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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 Irma on January 20, 2008, at 12:50:03
I've only started medicating w/antidepressants in the past few yrs. but I still do it off and on (couple months at a time) because I hate the side effects (dry mouth & constipation). I'm not totally a basket case when not medicating, just stuck w/dwelling thoughts, unhappiness, some anger ... things that just make me an unpleasant person to me, and what I perceive to be to others as well. Some OCD - evening binge eating, overshopping, concentration probs, etc.
I started meds thru my regular dr, who is currently unavailable to me, and now thru another GP. With old doc, started on Zoloft - bad side effects, switched to a couple others with same results (Paxil, Lexapro). Also used Ativan to control anxiety when marriage breakup was occuring. Finally switched to Wellbutrin XL with better response - still dry mouth, which really bugs me - but no constipation. Also helped me lose weight which probably played a huge role in me "liking" the drug. Again, stopped meds after a few mos. and stopped/started when the "old" me got too hard to deal with. Told old doc this is what I was doing and he said it was ok. I stopped Wellb for several months, old doc became unavailable and recently, when got too weepy and dwelling, went to new doc who prescribed Cymbalta 20. WOW! The first 4 weeks on Cymb were wonderful. The most amazing response was that it TOTALLY stopped my binge eating at night. While I knew that binging was connected to depression, I never imagined that a drug would stop that dead. I hadn't felt that kind of relief EVER. Of course, it didn't last, so after 4-5 weeks, I called doc and asked to increase to 40mg which he ok'd. Side effects elevated, started getting angrier & more unsettled, and binge eating was back to being bad again. Met w/doc and he said go back to 20 for another 4 wks and we'll see what's what. Suggested after that time, maybe adding low-dose Effexor to Cymbalta to help w/OCD.
Now to the trust/figuring out part ... I have smoked pot pretty much daily for a long time, well over 25 yrs. There have been times I stopped for weeks/months, but it has been my solace at the end of the day. Never smoked any other time of day than relaxing b4 bed. Hmmm ... now as I write this I'm questioning ... pot ... evening binging ... have I just taught myself to binge?? But I do binge without the pot as well and certainly the overshopping is not related to pot. So - back to the pot issue. At one point with the old doc, I finally told him I was a pot smoker. For whatever reason, when I told him, I prefaced that it was "off the record". He made no comment about it at all, which in my mind, meant, well, it can't be horribly bad.
Wen I went to the new doc (only started w/him in Dec), I did not tell him about the pot. I actually was ready to, but as he went thru the routine checklist of problems (allergies, headaches, etc.) - when he got to "use drugs", he was looking at his paper, I said (very quietly) eeeeeh ... and he just continued, kind of answering for me, saying "no" and went on to next question. Now, wouldn't that be something a doc, who's going to prescribe meds that affects your brain, would pay more attention to?? I mean, not just him, but my old doc, who I had gone to for at least 15 yrs. ... ?? So, I'm at the same time, trusting the docs that the pot is no huge deal, and wondering why they don't look at street drug use more critically.
I guess I could go on and on about many aspects of my "problems", but I'll stop here ... I'm interested in any thoughts you have based on what I've already said so far ...
Thanks!(Can I also get this off my chest ... I've been reading these boards for a while now and it drives me nuts to have it keep opening up multiple windows!!! You too??
Also, good thing I copies & saved this post because I wrote it out, then registered (since it said I could post that way), but it never did post, so this is my 3rd attempt ... okay. Done complaining ... your help to my post is appreciated!)
Posted by Deputy 10derHeart on January 20, 2008, at 13:22:34
In reply to Trusting Drs figuring out what's wrong, posted by Irma on January 20, 2008, at 12:50:03
Hi Irma,
In addition to moving your post to this board where you wanted it, I posted some 'technical assistance' in my reply over on the Faith board - here's a link:
http://www.dr-bob.org/babble/faith/20070227/msgs/807938.html
Hope it solves the problem. Please let us know if you need any other help...:-) -
-- 10derHeart, acting as deputy for Dr. Bob
Posted by Phillipa on January 20, 2008, at 19:06:47
In reply to Trusting Drs figuring out what's wrong, posted by Irma on January 20, 2008, at 12:50:03
Hi Irma and welcome to babble. I have never smoked pot but hear it does cause binge eating. I think it's important that you mention this to your new doc. Could be the reason med not working don't know just a thought. Phillipa
Posted by Cecilia on January 20, 2008, at 19:37:09
In reply to Trusting Drs + figuring out what's wrong, posted by Irma on January 20, 2008, at 11:55:55
My only comment-NEVER assume that anything you say to any doctor or other health professional is "off the record." I guarantee it'll be on your record forever. Cecilia
Posted by 4WD on January 20, 2008, at 19:48:11
In reply to Re: Trusting Drs figuring out what's wrong, posted by Cecilia on January 20, 2008, at 19:37:09
Yeah I agree with Cecilia. Once you are down in their minds and in your chart as a "drug abuser" you will be viewed with suspicion in all sorts of circumstances.
If you fall in the bathtub or something and injure your back and are in severe pain and then go to the doctor and ask for something for pain , they are very likely to label your visit as "drug seeking behavior.
So be careful. If it were street drugs like coke or meth or something like that or if you had a problem with abusing narcotics or anxiolytics, though, I would tell my doctor.
I am a recovering addict myself. I had all my doctors and dentists put in my chart that if they gave me Lortab, I would abuse it. So I've cut myself off, which is a good thing.
I got off on a whole different subject. Sorry.
Marsha
Posted by Racer on January 20, 2008, at 21:09:53
In reply to Trusting Drs figuring out what's wrong, posted by Irma on January 20, 2008, at 12:50:03
Welcome to Babble! If I'd been able to have children, I always planned to name a daughter Irma, so I particularly like your name.
As for the Cymbalta/Effexor combination your doctor is suggesting, that just doesn't sound right to me. They're both the same class of drug, and adding them to one another doesn't sound all that reasonable to me. In fact, because they're both serotinergic medications, it sounds downright dangerous to me. I strongly urge you to ask him about it, at least -- and really, I urge you to consider seeing a psychiatrist for psychiatric drugs. They're just more experienced with them, and that makes such a difference.
Two serotinergic drugs at once can cause a reaction called serotonin syndrome, which can be fatal. It's rare, but why take a chance?
As for what you've said so far, my best advice is to educate yourself about the use of antidepressants, and about depression in general. The thinking on most of these drugs is to continue taking them for at least six months past the point of remission. That reduces the risk of relapse. Tapering off, rather than cold turkey, is also recommended, to prevent rebound depression. If you're medicating depression which has become recurrent, the best recommendation is to stay on the medication for about two years, then taper off and see how you do. Stopping and starting medications is usually counter-productive -- you probably haven't gotten the optimal effect of the medication, and then stopping it you get both rebound depression and probably a high rate of relapse, as well. Many of the side effects of medications for depression can be mitigated with adjunctive medications, and it's worth discussing those options with your doctor, too. In fact, that's one of the best reasons to see a psychiatrist for psychiatric medications: you're more likely to find someone with more experience mitigating these side effects.
"Depression" can mean a lot of different things -- the symptoms involved vary a lot, and which symptoms are most problematic for any one person may vary over time. The medications out there right now often vary in how well they treat specific symptom clusters, which means that your reactions to medications may help predict which medications are most likely to be helpful for you. The sorts of symptoms you're describing sound to me as though you may have a somewhat more complex picture than most GPs are equipped to handle. That said, I think it's probable that sticking with Cymbalta, at a higher dose, is probably your best bet. MANY adverse effects pass after you've adjusted to a medication. If you can get through the first four to eight weeks, you're likely to find that most of the problems you started out with are gone -- and considering how beneficial treatment for depression can be, it's worth it if it works out.
After reading your post, I'd also recommend both psychotherapy, because it can be more helpful than medications for addressing some of the issues you've brought up, and also discussing pot with your doctor. Pot is a drug, meaning it's going to interact with the medications you're being prescribed. If you don't trust your doctor enough to discuss it with him, it might be a sign that this isn't a good fit for you and another doctor might be in order. (By the way, firing doctors can leave you with quite a good feeling of strength and power. I recommend trying it sometime.)
I hope that helps, and again -- welcome to Babble!
Posted by Irma on January 21, 2008, at 18:18:59
In reply to Trusting Drs figuring out what's wrong, posted by Irma on January 20, 2008, at 12:50:03
Thank you all ... for your help with my posts, for your welcome and for your advice.
Regarding the pot - I told my old doc because I trusted him. I had been going to him for many years and simply felt/knew that I could confide in him. He recently stopped taking pts. under age 65 and turned over all my records to me and referred me to the new physician. I poured thru my records to see if he had noted anything at all about the pot, but saw nothing. Also, the new doc knew he was my previous physician, I gave him my records and he never reference pot use and - as I said - he skipped right over the "other drug use" question with a "no" so I'm fairly confident it's not in my record. I would think a pot-only smoker though would be a lot less likely to be labeled an abuser than someone doing coke or crack. Anyhoo ... the new doc ... I'm just not sure of. He made a comment on our first meeting about how he takes a special interest in mental health, kind of implying it was a hobby interest of his. Maybe that's just how I heard it, but I really do have reservations about GPs prescribing these types of meds. When I first started taking AD with my old doc, he mentioned to me that a majority of people treated with AD are prescribed by GPs. Not sure if that's true ... or if it's the way it should be.
So let me ask this ... I do have a concern about becoming a patient of a psychiatrist. I know we're all supposed to buck up and stand up to the stigma of depression/mental health, but I'm worried that going that route would label me very dramatically. I guess the only ones who would know without my telling them though would be my health insurace. Any thoughts on this?
And finally, back to the workings of this Board, can someone tell me why my post is not listed here?
http://www.dr-bob.org/babble/I understand that when I post, I can bookmark it, but what if I'm at a different computer - without the bookmark? I thought my post would appear in the main index ... it's like everyone else can see my post except me. Is that the way this works?? Really??? Cause if it is, it's triggering some MAJOR OCD heebie-jeebies for me!
Thanks!
Posted by Irma on January 21, 2008, at 18:25:27
In reply to Re: Trusting Drs figuring out what's wrong, posted by Irma on January 21, 2008, at 18:18:59
NEVERMIND ... I FOUND it!!! Silly me, I was figuring the posts were set up by date posted. OK, I'll be fine ...
:)
This is the end of the thread.
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