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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Enigma on April 11, 2006, at 15:07:46
My doctor, in plain words, is an idiot, and seems to care almost nothing for her patients, or what she does for a living.
With that, I've been on Celexa for about 3 weeks now. I have severe atypical depression.
Started slow, 5 mg for 4 days. Then 10 mg for 2 weeks, then 20 mg for the past 4-5 days. I was getting tired during the day before, but when I went to 20, I'm exhausted all day and I feel absolutely 0 benefit from the drug. It's even given me some anxiety.
I already have sleep problems, which I'll get into in another message, but I *do* sleep a solid 7-8 hours a night, and currently on disability.
Should I dump this drug altogether? Taper down?
I will call my "doctor", but I already know what she'll say, since she could care less that I'm suffering. She'll just say, textbook style, give it a month, and see what happens, or worse yet, go up on the dosage, which will probably have me asleep all day (which I will refuse to do).Bah. I need EMSAM now.
Posted by med_empowered on April 11, 2006, at 15:18:25
In reply to Celexa is making me a zombie, continue or quit?, posted by Enigma on April 11, 2006, at 15:07:46
i'd say taper off, if you feel that awful. If you doc sucks, you can always get a new one. One trick that sometimes helps: go into your next session, and instead of asking if there's something you can do about the situation, just say you've stopped taking the celexa and you aren't going to take it again and that you need something that will help with your depression w/o making you a zombie. Your doc could hit the roof and decide to send you to another doc, hit the roof and complain about "non-compliance"...but most likely she'll be peeved, but work with you. If the antidepressant route is really the way to go for you, you could try something like Wellbutrin (apaprently helpful for atypical depression) or some of the TCAs, the newer ADs (effexor, cymbalta), anti-depressant cocktails (example: "California Rocketfuel")....so on and so forth.
I know this sounds manipulative, but this is really YOUR life here, and its not like you have florid psychosis or something like that in which medication is needed to make you coherent...you have severe depression which sucks, but can be treated in a number of different ways, with various meds (or without meds), so you really need to push your doc to be flexible here--there's really no good reason for you to feel like a zombie.
Personally, I think you need a more aggressive approach than just "take the celexa--wait a month". I mean, if your depression is so severe you're not working, you really need a doc who will get creative and really attack the problem, not just throw a pill your way and tell you to wait it out.
Good luck!
Posted by bart on April 11, 2006, at 17:10:09
In reply to Celexa is making me a zombie, continue or quit?, posted by Enigma on April 11, 2006, at 15:07:46
man I have dealt with the same problems too with every ssri you can think of. For a long time, I thought I must be crazy because I never heard doctors or anyone else address the issue until I starting coming to this forum. My solution lies in cutting the dose in half or add a mildly motivating drug to it like provigil for daytime drowsiness.
Posted by Enigma on April 11, 2006, at 17:45:15
In reply to Re: Celexa is making me a zombie, continue or quit, posted by med_empowered on April 11, 2006, at 15:18:25
>I mean, if your depression is so severe you're not working, you really need a doc who will get creative and really attack the problem, not just throw a pill your way and tell you to wait it out.
>
> Good luck!Man, I couldn't agree more with your last sentence there. I have yet to find an aggressive doctor, out of like 10++ different pdocs (not including therapists - they were a waste of time too, except one). Unfortunately, just about ALL the docs I've seen were like the sentence you wrote above - "throw a pill your way and tell you to wait it out".
The reason I stay with this doc, is that she's readily willing to write my 'doctor's notes' that I need for disability. Personally, I just don't think she cares one way or the other. I'm currently trying to get an appt with a homeopathic "doc" now. I'll try anything at this point.
The doctor right before that thought I would be better served by going back to WORK!. I almost punched him in the face as he basically refused to write me a note allowing me time off. I can't even function AT HOME, let alone at work as a software engineer!!! I even tried to show him all the HR "failure at work" letters I got from my boss.
No amount of explanation worked with this joker. He must of thought I was trying to "work the system" or something. What a #@!^@ !@^&!^!!The doc before him? He refused to take me as a patient and directed me to where I am now. I believe he thought (he never admitted this, but I'm sure of it) I was untreatable (or, very difficult to treat), and didn't want the bother.
I saw him a few times, and he kept repeating how "you've been at this for a while", meaning the drug game, as I like to call it. So, he didn't think he could help me, nor did he even want to try, so he happily bounced me to another facility.
My other doc, 2 docs ago, would write notes for me as well, but he was also a joke, as far as tossing pill after pill at me and not really trying to get at the root of my specific problems. I'm so angry with the medical industry as a whole, I can't even put it into words.
Mind you, I am a model patient. Calm, courtious, etc. I try to calmly explain where I'm at, and they just don't listen.
I *HAD* one GREAT doc, unfortunately he wasn't a pdoc, and then, he retires early!! Just my luck.
So bitter subject with me? Hell yes. I could care less if I've offended any docs that skim these boards. From MY experience, most of you don't deserve 1/10th what you get paid, an ounce or respect, and should seriously consider other fields of work... something say, like ditch-digging!!!
(I know, I know, warning... please be civil...)
Posted by Enigma on April 11, 2006, at 17:52:01
In reply to Re: Celexa is making me a zombie, continue or quit?, posted by bart on April 11, 2006, at 17:10:09
Oh, almost forgot.
Tried Wellbutrin - no AD effect for me, did give me energy though - took it for 2-3 years!
Tried Cymbalta - gave me a suicidal reaction and spent 2-3 days in the hospital - no lie.
Tried Provigil - didn't do a thing (didn't give me any energy)
Tried Effexor - worst AD I've ever tried (besides Cymbalta; side-effect nightmare, + withdrawal for 6-8 MONTHS. You couldn't pay me enough to touch that again.And many, many others.
I called BCBS about EMSAM coverage and the lady told me to call back Friday. Something about that they are deciding on the co-pay amount, and/or, deciding if it needed more scrutiny (not the word she used, but something like that).
So, I'll let you know Friday if BCBS New England is going to cover it.
Posted by blueberry on April 11, 2006, at 18:46:09
In reply to Celexa is making me a zombie, continue or quit?, posted by Enigma on April 11, 2006, at 15:07:46
You could drop the dose down a bit and stay there. A recent 6 year study with thousands of patients showed that the usual 6 to 8 weeks trial was not enough. Many people who had an inadequate response in that time frame had a good response at 12 weeks. The zombiness may go away by then too.
Easier said than done, believe me I know.
When seeing the doctor, keep the attitude in mind that you are the paying customer. I mean, when you spend money for anything else you expect to get your money's worth, right? Whatever thoughts, words, or phrases you use, make sure to convey that message.
You can also be right up frank and honest. Let them know exactly how bad and how serious the situation is and how disappointed you are with their performance. Tell them you know they can do better and you want to see results.
Posted by Racer on April 11, 2006, at 18:51:01
In reply to Re: Celexa is making me a zombie, continue or quit, posted by Enigma on April 11, 2006, at 17:52:01
I've never tried Celexa, but you're kinda describing me on Lexapro. I stopped taking it when it got to where I wouldn't even speak because it was too much energy...
The bad news is that I would kinda recommend giving Celexa 4 full weeks... If you can live through the four weeks at the prescribed dose, it makes it a heck of a lot easier to convince your doctor that you really did try, and it really doesn't work. Sometimes it's easier to deal with a pdoc that way.
On the other hand, I know how hellish it can be to stay on a drug you know isn't working. So, I would also kinda recommend tapering down, over maybe a week, and making a new appointment with this pdoc to talk about alternatives. If you make the appointment for past Friday, you'll even know how much the EMSAM will be. :-)
In terms of meds, have you ever had even a partial response to anything you've tried? If so, what is it? Someone here might be able to recommend a direction to talk to your doctor about...
> >
> Tried Wellbutrin - no AD effect for me, did give me energy though - took it for 2-3 years!Were you taking it with another drug? Maybe a combination of something that maybe worked with Wellbutrin to add energy? If you haven't tried it, it's probably worth a shot.
> Tried Provigil - didn't do a thing (didn't give me any energy)
How long did you take it, how high a dose, and what else were you taking? It's possible that it might help if you took either more of it or for a longer time or with another drug. It could be that you were taking it with a Zombifying med that it couldn't help with, or that it was giving you such a subtle boost that you weren't aware of it. Also, my experience is that when Provigil was working, I didn't know it was doing anything. Only when it got too high a dose, and started making me jittery was I aware of it. Obviously, that doesn't mean that it's going to be helpful for you, just offering my own experience, in case it comes up again as worth a try...
> Tried Effexor - You couldn't pay me enough to touch that again.
>You and me both. That's one of the few drugs that I absolutely, positively, no matter what anyone says, refuse to take again...
>
> So, I'll let you know Friday if BCBS New England is going to cover it.
>Yes, do, because we have BCBS-Texas, and EMSAM is my pdoc's next choice for me....
Posted by Caedmon on April 11, 2006, at 19:29:40
In reply to Re: Celexa is making me a zombie, continue or quit » Enigma, posted by Racer on April 11, 2006, at 18:51:01
Maybe you could ask about augmenting it with Wellbutrin since that gave you energy?
I had that reaction on Lexapro. It was GREAT for my anxiety for about 4 months, then I started to get incredibly apathetic and tired. By the end I thought someone was sneaking potent indica marijuana into my breakfast muffins.
- C
Posted by Phillipa on April 11, 2006, at 22:03:22
In reply to Re: Celexa is making me a zombie, continue or quit, posted by Caedmon on April 11, 2006, at 19:29:40
If you can believe this a 30day of 20mg of the ENSAM patch reported by two other posters one is $440 a month the other in the $500 something range. Leave it to the drug companies. They know most only 50-70% respond to them and it was on ABC news . But my fear is the docs are too uneducated about the MAOI's and only want patients who respond to meds to make it easy for the l0minute appointment. Mine point blank said I don't have time to talk that's what the therapists are for. We need a plan and a good one. Love Phillipa ps they only know the bad about MAOI's. Where is that Amy Harmon from the NY Times who interviewed a bunch of pbabblers. Although she was skewed in her remarks who knows maybe she can help. I keep folders with all my E-mails in them and dont delete them or babblemails If I made one on her I will have her telephone number and E-mail address she contacted me.
Posted by fairywings on April 12, 2006, at 0:35:38
In reply to Re: Celexa is making me a zombie, continue or quit, posted by med_empowered on April 11, 2006, at 15:18:25
>>Your doc could hit the roof and decide to send you to another doc, hit the roof and complain about "non-compliance"...but most likely she'll be peeved, but work with you.
Hmmmmm....I never thought about it b4 - my pdoc has never been peeved with me when I've quit a med because it made me feel bad, and he's always worked with me to find something to help. I've never considered it manipulative to quit a med when it made me feel bad - just survival.
What in the heck is "California Rocket Fuel"?
fw
Posted by SLS on April 12, 2006, at 6:51:42
In reply to Re: Celexa is making me a zombie, continue or quit » med_empowered, posted by fairywings on April 12, 2006, at 0:35:38
> What in the heck is "California Rocket Fuel"?
It's a combination of Effexor + Remeron.
Their mechanisms of action are complementary and perhaps synergistic.
- Scott
Posted by med_empowered on April 12, 2006, at 7:16:09
In reply to Re: Celexa is making me a zombie, continue or quit » med_empowered, posted by fairywings on April 12, 2006, at 0:35:38
hey! I don't consider stopping/starting meds and then telling the doc "manipulative" or "non-compliant," either. But...I've noticed from talking to friends and reading posts here that docs vary WILDLY in terms of how they manage (or mis-manage) their relationships with patients...some docs do get upset about those sorts of things, and I've had docs try to coax me one way or another w/o any real "reason" (I'm thinking "real" as in data, numbers--actual hard evidence that drug X could hold any benefit) to do so. Glad you have a good doc, though.
Posted by fairywings on April 12, 2006, at 8:01:09
In reply to Re: Celexa is making me a zombie, continue or quit, posted by SLS on April 12, 2006, at 6:51:42
Interesting....wonder how it got dubbed that, and do pdocs refer to it as that....or just patients....I'd never heard of it.
Thanks Scott.....
fw
Posted by SLS on April 12, 2006, at 8:16:30
In reply to Re: Celexa is making me a zombie, continue or quit » SLS, posted by fairywings on April 12, 2006, at 8:01:09
> Interesting....wonder how it got dubbed that, and do pdocs refer to it as that....or just patients....I'd never heard of it.
>
> Thanks Scott.....
> fwI'm pretty sure that it's a term that some doctors came up with. Stephen Stahl, MD of the University of California, San Diego might have had a hand in it.
- Scott
Posted by fairywings on April 12, 2006, at 10:06:23
In reply to hey fairywings..., posted by med_empowered on April 12, 2006, at 7:16:09
> some docs do get upset about those sorts of things, and I've had docs try to coax me one way or another w/o any real "reason" (I'm thinking "real" as in data, numbers--actual hard evidence that drug X could hold any benefit) to do so. Glad you have a good doc, though.
>Hey Med...Yeah he's a really good guy...very humble...which is probably why he doesn't get upset about anything. I know we're really lucky to have him for a doc.
fw
Posted by Enigma on April 12, 2006, at 11:49:45
In reply to Re: Celexa is making me a zombie, continue or quit » Enigma, posted by Racer on April 11, 2006, at 18:51:01
> I've never tried Celexa, but you're kinda describing me on Lexapro. I stopped taking it when it got to where I wouldn't even speak because it was too much energy...
Ouch. Unfortunately that sounds familiar to other things I've tried.
>
> The bad news is that I would kinda recommend giving Celexa 4 full weeks... If you can live through the four weeks at the prescribed dose, it makes it a heck of a lot easier to convince your doctor that you really did try, and it really doesn't work. Sometimes it's easier to deal with a pdoc that way.I hear ya, but once the suicidal thoughts kicked in last night, I'm quitting this medicine cold turkey. Bad, I know, but I don't care. I've already deemed this drug as "evil" and don't want anything to do with it anymore.
> In terms of meds, have you ever had even a partial response to anything you've tried? If so, what is it? Someone here might be able to recommend a direction to talk to your doctor about...
Prozac made me feel a little better, but also gave me severe anxiety that Klonpin couldn't overcome. I was even getting anxiety attacks, and once, I felt like I was losing my mind completly. It was horrible. So, can't take prozac anymore.
Risperdal seemed to help a little, then pooped out, but I can't say for sure that it was the drug that was "helping", as I normally go up and down like a yo-yo. Currently, I can be in bed depressed one day, and out working in the yard the next. It's insane, and VERY hard to deal with. This makes planning ANYTHING in the future next to impossible.
> > Tried Wellbutrin - no AD effect for me, did give me energy though - took it for 2-3 years!
>
> Were you taking it with another drug? Maybe a combination of something that maybe worked with Wellbutrin to add energy? If you haven't tried it, it's probably worth a shot.I tried it with a few different drugs. First with depakote, which unknowingly caused me CFS, Chronic Fatigue Syndrome, until I finally figured out that was the cause, and quit it like a bad habit.
Unfortunately, Depakote worked on my severe irritability, rage, mania, etc, but, those symptoms went away over the years anyway.
> > Tried Provigil - didn't do a thing (didn't give me any energy)
>
> How long did you take it, how high a dose, and what else were you taking?Eeek. I forget. So many drugs, so many "cocktails". I'll go downstairs and check the bottle. I keep most of them. Got a big collection now. :) Darn, can't find a bottle. I forget the dose, how long I took it, and even what I mixed it with. Sorry. :(
All I remember is that is gave me 0 energy, and I believe I upped the dosage as well, and gave the drug a chance too.Jeez. What a horrible mood I'm in today. This bites.
Posted by Racer on April 12, 2006, at 15:12:44
In reply to Re: Celexa is making me a zombie, continue or quit, posted by Enigma on April 12, 2006, at 11:49:45
> >
>
>
> I hear ya, but once the suicidal thoughts kicked in last night, I'm quitting this medicine cold turkey. Bad, I know, but I don't care. I've already deemed this drug as "evil" and don't want anything to do with it anymore.Actually, I don't think that's a bad idea. I'm sorry it's that bad for you. The only reason I suggested it at all was just to get the idea across to your pdoc that you're cooperating and giving the drugs a fair try. But I didn't suggest sticking it out because I thought it was likely to change, and I think I'd be likely to stop, too.
>> Prozac made me feel a little better, but also gave me severe anxiety that Klonpin couldn't overcome. I was even getting anxiety attacks, and once, I felt like I was losing my mind completly. It was horrible. So, can't take prozac anymore.
Hm... If Prozac helped a little, that's good. Shows that there is likely something helpful, you just haven't found it yet. I forget -- sorry, pea brain today -- had you tried Paxil? That might be helpful for you, not as deadening as Celexa, not as agitating as Prozac. I had a bad reaction to Zoloft, but a lot of other people do really well on it. Might be worth a shot, too.
But what about TCAs? They can be much more helpful than SSRIs for a lot of people. I am not sure which of them target serotonin, and since Prozac helped I would get that's part of what's going to be helpful for you.
>
> Risperdal seemed to help a little, then pooped out, but I can't say for sure that it was the drug that was "helping", as I normally go up and down like a yo-yo.
Have you ever tried Buspar? I know a lot of people think it's not that great, but it did help me a lot. I didn't stay on it long, because of the sedation/fatigue/amotivation/what have you, but that's part of the reason we're trying Dexedrine right now: get something taht can counter the whatever well enough for me to take Buspar. It was the best I've ever tried for anxiety. Then again, benzos don't help anxiety much for me. They tend to leave me sedated -- and more wound up. NOT a good combination...
I'm sorry you're having so much trouble. I hope somethingworks out for you soon.
Posted by blueberry on April 12, 2006, at 18:21:29
In reply to Re: Celexa is making me a zombie, continue or quit, posted by Enigma on April 12, 2006, at 11:49:45
You know, forget my earlier post. I'm with you. Stop the med. Not abruptly though.
I used to take 7.5mg lexapro for about 10 weeks. The whole time I was just a zombie and actually more depressed than I had been.
Just 5 days ago I started it again at just 2.5mg, thinking it would calm my severe anxiety/terror stuff. Beginning today it is doing that. But oh my, it really is a much worse depression with this stuff.
I can't stay with it. There is no way I could suggest you to.
This is the end of the thread.
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