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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 randermin on January 23, 2007, at 6:35:58
Hello, I'm new to the forum so far, Ive got a lot of questions so I'll split them into two posts, the other one being the "sleep meds" post, because that is really my chronic problem and I should try and keep it simple for now by raising the AD question...here goes:
I've had major depression, sporadically treated, throughout my life, call it unipolar w/ atypical symptoms... whatever label seems to fit, anyway Its always been there, but I've only recently felt like agreeing to try medication again. in the past I'd been on prozac but I was too young to feel any change, and celexa later for a short time. that was still a good while ago.
My doc (what is a Pdoc?) gave me effexor, which definitely worked, but I had to stop it for these reasons.
1: it caused insomnia, not in initiating sleep, but staying alseep. chronic insomnia, DSPS really is the real bane of my existance, so any AD that interferes with sleep just doesnt work for me, because I get sleep deprived very easily.2: I felt some profound emotional blunting, which I did not like at all, but I suppose thats always a trade-off to some degree.
so, after that I tried mirtazipine, as a possible two birds with one stone deal. this hasn't worked well either, because the anti-histamine sedation makes me feel very unrested and flu-like, it doesn't put me out anyway on its own, so really this one just makes me feel sh*tty, not rested, and aggravates the dsps.
so now I'm not taking any anything other than sleep meds, but I do need an antidepressant...so my question is:
Are there any antidepressants out there that aren't activating OR sedating, just neutral, yet still effective? and on top of that, I really do not want any of the ssri emotion-numbing effects, but it seems that other modes of action tend to go back into being too activating... So, no antihistamine sedation, but no 'wired' insomnia, AND no emotional blunting are all attributes that I'd love to see in a drug. please, I'd love to hear any suggestions or comments. any help at all would be very much appreciated. thanks -r
Posted by randermin on January 23, 2007, at 8:07:53
In reply to AD suggestions? -my history w/ a few so far...., posted by randermin on January 23, 2007, at 6:35:58
I guess what I mean to ask is, is there something like effexor, but without insomnia, and not so restrictive of your natural emotions? remeron is too sedating, and I rely on enough sleep meds anyway, maybe paxil, but I hear it really messes with your emotions/personality.. any ideas?
Posted by falconman on January 23, 2007, at 9:24:10
In reply to Re: AD suggestions? -my history w/ a few so far..., posted by randermin on January 23, 2007, at 8:07:53
I think alot of us want a drug similar to what your after. Does it exist? I've been on so many and aside from MAOI's they have all caused emotional blunting. However MAOI's in my experience are either very sedating or very activating. I'm going to try Tianeptine, but I'd be surprised if you can get it off your doc.
Take care
Posted by Phillipa on January 23, 2007, at 10:12:47
In reply to Re: AD suggestions? -my history w/ a few so far... » randermin, posted by falconman on January 23, 2007, at 9:24:10
No I wish I did. Love Phillipa
Posted by Quintal on January 23, 2007, at 11:40:38
In reply to AD suggestions? -my history w/ a few so far...., posted by randermin on January 23, 2007, at 6:35:58
Parnate plus Klonopin was about the only combo that did for me what you are asking for in an antidepressant. The Parnate acted as a stimulant in the morning and the Klonopin took over at night when the Parnate wore off and I fell into a deep sleep.
Pdoc means psychiatrist. You'll need one to get an MAOI like Parnate if you don't have one already.
Q
Posted by randermin on January 24, 2007, at 8:39:06
In reply to Re: AD suggestions? -my history w/ a few so far.... » randermin, posted by Quintal on January 23, 2007, at 11:40:38
thanks, I guess what would really help is a list of any antidepressants that are neutral to sleep, and any personal notes if anyone has experience with any of them... my doctor suggested paxil, but Ive heard that its very emotional blunting, and I don't really want to go down that route again. any other ideas?
Posted by Quintal on January 24, 2007, at 8:59:51
In reply to Re: AD suggestions? -my history w/ a few so far..., posted by randermin on January 24, 2007, at 8:39:06
The TCA trimipramine and Remeron are neutral to sleep in that they don't distort sleep architecture as much as other antidepressants but they are very sedating. There are no truly sleep neutral antidepressants as far as I'm aware.
Q
Posted by randermin on January 24, 2007, at 19:33:33
In reply to Re: AD suggestions? -my history w/ a few so far... » randermin, posted by Quintal on January 24, 2007, at 8:59:51
well I just saw my doctor and he said the next thing to try would be lamictal, so I guess I'll read up on that... I'm still wondering, though, if shouldn't be going on an maoi.
even though my doc considers that a last resort, I just have a fear of anything indicated for mood stailizing or antipsychotic action, that I would be having my identity or my feelings subverted somehow. the idea of that scares me, I once tried serouquel as a sleep aid and I felt as if I where having my soul sucked out of me!
Posted by Quintal on January 24, 2007, at 21:53:28
In reply to Re: AD suggestions? -my history w/ a few so far..., posted by randermin on January 24, 2007, at 19:33:33
Lamictal is good so long as you have something to help with sleep if you need it, yet some people say they feel tired and sedated on Lamictal. Mood stabilizers aren't as bad as antipsychotics for causing mood flattening and emotional blunting. Lamictal may work very well for you.
Q
Posted by randermin on January 28, 2007, at 20:13:13
In reply to Re: AD suggestions? -my history w/ a few so far... » randermin, posted by Quintal on January 24, 2007, at 21:53:28
Mood stabilizers aren't as bad as antipsychotics for causing mood flattening and emotional blunting. Lamictal may work very well for you.
>
> Qokay, but would you say lamictal is worse than ssri's in terms of its effects on emotional capacity?
what I'm really worried about isn't just ssri style "blunting" but maybe something more profound, where I might feel like my personal sense of self, or I guess my core emotions are actually affected...
It's hard for me to put it into words, but the idea really scares me, in the sense that I would be kind of internally institutionalized. (!)
thats what I'm afraid of. more like the zombie effect of seroquel I guess... and its why I'm thinking that a reversable maoi, tca, or just an ssri would really be better for me after all. does anyone know what I mean?
Ive taken seroquel on just one occasion as a treatment for insomnia, and it was terrible. I felt like I was being sucked into some kind of lifeless oblivion which I had to fight. I stayed up all night fighting against that kind of zombie state.
so I guess Ive conveyed it more than enough, basically I just want avoid taking what ever is the most spiritualy intrusive, maybe that turns out to be an ssri I just dont know, but any help would be very much appreciated. thanks alot -o
(randermin is just silly)
Posted by Quintal on January 28, 2007, at 20:58:46
In reply to Re: AD suggestions? -my history w/ a few so far..., posted by randermin on January 28, 2007, at 20:13:13
>okay, but would you say lamictal is worse than ssri's in terms of its effects on emotional capacity?
No, SSRIs are the worst for me in terms of emotional blunting, as bad as antipsychotics but without the drowsiness. It supposedly has something to do with dopamine (the feel-good neurotransmitter) being downregulated by high levels of serotonin.
>It's hard for me to put it into words, but the idea really scares me, in the sense that I would be kind of internally institutionalized. (!)
I think I know what you mean and I remember worrying about that myself, but Lamictal just kept my mood rock solid and steady. I had more focus and felt calmer, I didn't feel that I was being restrained or flattened in any way. It's the idea of the 'Chemical Straightjacket' I think we fear, but Lamictal isn't like that.
>Ive taken seroquel on just one occasion as a treatment for insomnia, and it was terrible. I felt like I was being sucked into some kind of lifeless oblivion which I had to fight. I stayed up all night fighting against that kind of zombie state.
I had the same problem with Seroquel and trazodone - almost like I was having an anaesthetic and I didn't want to go under. They're very sedating but not relaxing, and they don't always help people sleep.
MAOIs, particularly Parnate, sound like the type of antidepressant you're looking for. They seem to enhance emotions rather than suppressing them. They do reduce (almost eliminate in fact) REM sleep though and insomnia is a common side effect.
Q
Posted by randermin on January 28, 2007, at 21:44:14
In reply to Re: AD suggestions? -my history w/ a few so far... » randermin, posted by Quintal on January 28, 2007, at 20:58:46
thanks alot, I definitely feel better about all of this now that I know at least someone else has had those same reactions that I had.
just one last question: why is parnate better for you instead of lamictal ?
Posted by Quintal on January 28, 2007, at 22:22:51
In reply to Re: AD suggestions? -my history w/ a few so far..., posted by randermin on January 28, 2007, at 21:44:14
Parnate was stimulating and got me revved up and going in the morning. Lamictal kept me from going manic and helped me from crashing as the Parnate wore off at night. I took them both together, Lamictal 200mg and Parnate 80-120mg along with 4mg Klonopin to help with the jitters from Parnate and social anxiety. That combo was very effective, perhaps the most effective I've ever taken.
Q
Posted by randermin on January 28, 2007, at 22:58:06
In reply to Re: AD suggestions? -my history w/ a few so far..., posted by randermin on January 28, 2007, at 21:44:14
okay, thanks again.
This is the end of the thread.
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