 7, 2006, at 21:04:18
In reply to Re: Constant drug changes? and Depression, posted by linkadge on January 7, 2006, at 17:46:03
For me the drug Effexor and Cymbalta were like chasing a fleeting high. Those drugs got me very up, very down, and very anxious, all within a matter of hours. I guess this is what bipolar is like! I am not bipolar, and stopped chasing what I think I should be like, and got back on the drug that at least gets me to work everyday, Lexapro. It is not exiting, no high, but no panic attacks and terrible anxiety either. I guess I can't have it both ways!
Posted by Phillipa on January 7, 2006, at 21:13:43
In reply to Re: Constant drug changes? and Depression, posted by flmm on January 7, 2006, at 21:04:18
I've yet to find an AD that does anything for me except create anxiety and it doesn't go away it gets worse. Fondly, Phillipa
Posted by vbAgent on January 7, 2006, at 21:14:39
In reply to Re: Constant drug changes? and Depression, posted by linkadge on January 7, 2006, at 17:46:03
Abraham Maslow once said, "When the only tool you have is hammer, you tend to treat everything as if it were a nail." Psychiatry practices the art of trial and error. It can be like a big chemistry experiment if one isn't careful.
Moving from drug to drug without success is certainly a frustrating experience. Been there, done that, and I don't like it at all. Naturally, and insidiously, doubt invades the mind. A person drifts along unsure what to do. They don't realize how self-absorbed they are; they don't realize the futility of trying to fix what may not be broken. As a result, one forgets to live. So, this person remains depressed and anxious because of the mistaken belief that happiness is an elusive, unreachable state of mind (without a pill)...That is, at least until this maladjusted person learns to roll with the punches, not sweat the small stuff, and consciously accept responsibility for his/her life. It's so much easier said than done! Just go with the flow. Don't take yourself or life's little annoyances so seriously. Use medication as a tool, not as the answer to happiness.
Posted by flmm on January 7, 2006, at 21:38:17
In reply to Re: Constant drug changes? and Depression, posted by vbAgent on January 7, 2006, at 21:14:39
Well said agent!
Posted by Tomatheus on January 7, 2006, at 22:30:57
In reply to Constant drug changes? and Depression, posted by flmm on January 7, 2006, at 11:36:11
> I am getting the feeling a lot of people on this board are always changing drugs to battle depression.
For me, sometimes all it takes to get a "feeling" about something is to read a single message. Is there a specific message that you're referring to?
> These drugs are not intended to make you high, or even happy, just not depressed! Lets keep it in perspective..........
What you seem to be unable to realize is that "these drugs" affect everybody differently. Many of those who fall within the bipolar spectrum (myself included) experience depression on a constant or nearly constant basis when left untreated. Like everybody else suffering from depression, they take antidepressants to relieve their depressive symptoms - so they can experience the same "normal" range of emotions that most people take for granted. Depending on where they fall within the spectrum, individuals with treatment-induced bipolar disorder may become constantly (hypo)manic upon the administration of certain antidepressants, or they may cycle back and forth between (hypo)mania and depression. Some bipolar individuals respond this way to all antidepressants, but others only develop (hypo)manic symptoms in response to certain classes of antidepressants. Individual responses can vary considerably.
Do patients with treatment-induced bipolar disorder hope to respond to antidepressants (or at least certain classes of antidepressants) in the way that they do? Do they hope that they can experience an abnormal reaction to an antidepressant so that they'll end up having to try out various combinations of mood stablizers and antidepressants until they find something that actually relieves at least some of their depressive symptoms without triggering any mania? I think I speak for most, if not all, patients with treatment-induced forms of bipolar disorder when I say hell no! We're not looking for any kind of high, and even though hypomania may be blissfully intoxicating, that's not the effect that any of us are trying to get from an antidepressant. Like other depressives, those of us with treatment-induced forms of bipolar disorder want nothing more than to experience the "normal" ups and downs that we're supposed to feel in response to environmental stimuli. We don't ask to respond to a medication in a way that's different from how most people respond to it (or how it's intended, as you put it), and I think it's insulting to even imply that we do.
Maybe with a little bit more perspective, you'd be able to realize that patients who happen to experience (hypo)manic symptoms in response to certain antidepressants never asked to be the way that they are and certainly never took antidepressants with the goal of getting "high."
Tomatheus
Posted by linkadge on January 8, 2006, at 8:55:21
In reply to Re: Constant drug changes? and Depression, posted by vbAgent on January 7, 2006, at 21:14:39
When I started out, I may have had a minor chemical imballence. But after years of treatment I really had a chemical imballence.
Before treatment, a bad day was a just bad day. But after being in the "system" so long, a bad day was some exotic misalignment of my gabaergic, noradrenergic, serotonergic axis bla bla.
But the dangerous part was that I acted on such beliefs. I acted without any real proof, but just my preception of what was wrong.
But it was a kinder way to frame things I'll give it that. No longer was I dumb, I just had reduced acetlycholine output or some other B.S.
Linkadge
Posted by flmm on January 8, 2006, at 11:37:20
In reply to Re: Constant drug changes? and Depression, posted by linkadge on January 8, 2006, at 8:55:21
i think you get the point tomatheus. I was talking about some people, myself included, who get an initial "high" at the begining of antidepressant usage, and mistaking that for remission! We all know that everyone is different, and your defensive stance is really not the reaction I was after! I was merely making a general point, and the people who get it, know what I meant!
Posted by Tomatheus on January 8, 2006, at 12:19:34
In reply to Re: Constant drug changes? and Depression, posted by flmm on January 8, 2006, at 11:37:20
> We all know that everyone is different, and your defensive stance is really not the reaction I was after!
I think everybody here also understands that antidepressants aren't supposed to make people "high." But for individuals who switch into hypomanic states or go through cycles of hypomania and depression, a "high" is sometimes the unintended consequence of treatment. Patients like myself who experience treatment-induced hypomanic episodes know as well as anybody else that antidepressants are just supposed to relieve depression and not cause one to feel "high," and I find it frustrating when others imply that we don't understand this.
Tomatheus
Posted by linkadge on January 8, 2006, at 13:04:34
In reply to Re: Constant drug changes? and Depression, posted by Tomatheus on January 8, 2006, at 12:19:34
Thats what they're intended to do, but unfortunately they don't always work that way.
Recalling that the MAOI drugs were actually discovered based on their propensity to make normal, nondepressed people feel better than well.
I'm not saying that everybody goes "manic" on these drugs, but I am saying that they are powerfull, and that they can influence many aspects of contiousness.
I recall feeling slighly better than well on certain antidepressants. I had no symptoms of mania, but I just felt better than well.
That fact influcence many aspects of my life, and influenced many decisions I made about treatment.
That is why, in many ways I would consider them addictive. My behavior resembled that of a junkie in many ways.
Linkadge
Posted by blueberry on January 8, 2006, at 13:43:11
In reply to Constant drug changes? and Depression, posted by flmm on January 7, 2006, at 11:36:11
I've tried dozens of antidepressants and never had a euphoric high. Sounds nice though.
I'm guilty. I switch meds a lot. But only when they don't work after 6 weeks, or if there are intolerable side effects that I can't get through, or if the med does the opposite of what it is supposed to do and makes me feel much more depressed instead.
I've been through 3 different meds in the last 5 months. Not sure if that's what you would call constant drug changes. But if they don't show any benefit at 6 weeks in clinical trials, it is considered a failure, so I move on.
I do know that the constant med changes come to a screaching halt when you finally land on the right meds. I was on a constant stable dose of prozac and zyprexa for 5 full years with not even a thought of trying another med, simply because finally I had found the right ones. Those 5 wonderful years never would have happened if I had given in and settled for mediocre results on other meds that didn't quite do the job.
Posted by Declan on January 8, 2006, at 14:10:13
In reply to Re: Constant drug changes? and Depression, posted by linkadge on January 8, 2006, at 13:04:34
Hi Link
Just out of interest, which ADs did you feel slightly better than well on?
Declan
Posted by ed_uk on January 8, 2006, at 15:24:05
In reply to Re: Constant drug changes? and Depression, posted by Declan on January 8, 2006, at 14:10:13
I knew you'd ask that Deccie ;-)
Ed
Posted by linkadge on January 8, 2006, at 16:15:49
In reply to Re: Constant drug changes? and Depression, posted by linkadge on January 8, 2006, at 13:04:34
I think it might have been a zoloft, clomipramine combination.
I suppose this was triple uptake inhibiton to a certain extent.
It gave me a sence of controll, when I could make myself feel better by taking a pill. There were things that I didn't want to deal with. I could forget about them for a little longer by obsessing about drugs.
But I stopped eventually, because I found myself actually focusing more on drugs and less on how to actually solve my real world problems.
I wasn't manic, not even really hypomanic. But when I changed drugs all the time it gave me a sence that things were "happening" in my life.
Tomorrow is going to be better, because tomorrow I try drug x.
Linkadge
Posted by vbAgent on January 8, 2006, at 16:42:24
In reply to Re: Constant drug changes? and Depression, posted by linkadge on January 8, 2006, at 16:15:49
Since I like quoting, here's something from Joseph Addison: "The three great requirements for a happy life are: something to do, something to love, and something to hope for."
Let us not change drugs because it's something to do and something to hope for. This is a misguided attempt to find happiness.
Linkadge, you have a lot of insight and common sense. Don't discount or forget about the power of your mind.
Posted by linkadge on January 8, 2006, at 18:13:38
In reply to Re: Constant drug changes? and Depression - link, posted by vbAgent on January 8, 2006, at 16:42:24
Thanks, thats a good quote.
I come her now because I had spent so much time here (when I was on meds), that I've made friends.
Boards like this can be a double edged sword. It was great that I felt support, but sometimes I got the wrong ideas about things.
Linkadge
Posted by vbAgent on January 8, 2006, at 19:40:25
In reply to Re: Constant drug changes? and Depression - link, posted by linkadge on January 8, 2006, at 18:13:38
> Thanks, thats a good quote.
>
> I come her now because I had spent so much time here (when I was on meds), that I've made friends.
Yep, many years ago I contributed under the nick *Cressida*...and although I still add my two cents now and then, I haven't made any friends here.
> Boards like this can be a double edged sword. It was great that I felt support, but sometimes I got the wrong ideas about things.Quite true and excellent observation btw. Relying on others is sometimes a risky business. I consider the source before taking advice seriously. Are they speaking from experience? A position of authority? - If so, what are their qualifications? So, I consider a checklist of requirements. If any are unmet, I take their advice with a grain of salt or just discard it altogether.
This reply may not belong on this board...Oh well.
Posted by fires on January 8, 2006, at 20:51:04
In reply to Constant drug changes? and Depression, posted by flmm on January 7, 2006, at 11:36:11
My ideas as to why some are constantly changing ADs:
1) They have underlying medical conditions which cause or exacerbate depression, and don't respond to ADs.
2) Some here are mildly depressed and have the luxury of shopping for the best AD for them. This group doesn't seem to have severe anhedonia. The severely depressed don't generally show up here, especially if they experience anhedonia. Typing something on a computer is far beyond their capabilities. The severely depressed are so afraid of sudden and unpredictable "relapses", that they are willing to settle for any AD that keeps them out of a living h*ll.
3) A few here are putting us all on -- they don't have depression or any other brain disorder(s).
Posted by vbAgent on January 8, 2006, at 21:39:26
In reply to Re: Constant drug changes? and Depression » flmm, posted by fires on January 8, 2006, at 20:51:04
> My ideas as to why some are constantly changing ADs:
>
> 1) They have underlying medical conditions which cause or exacerbate depression, and don't respond to ADs.
>
> 2) Some here are mildly depressed and have the luxury of shopping for the best AD for them. This group doesn't seem to have severe anhedonia. The severely depressed don't generally show up here, especially if they experience anhedonia. Typing something on a computer is far beyond their capabilities. The severely depressed are so afraid of sudden and unpredictable "relapses", that they are willing to settle for any AD that keeps them out of a living h*ll.
>
>
> 3) A few here are putting us all on -- they don't have depression or any other brain disorder(s).
Remain mindful that this is a forum, a place for open discussion. It is not my job or someone else's to judge who might be a wolf in sheep's clothing. fires, the 3rd idea is a red herring because it diverts attention away from the point and doesn't explain why people constantly change ADs. Otherwise, a top quality post. Do you think that a lot of people fake mental illness? Like malingering or drug-seeking? Sorry fires, don't take this personally or the wrong way. I am bored, full of coffee, and just very opinionated in a defensive way at times.
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