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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by deniseuk190466 on December 1, 2006, at 13:16:45
I really don't know what to do anymore and the thought of just jumping off a cliff is becoming more and more appealing.
My NHS psychiatrist has pretty much abandoned me by his refusal to treat me anymore as an outpatient and the only other option was to go to a day care centre where they are very much focused on therapy, they won't even try me on another medication.
The mirtazapine I was taking on it's own wasn't helping, I was having big anxiety problems on it and I had some Seroxat left which I've been taking. I have been having to take 30mg instead of 40mg as I've almost ran out and not sure who I'm going to get to prescribe it for me. I've been having a lot of anxiety on this as well so not sure it's even going to work at all. It's the sort of anxiety that leaves you weak and listless at the end of the day. Fortnuately, I have Zyprexa and that helps tremendously with the anxiety but don't want to keep taking it.
From looking through my notes I had a response to Seroxat at 40mg after two years of trying a number of medications, the latter ones were Effexor which seemed to help with the anxiety but didn't do much for the depression, then lamictal which I was on for months on it's own and then Nardil which helped with the anxiety but not the depression (it was more of a relaxed/stoned type of depression).
I have tried to replicate by taking Nardil again and then switching to Seroxat in the hope that it would work again but no such luck.
I am really tired of all of this, I don't see therapy as helping me and I'm thinking maybe Effexor plus Seroxat combined would help. Or am I just fooling myself. Even if it would I don't have anyone that would prescribe it anymore.
I'm fantasising more and more about ending it. At least at the beginning of this year I was still looking for jobs, still keeping going but now I just feel like giving up altogether.
Anyone got any suggestions.
Denise
Posted by med_empowered on December 1, 2006, at 15:13:31
In reply to Not sure what to do anymore. Effexor/Paxil combo?, posted by deniseuk190466 on December 1, 2006, at 13:16:45
I think you should try the therapy. Psychotherapy can actually be pretty effective in cases that are resistant to medical treatments. I think its worth a shot.
If the therapy doesn't work, or you need a "boost," you can try finding someone to RX stuff for you. I don't know how things work in the UK, but here in the US most psychiatric RXs (about 70%, I believe) are actually written by *non-psychiatrists*; family docs write alot of these (sometimes under the advice of therapists). So, you don't necessarily need a psychiatrist to have access to any psychiatric meds that may prove beneficial.
Good luck!
Posted by blueberry on December 1, 2006, at 15:57:13
In reply to Not sure what to do anymore. Effexor/Paxil combo?, posted by deniseuk190466 on December 1, 2006, at 13:16:45
Denise,
You have good friends here who care about you.
Therapy might not work but it could provide some coping techniques to get through the worst.
I do not know how the system works in the UK. Can you go to a regular doctor or a different psychiatrist? I can't believe your pdoc has refused further treatment. What, he only takes the garden variety easy cases? What a wimp. There must be a way to get another doctor. I would do whatever it takes to get that done.
What about common herbs for depression and anxiety...I'm thinking of St Johns Wort and/or Rhodiola Rosea. Can you buy those there? If not you can mailorder them, yeah?
If you think effexor/paxil combo would help, well, that's your call. But it is dangerous to mix two meds that work on serotonin. You would have to keep the doses low and study up on serotonin syndrome. How about paxil/zyprexa combo? Or effexor/zyprexa combo? You like zyprexa and it usually does turbocharge antidepressants and make them work better. I don't like to suggest antipsychotics, but if it will save someone's life or improve someone's life significantly then I'm all for it.
Just some ideas. Please keep us updated on what's going on.
Posted by Phillipa on December 1, 2006, at 19:43:11
In reply to Re: Not sure what to do anymore. Effexor/Paxil combo? » deniseuk190466, posted by blueberry on December 1, 2006, at 15:57:13
I've been thinking about St John's Wort lately too. As these pharmacitacals just pile up and don't help. Denise I don' t know what to say as I know that the UK is next to impossible. And two weeks ago in the US I had a pdoc refuse to treat me. He said he didnt have to explain why either. Love Phillipa
Posted by madeline on December 3, 2006, at 7:24:37
In reply to Not sure what to do anymore. Effexor/Paxil combo?, posted by deniseuk190466 on December 1, 2006, at 13:16:45
Why do you think therapy wouldn't help you?
Posted by SLS on December 3, 2006, at 7:52:41
In reply to Not sure what to do anymore. Effexor/Paxil combo?, posted by deniseuk190466 on December 1, 2006, at 13:16:45
> The mirtazapine I was taking on it's own wasn't helping, I was having big anxiety problems on it
Do you think mirtazapine was making your anxiety worse?
You could use Effexor as a base and try adding mirtazapine or bupropion (Zyban).
When you use the word "depression", what do you mean by that?
- Scott
Posted by deniseuk190466 on December 10, 2006, at 10:59:22
In reply to Re: Not sure what to do anymore. Effexor/Paxil com » deniseuk190466, posted by SLS on December 3, 2006, at 7:52:41
Hi Scott,
Yes I think the mirtazapine was definately making my anxiety worse as did the Cymbalta. Strangely though when I took effexor over two years ago I don't remember getting any anxiety on it although it didn't alleviate my depression.
Sorry for taking so long to respond, although I'm sure you haven't been hanging off the edge of your seat in anticipation :-)
When I speak about my depression, I'm not that bad that I can't get out of bed or have a shower or even work. I mean anhedonia, not interested in doing pleasurable things, a lot of agitation and restlessness and a lot of somatic symptoms, tightness in my jaw all the time and just feeling really uncomfortable. I do have a lot of suicidal fantasies.
I've been going to this Day centers and although the two therapy groups (Coping with Depression and Coping with anxiety) are enjoyable and the other patients are really nice. However, the professor there won't try any medication on me, infact he pretty much told me to "Go away and live my life", he frightens me with his attitude because as far as he is concerned because I seem ok on the outside, this must mean I'm feeling ok on the in and he seems to be anti meds.
I'm now thinking of paying privately to see someone again although being unemployed I'm a bit worried about spending too much on psychiatrists.
By the way have you really heard bad things about side effects of Deep Brain Stimulation? I thought the Mayberg study was pretty successful.
Denise
Posted by SLS on December 10, 2006, at 13:31:56
In reply to Re: Not sure what to do anymore. To SLS, posted by deniseuk190466 on December 10, 2006, at 10:59:22
> Hi Denise
It sounds like this professor is really sabotaging your treatment with the things he has said to you. Fortunately, you seem to be self-confident enough not to internalize his negative messages and persistent enough to search for another practitioner more focused on the clinical identification and treatment of your condition. I'm sorry that it should be such a financial hardship for you.
> By the way have you really heard bad things about side effects of Deep Brain Stimulation? I thought the Mayberg study was pretty successful.
Yes, the Mayberg procedures were clinically effective. However, I read recently that the procedure produced some cognitive side effects when used for Parkinsons Disease. Unfortunately, I can't find the article I read. Of course, this does not necessarily mean that DBS produces the same effects when used for depression.
- Scott
This is the end of the thread.
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